Constanza del Puerto

Intralesional methotrexate as an adjuvant treatment for pyoderma gangrenosum: A case report.

A 35‐year‐old man presented with an eighteen‐month history of painful ulcers on both calves. Three ulcers with erythematous‐violaceous undermined borders were noticed on his right leg and one on the left leg [Figure 1]. A detailed laboratory evaluation was done including complete blood counts, erythrocyte sedimentation rate, antinuclear antibodies, chest radiograph, quantiferon gold assay for tuberculosis and human immunodeficiency virus (HIV) serology all of which were unremarkable. Bacterial, fungal and mycobacterial cultures from the ulcer were negative. A skin biopsy showed ulceration surrounded by granulation tissue with a scant, diffuse infiltrate of lymphocytes, neutrophils and plasmacytes and fibrosis but without any signs of vasculitis [Figure 2] and a negative periodic acid‐Schiff stain, all suggestive of pyoderma gangrenosum. Associated systemic diseases were ruled out with normal blood and urine protein electrophoresis, sacroiliac radiography, rheumatoid factor and gastroenterology evaluation including colonoscopy.

Ectopic extramammary Paget's disease on the face

Indian Journal of Dermatology, Venereology, and Leprology | November-December 2012 | Vol 78 | Issue 6 760 A pruritic variant of porokeratosis. J Dermatol 2006;33:813-6. 4. Choi KH, Kim TY. A case of inflammatory disseminated superficial porokeratosis in a colon cancer patient. Ann Dermatol 2009;21:150-3. 5. Stork J, Kodetová D. Disseminated superficial porokeratosis: An eruptive pruritic papular variant. Dermatol 1997;195:3045.

Vitamin D axis and its role in skin carcinogenesis: a comprehensive review

Vitamin D (VD) is a secosteroid hormone that is mainly synthesized in the skin upon exposure to UVB radiation. VD is widely known for its role in calcium metabolism; however, multiple endocrine, paracrine and autocrine functions of VD have been described, including a prominent role on carcinogenesis. In recent years, multiple associations between VD deficiency and different types of cancer have been described, supported by evidence of anti-proliferative, anti-angiogenic, pro-apoptotic, cell-differentiating and anti-invasive effects of this hormone. An immunomodulatory role of VD associated to cancer microenvironment has also been suggested. Regarding skin cancer, it has been shown that VD inhibits tumor development in basal cell carcinoma, squamous cell carcinoma, and melanoma in vitro. Some studies have suggested that lower VD levels may be a risk factor for skin cancer, while others have shown the opposite; there is also preliminary evidence on the role of VD supplementation for the prevention of melanoma in vivo. In this review, we explore the mechanisms of VD effects on carcinogenesis and the available scientific evidence of the interplay between VD and the genesis of both non-melanoma and melanoma skin cancer.

Experiencia en loxoscelismo cutáneo y cutáneo visceral de manejo hospitalario: clínica, evolución y propuesta terapéutica

BACKGROUND Loxoscelism is a common pathology in our environment with a broad spectrum of differential diagnoses and presentations, with potentially serious complications, even to the point of death. To date, there is no standard treatment for these patients. AIM To describe the clinical manifestations, main complications, therapeutic management, and evolution of loxoscelism in an inpatient setting from a tertiary hospital in Chile. METHODS All patients consulting and hospitalized in the hospital of the Pontificia Universidad Católica de Chile with diagnosis of loxoscelism between 2014 to 2017 and evaluated by dermatologist were included. Review of clinical files, including symptoms, images, laboratory parameters and treatment. RESULTS We evaluated seventeen inpatient with loxoscelism, whose presentation responds to the national epidemiological pattern. Most cases were managed with antibiotics, systemic corticosteroids, antihistamines, and dapsone. From these, 11.8% corresponded to viscerocutaneous loxoscelism, successfully managed with supportive measures, systemic corticosteroids and antihistamines. Fifty-nine percent healed their cutaneous lesions after one month of treatment, with slight residual scarring or post inflammatory hyperpigmentation, without associated mortality in our series. DISCUSSION Most cases of cutaneous loxoscelism presented excellent response and rapid resolution of the disease after combined therapy with systemic corticosteroids, antibiotics and dapsone, suggesting that the use of these therapies could stop the progression of cutaneous necrosis and prevent complications associated with loxoscelism.

Circulating vitamin D–binding protein and free 25-hydroxyvitamin D concentrations in patients with melanoma: A case-control study

Armstrong et al did not fully report the association between psoriasis and the amount of cigarettes smoked. The association between duration of smoking and psoriasis has been controversial. In this study, we clearly showed that there is a positive correlation between the amount and/or duration of smoking and the occurrence of psoriasis. However, our study has a limitation in that any change in smoking status after registration has not been reflected. In addition, association does not demonstrate cause and effect; therefore, further investigation is needed.

Rheumatoid arthritis and pseudo-vesicular skin plaques: rheumatoid neutrophilic dermatosis

A 54 year-old woman with a 3-year history of rheumatoid arthritis (RA) consulted us because of weight loss, fever and skin eruption. On physical examination, erythematous plaques with a pseudo-vesicular appearance were seen on the back of both shoulders. Histological examination was consistent with rheumatoid neutrophilic dermatosis (RND). After 3 days of prednisone treatment, the skin eruption resolved. RND is a rare cutaneous manifestation of seropositive RA, characterized by asymptomatic, symmetrical erythematous plaques with a pseudo-vesicular appearance. Histology characteristically reveals a dense, neutrophilic infiltrate with leucocitoclasis but without other signs of vasculitis. Lesions may resolve spontaneously or with RA treatment. This case illustrates an uncommon skin manifestation of active rheumatoid arthritis.

Vasculitis séptica por Listeria monocytogenes

Septic vasculitis is a medium and small-vessel vasculitis caused by direct action of pathogens, associated with bacteremia. It is an uncommon condition; clinical manifestations include purpura, ulcers and vesicles-pustules. Most cases of septic vasculitis are related to meningococcemia. There are no cases reported in medical literature associated to Listeria spp. We report a case of a 71 year-old man who presented sepsis by Listeria monocytogenes, and then evolved with purpuric skin lesions. Skin biopsy revealed a septic vasculitis.