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Planella-Fontanillas N, Pesqué D, Parra-Navarro L, Pujol RM. A 71-year-old Woman with CREST Syndrome and Multiple Waxy Facial Papules and Plaques: A Quiz. Acta Derm Venereol 2024; 104:adv40419. [PMID: 38850086 PMCID: PMC11181914 DOI: 10.2340/actadv.v104.40419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 05/15/2024] [Indexed: 06/09/2024] Open
Abstract
Abstract is missing (Quiz)
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Escolà H, Segura Tigell S, Pujol RM. [Translated article] Diffuse Firm Swelling of the Right Areola. ACTAS DERMO-SIFILIOGRAFICAS 2024:S0001-7310(24)00426-5. [PMID: 38821352 DOI: 10.1016/j.ad.2024.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 01/17/2023] [Accepted: 01/25/2023] [Indexed: 06/02/2024] Open
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Pesqué D, Mensa-Vilaró A, García-Herrera A, Planella-Fontanillas N, March-Rodríguez Á, Pujol RM, Aróstegui JI, Giménez-Arnau AM. Low-level NLRP3 somatic mosaicism in adult-onset cryopyrin-associated periodic syndrome misdiagnosed as chronic urticaria. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024:S2213-2198(24)00435-5. [PMID: 38697474 DOI: 10.1016/j.jaip.2024.04.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 04/14/2024] [Accepted: 04/16/2024] [Indexed: 05/05/2024]
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Lobato-Berezo A, Escolà-Rodríguez A, Courtney A, Chim I, Ruiz-Villaverde R, Imbernón-Moya A, Velasco-Tamariz V, Vañó-Galván S, Gil-Redondo R, Del Boz J, Garnacho Saucedo G, Starace M, Saceda-Corralo D, Quadrelli F, Piraccini BM, Pujol RM. Acne keloidalis nuchae: An international multicentric review of 79 patients. J Eur Acad Dermatol Venereol 2024; 38:e342-e345. [PMID: 37909243 DOI: 10.1111/jdv.19609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 10/24/2023] [Indexed: 11/02/2023]
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Rovira-López R, Pérez-Jurado LA, Pujol RM. Macrocheilia as an Atypical Clinical Presentation of Capillary Malformation-Arteriovenous Malformation Type 2. JAMA Dermatol 2024; 160:474-476. [PMID: 38353959 DOI: 10.1001/jamadermatol.2023.5805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/18/2024]
Abstract
This case report describes a 53-year-old man with multiple erythematous macules and papules diffusely distributed on the frontal area, cheeks, eyelids, nose, and supralabial skin.
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Escolà H, Llombart B, Escolà-Rodríguez A, Barchino-Ortiz L, Marcoval J, Alcaraz I, Beà-Ardébol S, Toll A, Miñano-Medrano R, Rodríguez-Jiménez P, López-Nuñez M, Ferrándiz-Pulido C, Jaka A, Masferrer E, Aguayo-Ortiz RS, Yébenes M, Arandes-Marcocci J, Ruiz-Salas V, Turrión-Merino L, Just M, Sánchez-Schmidt J, Leal L, Mayo-Martínez F, Haya-Martínez L, Sandoval-Clavijo A, Greta Dradi G, Delgado Y, Verdaguer-Faja J, López-Castillo D, Pujol RM, Deza G. Treatment of extramammary Paget's disease with imiquimod in a real-life setting: a multicenter retrospective analysis in Spain. Clin Exp Dermatol 2024:llae092. [PMID: 38531692 DOI: 10.1093/ced/llae092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 03/07/2024] [Accepted: 03/23/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND Topical imiquimod has shown to be an effective treatment for EMPD, although available evidence supporting its use is based on case reports and small series of patients. OBJECTIVES To investigate the therapeutic outcomes and analyze potential clinico-pathological factors associated with imiquimod response in a large cohort of EMPD patients. METHODS Retrospective chart review of 125 EMPD patients treated with imiquimod at 20 Spanish tertiary-care hospitals. RESULTS During the study period, patients received 134 treatment regimens with imiquimod, with 70 (52.2%) cases achieving complete response (CR), 41 (30.6%) partial response and 23 (17.2%) no response. The cumulative CR rates at 24 and 48 weeks of treatment were 46.3% and 71.8%, respectively, without significant differences between first-time and previously treated EMPD. Larger lesions (≥6 cm; p = 0.038) and EMPD affecting >1 anatomical site (p = 0.002) were significantly associated with a worse treatment response. However, the CR rate did not differ significantly by the number of treatment applications (≤4 vs. > 4 times/week; p = 0.112). Among patients who achieved CR, 30 (42.9%) developed local recurrences during a mean follow-up period of 36 months, with an estimated 3 and 5-year recurrence free-survival of 55.7% and 36.4%, respectively. CONCLUSIONS Imiquimod appears as an effective therapeutic alternative for both first-line and previously treated EMPD lesions. However, a less favorable therapeutic response could be expected in larger lesions and those affecting >1 anatomical site. Based on our results, a 3-4 times weekly regimen of imiquimod with a treatment duration of at least 6 months could be considered an appropriate therapeutic strategy for EMPD patients.
