1
|
Alturo-Pons A, Alamon-Reig F, Sanmartín Novell V, Vilardell F, Martí RM. [Translated article] Congenital and Acquired Epidermodysplasia Verruciformis: A Series of 7 Cases. Actas Dermosifiliogr 2023; 114:T179-T182. [PMID: 36464007 DOI: 10.1016/j.ad.2022.01.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 01/17/2022] [Indexed: 12/02/2022] Open
Affiliation(s)
- A Alturo-Pons
- Servicio de Dermatología, Hospital Universitari Arnau de Vilanova, Universitat de Lleida, IRBLleida, Lleida, Spain
| | - F Alamon-Reig
- Servicio de Dermatología, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - V Sanmartín Novell
- Servicio de Dermatología, Hospital Universitari Arnau de Vilanova, Universitat de Lleida, IRBLleida, Lleida, Spain
| | - F Vilardell
- Servicio de Anatomía Patológica, Hospital Universitari Arnau de Vilanova, Universitat de Lleida, IRBLleida, Lleida, Spain
| | - R M Martí
- Servicio de Dermatología, Hospital Universitari Arnau de Vilanova, Universitat de Lleida, IRBLleida, Lleida, Spain.
| |
Collapse
|
2
|
Alturo-Pons A, Alamon-Reig F, Sanmartín Novell V, Vilardell F, Martí RM. Congenital and Acquired Epidermodysplasia Verruciformis: A Series of 7 Cases. Actas Dermosifiliogr 2023; 114:179-182. [PMID: 36055387 DOI: 10.1016/j.ad.2022.01.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/28/2021] [Accepted: 01/17/2022] [Indexed: 02/06/2023] Open
Affiliation(s)
- A Alturo-Pons
- Servicio de Dermatología, Hospital Universitari Arnau de Vilanova, Universitat de Lleida, IRBLleida, Lleida, España
| | - F Alamon-Reig
- Servicio de Dermatología, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, España
| | - V Sanmartín Novell
- Servicio de Dermatología, Hospital Universitari Arnau de Vilanova, Universitat de Lleida, IRBLleida, Lleida, España
| | - F Vilardell
- Servicio de Anatomía Patológica, Hospital Universitari Arnau de Vilanova, Universitat de Lleida, IRBLleida, Lleida, España
| | - R M Martí
- Servicio de Dermatología, Hospital Universitari Arnau de Vilanova, Universitat de Lleida, IRBLleida, Lleida, España.
| |
Collapse
|
3
|
Matas-Nadal C, Soria X, Gonzalez-Farré M, Baradad M, Tuset N, Rius Riu F, González M, Gatius S, Vilardell F, López-Ortega R, Martí RM. Abdominal tumors in patients with neurofibromatosis type I: Genotype-phenotype relationships. Eur J Med Genet 2022; 65:104609. [PMID: 36096471 DOI: 10.1016/j.ejmg.2022.104609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 08/15/2022] [Accepted: 09/06/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Gastrointestinal stromal tumors have been detected in 25% of the necropsies performed on NF1 patients, but have been reported only in 7% of NF1 patients in the largest series. Such data imply an important gap between the true presence of tumors and those diagnosed. Few genotype-phenotype relationships have been described but to date none referring to abdominal tumors. OBJECTIVES Evaluate retrospectively the efficacy of a regular and proactive follow-up of NF1 patients to early diagnose abdominal tumors and report their mutations. METHODS Cohort study performed between 2010 and 2020, with 43 NF1 adult patients followed at our Dermatology department. RESULTS Eight abdominal tumors were diagnosed in six patients, meaning that 14% of the followed patients developed an abdominal tumor. Five patients (83%) were asymptomatic. Five (83.3%) had a family history of NF1 with abdominal tumors (patients 1,2 and 3,4,5 were relatives). CONCLUSIONS Although currently gastrointestinal routine screening investigations for asymptomatic patients are not recommended in the guidelines, the family aggregation in our series suggests it should be considered a close follow-up of the relatives of a patient with an NF1-related abdominal tumor. Also, for the first time, two mutations [c.2041C > T (p.Arg681Ter) and c.4537C > T (p.Arg1513*)] have been associated with family aggregation of abdominal tumors in NF1 patients.
