T. Fernández-Morano

Topical cidofovir for viral warts in children

References 1 Johnstone MA, Albert DM. Prostaglandin-induced hair growth. Surv Ophthalmol 2002; 47(Suppl 1): S185–S202. 2 Wand M, Ritch R, Isbey EK et al. Latanoprost and periocular skin color changes. Arch Ophthalmol 2001; 119: 614–615. 3 Seckin D, Yildiz A. Repigmentation and curling of hair after acitretin therapy. Australas J Dermatol 2009; 50: 214–216. 4 Zarafonetis CJ. Darkening of gray hair during para-amino-benzoic acid therapy. J Invest Dermatol 1950; 15: 399–401. 5 Juhlin L, Ortonne JP. Red scalp hair turning dark-brown at 50 years of age. Acta Derm Venereol 1986; 66: 71–73. 6 Abdel-Malek ZA, Swope VB, Amornsiripanitch N et al. In vitro modulation of proliferation and melanization of S91 melanoma cells by prostaglandins. Cancer Res 1987; 47: 3141–3146. 7 Nordlund JJ, Collins CE, Rheins LA. Prostaglandin E2 and D2 but not MSH stimulate the proliferation of pigment cells in the pinnal epidermis of the DBA ⁄ 2 mouse. J Invest Dermatol 1986; 86: 433–437. 8 Pentland AP, Mahoney MG. Keratinocyte prostaglandin synthesis is enhanced by IL-1. J Invest Dermatol 1990; 94: 43–46. 9 Anbar TS, El-Ammawi TS, Barakat M et al. Skin pigmentation after NB-UVB and three analogues of prostaglandin F(2alpha) in guinea pigs: a comparative study. J Eur Acad Dermatol Venereol 2010; 24: 28–31. 10 Sasaki S, Hozumi Y, Kondo S. Influence of prostaglandin F2alpha and its analogues on hair regrowth and follicular melanogenesis in a murine model. Exp Dermatol 2005; 14: 323–328.

Behaviour, attitudes and awareness concerning sun exposure in adolescents on the Costa del sol

A history of sunburn and cumulative sun exposure during adolescence are the most important risk factors for the development of skin cancer. Skin cancer can be prevented by reducing sun exposure, particularly during adolescence, which is precisely the age group that could best benefit from primary prevention campaigns.ObjectiveTo determine the behaviour, attitudes and understanding of adolescents concerning sun exposure.MethodsThis cross-sectional descriptive study undertaken during 2011 included secondary school adolescents from randomly selected schools on the Costa del Sol, southern Spain. A validated beachside questionnaire was used to record data on demographics, skin colour, phototype, sun exposure habits, sunburns, practices, attitudes and knowledge about the sun.ResultsThe study involved 270 students, aged 14–17 years, from 11 schools; 50.4% were female, 43.7% were aged 14 years, and 85.9% were Spanish. Most had a light skin colour (49.3%) and phototypes III (42.2%) or IV (34.8%). Most (71%) went to the beach on more than 16 days and 74.4% had had sunburn the previous summer. Sun cream was used by 47.8% and 1.1% wore long sleeves or trousers. Concerning attitudes, 60.7% stated they felt better when they were tanned, and concerning understanding, most were aware of the harmful effects of the sun on the skin.ConclusionAdolescents comprise a special risk group with a positive attitude towards tanning. Further studies are required to assess educational stategies in order to reduce the desire to have a suntan, and improve sun protection practices and habits targeted at this age group.

Tratamiento de verrugas anogenitales con cidofovir tópico

BACKGROUND Cidofovir is an antiviral agent which inhibits the DNA polymerase of different viruses. Its use has been described for papillomavirus infections. METHODS Descriptive retrospective study, including patients with difficult to treat anogenital warts who were treated with cidofovir cream. RESULTS Nine immunocompetent patients were treated, where 6 of them had a complete response and 3 of them a partial response. CONCLUSION Cidofovir cream could be a useful therapeutic alternative, although further studies are required to establish the best dosage and its cost-effectiveness.

