A. García-Cruz

¿Quién financia la investigación de los dermatólogos españoles? Análisis del año 2008 y comparación con otros grupos

BACKGROUND References have been made in the literature to the funding of clinical trials by the pharmaceutical industry. Other types of funding, however, have been less well studied. OBJECTIVE To describe the sources of funding for research by Spanish dermatology departments published in 2008. MATERIAL AND METHODS A bibliometric study was performed of the research articles published by Spanish, French, and British dermatology departments and by Spanish rheumatology departments in 2008 according to MEDLINE records. RESULTS Articles published by Spanish dermatology departments received funding in 36.4% of cases. This percentage is lower than that found for the other groups studied and remained low for all different types of funding. Statistically significant relationships were found between a higher percentage of funding and a higher level of evidence, as well as between a higher level of funding by the pharmaceutical industry and the publication of research into quality of life and pharmacological treatment. Inadequate declaration of funding was observed in 57.1% of articles from Spanish dermatology departments and the role of the sponsor was not declared in any article. Similar findings were obtained for the other groups studied. CONCLUSIONS The proportion of research articles published by Spanish dermatology departments that receive external funding is low, and this is associated with a lower level of scientific evidence. In order to obtain more external funding, we must improve our competitiveness.

Generalised tetanus in a patient with a chronic ulcerated skin lesion.

Chronic ulcerated skin lesions and skin biopsies should be considered as wounds prone to tetanus

Genital ulcer in a patient with chronic lymphocytic leukaemia.

A 73-year-old man presented with a 2-month history of a painless ulcer on his penis. He had been diagnosed with B-cell chronic lymphocytic leukaemia 2 years previously; it was Rai stage II and Binet stage A (Table 1). He was taking chlorambucil and prednisone, the latter to treat haemolytic anaemia and thrombocytopenia diagnosed 2 months before his presentation to us. The patient denied any risky sexual behaviour or having had previous lesions in this location. On physical examination, two contiguous superficial indurated ulcers with sharp edges were found on the foreskin. Disseminated petechiae were present. None of the regional lymph nodes was palpable, and no other mucosal areas were affected. Laboratory investigations showed that the patient had low levels of haemoglobin at 8 g ⁄ dL (normal range 13.5–17.5 g ⁄ dL) and of platelets at 20 · 10 ⁄ L (normal range 150– 400 · 10 ⁄ L), and an increased level of white cells at 64 · 10 ⁄ L with 1.2% polymorphonuclear leucocytes (normal ranges 4–11 · 10 ⁄ L and 40–74%) The patient was negative for syphilis (luetic serology). Direct immunofluorescence tests for herpes simplex viruses 1 and 2 of the ulcer smear and microbiological cultures were negative. A biopsy was taken from a lesion for histopathological examination.

Giant verrucous lesion on the scalp

A 41-year-old woman presented with an asymptomatic tumoral lesion on her scalp, which had been progressively enlarging over the previous 10 years. The patient’s medical history was not contributory. She had not received radiotherapy in that location, and she also denied receiving any trauma to the scalp or having any other potential triggering factors. There was no evidence of wasting syndrome. On physical examination, an exudative, verrucous, well-delimited lesion, 90 · 80 · 60 mm in size, was seen (Fig. 1). A biopsy was taken from the lesion.