M. de Troya Martín

Comparative epidemiological study of non-melanoma skin cancer between Spanish and north and central European residents on the Costa del Sol.

Background  Non‐melanoma skin cancer (NMSC) is the most common tumour in white people. The progressive increase of these malignancies in such populations as those found in Europe represents an important public health concern which it is presumed will have a great impact on healthcare costs. However, the lack of comparable epidemiological information between countries hinders the development of a common health policy.

Evaluación de la ecografía cutánea de 15 Mhz en la estimación preoperatoria del espesor tumoral en el melanoma maligno

BACKGROUND Tumor thickness is of great importance in the management of cutaneous malignant melanoma (MM): this variable not only affects prognosis but is also a key factor in planning surgical margins and selecting candidates for sentinel node biopsy. Breslow depth is the standard histologic measure of thickness, but technological advances have provided imaging techniques such as cutaneous ultrasound that can potentially assess tumor thickness and enable prompt initiation of definitive treatment. OBJECTIVES a) To evaluate the utility of ultrasound assessment of tumor thickness in MM, and b) to analyze histologic variables that affect ultrasound assessments of thickness. MATERIALS AND METHODS Retrospective study of a consecutive series of 79 primary cutaneous MMs in which tumor thickness had been assessed by 15-MHz ultrasound before surgery. We gathered data from histology reports, studying Breslow depth and the presence of ulceration, regression, inflammatory infiltrate, and associated nevi. Correlation coefficients were calculated to evaluate the strength of association between Breslow depth and thickness assessed by ultrasound. We also calculated the sensitivity, specificity, and positive and negative predictive values of ultrasound measurement in the diagnosis of MMs more than 1mm thick. Associations between histologic variables and the overestimation of thickness by ultrasound were also analyzed. RESULTS The 79 primary MMs studied had a mean (SD) Breslow depth of 0.8 (1.4) mm. There was moderate correlation and agreement between Breslow depth and the ultrasound assessment of thickness (Pearson correlation coefficient, 0.678; intraclass correlation coefficient, 0.78). The tendency of ultrasound to overestimate thickness was nonsignificantly related to the presence of a moderate to intense infiltrate and associated nevi (P>.05). The sensitivity of ultrasound for the diagnosis of MM over 1mm thick was 82%; specificity was 80%, and positive and negative predictive values were 54% and 94%, respectively. CONCLUSIONS Ultrasound imaging quite correctly identifies thin MMs and can be useful for planning adequate surgical margins; however, there are limitations on its usefulness in the diagnosis of thick MMs. Additional studies are required to confirm whether certain histologic characteristics, such as the presence of a moderate to intense inflammatory infiltrate or associated nevi can lead to overestimation of thickness by ultrasound, limiting the clinical utility of this imaging technique in MM management.

Ecografía aplicada al manejo del melanoma maligno cutáneo

In the last few decades, the role of cutaneous ultrasound has increased in dermatology. This technique currently has multiple applications, both in inflammatory and tumoural disease. Indeed, melanoma is one of the tumours benefitting most from technological advances in ultrasound, both for initial diagnosis and for follow-up. Today, cutaneous ultrasound is a noninvasive diagnostic technique, whose main applications in melanoma are to determine tumoural thickness and analyse intratumoural vascularisation. This allows prognostic factors to be determined in real time and contributes to the diagnosis of subcutaneous and nodal metastases during initial staging and follow-up with a view to reducing morbidity and mortality.In the last few decades, the role of cutaneous ultrasound has increased in dermatology. This technique currently has multiple applications, both in inflammatory and tumoural disease. Indeed, melanoma is one of the tumours benefitting most from technological advances in ultrasound, both for initial diagnosis and for follow-up. Today, cutaneous ultrasound is a noninvasive diagnostic technique, whose main applications in melanoma are to determine tumoural thickness and analyse intratumoural vascularisation. This allows prognostic factors to be determined in real time and contributes to the diagnosis of subcutaneous and nodal metastases during initial staging and follow-up with a view to reducing morbidity and mortality.

Ecografía aplicada al manejo del cáncer cutáneo no melanoma

Cutaneous ultrasound plays an important role in the study and management of non-melanoma skin cancer. Among other factors, this technique contributes to the diagnosis and differential diagnosis of these tumours, the establishment of their size and relation to neighbouring structures, the delimitation of surgical margins, and the detection of subclinical and recurrent lesions. The present article analyses the role of cutaneous ultrasound in the field of non-melanoma skin cancer (basal and squamous cell carcinomas, lymphomas and dermatofibrosarcoma) through a literature review.

Hipopigmentación genital similar a vitíligo tras tratamiento con imiquimod 5

Imiquimod cream is a topical imidazoquinoline amine widely used in dermatology. It has antitumor, antiviral, and immunomodulatory properties that modify biologic response. It was first approved in 1997 for the treatment of genital warts and later received authorization for use in superficial basal cell carcinoma and actinic keratosis. Treatment regimens vary according to the disease. The summary of product characteristics for imiquimod mentions the possibility of ‘‘mild or moderate hypopigmentation’’ following its use but total loss of pigmentation, which is particularly relevant in the genital region, is not mentioned as a possible adverse effect.

Características clínico patológicas del melanoma en residentes europeos de la Costa del Sol occidental

OBJECTIVE To compare clinical and pathological features of melanoma in Spanish patients with those of patients from Central or Northern Europe living in the health district of Costa del Sol Occidental in southern Spain. METHODS We conducted a descriptive cross-sectional study of all cases of primary cutaneous melanoma histologically confirmed between 2005 and 2011 in the health care district covered by Hospital Costa del Sol in Marbella. We analyzed clinical and pathological features and performed a descriptive analysis of the 2 populations, in addition to univariate analysis with place of birth (Spain vs Central or Northern Europe) as the independent variable. RESULTS Compared with Spaniards, patients from Central or Northern Europe were 10 years older at the time of melanoma diagnosis (66.2 vs 56.2 years, P<.001), had lighter skin (types I or II) (90.3% vs 67.1%, P<.001), and greater recreational sun exposure (93.7% vs 66.2%, P<.001). In addition, multiple melanomas (17.6% vs 4.4%, P=.001), nonmelanoma skin cancer (47.2% vs 15.7%, P<.001), and a family history of melanoma (9.5% vs 2.3%, P=.01) were more common in these patients. Central and Northern Europeans also had a higher overall frequency of melanoma on the trunk (46.3% vs 38.7%) and melanoma in situ (54.7% vs 41.8%, P=.03). CONCLUSION Differences in melanoma presentation between Spanish patients and patients from Central or Northern Europe appear to be linked to phenotypic and lifestyle factors. A better understanding of these differences will help to tailor melanoma prevention and follow-up programs for multicultural populations, such as those on Spains Costa del Sol.