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Pesqué D, Curto-Barredo L, Pastor-Nieto MA, Pujol RM, Giménez-Arnau AM. Allergic Contact Dermatitis due to Over-the-Counter Antifungal Nail Brush: Is Resacetophenone an Under-Recognized Allergen? Dermatitis 2024; 35:190-191. [PMID: 37615604 DOI: 10.1089/derm.2023.0103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
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March-Rodriguez A, Alcalá R, Pujol RM. Eruptive syringomas associated with milia-like idiopathic calcinosis cutis. Pediatr Dermatol 2024. [PMID: 38342575 DOI: 10.1111/pde.15534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 01/07/2024] [Indexed: 02/13/2024]
Abstract
An 11-year-old boy presented generalized eruptive syringomas (ESs) associated with multiple milia-like whitish palmar papules corresponding to dermal calcium deposits. A relationship between calcium deposits distribution to an underlying eccrine duct was noted on pathology. The observation of dermal calcium deposits and its association with generalized ESs may support a possible sweat duct origin of this uncommon and peculiar form of superficial calcinosis cutis.
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Planella-Fontanillas N, Rial-Villavecchia A, Villar-García J, Parra-Navarro L, Santiago-Díaz P, Pujol RM, Rodríguez-Morera J. Hepatic inflammatory pseudotumours mimicking metastatic disease in a non-HIV patient with secondary syphilis. J Eur Acad Dermatol Venereol 2024. [PMID: 38339861 DOI: 10.1111/jdv.19847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 01/24/2024] [Indexed: 02/12/2024]
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Lobato-Berezo A, Pujol RM. Oral Condyloma Lata in Secondary Syphilis With Kissing Distribution. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:T183. [PMID: 38048952 DOI: 10.1016/j.ad.2023.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 09/04/2022] [Indexed: 12/06/2023] Open
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Lobato-Berezo A, López-Trujillo E, Pujol RM. Tufted Hair Follicles Associated With Lipedematous Alopecia: Magnetic Resonance Imaging and Ultrasounds Assessment. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:T198-T199. [PMID: 37952838 DOI: 10.1016/j.ad.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 07/07/2022] [Indexed: 11/14/2023] Open
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Lobato-Berezo A, Pujol RM. Oral Condyloma Lata in Secondary Syphilis With Kissing Distribution. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:183. [PMID: 37661076 DOI: 10.1016/j.ad.2022.09.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/02/2022] [Accepted: 09/04/2022] [Indexed: 09/05/2023] Open
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Lobato-Berezo A, López-Trujillo E, Pujol RM. Tufted Hair Follicles Associated With Lipedematous Alopecia: Magnetic Resonance Imaging and Ultrasounds Assessment. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:198-199. [PMID: 37321547 DOI: 10.1016/j.ad.2022.07.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 07/04/2022] [Accepted: 07/07/2022] [Indexed: 06/17/2023] Open
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Pesqué D, Ciudad A, Andrades E, Soto D, Gimeno R, Pujol RM, Giménez-Arnau AM. Solar Urticaria: An Ambispective Study in a Long-term Follow-up Cohort with Emphasis on Therapeutic Predictors and Outcomes. Acta Derm Venereol 2024; 104:adv25576. [PMID: 38189220 PMCID: PMC10789168 DOI: 10.2340/actadv.v104.25576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 11/17/2023] [Indexed: 01/09/2024] Open
Abstract
Solar urticaria is a rare photodermatosis with several unknown pathogenic, clinical and therapeutic aspects. This study analysed the clinical and therapeutic features of a long-term follow-up solar urticaria cohort, with a focus on omalizumab management and outcomes, and characterized omalizumab response with the use of the high-affinity immunoglobulin E (IgE) receptor (FcεRI) and the Urticaria Control Test. An observational, unicentric, ambispective study was conducted from 2007 to 2023. Solar urticaria was diagnosed in 41 patients with a median follow-up of 60 months. Thirteen patients were prescribed omalizumab, with a median treatment time of 48 months. A significant decrease in FcεRI baseline levels and subsequent median increase in Urticaria Control Test was evidenced after omalizumab prescription in all patients. Drug survival at 48 months was at 88.9%. Omalizumab stepping-down protocol led to sustained omalizumab discontinuation in only 1 patient. Median basal Urticaria Control Test was lower (p < 0.01) in patients who were prescribed omalizumab and in patients without remission. This study contributes to our knowledge of omalizumab outcomes in real-life clinical practice and highlights the pathogenic importance of IgE-mediated pathways in solar urticaria, where FcεRI emerges as a possible biomarker of omalizumab response.
