Outbreak of cutaneous leishmaniasis in Fuenlabrada, Madrid.

BACKGROUND: Leishmaniasis, an endemic infection in Spain, is caused by protozoan parasites of the Leishmania genus. Between 2010 and 2012, there was an outbreak of cutaneous and visceral leishmaniasis in Fuenlabrada, Madrid. OBJECTIVES: To describe the cases of cutaneous leishmaniasis diagnosed over a 17-month period at the dermatology department of Hospital de Fuenlabrada. MATERIAL AND METHODS: We analyzed the epidemiological, clinical, histological, and microbiological features of each case and also evaluated the treatments administered and outcomes. RESULTS: We studied 149 cases. The incidence of cutaneous leishmaniasis showed a peak in the age range between 46 and 60 years and was similar in men and women. At the time of consultation, the lesions had been present for between 2 and 6 months in the majority of patients. The most common clinical presentation was with erythematous plaques and papules without crusts (52% of cases). Lesions were most often located in sun-exposed areas and were multiple in 57% of patients. In 67% of cases, the histological study showed non-necrotizing granulomatous dermatitis with no evidence of parasites using conventional staining methods. Diagnosis was confirmed by polymerase chain reaction (PCR) in 98% of patients. In the remaining cases, the histological study revealed Leishman-Donovan bodies in the skin. Intralesional pentavalent antimonials were the most commonly used drugs (76% of cases) and produced satisfactory results. CONCLUSIONS: We have presented a large series of cases of cutaneous leishmaniasis diagnosed in the context of an outbreak. Multiple papules were the most common clinical presentation, with histology that showed non-necrotizing granulomatous dermatitis with no evidence of parasites. PCR of skin samples was the test that most frequently provided the diagnosis.

Eosinophilic, polymorphic and pruritic eruption associated with radiotherapy (EPPER) in two patients with breast tumour.

Eosinophilic polymorphic and pruritic eruption associated with radiotherapy (EPPER) is a rare entity that appears in oncological patients after radiotherapy. We describe two patients with breast tumour who presented with EPPER in a different area from the one that had been irradiated. One of them needed different types of treatment, topical and systemic corticosteroids, antihistamines and narrowband ultraviolet B. The other one responded to the application of topical corticosteroids. We suggested that this eruption could be more frequent than has been reported.

Absence of EBV genome in lymphoepithelioma-like carcinomas of the larynx.

Undifferentiated nasopharyngeal carcinomas are universally associated with Epstein-Barr virus (EBV). This association has been exclusively established in lymphoepithelioma-like carcinomas in some locations. The relationship between EBV and lymphoepithelioma-like carcinomas in the larynx is unknown. In none of the few laryngeal lymphoepithelioma-like carcinomas reported have EBV investigations been carried out. We present here two supraglottic laryngeal lymphoepithelioma-like carcinomas in which EBV antigens were not demonstrable using immunohistochemical and molecular methods. Our results suggest that EBV may not be involved in laryngeal lymphoepithelioma-like carcinoma at least in Western patients.