Lesiones eccematosas y cuadro ictiosiforme adquirido como forma de presentación de un linfoma anaplásico de células grandes CD30+ / Eczematous lesions and acquired ichthyosis as a presenting finding of CD30+ anaplastic large cell lymphoma

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Cross-reactivity in AED-induced severe cutaneous adverse reaction: a case report

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Lesiones eccematosas de distribución generalizada / Widespread eczematous lesions

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Elefantiasis nostras verrucosa / Elephantiasis nostras verrucosa

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Efectos adversos cutáneos del imatinib (inhibidor de la tirosín cinasa) / Adverse Skin Effects of Imatinib, a Tyrosine Kinase Inhibitor

El imatinib mesilato es un inhibidor de la tirosín cinasa de administración oral que inhibe la BCR-abl, c-KIT y el platelet-derived growth factor receptor (PDGFR). Sus indicaciones fundamentales son la leucemia mieloide crónica y los tumores del estroma gastrointestinal. En Dermatología se emplea en enfermedades como el dermatofibrosarcoma protuberans, esclerosis sistémica y mastocitosis sistémica, entre otras. Es un fármaco en general bien tolerado, con la mayoría de efectos adversos leves o moderados. Los efectos secundarios dermatológicos son muy frecuentes e incluyen erupciones cutáneas inespecíficas como edema o erupciones maculopapulosas o con características clínicas distintivas (liquenoides, psoriasiformes, pustulosis exantemática aguda generalizada, síndrome de Stevens- Johnson…). Identificar y tratar correctamente estas reacciones puede ayudar a optimizar la adherencia del paciente al tratamiento y mejorar el pronóstico de su enfermedad de base

Imatinib mesylate is a tyrosine kinase inhibitor that targets the BCR-ABL, c-kit, and PDGF (platelet-derived growth factor) receptors. Imatinib is mainly indicated for chronic myeloid leukemia and gastrointestinal stromal tumors but is also prescribed by dermatologists for dermatofibrosarcoma protuberans, systemic sclerosis, and systemic mastocytosis, among other conditions. Most adverse effects are mild or moderate and therapy is generally well tolerated. Adverse skin effects are very common and include nonspecific manifestations such as edema and maculopapular rashes or eruptions of diverse types (lichenoid or psoriasiform lesions, acute generalized exanthematic pustulosis, Stevens-Johnson syndrome, and more). Identifying and properly treating these reactions can help optimize adherence to treatment and improve the prognosis of the underlying disease

Problema de pele em paciente estomizada: relato de caso / Skin problems in a stomized patient: a case report

Objetivo: Relatar o caso vivenciado na prática de enfermagem, no manejo de complicações de pele periestoma,e avaliar as mudanças clínicas obtidas após a utilização de protetores cutâneos. Relato de caso: O estudo foi desenvolvido em uma paciente estomizada de 57 anos, cuja pele periestoma apresentava extensa dermatite periestomal com aspecto brilhante, altamente exsudativa, irritativa e dolorosa, em que o dispositivo para estomia mantinha-se adaptado por menos de 24 horas. Conclusão: Após o manejo dos protetores cutâneos, houve evolução satisfatória em relação à lesão periestomal e no emocional, o que resultou no fechamento da ileostomia.

Objective: To report a case experienced in nursing practice regarding the management of peristomal skin complications, as well as to evaluate the clinical changes obtained after the use of skin protectors. Case report: this study was developed in a patient with stoma 57, whose skin had extensive peristomal dermatitis, glossy, highly exudative, irritating and painful, who had a device installed for ostomy adapted forless than 24 hours. Conclusion: After the management of skin protectors, there was satisfactory progress in relation to peristomal and emotional injury, which resulted in the closure of the ileostomy.

Lactant de 6 mesos amb erupció facial intermitent / No disponible

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Ojo con los tatuajes temporales / Beware of temporary tattoos

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[Disseminated perinaevic Meyerson phenomenon revealing melanoma]. / Phénomène de Meyerson périnævique disséminé révélateur d'un mélanome.

