Pediatric dermatofibrosarcoma protuberans in Madrid, Spain: multi-institutional outcomes.

Little is known about the incidence and management of dermatofibrosarcoma protuberans (DFSP) in children. We conducted a retrospective review of all patients younger than 18 years of age treated for DFSP over a period of 11 years (2000-2011) in Madrid, Spain. The sample consisted of 13 children. The average annual incidence of DFSP in the pediatric population corresponded to 1.02 cases per million person-years (95% confidence interval 0.55, 1.73). Sites of involvement were diverse, with 15.3% of tumors found in acral locations. The median tumor size was 3.5 cm × 3 cm and the median time from apparent onset to diagnosis was 36 months. Histopathologic examination revealed conventional (77.0%), pigmented (15.4%), and myxoid (7.6%) variants. The mitotic index was consistently <5 per 10 high-power fields. All lesions were removed using surgical excision. One patient developed a local recurrence because of initial affected margins; none developed metastases. The median duration of clinical follow-up was 70.5 months. This study estimated the average annual incidence rate of DFSP in a population of patients younger than 18 years and reviewed the experience of several hospitals in the management of this tumor.

Dermoscopic features of melanocytic nevi in seven different anatomical locations in patients with atypical nevi syndrome.

BACKGROUND: Dermoscopic screening facilitates early detection of melanoma and is recommended in patients with multiple or atypical nevi. OBJECTIVES: To investigate whether dermoscopic features of acquired melanocytic nevi differ between six body sites (neck, axilla, pectoral area, shoulders, buttocks, legs) and the trunk. METHODS AND MATERIALS: One hundred six patients with atypical nevi syndrome from a Digital Dermoscopy Unit were evaluated for the presence of nevi in each of seven body sites, and nevi representative of each region were selected as the predominant nevi. Dermoscopic features of 684 melanocytic nevi located in seven different body sites were analyzed. RESULTS: Globular and globular-homogeneous pattern nevi showed a cephalad distribution. Nevi at the neck, axilla, shoulders, and pectoral area showed a higher proportion of globular and globular-homogeneous patterns than other locations (p < .001). Comma vessels were also more frequent on the neck, axillary area, and shoulders (p < .001). A reticular pattern was more frequent on caudal areas (legs, buttocks and lower back, and abdomen; p < .001). CONCLUSIONS: Dermoscopic differences were found in different body areas. This information should be considered in the evaluation of lesions in patients with atypical nevus syndrome.

[Biologic therapy and psoriasis]. / Terapia biológica y psoriasis.

Psoriasis is a common, persistent, inflammatory skin disorder that can have a major effect on patient quality of life. Conventional psoriasis treatment fail to meet the clinical needs for a save and remittive therapy. The implication of an immunological lymphocyte T phenomena in the pathogenesis of psoriasis has led to research for new treatment options over the past few years. With advances in molecular research and technology, several biological therapies may be employed in the treatment of psoriasis. Biological treatments are designed to modulate key steps in the pathogenesis of psoriasis. They act by: inhibition of activation of antigen-presenting cells, inhibition of activation and proliferation of lymphocytes, immune deviation (from a T1 immune response to a T2 immune response) and reduction of pathogenic T cells and blocking the activity of inflammatory cytokines. Different biological treatments are discussed in this article.