Buenaventura Hernández-Machín

Office-based radiation therapy for cutaneous carcinoma: Evaluation of 710 treatments

Skin cancers are the most common malignancies and, historically, ionizing radiation has played an important role in their treatment. However, less experienced dermatologists generally consider radiation last in the line of therapeutic options. The authors sought to evaluate the effectiveness and safety of office‐based elective radiation therapy for cutaneous carcinoma.

Lupus eritematoso neonatal: 4 casos y revisión clínica

Resumen El lupus eritematoso neonatal (LEN) es una enfermedad poco frecuente del recien nacido debido al paso transplacentario de anticuerpos maternos anti-Ro/SSA, anti-La/SSB y/o anti-U 1 RNP en la que las afectaciones cutaneas y cardiacas son las mas destacadas. Realizamos un estudio retrospectivo de casos diagnosticados de LEN en los ultimos 10 anos en el Hospital Universitario Insular de Gran Canaria en el que se obtuvieron datos completes de 4 enfermos. En 3 casos se presentaron anticuerpos circulantes anti-Ro en la madre y en los neonatos, mientras que en el otro era anti-RNP. Dos madres estaban diagnosticadas de lupus sistemico, una de enfermedad mixta del tejido conjuntivo y otra de vasculitis leucocitoclastica. Las lesions cutaneas consistieron en lesiones urticariformes y descamativas. Un paciente presento ulceracion. El estudio histologico de las lesiones urticariformes mostro un infiltrado perivascular inespecifico; las lesiones descamativas fueron compatibles con lupus eritematoso subagudo.

Bilateral areolar sebaceous hyperplasia in a female.

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Leflunomide in the Treatment of Palmoplantar Pustulosis

In 1995, a 30-year-old woman presented with a 6-day history of fever and pruritic pustules on her left hand. Physical examination revealed confluent pustules surrounded by erythema on the dorsal aspect of the left hand, palm, and wrist (Figure 1). There were no lesions in other locations. Her medical history was otherwise unremarkable. A complete laboratory blood cell count showed a slightly low white blood cell count (3600/μL [reference range, 4500-10 800/μL]; to convert to 10/L, multiply by 0.001). Findings from biochemical tests were within reference range. Cultures of the pustules were negative for organisms. Findings from skin biopsy specimens showed an intraepidermal pustule with mild acantholysis and moderate mononuclear infiltrate in dermis. A diagnosis of localized pustulosis was made. The patient was initially treated with topical and oral antibiotics with poor response. After a month, oral retinoids and topical steroids were added to her treatment, but the patient experienced new flares. Seven months after the onset of the process, she complained about arthralgias and chest and back pain. Imaging studies (radiography, computed axial tomography) revealed sacroileitis. A diagnosis of incomplete SAPHO syndrome (sacroileitis, acne, pustulosis, hyperostosis, osteitis) was made. Therapy was begun with methotrexate, 7.5 mg/wk, and the dosage was subsequently increased to 10 mg/wk. Two months later there was no improvement, so oral cyclosporine was added to her drug regimen but was poorly tolerated because of headache. During the following 4 years the patient subsequently failed treatment with sulfone, prednisone, colchicine, sulfasalazyn, and numerous nonsteroidal antiinflammatory drugs (NSAIDs).

First-line treatment in lymphomatoid papulosis: a retrospective multicentre study

Data regarding response to treatment in lymphomatoid papulosis (LyP) are scarce.

Treatment of stage Ia and Ib mycosis fungoides with psoralen UVA monotherapy: an observational study in tertiary hospitals in the Canary Islands

Mycosis fungoides (MF) is the most common form of primary cutaneous T cell lymphoma. Psoralen combined with ultraviolet A (PUVA) is a first‐line treatment for early‐stage disease.

Linfoma primario cutáneo B de célula grande difuso tipo piernas según la nueva clasificación de la OMS-EORTC. dos casos

Resumen Los linfomas primarios cutaneos son un grupo heterogeneo de procesos linfoproliferativos que se caracterizan por afectacion cutanea sin evidencia de enfermedad sistemica en el momento del diagnostico. Por lo general tienen un comportamiento clinico indolente, y solo ocasionalmente suele observarse el desarrollo de enfermedad extracutanea. A partir de la decada de 1980, se han considerado los linfomas primarios cutaneos de celulas B como un grupo especifico de linfomas, diferenciandose tanto de los linfomas de celulas T como de los linfomas cutaneos secundarios de celulas B. Tanto la EORTC como la OMS han propuesto clasificaciones alternatives para estas entidades con discrepancias importantes que ultimamente se han aclarado elaborando una nueva clasificacion (clasificacion de la OMS-EORTC de los linfomas cutaneos) que unifica criterios hasta ahora dispares. Se presentan dos nuevos casos de linfoma primario cutaneo B de celula grande difuso tipo piernas segun esta nueva clasificacion.

Refractory Subacute Cutaneous Lupus Erythematosus With a Response to Efalizumab

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Lupus eritematoso cutáneo subagudo refractario con respuesta a efalizumab

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Disseminated Crusted Papules in a Newborn

The patient was a 1-month-old girl with a good general state, born after an uncomplicated pregnancy and delivery, and with no family or personal history of interest. The patient was referred to us for the presence of crusted lesions on the scalp since birth. These lesions had spread onto the trunk, axillas, and buttocks. The patient presented generalized, crusted, sometimes honey-colored, erythematous papules that were not infiltrated. The majority were situated on the scalp, axillas, upper part of the back, buttocks, and abdomen. There were also a number of residual lesions (Figure 1). Histopathology The pathologic study revealed parakeratosis in the epidermis and a band infiltrate that blurred the dermal-epidermal junction and that was formed of homogeneous, round, histiocytic cells, some with reniform nuclei, and with infrequent mitoses. There were occasional eosinophils (Figure 2). The histiocytic cells were positive for S100 protein and CD1a (Figure 3).