Collapse
Affiliation(s)
- C Matas-Nadal
- Dermatology Department, Hospital Universitari Arnau de Vilanova, Lleida, Spain; IRB Lleida, Spain.
| | - X Soria
- Dermatology Department, Hospital Universitari Arnau de Vilanova, Lleida, Spain; IRB Lleida, Spain
| | - M Gonzalez-Farré
- Dermatology Department, Hospital Universitari Arnau de Vilanova, Lleida, Spain; University of Lleida, Spain
| | - M Baradad
- Dermatology Department, Hospital Universitari Arnau de Vilanova, Lleida, Spain; IRB Lleida, Spain; University of Lleida, Spain
| | - N Tuset
- Medical Oncology Department, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - F Rius Riu
- Endocrinology Department, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - M González
- General Surgery Department, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - S Gatius
- IRB Lleida, Spain; Department of Pathology and Molecular Genetics, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - F Vilardell
- IRB Lleida, Spain; Department of Pathology and Molecular Genetics, Hospital Universitari Arnau de Vilanova, Lleida, Spain; Centre of Biomedical Research on Cancer (CIBERONC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - R López-Ortega
- Laboratori Clínic ICS Lleida, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - R M Martí
- Dermatology Department, Hospital Universitari Arnau de Vilanova, Lleida, Spain; IRB Lleida, Spain; Centre of Biomedical Research on Cancer (CIBERONC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; University of Lleida, Spain
| |
Collapse
|
4
|
Moreno S, Maiques O, Gatius S, Veà A, Barrera J, Barcelo C, Santacana M, Soria X, Matias-Guiu X, Martí RM. Descriptive study of naevus involution in a series of 74 patients with atypical naevus syndrome under SIAscopy digital follow-up. J Eur Acad Dermatol Venereol 2019; 34:1210-1217. [PMID: 31732990 DOI: 10.1111/jdv.16084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 10/24/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Characterization of nevi involution could help to understand the biological behaviour of melanocytic neoplasms. OBJECTIVE To describe the frequency and morphology of naevus involution in a series of patients with atypical naevus syndrome under digital follow-up with a SIAscopy program and, in a small sample of fading nevi, to analyse histopathological features and immunohistochemical biomarkers. METHODS Seventy-four patients registered from April 2007 to July 2014 in the SIAscopy system of the Department of Dermatology of Hospital Arnau de Vilanova of Lleida, Spain, were reviewed. Fourteen naevus cases with fading features were prospectively excised during follow-up. Eleven already excised naevus controls were randomly selected from our archive. RESULTS We observed that 81% of patients showed, at least, one involutive naevus and 25% of recorded nevi presented this phenomenon; the mean time of involution was 46.7 months. The predominant structural pattern was reticular (>70%), and the most frequently observed regression structures were vascular (33.8%). Histopathological significant higher intensity of inflammatory infiltrate in controls and higher presence of laminar and compact fibrosis and increase of vessels in cases were demonstrated. Regarding immunohistochemical biomarkers, only higher expression of cytoplasmic activated caspase 3 in controls was significant. CONCLUSIONS Naevus involution is a common phenomenon in patients with dysplastic naevus syndrome. It is usually a slow process, more frequent in naevus with reticular pattern. SIAscopy regression structures are uncommon, with the exception of vascular ones. Histologically, fading involutive pattern is characterized by scarce inflammatory infiltrate and melanophages, delicate fibrosis and increase of vessels.