BACKGROUND: Meyerson phenomenon (MP) consists of an eczematous reaction occurring around a pre-existing dermatologic lesion that is usually melanocytic and generally benign, and which is known as a Meyerson naevus. We report a case of multiple Meyerson naevi revealing melanoma, which itself was surrounded by a halo of eczema. PATIENTS AND METHODS: A 55-year-old man of phototype III with atopic eczema presented for pruritic eczema present for a fortnight, found solely on and around the naevi on his trunk and at roots of his limbs. One of the melanocytic lesions affected by these Meyerson phenomena was clinically atypical and had been active for several years. Excision confirmed the diagnosis of level II extensive superficial melanoma measuring 0.75 mm in thickness and associated with lesional and perilesional eczematous remodelling. After surgery involving a 1-cm excision margin and local corticosteroid therapy of the eczema, the Meyerson phenomenon subsided with complete remission of the melanoma at 1 year. DISCUSSION: Meyerson phenomenon can affect one or more naevi at the same time; it is generally transient, may recur on occasion, and has a favourable outcome either spontaneously or with corticosteroid treatment. When not removed for histological verification, the melanocytic lesion regains its initial appearance following resolution of the phenomenon. MP differs from Sutton phenomenon (SP), which is a perinaevic vitiligo reaction leading to complete or partial regression of the melanocytic lesion, which may be either benign or malignant. CONCLUSION: This case of Meyerson phenomenon revealing melanoma shows that the melanocytic lesions targeted by MP are not necessarily benign.

[Eosinophilic dermatosis associated with hematological disorders: A clinical, histopathological and immunohistochemical study of six observations]. / Dermatose éosinophilique associée aux hémopathies : étude clinique, histopathologique et immunohistochimique de six cas.

BACKGROUND: Eosinophilic dermatosis of hematologic disease (EDH) or insect bite-like reaction is a pruritic dermatitis described mostly in patients with chronic lymphocytic leukaemia (CLL). We describe six patients with the disorder in association with CLL and other blood dyscrasias. PATIENTS AND METHODS: We reviewed the medical records of patients with EDH seen between 2004 and 2009 in our department and re-examined histological slides. RESULTS: Mean age at dermatosis onset was 75.6 years and the sex ratio was 1. There were three CLL, two mantle-cell lymphomas and one MALT-type lymphoma. The dermatitis was quite polymorphic, with erythematous papules, wheals and plaques. The initial skin lesions appeared at the same time as or after the diagnosis of haematological neoplasm. Their reappearance heralded relapse of the blood disease in three cases. Histologically, all lesions had a dense dermal infiltrate of small, mostly CD4+ T-cells, with numerous eosinophils. In three patients, there was marked folliculotropism, resembling folliculotropic T-cell lymphoma. In most cases, EDH disappeared after appropriate chemotherapy for the blood disorder. DISCUSSION: Our cases show that the clinical expression of EDH is quite polymorphic. Its appearance may precede relapse of or may indicate prompt search screening for blood dyscrasia. The most efficient treatment of this dermatosis appears to be specific chemotherapy for the blood dyscrasia. There is reason to believe that a population of T-helper 2 (Th2) lymphocytes, reactive to malignant B-cells, induces tissue eosinophilia, mainly through production of interleukin (IL)-5, among other cytokines. Eosinophils appear to be the main effector cells.

Lipoatrofia semicircular de origen laboral / Occupational semicircular lipoatrophy

Objetivo: En 2007 se notificaron en Cataluña una serie de casos de lipoatrofia semicircular potencialmente relacionados con determinados factores de riesgo presentes en los puestos de trabajo. El objetivo del presente trabajo es proponer una definición y clasificación de caso de lipoatrofia semicircular de origen laboral (LSOL) y describir los resultados de los casos estudiados en la Mutua Asepeyo en Cataluña. Métodos: Se examinaron 153 trabajadores con sospecha de lipoatrofia semicircular con un mismo protocolo de actuación. Se describen los resultados de 148 casos atendidos consecutivamente y pertenecientes a 27 empresas diferentes. El estudio se llevó a cabo entre abril y septiembre de 2007. Resultados: El mayor porcentaje de casos de lipoatrofia semicircular se da en mujeres (94%), con un rango de edad predominante para los dos sexos entre 31 y 41 años (46%), con normopeso (69%), con afectación en los muslos (96%) y en trabajadores con tareas administrativo-ofimáticas (97%) que referían apoyarse en la mesa de trabajo como factor de riesgo relacionado con su patología(58%). Adicionalmente, se objetiva el aumento de las cargas electrostáticas y la disminución de la humedad relativa ambiental en 19 casos procedentes de 6 empresas. Conclusión: La vigilancia médica de los trabajadores afectados por lipoatrofia semicircular debe realizarse de forma protocolizada para identificar adecuadamente los casos de origen laboral. En nuestro estudio, el origen laboral del problema se ha podido determinar aproximadamente en la mitad de los casos. Aunque sigue sospechándose etiología laboral en la mayoría de los casos, ha sido imposible disponer, en esta fase del estudio, de las mediciones técnicas necesarias para identificar los factores de riesgo laborales considerados como potencialmente causales(AU)