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Escolà H, Llombart B, Escolà-Rodríguez A, Barchino-Ortiz L, Marcoval J, Alcaraz I, Beà-Ardébol S, Toll A, Miñano-Medrano R, Rodríguez-Jiménez P, López-Nuñez M, Ferrándiz-Pulido C, Jaka A, Masferrer E, Aguayo-Ortiz RS, Yébenes M, Arandes-Marcocci J, Ruiz-Salas V, Turrión-Merino L, Just M, Sánchez-Schmidt J, Leal L, Mayo-Martínez F, Haya-Martínez L, Sandoval-Clavijo A, Dradi GG, Delgado Y, Verdaguer-Faja J, López-Castillo D, Pujol RM, Deza G. Therapeutic outcomes and survival analysis of Extramammary Paget's disease: A multicentre retrospective study of 249 patients. J Am Acad Dermatol 2024; 90:66-73. [PMID: 37704106 DOI: 10.1016/j.jaad.2023.08.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 08/13/2023] [Accepted: 08/15/2023] [Indexed: 09/15/2023]
Abstract
BACKGROUND Evidence regarding long-term therapeutic outcomes and disease-specific survival (DSS) in Extramammary Paget's disease (EMPD) is limited. OBJECTIVES To assess the DSS and outcomes of surgical and nonsurgical therapeutic modalities in a large cohort of EMPD patients. METHODS Retrospective chart review of EMPD patients from 20 Spanish tertiary care hospitals. RESULTS Data on 249 patients with a median follow-up of 60 months were analyzed. The estimated 5-, 10-, and 15-year DSS was 95.9%, 92.9%, and 88.5%, respectively. A significantly lower DSS was observed in patients showing deep dermal invasion (≥1 mm) or metastatic disease (P < .05). A ≥50% reduction in EMPD lesion size was achieved in 100% and 75.3% of patients treated with surgery and topical therapies, respectively. Tumor-free resection margins were obtained in 42.4% of the patients after wide local excision (WLE). The 5-year recurrence-free survival after Mohs micrographic surgery (MMS), WLE with tumor-free margins, WLE with positive margins, radiotherapy, and topical treatments was 63.0%, 51.4%, 20.4%, 30.1%, and 20.8%, respectively. LIMITATIONS Retrospective design. CONCLUSIONS EMPD is usually a chronic condition with favorable prognosis. MMS represents the therapeutic alternative with the greatest efficacy for the disease. Recurrence rates in patients with positive margins after WLE are similar to the ones observed in patients treated with topical agents.
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March-Rodriguez A, Escolà H, Lobato-Berezo A, Curto-Barredo L, Pujol RM. Woolly hair nevus type 1 caused by somatic HRAS p.A59T mutation. Int J Dermatol 2024; 63:135-136. [PMID: 38013513 DOI: 10.1111/ijd.16935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/17/2023] [Accepted: 11/14/2023] [Indexed: 11/29/2023]
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Nicolàs LSDS, Czarnowicki T, Akdis M, Pujol RM, Lozano-Ojalvo D, Leung DYM, Guttman-Yassky E, Santamaria-Babí LF. CLA+ memory T cells in atopic dermatitis: CLA+ T cells and atopic dermatitis. Allergy 2024; 79:15-25. [PMID: 37439317 DOI: 10.1111/all.15816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 06/07/2023] [Accepted: 06/29/2023] [Indexed: 07/14/2023]
Abstract
Circulating skin-homing cutaneous lymphocyte-associated antigen (CLA)+ T cells constitute a small subset of human memory T cells involved in several aspects of atopic dermatitis: Staphylococcus aureus related mechanisms, the abnormal Th2 immune response, biomarkers, clinical aspects of the patients, pruritus, and the mechanism of action of targeted therapies. Superantigens, IL-13, IL-31, pruritus, CCL17 and early effects on dupilumab-treated patients have in common that they are associated with the CLA+ T cell mechanisms in atopic dermatitis patients. The function of CLA+ T cells corresponds with the role of T cells belonging to the skin-associated lymphoid tissue and could be a reason why they reflect different mechanisms of atopic dermatitis and many other T cell mediated skin diseases. The goal of this review is to gather all this translational information of atopic dermatitis pathology.