Collapse
Affiliation(s)
- S Moreno
- Department of Dermatology, Hospital Universitari Arnau de Vilanova, University of Lleida, IRBLleida, Lleida, Spain.,Department of Dermatology, Hospital del Vendrell, Xarxa Sanitària i Social de Santa Tecla, Tarragona, Spain
| | - O Maiques
- University of Lleida, IRBLleida, Lleida, Spain.,Centre for Cancer and Inflammation, Barts Cancer Institute, Queen Mary University of London, London, UK
| | - S Gatius
- Department of Pathology and Molecular Genetics, Hospital Universitari Arnau de Vilanova, University of Lleida, IRBLleida, Lleida, Spain.,Centre of Biomedical Research on Cancer (CIBERONC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - A Veà
- Department of Dermatology, Hospital Universitari Arnau de Vilanova, University of Lleida, IRBLleida, Lleida, Spain.,Department of Dermatology, Hospital Comarcal de Móra d'Ebre, Tarragona, Spain
| | - J Barrera
- Department of Dermatology, Hospital Universitari Arnau de Vilanova, University of Lleida, IRBLleida, Lleida, Spain
| | - C Barcelo
- University of Lleida, IRBLleida, Lleida, Spain
| | - M Santacana
- Department of Pathology and Molecular Genetics, Hospital Universitari Arnau de Vilanova, University of Lleida, IRBLleida, Lleida, Spain.,Centre of Biomedical Research on Cancer (CIBERONC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - X Soria
- Department of Dermatology, Hospital Universitari Arnau de Vilanova, University of Lleida, IRBLleida, Lleida, Spain
| | - X Matias-Guiu
- Department of Pathology and Molecular Genetics, Hospital Universitari Arnau de Vilanova, University of Lleida, IRBLleida, Lleida, Spain.,Centre of Biomedical Research on Cancer (CIBERONC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - R M Martí
- Department of Dermatology, Hospital Universitari Arnau de Vilanova, University of Lleida, IRBLleida, Lleida, Spain.,Centre of Biomedical Research on Cancer (CIBERONC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| |
Collapse
|
5
|
Fernández-de-Misa R, Hernández-Machín B, Combalía A, García Muret MP, Servitje O, Muniesa C, Gallardo F, Pujol RM, Martí RM, Ortiz-Brugués A, Maroñas-Jiménez L, Ortiz-Romero PL, Blanch Rius L, Izu R, Román C, Cañueto J, Blanes M, Morillo M, Bastida J, Peñate Y, Pérez Gala S, Espinosa Lara P, Pérez Gil A, Estrach T. Prognostic factors in patients with primary cutaneous anaplastic large cell lymphoma: a multicentric, retrospective analysis of the Spanish Group of Cutaneous Lymphoma. J Eur Acad Dermatol Venereol 2019; 34:762-768. [PMID: 31591786 DOI: 10.1111/jdv.16006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 09/25/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Reliable prognostic factors for patients with primary cutaneous anaplastic large cell lymphoma (PCALCL) are lacking. OBJECTIVE To identify prognostic factors for specific survival in patients with PCALCL. METHODS Using the convenience sampling method, patients with PCALCL diagnosed from May 1986 to August 2017 in 16 University Departments were retrospectively reviewed. RESULTS One hundred eight patients were included (57 males). Median age at diagnosis was 58 years. All of them showed T1-3N0M0 stages. Seventy per cent of the cases presented with a solitary lesion, mostly at the limbs. Complete response rate after first-line treatment was 87%, and no advantage was observed for any of them (surgery, radiotherapy, chemotherapy or other approaches). Nodal and visceral progression rate was 11% and 2%, respectively. 5-year specific survival (SSV) reached 93%; 97% for T1 patients and 84% for T2/T3 patients (P = 0.031). Five-year SSV for patients developing early cutaneous relapse was 64%; for those with late or no relapse, 96% (P = 0.001). Estimated median SSV for patients showing nodal progression was 103 months (95% CI: 51-155 months); for patients without nodal progression, estimated SSV did not reach the median (P < 0.001). Nodal progression was an independent predictive parameter for shorter survival (P = 0.011). CONCLUSION Multiple cutaneous lesions at presentation, early skin relapse and nodal progression portrait worse prognosis in patients with PCALCL.
