María Luisa Martínez

Administration of recombinant human granulocyte colony-stimulating factor to normal donors: results of the Spanish National Donor Registry. Spanish Group of Allo-PBT.

A Spanish National PBPC Donor Registry has recently been established for short- and long-term safety data collection in normal donors receiving rhG-CSF. To date, 466 donors have been included in the Registry. Median (range) dose and duration of rhG-CSF administration was 10 μg/kg/day (4–20) and 5 days (4–8), respectively. Donors underwent a median of two aphereses (range, 1–5). Adverse effects consisted mainly of bone pain (90.2%), headache (16.9%) and fever (6.1%), but no donor discontinued rhG-CSF prematurely due to toxicity. Side-effects were more frequent in donors receiving >10 μg/kg/day than in those with lower doses (82.8% vs 61.8%; P = 0.004). A significant decrease between baseline and post-apheresis platelet counts was the most important analytical finding (229 × 109/l vs 140 × 109/l; P < 0.0001), with a progressive reduction in platelet count with each apheresis procedure. one donor developed pneumothorax that required hospitalization due to central venous line placement. the mean cd34+ cell dose collected was 6.9 × 106/kg (range, 1.3–36), with only 14 donors (2.9%) not achieving a minimum target of CD34+ cells of 2 × 106/kg. No definitive information about potential long-term side effects is yet available. However, we hope this National Registry will serve as a useful basis for better monitoring of the efficiency and side-effects of cytokine administration in healthy people.

Disseminated Blastoschizomyces capitatus infection in acute myeloblastic leukaemia : Report of three cases

Three new cases ofBlastoschizomyces capitatus infection occurring in neutropenic patients with acute myeloblastic leukaemia are reported.B. capitatus was isolated from blood cultures in all patients. All three patients were treated with amphotericin B, but only one was cured from the infection. Our study confirms the emergence ofB. capitatus as an opportunistic agent of disseminated fungal infection in leukaemic patients.

Acral papular mucinosis: a new case of this rare entity

Acral persistent papular mucinosis (APPM) is a rare subtype of localized lichen myxedematosus. It consists of small papules localized exclusively on the back of the hands, wrists and extensor aspects of distal forearms with no other clinical or laboratory manifestations. The lesions tend to persist and may increase slowly in number. Histologically, hematoxylin-eosin and Alcian blue staining demonstrate mucin accumulation in the upper reticular dermis with separation of collagen fibers as a result of hyaluronic acid deposition. Treatment is rarely necessary due to the absence of symptoms. We present a 27-year-old healthy woman with asymptomatic papules on her upper extremities, which adequately meet clinical and pathological criteria of acral papular mucinosis.

Exuberant granulation tissue successfully treated with ingenol mebutate. Two cases report

We present two 80-year-old men, both affected by squamous cell carcinoma of the scalp that were excised with safety margins and covered with full-thickness skin grafts from abdominal region. They followed postoperative care every 48 hr. Surgical sponge was removed on Day 7 in both cases and the interrupted stitches were removed on Day 10. Initially, both skin grafts evolved appropriately, but on the following weeks, some regions of exuberant granulation tissue appeared (Figures 1a and 2a). An attempt to cauterize this tissue with silver nitrate was carried out once per week during 1 month without improvement in either of the two patients. A biopsy was made in each case to rule out squamous cell carcinoma recurrence. Finally, treatment with 150 mg/g of ingenol mebutate gel was thought to be an alternative choice on exuberant granulation tissue and so try to treat possible actinic keratosis surrounding. Under consent of both patients, ingenol mebutate gel was applied over the exuberant granulation tissue, once a

Osteoma cutis: rare painful tumor in atypical location

Osteoma cutis or cutaneous ossification is a rare entity characterized by the formation of bone in the skin. We present an isolated primary osteoma cutis located on the palm, an atypical location.

Varón de 65 años con múltiples malformaciones vasculares cutaneomucosas

Varón de 65 años, natural de Turquı́a, que consultó por unas lesiones cutáneas asintomáticas, de color azulado, de aparición progresiva desde su juventud. Negaba sangrado digestivo, sin rectorragia ni melenas. Referı́a que su madre tenı́a lesiones similares. En la exploración se apreciaban tumoraciones azuladas de consistencia blanda, aspecto vascular y distribución generalizada, incluida la mucosa oral (fig. 1). La biopsia cutánea demostró ectasias vasculares de forma y tamaño irregulares en la dermis, rodeadas por una capa de células endoteliales (fig. 2), D2-40 negativas. Tanto en la colonoscopia (fig. 3 A y B) como en la gastroscopia se hallaron múltiples lesiones de aspecto vascular; algunas de ellas fueron esclerosadas con etoxiesclerol al 2%. En la resonancia magnética se identificó una tumoración de partes blandas angiomatosa, polilobulada, parcialmente bien delimitada, de 10 8 5 cm, en el compartimento anterior y lateral derecho de la pared toracoabdominal. Diagnóstico: sı́ndrome de nevus azul en tetina de goma.

Carcinoma de células de Merkel: a propósito de un caso

Merkel cell carcinoma is an unusual cutaneous neoplasm of aggressive characteristics, classified within neuroendocrine carcinomas; clinically polymorphic and histologically similar to other skin tumors making it difficult for early diagnosis. Given its low incidence; the pathogenesis of this tumor, the recent description of a viral association and its treatment, are still matter of research; for this reason it is important to know its pathophysiology and clinical manifestations in order to perform a clear diagnostic approach in early stages, and treatment in accordance with the patient’s condition. We describe the case of an inmunosupressed patient with a Merkel cell carcinoma on face and scalp, recurrent and metastatic, with an evolution consistent to reports in the literature.