Granuloma aséptico facial idiopático: hallazgos clínicos y ecográficos de 3 casos

Idiopathic facial aseptic granuloma is a typical childhood disease characterized by the presence of one or more asymptomatic nodules on the cheek. Although pathogenesis remains unclear, the disease is thought to be a type of childhood rosacea. It resolves spontaneously, yet it could be confused with other lesions that require treatment.We present clinical and ultrasound findings and outcome from 3 new cases. In 2 cases, the lesion presented as childhood rosacea. Ultrasound revealed a characteristic pattern, with variations depending on the stage of development.High-frequency ultrasound can facilitate the differential diagnosis and thus obviate unnecessary biopsy or excision.     

Características clínicas y epidemiológicas de los pacientes con esclerodermia

IntroductionScleroderma is a term used to refer to a group of fibrosing disorders affecting the skin. Two types of scleroderma can be differentiated: systemic sclerosis (SS), with visceral involvement, and localised scleroderma or morphea, confined to the skin and underlying tissues. Few studies have evaluated the characteristics of these patients. The aim of this study was to analyse demographic and clinical features of patients with a diagnosis of scleroderma.Material and methodsAn analysis was performed on the data from adult patients with a diagnosis of scleroderma and followed-up in a single speciality clinic in a tertiary hospital.ResultsThe study included 100 patients (80 with SS and 20 with morphea). The median age of onset was 45 years, and women were more frequently affected than men. Patients were classified according to the subtype of scleroderma. Prevalence of concomitant autoimmune diseases (28% patients) and lichen sclerosus (5%) were also analysed. Another classification is proposed by us for patients with morphea according to the distribution of lesions: isomorphic morphea (lesions on areas of skin friction) and non-isomorphic morphea (other locations). Patients with isomorphic morphea were more predominantly female, with a higher prevalence of overweight and obesity, and a higher association with lichen sclerosus. Patients with non-isomorphic morphea required systemic treatment less frequently.ConclusionsThe present study suggests that a classification for patients with morphea according to distribution patterns could differentiate two subtypes of patients that seem to have differences in disease course.     

Características clínicas,dermatoscópicas e histológicas de varios casos de vasculitis eosinofílica recurrente cutánea

Primary recurrent cutaneous eosinophilic vasculitis is a rare condition characterized by pruritic, erythematous, purpuric plaques associated to edema. We compared and analyze the clinical, dermoscopic and histological features of the disease in 4 patients from our hospital and 13 patients published in the literature. Seventeen patients were included, with a median age of 56 yo, a median duration of disease of 6 months. Lesions were most frequently generalized (47%) or localized in lower limbs (41%). The most frequent features were purpuric color (71%), local edema (65%), necrotizing vasculitis (94%) and eosinophil infiltration (100%) in histology. Most of the patients (82.4%) were given oral steroids with a median dose of 30 mg. Primary recurrent cutaneous eosinophilic vasculitis might be an infra-diagnosed condition. The analysis of the patients allowed us to propose diagnostic criteria for the definition of this disease. We suggest a therapeutic strategy with high-potency steroids and dapsone, which might be considered as first-line treatment.     

Registro nacional de melanoma cutáneo. Características del tumor en el momento del diagnóstico: 15 años de experiencia

Background and objectivesThe Spanish National Cutaneous Melanoma Registry (Registro Nacional de Melanoma Cutáneo [RNMC]) was created in 1997 to record the characteristics of melanoma at diagnosis. In this article, we describe the characteristics of these tumors at diagnosis.Patients and methodsThis was a cross-sectional observational study of prevalent and incident cases of melanoma for which initial biopsy results were available in the population-based RNMC.ResultsThe RNMC contains information on 14,039 patients. We analyzed the characteristics of 13,628 melanomas diagnosed between 1997 and 2011. In total, 56.5% of the patients studied were women and 43.5% were men. The mean age of the group was 57 years (95% CI, 56.4-57 years) while median age was 58 years. The most common tumor site was the trunk (37.1%), followed by the lower limbs (27.3%). The most frequent clinical-pathologic subtype was superficial spreading melanoma (n = 7481, 62.6%), followed by nodular melanoma (n = 2014, 16.8%). Localized disease was observed in 86.2% of cases (n = 10,382), regional metastasis in 9.9% (n = 1188), and distant metastasis in 3.9% (n = 479). Independently of age at diagnosis, men had thicker tumors, more ulceration, higher lactate dehydrogenase levels, and a higher rate of metastasis than women (P < .001).ConclusionsBased on our findings, melanoma prevention campaigns should primarily target men over 50 years old because they tend to develop thicker tumors and therefore have a worse prognosis.