Collapse
Affiliation(s)
- R Fernández-de-Misa
- Department of Dermatology and Research Unit, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
| | - B Hernández-Machín
- Department of Dermatology, Sefton Suite, DMC Healthcare, NHS Trust Liverpool, Liverpool, UK
| | - A Combalía
- Department of Dermatology, Hospital Clínico, University of Barcelona, Barcelona, Spain
| | - M P García Muret
- Department of Dermatology, Hospital Santa Creu i Sant Pau, UAB, Barcelona, Spain
| | - O Servitje
- Department of Dermatology, Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain
| | - C Muniesa
- Department of Dermatology, Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain
| | - F Gallardo
- Department of Dermatology, Hospital del Mar, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - R M Pujol
- Department of Dermatology, Hospital del Mar, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - R M Martí
- Department of Dermatology, Hospital Univeritari Arnau de Vilanova, IRBLleida, Lleida, Spain.,Centre of Biomedical Research on Cancer (CIBERONC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - A Ortiz-Brugués
- Department of Dermatology, Hospital Univeritari Arnau de Vilanova, IRBLleida, Lleida, Spain
| | - L Maroñas-Jiménez
- Department of Dermatology, Hospital Universitario 12 de Octubre, i+12 Research Institute, Universidad Complutense, Madrid, Spain
| | - P L Ortiz-Romero
- Centre of Biomedical Research on Cancer (CIBERONC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Department of Dermatology, Hospital Universitario 12 de Octubre, i+12 Research Institute, Universidad Complutense, Madrid, Spain
| | - L Blanch Rius
- Department of Dermatology, Hospital de Basurto, Bilbao, Spain
| | - R Izu
- Department of Dermatology, Hospital de Basurto, Bilbao, Spain
| | - C Román
- Department of Dermatology, Hospital Universitario de Salamanca, Salamanca, Spain
| | - J Cañueto
- Department of Dermatology, Hospital Universitario de Salamanca, Salamanca, Spain
| | - M Blanes
- Department of Dermatology, Hospital General Universitario de Alicante, Alicante, Spain
| | - M Morillo
- Department of Dermatology, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - J Bastida
- Department of Dermatology, Hospital Universitario Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - Y Peñate
- Department of Dermatology, Complejo Hospitalario Universitario Insular Materno-Infantil, Las Palmas de G.C, Spain
| | - S Pérez Gala
- Department of Dermatology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - P Espinosa Lara
- Department of Dermatology, Hospital Universitario Infanta Cristina, Parla, Madrid, Spain
| | - A Pérez Gil
- Department of Dermatology, Hospital Virgen de Valme, Sevilla, Spain
| | - T Estrach
- Department of Dermatology, Hospital Clínico, IDIBAPS, University of Barcelona, Barcelona, Spain
| |
Collapse
|
6
|
Fernández-de-Misa R, Hernández-Machín B, Servitje O, Valentí-Medina F, Maroñas-Jiménez L, Ortiz-Romero PL, Sánchez Schmidt J, Pujol RM, Gallardo F, Pau-Charles I, García Muret MP, Pérez Gala S, Román C, Cañueto J, Blanch Rius L, Izu R, Ortiz-Brugués A, Martí RM, Blanes M, Morillo M, Sánchez P, Peñate Y, Bastida J, Pérez Gil A, Lopez-Lerma I, Muniesa C, Estrach T. First-line treatment in lymphomatoid papulosis: a retrospective multicentre study. Clin Exp Dermatol 2017; 43:137-143. [DOI: 10.1111/ced.13256] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2016] [Indexed: 11/30/2022]
Affiliation(s)
- R. Fernández-de-Misa
- Department of Dermatology and Research Unit; Hospital Universitario Nuestra Señora de Candelaria; Santa Cruz de Tenerife Spain
| | - B. Hernández-Machín
- Department of Dermatology; Clínica Buenaderma; Las Palmas de Gran Canaria Spain
| | - O. Servitje
- Department of Dermatology; Hospital Universitari de Bellvitge; IDIBELL; Barcelona Spain
| | - F. Valentí-Medina
- Department of Dermatology; Hospital Universitari de Bellvitge; IDIBELL; Barcelona Spain