Campaña de prevención y detección de cáncer cutáneo en campos de golf de la Costa del Sol

BACKGROUND AND OBJECTIVES Skin cancer prevention and detection campaigns targeting specific groups are necessary and have proven to be more effective than those aimed at the general population. Interventions in outdoor tourist spots have proven successful, although none have specifically targeted golf courses. The aims of this study were to describe the risk profile of golfers and golf course workers and evaluate the impact of a skin cancer prevention and early detection intervention. MATERIAL AND METHODS This was a cross-sectional descriptive study conducted at 6 golf courses. The intervention included a skin examination and completion of a questionnaire about demographic details, risk factors, and sun exposure and sun protection habits. Participants were also given advice on sun protection measures, self-examination, and use of sunscreens, and were asked about their satisfaction with the intervention and their intention to change their current behaviors. The effect was measured in terms of the diagnoses made, satisfaction with the intervention, reported intention to change, and potential effect in terms of existing risk factors. RESULTS Of the 351 participants (57% golfers and 43% golf course workers), 70.4% had fair skin, 11.7% had a family history of skin cancer, and 8.5% had a personal history of skin cancer. Skin cancer and actinic keratoses were diagnosed in 10.7% and 40% of the golfers, respectively. The session was rated positively by 99.4% of the participants; 93.9% stated that they intended to improve their sun exposure habits and 93.4% said that they planned to examine their skin more frequently. CONCLUSIONS Our findings confirm that golf course workers and, in particular, golfers are an important target for skin cancer prevention campaigns. This is the first intervention to specifically target golf courses, and it proved to be both feasible and useful. Its success appears to be attributable to numerous factors: it was conducted at golf courses, had multiple components, and was preceded by a motivational campaign.

Sensitivity to change of the Beach Questionnaire to behaviour, attitudes and knowledge related to sun exposure: quasi-experimental before-after study

BackgroundHealth questionnaires must present accredited measurement properties such as validity, reliability and sensitivity to change, the latter being essential for interventions to be planned and for evaluating their effectiveness. The aim of this study was to evaluate the sensitivity to change of a Beach Questionnaire.MethodsQuasi-experimental before-after study carried out in 2011, for a study population of adolescents attending schools in the Costa del Sol. First, the questionnaire was administered to the adolescents, after which a multicomponent educational intervention was carried out; finally, three months later, the same questionnaire was re-administered to the same adolescents. Changes were assessed in the categories of each item, using the McNemar test, and the changes in the scores, standardised to a range of 0–100, using the Student t test for paired samples, and including the mean of the differences and the 95% confidence interval. The level of statistical significance was set at p < 0.05.Results228 adolescents, aged 14–17 years, and 55.3% were girls. Statistically significant changes were observed in sunburn experiences, exposure to the sun at mid-day and attitudes to sun exposure and suncreams. For the seven items related to knowledge about sun exposure, a higher rate of correct answers was observed. The analysis of changes, within the standardised range, revealed a significant improvement in the scores for sun exposure habits (MD 4.33; CI 95% 2.2-6.5), attitudes to sun exposure (MD 2.22; CI 95% 1.2-3.2) and knowledge (MD 9.10; CI 95% 7.1-11.1), but not in those for sun-protection practices (MD 0.23; CI 95% -1.2-1.7).ConclusionsThe Beach Questionnaire on behaviour, attitudes and knowledge related to sun exposure is the first such instrument in Spanish language to provide sufficient sensitivity to change. It constitutes a useful tool for epidemiologic research into photoprotection and for skin cancer prevention programmes.

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

OriginalEfectividad del genotipado del virus del papiloma humano frente a la citología anal en la identificación de neoplasia intraepitelial de alto gradoEffectiveness of human papillomavirus genotyping for detection of high-grade anal intraepithelial neoplasia compared to anal cytology

INTRODUCTION The incidence of high-grade anal intraepithelial neoplasia (HGAIN) -with an aetiological based on high-risk types of human papillomavirus- is increasing in some high-risk groups. Screening for HGAIN includes routine anal cytology and, more recently, HPV genotyping. The main objective of this study was to determine the sensitivity and specificity of anal cytology and HPV genotyping for the detection of HGAIN. MATERIALS AND METHODS This is a study to determine the correlation of cytological and microbiological findings with anal biopsy findings in a cohort of patients at high risk of developing AIN referred to the department of sexually transmitted infections of the Hospital Costa del Sol, Spain, between January 2008 and December 2014. RESULTS Of the 151 patients subjected to screening, a total of 92 patients, all of them with the result of three screening test (anal cytology, genotyping and biopsy) were included in the study. Just under two-thirds (62%) of them were HIV-positive. The sensitivity and specificity of anal cytology to detect HGAIN were 52.8 and 85.7%, respectively (k: 0.328), and 78 and 62.8% to detect two or more HPV oncogenic genotypes (k: 0.417). The detection of oncogenic HPV genotypes allowed the identification of 23 new cases of HGAIN that had been underdiagnosed with anal cytology, with 14 cases containing at least three high-risk genotypes. CONCLUSION Anal cytology did not show enough sensitivity in HGAIN screening. HPV genotyping has shown to be a useful tool to detect HGAIN cases, although it could lead to an over-diagnosis as a solitary screening procedure.