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Ciudad A, Rivera M, Pujol RM, Martín-Ezquerra G. Variability of Mucocutaneous Signs Within the Spectrum of Reactive Arthritis Syndrome. ACTAS DERMO-SIFILIOGRAFICAS 2023:S0001-7310(23)01005-0. [PMID: 38159840 DOI: 10.1016/j.ad.2023.09.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/04/2023] [Accepted: 09/19/2023] [Indexed: 01/03/2024] Open
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Pesqué D, March-Rodríguez Á, Curto-Barredo L, Soto D, Gimeno R, Pujol RM, Giménez-Arnau AM. Autoimmune Diseases and Low Baseline IgE in Chronic Spontaneous Urticaria: A Clinical and Therapeutic Prospective Analysis in Real-Life Clinical Practice. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:3763-3771.e5. [PMID: 37716526 DOI: 10.1016/j.jaip.2023.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 08/11/2023] [Accepted: 09/01/2023] [Indexed: 09/18/2023]
Abstract
BACKGROUND Autoimmunity contributes to the pathogenesis of chronic spontaneous urticaria (CSU). The subtyping of CSU has revealed an autoimmune form of CSU. Despite autoimmune diseases having been associated with CSU, there are few prospective studies that have evaluated the characteristics and biomarkers of patients with CSU and autoimmune disease in a real-life practice setting. OBJECTIVE To evaluate the presence of specific biomarkers for the presence of autoimmune disease in CSU and to analyze the clinical and therapeutic features of patients with CSU and autoimmune disease. METHODS The clinical, laboratory, and therapeutic features of patients with CSU at a tertiary-level center were prospectively collected. Data obtained were compared in function of the presence/absence of autoimmune disease and typified according to IgE levels. RESULTS Patients with CSU who had associated autoimmune disease corresponded to middle-aged women with a common pattern of blood test findings: both low baseline IgE and high-affinity receptor of IgE expression, basopenia, eosinopenia, higher baseline erythrocyte sedimentation rate and D-dimer, increased presence of antinuclear antibodies, IgG against thyroid peroxidase, and positive autologous serum skin test result. Total baseline IgE less than or equal to 43.8 IU/mL was both the optimal cutoff to predict autoimmune disease in the CSU cohort and a significant risk factor for the presence of autoimmune disease in the regression analysis. CONCLUSIONS In real-life clinical practice, characteristics of patients with CSU and autoimmune disease share common features with type IIb autoimmune CSU. Total baseline IgE less than or equal to 43.8 IU/mL has been detected as a possible biomarker of autoimmune disease in patients with CSU.
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Blanco G, López‐Aventín D, Pujol RM, Gómez‐Llonín A, Puiggros A, López‐Sánchez M, Estrach T, García‐Muret MP, López‐Lerma I, Servitje O, Bellosillo B, Muro M, Espinet B, Rabionet R, Gallardo F. High-throughput RNA sequencing of the T cell receptor alpha and beta chains for simultaneous clonality and biological analyses in Sezary syndrome. J Clin Lab Anal 2023; 37:e24982. [PMID: 38115685 PMCID: PMC10756948 DOI: 10.1002/jcla.24982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 10/17/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Previous investigations pointed out a role for antigen stimulation in Sezary syndrome (SS). High-throughput sequencing of the T cell receptor (TR) offers several applications beyond diagnostic purposes, including the study of T cell pathogenesis. METHODS We performed high-throughput RNA sequencing of the TR alpha (TRA) and beta (TRB) genes focusing on the complementarity-determining region 3 (CDR3) in 11 SS and one erythrodermic mycosis fungoides (MF) patients. Five psoriasis patients were employed as controls. Peripheral blood CD4+ cells were isolated and RNA sequenced (HiSeq2500). High-resolution HLA typing was performed in neoplastic patients. RESULTS Highly expanded predominant TRA and TRB CDR3 were only found in SS patients (median frequency: 94.4% and 93.7%). No remarkable CDR3 expansions were observed in psoriasis patients (median frequency of predominant TRA and TRB CDR3: 0.87% and 0.69%, p < 0.001 compared to SS). CDR3 almost identical to the predominant were identified within each SS patient and were exponentially correlated with frequencies of the predominant CDR3 (R2 = 0.918, p < 0.001). Forty-six different CDR3 were shared between SS patients displaying HLA similarities, including predominant TRA and TRB CDR3 in one patient that were found in other three patients. Additionally, 351 antigen matches were detected (Cytomegalovirus, Epstein-Barr, Influenza virus, and self-antigens), and the predominant CDR3 of two different SS patients matched CDR3 with specificity for Influenza and Epstein-Barr viruses. CONCLUSIONS Besides detecting clonality, these findings shed light on the nature of SS-related antigens, pointing to RNA sequencing as a useful tool for simultaneous clonality and biological analysis in SS.