Objective: In 2007 several cases of semicircular lipoatrophy were reported as potentially related to occupational risk factors. The aim of this study is to propose a case defi nition and classifi cation for occupational semicircular lipoatrophy (OSL) and to summarize the results of the cases examined through the Asepeyo insurance company in Cataluña. Methods: 153 workers with suspected semicircular lipoatrophy were examined using a standardized protocol. Results for 148 consecutive cases, from 27 different companies, are described. The evaluations were conducted between April and September of 2007. Results: Most cases with semicircular lipoatrophy were women (94%), with a similar age range for both sexes, between 31 and 41 years (46%); normal body mass index (69%); lesions appearing on the thighs (96%); in jobs with administrative or office-related tasks(97%); and with a high proportion (58%) of patients reporting leaning on their desks as a risk factor (58%). Additionally, increases inelectrostatic charge burden and decreases in ambient relative humidity were confirmed in 19 cases from six different companies. Conclusions: Surveillance of workers with semicircular lipoatrophy would benefit from specific protocols to allow identification of work-related cases. In this study, an association between the case and the working conditions was observed in approximately half of the cases. Even though the majority of the cases are suspected to be work-related, it has not been possible to confirm these, given the absence of objective measurements of the suspected occupational causes(AU)

Paciente con diabetes tipo 2 y liquen escleroatrófico / A type 2 diabetic patient with scleroatrophic liquen

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Dermatitis palmar juvenil de las piscinas / Juvenile palmar dermatitis acquired at swimming pools

La dermatitis palmar de las piscinas es un proceso benigno relativamente frecuente, debido al incremento de las actividades deportivas en las piscinas. Las lesiones se localizan en las zonas de roce y apoyo de las regiones palmares, y se producen por la fricción continuada con las superficies rugosas del borde de las piscinas, a lo que contribuye la fragilidad cutánea consecutiva al contacto continuado con el agua. El descanso de las actividades en la piscina durante unos días da lugar a la remisión del proceso(AU)

Palmar dermatitis acquired at swimming pools is a benign process that is relatively frequent due to the increase in sports activities in swimming pools. The lesions are located on the friction and support areas of the palmar regions and are caused by the continuous friction with the rough surfaces of the edges of swimming pools, made easier by the fragility of the skin following the continuous contact with the water. A break from the swimming pool activities for a few days heals the process(AU)

Hábito de fumar y piel / Smoking and the Skin

El hábito de fumar constituye la principal causa evitable de enfermedad y muerte en el mundo occidental. Su consumo se relaciona directamente con enfermedades cardiovasculares, bronquitis crónica y numerosos procesos neoplásicos. El tabaco ejerce asimismo múltiples y diversos efectos sobre la piel, la mayor parte de ellos nocivos. En este sentido, el hábito de fumar se halla estrechamente relacionado con numerosas enfermedades dermatológicas como la psoriasis, la pustulosis palmoplantar, la hidrosadenitis supurativa, el lupus eritematoso sistémico y discoide, así como con procesos neoplásicos del labio, de la cavidad oral y de la región anogenital, entre otros. Existe una relación controvertida con el melanoma, el carcinoma escamoso de la piel, el carcinoma basocelular y el acné. Por otra parte, este hábito parece que ejercería un efecto protector frente al desarrollo de las aftas orales, de la rosácea, del herpes simple labial, del pénfigo vulgar y de la dermatitis herpetiforme. Aparte de la influencia que el hábito de fumar ejerce sobre las enfermedades dermatológicas, el consumo de tabaco es también responsable directo de distintas dermatosis como la estomatitis nicotínica, la lengua negra vellosa, la enfermedad periodontal, así como de algunos tipos de urticaria y de dermatitis de contacto. Además, no hay que olvidar la repercusión cosmética de este hábito, que conlleva una pigmentación amarilla de los dedos y de las uñas, una alteración del color normal de los dientes, una disminución del gusto y del olfato, halitosis e hipersalivación y un desarrollo precoz de arrugas faciales (AU)

