M. Fernández-Guarino

Intralymphatic granulomas as a pathogenic factor in cheilitis granulomatosa/Melkersson-Rosenthal syndrome: report of a case with immunohistochemical and molecular studies.

Orofacial granulomatosis, an uncommon immunologically mediated disorder, includes cheilitis granulomatosa and Melkersson-Rosenthal syndrome. It is clinically characterized by recurrent or persistent swelling of the orofacial tissues with a spectrum of other orofacial features and sometimes with neurological symptoms. The pathological findings are varied but are often characterized by the presence of noncaseating granuloma. We present a new case of orofacial granulomatosis with unusual histopathological findings, namely, intralymphatic granulomas. These may be the cause of the tissue edema. We demonstrated, by immunohistochemical studies, the lymphatic nature of the vessels affected by the granulomatous process.

Estudio retrospectivo, descriptivo y observacional del tratamiento de queratosis actínicas múltiples con metilaminolevulinato tópico y luz roja: resultados en la práctica clínica y correlación con la imagen de fluorescencia

Resumen Introduccion Las queratosis actinicas (QA) son una de las patologias cutaneas mas frecuentes en la practica clinica. En los ultimos 5 anos se han publicado varios estudios que evaluaban la eficacia de la terapia fotodinamica (TFD) en el tratamiento de multiples QA. Objetivo Evaluar los resultados de la TFD de multiples QA por localizaciones y su correlacion con la imagen de fluorescencia. Material y metodos Realizamos un estudio retrospectivo, descriptivo y observacional de los pacientes tratados por multiples QA con TFD en nuestro hospital. Se describe la edad, el sexo y la localizacion de las lesions (cara, cuero cabelludo y dorso de las manos) de los 57 pacientes. Se trato a todos los pacientes usando los mismos parametros: acido metilaminolevulinico (MAL, Metvix®) ocluido tres horas e irradiacion con luz roja de 630 nm, 37 J/cm2, 7,5 minutos (Aktilite®). Se describe la respuesta, periodo de remision, tolerancia, numero de sesiones y la fluorescencia segun localizaciones. Con la prueba Chi-cuadrado se evaluan las diferencias entre localizaciones y la correlacion de la imagen de fluorescencia con la respuesta clinica. Resultados En la cara se obtiene mayor grado de mejoria, se requieren menor numero de sesiones y mayores periodos de remision que en el resto de las localizaciones. El dorso de las manos es la zona mejor tolerada. Existe una correlacion alta y significativa entre el area de fluorescencia y su disminucion al aplicar el tratamiento, con el grado de respuesta clinica. Conclusiones Los resultados en el tratamiento de multiples QA con TFD son mejores, globalmente, en la cara que en el cuero cabelludo y en el dorso de manos. El diagnostico de fluorescencia puede ser una herramienta eficaz para predecir la respuesta al tratamiento.

Linear cutaneous lupus erythematosus

Moreover, with Alfred Fournier, the foremost syphilologist of that time, on the forefront, virtuous marriage of a virgin man and woman was proposed as the only method for syphilis’ prevention, as, during the century’s final 30 years, physicians were prohibited by law and male convention from informing the future brides of the risk they ran in marrying.[5] Applying the incitement of prophylaxis to marriage appeared to be the essential motivation of the antisyphilitic crusade; the control of sexuality.

Efficacy of Dapsone in Disseminated Granuloma Annulare: A Case Report and Review of the Literature

Granuloma annulare is a dermatosis of unknown cause that is generally self-limiting and has several clinical forms of presentation. It may be associated with pruritus or present asymptomatically. The disseminated variant of the disease accounts for 15 % of all cases. Most authors consider that the duration of this form is longer and that treatment response is worse than for localized forms. A range of therapeutic options have been tried for this disease with a wide range of outcomes. We present a patient with disseminated granuloma annulare who started treatment with dapsone after several therapeutic failures. With dapsone therapy, her cutaneous symptoms showed a clear improvement without any relevant side effects. We then review reports in the literature of cases of disseminated granuloma annulare treated with dapsone.

Papulosis linfomatoide: hallazgos clínico-patológicos en 18 pacientes

BACKGROUND Lymphomatoid papulosis (LyP) is a CD30(+) lymphoproliferative skin disease that has been described in association with Hodgkin lymphoma. It has also been reported to progress to mycosis fungoides or cutaneous anaplastic large-cell lymphoma. OBJECTIVE To study the clinical and histologic features of LyP and response to treatment in a patient series. MATERIALS AND METHODS For this retrospective, descriptive, observational study of patients with histologically confirmed LyP and sufficient follow-up data on record, we extracted histologic findings on skin biopsy, clinical presentation, clinical course, and response to treatments. RESULTS Eighteen patients (10 male, 8 female) were identified. Most biopsies (14/18, 78%) showed a wedge-shaped lymphocytic infiltrate with CD30(+), CD3(+), and CD56(-) cells. A type A histologic pattern was present in the biopsies of 83% of the patients. The most common presentation (83%) consisted of papules on the trunk; for 62% LyP resolved after a single episode. Twelve percent of the patients developed mycosis fungoides (mean follow-up, 7 years); no other associations were noted. DISCUSSION Although few series of patients with LyP have been published in recent years, the findings reported generally coincide with our observations. CONCLUSION LyP is typically a CD30(+) lymphoproliferative disorder that usually runs a benign course and responds well to treatment.

Photodynamic Therapy for Acne: Use of the Pulsed Dye Laser and Methylaminolevulinate

Recent decades have seen the inclusion of acne vulgaris as a potential new indication for photodynamic therapy. Photodynamic therapy and light sources can be considered to be additional tools for primary or adjunctive therapy in patients with recurrent acne or those in whom it is not possible to use other treatments. We investigated the use of pulsed dye laser plus methylaminolevulinate for photodynamic therapy and have performed a comparative study of the use of this laser alone and as an element in photodynamic therapy.

Studies of Methyl Aminolevulinate Photodynamic Therapy for Actinic Keratosis

Photodynamic therapy (PDT) for the treatment of actinic keratosis has been shown to be effective and safe in large clinical trials published in the last 5 years. However, evidence has since emerged that raises questions or that introduces new issues, such as the management of field cancerization, fluorescence diagnosis and results in transplant recipients. There also remains a need for more studies comparing PDT to additional treatments. We review the literature on these new topics in PDT.

Terapia fotodinámica en indicaciones no aprobadas

La terapia fotodinámica (TFD) es un tratamiento aprobado para su uso en el carcinoma basocelular, la enfermedad de Bowen y las queratosis actínicas. Sin embargo, más allá de estas indicaciones ha sido utilizada con éxito variable en otras neoplasias de origen epitelial, linfoide y vascular. En este capítulo se abordan estas indicaciones, la literatura publicada, su aplicación en la práctica habitual, sus ventajas e inconvenientes y su papel en el manejo de estas neoplasias.

Erythroderma That Spares the Major Flexion Creases

An 80-year-old man with no relevant history except for chronic gastritis presented with progressive brownish hyperpigmentation over the entire skin surface that had appeared 4 months earlier and was accompanied by severe pruritus. The patient had been assessed 2 years previously for lesions in the form of erythematous papules and plaques with well-defined borders on the arms, back, and groin. At that time, the histological study showed advanced lichenoid dermatitis with no other specific findings.