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Segura S, Podlipnik S, Boada A, Martí RM, Sabat M, Yélamos O, Zarzoso-Muñoz I, Azón-Masoliver A, López-Castillo D, Solà J, Baliu-Piqué C, Galvany-Rossell L, Pasquali P, Just-Sarobé M, Duran X, Carrera C, Richarz NA, Pujol RM, Malvehy J, Puig S. Melanoma-specific survival is worse in the elderly: a multicentric cohort study. Melanoma Res 2023; 33:532-538. [PMID: 37696262 DOI: 10.1097/cmr.0000000000000923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
We aimed to characterise cutaneous melanoma in the elderly and determine its association with poorer prognosis. We studied a prospective cohort of the melanoma population in Catalonia between 2012 and 2016. We compared young patient group (<75 years old) with elderly patient group (≥75 years old). We included 3009 patients (52.5% women) from 14 centres, with a mean age at diagnosis of 61.1 years. In the ≥75-year-old group there was a predominance of men (53.9% vs. 45.5%, P < 0.001), melanoma was more frequently located in the head and neck area (37.7% vs. 15.5%, P < 0.001) and lentigo maligna melanoma subtype was significantly more frequent (31.4% vs. 11.6%, P < 0.001), as were nodular melanoma and acral lentiginous melanoma ( P < 0.001). In older people, Breslow index, the presence of ulceration and mitotic rate were higher than in younger people. Kaplan-Meier survival curves showed longer melanoma-specific survival (MSS) and melanoma-free survival (MFS) in <75-year-old group compared to the elderly group. Cox regression models demonstrated reduced MSS in patients ≥75 years regardless of gender, location, IB, ulceration and lymph node status at diagnosis (HR 1.54, P = 0.013) whereas MFS was not independently associated with elderly when head and neck location was considered. Age appears to be an independent risk factor for MSS but not for MFS. Worse melanoma prognosis in elderly could be explained by factors unrelated to the tumour, such as age-related frailty and comorbidities that limit the access to systemic treatments and, eventually, age-related immune dysfunction.
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Rivera M, López-Trujillo E, Ciudad A, Martin-Ezquerra G, Pujol RM. Relapsing annular lesions: a diagnostic challenge. Clin Exp Dermatol 2023; 48:1402-1404. [PMID: 37539692 DOI: 10.1093/ced/llad256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 07/03/2023] [Accepted: 07/24/2023] [Indexed: 08/05/2023]
Abstract
We present a case of a 60-year-old patient who had several flares of nonscaling, erythematous, urticarial annular skin lesions on her abdomen, buttocks and proximal extremities, possibly related to COVID-19 vaccination. Skin biopsy and histopathological examination revealed a dense perivascular and interstitial inflammatory infiltrate involving the upper and mid dermis composed of lymphocytes and abundant eosinophils. Degranulation of eosinophils with occasional flame figures was also observed.
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March-Rodriguez A, Pesqué D, Lobato-Berezo A, Pujol RM. Cutaneous metastasis from pancreatic cancer misdiagnosed as neuropathic foot ulcer. Indian J Dermatol Venereol Leprol 2023; 89:883-885. [PMID: 37067127 DOI: 10.25259/ijdvl_561_2022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 11/24/2022] [Indexed: 03/30/2023]
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Manzanares N, Pesqué D, Pujol RM, Giménez-Arnau AM. Metformin-Induced Acute Urticaria Mimicking Chronic Spontaneous Urticaria. Dermatitis 2023. [PMID: 37878790 DOI: 10.1089/derm.2023.0155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
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March-Rodriguez A, Lobato-Berezo A, Pesqué D, Pujol RM. Nevoid acanthosis nigricans: two new cases with mutational analysis in FGFR2 and FGFR3. Int J Dermatol 2023; 62:e562-e564. [PMID: 37203864 DOI: 10.1111/ijd.16713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 04/28/2023] [Indexed: 05/20/2023]
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