Smoking is the main modifiable cause of disease and death in the developed world. Tobacco consumption is directly linked to cardiovascular disease, chronic bronchitis, and many malignant diseases. Tobacco also has many cutaneous effects, most of which are harmful. Smoking is closely associated with several dermatologic diseases such as psoriasis, pustulosis palmoplantaris, hidrosadenitis suppurativa, and systemic and discoid lupus erythematosus, as well as cancers such as those of the lip, oral cavity, and anogenital region. A more debatable relationship exists with melanoma, squamous cell carcinoma of the skin, basal cell carcinoma, and acne. In contrast, smoking seems to protect against mouth sores, rosacea, labial herpes simplex, pemphigus vulgaris, and dermatitis herpetiformis. In addition to the influence of smoking on dermatologic diseases, tobacco consumption is also directly responsible for certain dermatoses such as nicotine stomatitis, black hairy tongue, periodontal disease, and some types of urticaria and contact dermatitis. Furthermore, we should not forget that smoking has cosmetic repercussions such as yellow fingers and fingernails, changes in tooth color, taste and smell disorders, halitosis and hypersalivation, and early development of facial wrinkles (AU)

Dermatitis de contacto por calzado unilateral / Unilateral contact dermatitis caused by footwear

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Manifestaciones cutáneas de la sarcoidosis / No disponible

Aunque las manifestaciones cutáneas de la sarcoidosis, las agudas, pueden presentar remisiones, las crónicas pueden ser persistentes, y ser motivo importante de consulta. En nuestra serie de 110 pacientes, 25 presentaron afección cutánea (22,52%), de estos 20 tenían lesiones dérmicas específicas (18,2%) y 5 (4,5%) lesiones inespecíficas. Las lesiones específicas que predominaron fueron las erupciones maculopapulares y las placas y todas presentaron relaciones con estadios radiográficos de esta entidad, fundamentalmente en el estadio I y II. La presencia de afectación clínica fue más representativa en forma de erupciones maculopapulares y en placas, al igual que la evolución crónica. El estudio histopatológico, que según el órgano afectado ayudará al diagnóstico, y la piel por su accesibilidad y su especificidad con la demostración de granulomas sarcoideos, orienta a su confirmación y evita otros exámenes más agresivos y más costosos

Although acute cutaneous manifestations of sarcoidosis may present recurrences, those chronic may persist and be important causes of patient remission to health clinics and dermatologists. In our serie of 110 patients, 25 presented cutaneous affection (22,52 %), 20 out of them had specific skin lesions (18,2%) and 5 (4,5%) non specific lesions. The specific lesions that prevailed were maculopapular eruptions and plates, and all had relationships with radiographic studies of this entity, mainly in I and II stages. The persistence of affections were more representative in maculopapular eruptions and disease, biopsy with the histopathology study which depends of the affected organ, will help to the diagnosis; and the skin due to its accessibility and specificity with the demonstration in sarcoid granulomas guides to its confirmation and prevent more aggressive and expensive exams

Pellagra y piel / Pellagra and skin

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Meyerson phenomenon within a nevus flammeus. The different eczematous reactions within port-wine stains.

Only few reports about eczematous reactions overlying nevi flammei exist. All of them were observed in children. The description of an eczematous reaction within a congenital nevus flammeus on the left lower leg of a male adult gives reason to discuss this rare phenomenon. Eczema or inflammatory changes within a port-wine stain may mostly be a collision dermatosis with an atopic dermatitis, especially when they arise in children and are localized to the neck and face. When they are observed within a grossly visible vascular malformation, as for example in the Klippel-Trenaunay syndrome, they may have a pathogenesis similar to stasis dermatitis. In rare cases, an eczematous reaction within a nevus flammeus may be the result of genetic mosaicism and is interpreted as a variant of the so-called Meyerson phenomenon.