Efectividad del genotipado del virus del papiloma humano frente a la citología anal en la identificación de neoplasia intraepitelial de alto grado

INTRODUCTION The incidence of high-grade anal intraepithelial neoplasia (HGAIN) -with an aetiological based on high-risk types of human papillomavirus- is increasing in some high-risk groups. Screening for HGAIN includes routine anal cytology and, more recently, HPV genotyping. The main objective of this study was to determine the sensitivity and specificity of anal cytology and HPV genotyping for the detection of HGAIN. MATERIALS AND METHODS This is a study to determine the correlation of cytological and microbiological findings with anal biopsy findings in a cohort of patients at high risk of developing AIN referred to the department of sexually transmitted infections of the Hospital Costa del Sol, Spain, between January 2008 and December 2014. RESULTS Of the 151 patients subjected to screening, a total of 92 patients, all of them with the result of three screening test (anal cytology, genotyping and biopsy) were included in the study. Just under two-thirds (62%) of them were HIV-positive. The sensitivity and specificity of anal cytology to detect HGAIN were 52.8 and 85.7%, respectively (k: 0.328), and 78 and 62.8% to detect two or more HPV oncogenic genotypes (k: 0.417). The detection of oncogenic HPV genotypes allowed the identification of 23 new cases of HGAIN that had been underdiagnosed with anal cytology, with 14 cases containing at least three high-risk genotypes. CONCLUSION Anal cytology did not show enough sensitivity in HGAIN screening. HPV genotyping has shown to be a useful tool to detect HGAIN cases, although it could lead to an over-diagnosis as a solitary screening procedure.

Angiolymphoid Hyperplasia With Eosinophilia: Analysis of 7 Cases

Angiolymphoid hyperplasia with eosinophilia (ALHE), also known as epithelioid hemangioma, is a chronic, benign vascular proliferation for which no cases of malignant transformation have been reported to date. Spontaneous resolution has been described in some patients, particularly in those with small lesions. ALHE is characterized by a high rate of recurrence (approximately 30%), regardless of treatment modality. We describe the clinical and pathologic characteristics of 7 cases of ALHE diagnosed in our hospital between 2005 and 2011 (Table 1). Six of the patients were women; 5 of these were in their 40s and 1 was aged 75 years when the disease was diagnosed. The seventh patient was a 43year-old man. The predominant clinical presentation was erythematous papules and plaques (Fig. 1). Subcutaneous masses were observed in 2 cases. In all 7 patients, the lesions were located on the head and neck, specifically in retroauricular areas, on the helix of the ear, on the nose, on the temple, in the posterior cervical region, and in the frontal region (2 cases). The most common treatment was surgical excision (5 cases). This produced a satisfactory clinical outcome, although recurrence was observed in 4 cases. Recurrent lesions were treated with cryotherapy, intralesional corticosteroid injections, and electrocoagulation, resulting in complete resolution in 1 case; the remaining lesions remained stable. Spontaneous involution following biopsy was observed in 1 patient with a single papular lesion on the nasal dorsum. None of the patients had peripheral eosinophilia, palpable lymph nodes, or a history of trauma in the area of the

Análisis de la población con infección genital por Chlamydia trachomatis en una consulta de enfermedades de transmisión sexual

INTRODUCTION AND OBJECTIVES Chlamydia trachomatis genital infection is common in our setting and early treatment can prevent complications. The aim of this study was to report on patients diagnosed with C trachomatis genital infection in a sexually transmitted disease (STD) clinic. MATERIAL AND METHODS This was a descriptive, cross-sectional, observational study of patients diagnosed with C. trachomatis infection between 2010 and 2011. We recorded demographic data and information on sexual habits, concomitant sexually transmitted infections (STIs), and various aspects of treatment. RESULTS In total, 12.3% of the samples analyzed were positive for C trachomatis genital infection. Sixty-two patients (43 men) with a mean age of 31 years were studied; 75% were heterosexual and 87% had had a sexual partner in the previous 2 months. Condom use was inconsistent in 81%, 79%, and 65% of patients who practiced vaginal, oral, and anal sex, respectively. Thirteen percent of the patients had symptoms and anogenital warts were the most common associated STI. The most widely used treatment was doxycycline. CONCLUSIONS A high prevalence of genital C. trachomatis infection was detected in our STD clinic, and the majority of cases were found in young men. We observed a high rate of asymptomatic infection in patients who do not engage in high-risk sexual behavior and who had come to the clinic for another reason. Systematic screening of C. trachomatis infection should be implemented in STD units to enable the early treatment of patients and their recent sexual partners.