Survey on the Management of Dysplastic Nevus by Dermatologists in the Center-Spain section of the Spanish Academy of Dermatology and Venereology (AEDV). / Encuesta sobre el manejo del nevus displásico por los dermatólogos de la sección Centro de la Academia Española de Dermatología y Venereología (AEDV).

BACKGROUND AND OBJECTIVES: There are no clinical guidelines on the management of dysplastic nevus (DN). The aims of this study were to determine the percentage of dermatologists in the center-Spain section of the Spanish Academy of Dermatology and Venereology (AEDV) who would manage a histologically confirmed DN with a watch-and-wait approach or with wider surgical margins and to investigate whether their attitudes would vary depending on whether or not the patient had a personal and/or family history of melanoma. MATERIAL AND METHODS: We collected data from an anonymous survey sent to 738 dermatologists between June 15 and July 31, 2022. The independent variables were degree of dysplasia (low vs. high), margin status (positive vs. negative), and a personal or family history of melanoma (yes vs. no in both cases). The dependent variables were attitude towards management (watch-and-wait vs. re-excision with a surgical margin of 1 to 4mm or re-excision with a surgical margin of 5 to 10mm). RESULTS: We obtained 86 responses to the questionnaire. When pathology indicated a low-grade DN, 60.5% of dermatologists stated they would obtain a surgical margin of 1 to 4mm if the first margins were positive, and 97.7% would watch and wait if the report described negative margins. For high-grade DNs, 1.2% of dermatologists would watch and wait to manage DN with positive margins; 68.8% would use this approach for negative margins. A family or personal history of melanoma had no influence on most of the dermatologists' attitudes. CONCLUSIONS: Management strategies for DN among dermatologists from the center-Spain section of the AEDV varied, particularly when faced with low-grade DN with positive margins and high-grade DN with negative margins. A family or personal history of melanoma did not influence clinical attitudes in most cases.

Mondor's disease.

Mondor's disease (MD) is a rare condition, which is considered a thrombophlebitis of the subcutaneous veins. It commonly occurs on the anterolateral thoracoabdominal wall, but it can also occur on the penis, groin, antecubital fossa and posterior cervical region. The clinical features are a sudden and typically asymptomatic onset of a cord-like induration, although some patients report a feeling of 'strain'. It is a self-limiting process that lasts a short period of time, which may be the reason why there are few reports about its diagnosis and treatment. Its pathogenesis has remained unclear, because of the lack of methods to reliably differentiate between veins and lymphatic vessels. Immunohistochemical staining for CD31 and D240 has been identified recently as the best method to distinguish small veins from lymphatic vessels, making it a valuable technique in diagnosing not only MD, but also many other diseases in which veins or lymphatic vessels are affected. MD has been associated with several systemic diseases such as breast cancer and hypercoagulability states, thus laboratory studies are recommended to exclude any possible systemic disorders. As this condition is usually a benign and self-limiting process, vigorous treatment is only recommended when the process is symptomatic or recurrent.

Immunohistochemical clues to the diagnosis of Mondor's disease of the penis.

Mondor's disease of the penis is usually a benign, self-limiting process of acute onset. To date, there have been few studies about its diagnosis and treatment. It is difficult to differentiate MD of the penis from sclerosing lymphangitis of the penis, because the symptoms, epidemiology and aetiology are similar, and because veins are histologically very similar to lymphatics. We report a case of MD in which immunochemical markers such as CD31 and D240 allowed us to specifically discriminate between the small vein and lymphatic vessels. This is important not only for the recognition of MD at any site, but for many other diseases in which veins or lymphatic vessels are affected.