Fernando Alfageme

Spontaneous Regression in Merkel Cell Carcinoma: Report of Two Cases with a Description of Dermoscopic Features and Review of the Literature

Merkel cell carcinoma (MCC) is a malignant neuroendocrine tumor that typically affects elderly patients. It is aggressive, with frequent recurrences after excision. Regional and distant metastases develop in approximately 40% of cases. Patients without lymph node involvement have been reported to have a survival rate of 75% at 5 years, whereas patients with distant metastases have a survival rate of 25% at 5 years. The etiology of MCC remains unknown, although a polyomavirus has recently been linked to this tumor. The incidence reported is higher in men than in women. Surgery is the primary approach for clinically localized disease, although there is great variability regarding the use of further treatments. Some studies have suggested that the use of sentinel lymph node biopsy improves survival and decreases nodal recurrence. Recent studies have also demonstrated that the use of local adjuvant radiation after surgery lowers the risk of local and regional recurrences.

Afferent Projections to the Mediodorsal and Anterior Thalamic Nuclei in the Cat. Anatomical-Clinical Correlations.

Afferent projections to the mediodorsal and anterior thalamic nuclei in the cat were studied by means of stereotaxic injection of neuronal tracers (horseradish peroxidase and fluorochromes). Acetylcholinesterase reaction was studied, as well as horseradish peroxidase and NADPH‐diaphorase colocation in neuronal bodies which send and receive projections to and from the mediodorsal thalamic nucleus. Based on the connectivity and histochemistry findings, the possibility that prion agents responsible for fatal familial insomnia spread from the mediodorsal and anterior thalamic nuclei through a retrograde pathway is discussed. The possible pathophysiological implication of nitrergic systems in fatal familial insomnia is also considered.

Guidelines for Performing Dermatologic Ultrasound Examinations by the DERMUS Group.

To support standardization for performing dermatologic ultrasound examinations.

Ultrasound Evaluation as a Complementary Test in Hidradenitis Suppurativa: Proposal of a Standarized Report

BACKGROUND Staging and monitoring of patients with hidradenitis suppurativa (HS) have been traditionally based on clinical findings. However, the physical examination may show important limitations because of its poor sensitivity for differentiating between different lesion subtypes, and its low sensitivity to define the diseases activity. OBJECTIVE To develop a consensus ultrasound (US) report that could summarize the relevant anatomical characteristics and staging of patients considering the experience of radiologists and dermatologists working on imaging of HS. METHODS A questionnaire on different aspects related to US examination in HS was performed. A working group, called DERMUS, composed of doctors from 9 countries who have been working in dermatologic US applied in patients with HS on a regular basis were included to evaluate the different items provided. RESULTS A consensus US report to evaluate HS patients was established. CONCLUSION The authors present the first attempt to define a HS standardized sonographic report. This model would be the first effort to include this imaging technique as the first elective medical test for staging and monitoring patients, which can support therapeutic decisions by providing earlier, objective, deeper, anatomical, and comparative evaluations in this difficult to treat disease.

High-Frequency Color Doppler Sonography of Bullous Pemphigoid Correlation With Histologic Findings

Bullous pemphigoid is the most frequent autoimmune‐mediated blistering skin disease, belonging to the group of subepidermal bullae. We performed high‐frequency color Doppler sonography in 3 cases of bullous pemphigoid, in bullous and adjacent non‐bullous skin, which showed homogeneous sonographic findings. Subepidermal cystic structures with dermal hypoechogenicity were observed in bullous skin. In nonbullous skin, the dermis showed hypoechogenicity compared to normal skin. Color Doppler signals were increased in both areas. These findings correlate histologically with subepidermal bullae and dermal inflammatory infiltrates.

Ex Vivo High-Frequency Ultrasound for Assessment of Basal Cell Carcinoma: Ex Vivo High-Frequency Ultrasound for Basal Cell Carcinoma

The use of Mohs micrographic surgery for poorly defined cutaneous tumors is present in a few departments in Spain. Reintervention is occasionally necessary when the margins of the surgical specimen are invaded by the tumor. We propose the use of ultrasound to assess these margins by imaging the surgical specimen once excised.

Pre-surgical Sonographic Assessment of the Margins in Skin Lesions

A correct margin assessment in skin lesions is mandatory for avoiding recurrences that can be critical in skin cancer.