[Cutaneous adverse reaction to Bio-Alcamid implant]. / Reacción cutánea tras implante con Bio-Alcamid.

In the last years new and numerous materials for the correction of defects and wrinkles have been developed. One of these materials is Bio-Alcamid, a non reabsorbable gel polymer constituted by meshes of poly-alkyl-imide, without known adverse effects. We report a 34-year-old woman that had Bio-Alcamid implants for acne scars and several months after presented nodular lesions together with a painful inflammatory nodule. The nodule was drained and culture of the purulent material yielded Streptococcus viridans. A cytology and a cellular block of that material showed a granulomatous inflammatory reaction together with a foreign body. The different types of reactions to implants and their pathogenic mechanism are discussed. It is important to know these possible reactions to filler materials given their increasing use and the potential medico-legal consequences.

Dermatofibroma aneurismático o hemorrágico / Aneurysmal or hemorrhagic dermatofibroma

El Dermatofibroma aneurismático es una rara variante de dermatofibroma pero con características histopatológicas distintivas. En el seno de la lesión se advierten hendiduras y espacios vasculares (sin revestimiento endotelial), llenos de material hemático y acompañados de abundantes depósitos de hemosiderina, que resultan de la extravasación de sangre dentro del estroma tumoral. Este aspecto histopatológico hace discutible el término aneurismático como adjetivo más correcto o no para definir este tipo de dermatofibroma.Presentamos el caso de una lesión en una joven de 14 años cuyo diagnóstico inicial fue de lesión angiomatosa, y describimos las características clinicopatológicas del tumor, así como el diagnóstico diferencial, fundamentalmente con lesiones de estirpe vascular. asimismo discutimos los diferentes términos propuestos por los autores para definir este cuadro (AU)

Photosensitivity induced by oral itraconazole.

A case of photosensitivity induced by itraconazole is reported. A 70-year-old woman had erythema, oedema and vesicles on sun-exposed areas after 5 days of itraconazole treatment for oral candidiasis. Oral photochallenge using itraconazole and sun irradiation was positive, but photopatch test was negative. Photosensitivity from azoles is an uncommon adverse effect. Only three other cases have been described, two induced by ketoconazole and one by itraconazole.

[Validation of the Spanish version of the diagnostic questionnaire of the Working Group on Atopic Dermatitis of the United Kingdom]. / Validación de la versión española del cuestionario diagnóstico del Grupo de Trabajo sobre la Dermatitis Atópica del Reino Unido.

BACKGROUND: Although there are several diagnostic questionnaires for atopic dermatitis (AD), they have not yet been validated or cannot be used in population studies. Our objective was to validate the questionnaire developed by United Kingdom Working Party's Diagnostic criteria for Atopic Dermatitis (UKWPDCAD). METHODS: Validation was developed in two steps: first, the questionnaire was adapted by means of translation and back-translation. Second, validation was conducted with 237 patients referred to the hospital with diagnoses unknown to the investigators. Patients were independently assessed by the investigators who were blinded to the questionnaire. RESULTS: A total of 102 cases of AD were diagnosed among the 237 patients. The questionnaire showed a sensitivity of 76.5%, with a 95% confidence interval (CI) of 66.8%-84.1%. The specificity was 90.4% (CI = 83.8%-94.6%); the positive predictive value was 85.7% (CI = 76.4%-91.8%), and the negative predictive value 83.6% (CI = 76.3%-89%). CONCLUSIONS: The spanish version of the questionnaire has shown a high diagnostic accuracy, similar to the original written in english. We consider it a useful tool to be used in frequency studies of AD in large general populations.

Verrucous carcinoma in association with hypertrophic lichen planus.

Neoplastic transformation of lichen planus is a rare event. However, squamous cell carcinoma may develop in 0.3%-3% of patients with the oral form of the disease. On the other hand, less than 30 cases arising in cutaneous lichen planus have been reported, and only four cases of verrucous carcinoma in association with either form, one with an oral lesion and three with cutaneous lesions (one hypertrophic and one ulcerative). This report describes the unusual progression of a hypertrophic lichen planus plaque of the right leg to a verrucous carcinoma in a 40-year-old woman.