Infección cutánea por Staphylococcus lugdunensis: presentación de 16 casos

Introduction and objectiveStaphylococcus lugdunensis belongs to the group of coagulase-negative staphylococci. The aim of this report was to review the clinical and microbiologic features of cases of S. lugdunensis skin infections.Material and methodsObservational study of all cases of skin infections in which S. lugdunensis was isolated by the microbiology department of Hospital General San Jorge in Huesca, Spain, between 2009 and 2016.ResultsWe studied the cases of 16 patients. The most frequent site of infection was the inguinal-perineal region (n = 6, 37.5%), and pustules were the most common presentation (n = 5, 31.3%). Response to treatment was good in 87.6% of the patients (n = 14). However, infection recurred in 3 patients, 2 of whom were on anti-TNF therapy.ConclusionsS. lugdunensis should be considered a possible cause of infection when it is isolated in both skin and subcutaneous tissues, especially in patients on biologic therapies.     

Presentación cutánea anetodérmica de un trastorno linfoproliferativo postrasplante

—Posttransplant lymphoproliferative disorders (PLD) are a heterogeneous group of lymphocytic proliferations, usually with B-cell phenotype and frequently associated with Epstein-Barr virus (EBV), that occur during the post transplant immunosuppressive treatment threatening the life of the patient.The skin is a potential location for these PLD, although there are very few cases of PLD with cutaneous disease described to date.A 41 year-old male with renal transplantation 11 years earlier and treated with cyclosporin A (CsA) and prednisone consulted because of the presence of an anetodermal erythematous and purplish nodule of 1 year of evolution in the back, where there were other anetodermal lesions. Pathological evaluation showed a kappa-chain restricted lymphocytic B-cell proliferation with positivity for EBV LMP-1 (Latent Membrane Protein 1), and peritumor elastolytic changes. The tumor node regressed within 1 month with reduction the dose of CsA and with additional radiation therapy of the region.We present a new case of cutaneous EBV-associated B-cell phenotype PLD with the striking features of peritumor elastolytic changes and anetodermal presentation.     

Melanoma dérmico primario: presentación de un caso y revisión de la literatura

Patients with cutaneous metastatic melanoma of unknown primary origin (stage IV M1a disease according to the American Joint Committee on Cancer melanoma staging system) have an estimated 5-year survival rate of between 5% and 17.9% and a median survival of 6 months. However, certain patients with stage IV M1a disease have much higher survival rates. The existence of this subpopulation has given rise to the term primary dermal melanoma to describe such cases.We report a case of melanoma with characteristics consistent with primary dermal melanoma and review the relevant literature. A diagnosis of primary dermal melanoma requires careful clinical and pathologic correlation and should be considered in all patients with a solitary melanoma confined to the dermis and subcutaneous tissue when there is no evidence of a primary tumor or disease at other sites following appropriate staging studies. We believe that familiarity with this subtype of melanoma is essential in order to provide patients with optimal care and better prognostic information.     

Mucinosis folicular: un caso de presentación clínica inusual

Few cases of primary follicular mucinosis, not related to mycosis fungoides, are described in healthy adults. A 65-year-old woman presented with an erythematous patch on her right face. Histological examination revealed mucin depositions in the hair follicles. No other hematological or cutaneous diseases were detected.The aim of this case is to reinforce the concept of primary follicular mucinosis and to expand the spectrum of its clinical manifestations.