M. de Troya

A 30-year survey of paediatric tinea capitis in southern Spain

Background  Tinea capitis (TC) is the most common mycological infection in childhood. The epidemiology of TC varies depending on the geographical area and the time of study, and although it is an important public health problem in our area, only a few long‐term studies have focused on children.

A cost analysis of photodynamic therapy with methyl aminolevulinate and imiquimod compared with conventional surgery for the treatment of superficial basal cell carcinoma and Bowen’s disease of the lower extremities

Background  Superficial basal cell carcinoma (sBCC) and Bowen’s disease (BD) are usually slow‐growing, low‐grade malignancies that mainly affect older persons. Surgery is often the first choice of treatment and the modality with the lowest failure rate. However, non‐invasive procedures, such as topical methyl aminolevulinate photodynamic therapy (MAL‐PDT) and imiquimod, are increasingly demanded by dermatologists and patients, because of their generally favourable efficacy and adverse effects profile and their excellent cosmetic outcome.

Tinea incognito in children: 54 cases

The incidence of tinea incognito (TI) appears to have increased over recent years, although no large series of cases has been reported in children. The aim of this study was to analyse the main epidemiological, clinical and microbiological characteristics of TI diagnosed in children in comparison with other tineas. We undertook a retrospective study of 818 tineas diagnosed in children in a referral hospital between 1977 and 2006, concentrating on TI. Of the 54 TI diagnosed, 85% were in the last 15 years. Most children were older than 9 years of age. The most usual clinical forms were tinea corporis (46.3%) and tinea faciei (38.9%). Topical steroids alone had been used to treat 68.5% of the cases. Direct examination was positive in 91.5% of the cases examined. Culture was positive in 85.2% of cases. The most frequently isolated dermatophyte was Trichophyton mentagrophytes (44.4%). This is the largest case series of childhood TI reported to date. TI has increased over recent years and important differences were found between these TI and the other tineas in children over the same period.

Topical cidofovir for viral warts in children

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Es la ecografía cutánea de alta frecuencia una alternativa en el diagnóstico y manejo del carcinoma basocelular

High-frequency skin ultrasound (HFSU), a relatively new diagnostic technique still under investigation, has been shown to be a useful noninvasive procedure in different areas of dermatology. The physical principal underlying this technique is the emission of high-frequency ultrasonic pulses (> 10 MHz) by a transducer probe in contact with the skin, which are subsequently recorded by a processing unit as they are reflected back to the probe. The data generated can be displayed on screen in several modes, labeled A, B, C, etc. In B-mode (one of the most widely used display modes in cutaneous ultrasonography), the processing unit represents the electrical signals as dots of greater or lesser intensity on the screen. The images created represent a longitudinal or transverse section depending on the orientation of the probe relative to the structure under study. One important consideration is that the higher the wave frequency the higher the image resolution (defined as the ability of the system to discriminate between the echoes of 2 adjacent structures); however, the converse is true of tissue penetration, which correlates inversely with frequency. Thus, maximum skin

Utilidad de la ecografía cutánea en el diagnóstico de invasividad del carcinoma basocelular recurrente tras tratamiento no quirúrgico

INTRODUCTION AND OBJECTIVES Accurate subtyping of basal cell carcinoma (BCC) is crucial for the effective management of this disease and it is particularly important to distinguish between aggressive and nonaggressive histologic variants. Histologic subtype is not always accurately identified by biopsy and this can have serious implications. High-resolution ultrasound (HRUS) is a recent technique that has proven to be of value in differentiating between variants of BCC. The aim of this study was to investigate the potential usefulness of HRUS for detecting invasive disease in recurrent BCC treated nonsurgically following an initial diagnosis of noninvasive BCC by biopsy. MATERIAL AND METHODS This was a prospective observational study of consecutive cases of BCC with clinical suspicion of recurrence following nonsurgical treatment and a pretreatment diagnosis of superficial BCC by punch biopsy. Before surgical excision, the recurrent lesions were evaluated by HRUS followed by a punch biopsy of the site of suspected recurrence. The diagnostic agreement between HRUS, punch biopsy, and excisional biopsy was then evaluated. RESULTS Eight lesions were studied. HRUS identified invasive disease in 3 of the 4 cases that were incorrectly classified as superficial subtypes by punch biopsy. CONCLUSION HRUS could be useful for detecting persistent tumor after nonsurgical treatment and for choosing the site most likely to harbor invasive disease for punch biopsy.

Recalcitrant warts and topical cidofovir: predictive factors of good response

S. Silling,* U. Wieland, V. Fingerle, H. Rasokat, M. Fabri Institute of Virology, University of Cologne, Koeln, National Reference Center for Borrelia, Bayerisches Landesamt f€ ur Gesundheit und Lebensmittelsicherheit, Oberschleissheim, Department of Dermatology and Venereology, University of Cologne, Koeln, Center for Molecular Medicine, University of Cologne, Koeln, Germany *Correspondence: S. Silling. E-mail: steffi.silling@uk-koeln.de