| | - L. Maroñas-Jiménez
- Department of Dermatology; Hospital Universitario 12 de Octubre, i+12 Research Institute; Universidad Complutense Madrid; Madrid Spain
| | - P. L. Ortiz-Romero
- Department of Dermatology; Hospital Universitario 12 de Octubre, i+12 Research Institute; Universidad Complutense Madrid; Madrid Spain
| | - J. Sánchez Schmidt
- Department of Dermatology; Hospital del Mar; Universitat Autónoma de Barcelona; Barcelona Spain
| | - R. M. Pujol
- Department of Dermatology; Hospital del Mar; Universitat Autónoma de Barcelona; Barcelona Spain
| | - F. Gallardo
- Department of Dermatology; Hospital del Mar; Universitat Autónoma de Barcelona; Barcelona Spain
| | - I. Pau-Charles
- Department of Dermatology; Hospital Clínico; University of Barcelona; IDIBAPS; Barcelona Spain
| | - M. P. García Muret
- Department of Dermatology; Hospital Santa Creu i Sant Pau; UAB; Barcelona Spain
| | - S. Pérez Gala
- Department of Dermatology; Hospital Universitario Ramón y Cajal; Madrid Spain
| | - C. Román
- Department of Dermatology; Hospital Universitario de Salamanca; Salamanca Spain
| | - J. Cañueto
- Department of Dermatology; Hospital Universitario de Salamanca; Salamanca Spain
| | - L. Blanch Rius
- Department of Dermatology; Hospital de Basurto; Bilbao Spain
| | - R. Izu
- Department of Dermatology; Hospital de Basurto; Bilbao Spain
| | - A. Ortiz-Brugués
- Department of Dermatology; IRBLleida, Hospital Universitari Arnau de Vilanova; Lleida Spain
| | - R. M. Martí
- Department of Dermatology; IRBLleida, Hospital Universitari Arnau de Vilanova; Lleida Spain
| | - M. Blanes
- Department of Dermatology; Hospital General Universitario de Alicante; Alicante Spain
| | - M. Morillo
- Department of Dermatology; Hospital Universitario Virgen del Rocío; Sevilla Spain
| | - P. Sánchez
- Department of Dermatology; Hospital de León; León Spain
| | - Y. Peñate
- Department of Dermatology; Complejo Hospitalario Universitario Insular Materno-Infantil; Gran Canaria, Las Palmas de Gran Canaria Spain
| | - J. Bastida
- Department of Dermatology; Hospital Universitario Dr. Negrín; Las Palmas de Gran Canaria Spain
| | - A. Pérez Gil
- Department of Dermatology; Hospital Virgen de Valme; Sevilla Spain
| | - I. Lopez-Lerma
- Department of Dermatology; Hospital Universitari Vall d'Hebron; Barcelona Spain
| | - C. Muniesa
- Department of Dermatology; Hospital Universitari de Bellvitge; IDIBELL; Barcelona Spain
| | - T. Estrach
- Department of Dermatology; Hospital Clínico; University of Barcelona; IDIBAPS; Barcelona Spain
| |
Collapse
|
7
|
Casanova JM, Pujol RM, Ferrándiz C, Betlloch I, Bosch RJ, Fernández V, Martí RM, Requena L, Moreno JC, Alegre V, Vilata JJ, Vilar N, Jaén P, Bielsa I, Querol I, Azón T, Borrego L, Mascaró JM, Alsina M, Díaz RM, Suarez R, García-Bustinduy M, García-Patos V, Estrach T. Core Content for Undergraduate Medical Education in Spain: Recommendations of the Instructors' Group of the Spanish Academy of Dermatology and Venereology (AEDV). Actas Dermosifiliogr 2015; 107:125-32. [PMID: 26691244 DOI: 10.1016/j.ad.2015.09.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 09/30/2015] [Accepted: 09/30/2015] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Skin problems are among the most frequent reasons for seeking medical attention in primary care. In recent years, as a result of the process of adapting medical curricula to the requirements of the European Higher Education Area, the amount of time students spend learning the concepts of dermatology has been reduced in many universities. MATERIAL AND METHODS In order to reach a consensus on core content for undergraduate education in dermatology, we sent a survey to the 57 members of the instructors' group of the Spanish Academy of Dermatology and Venereology (AEDV), asking their opinions on what objectives should be set for a dermatology course in Spain. A total of 131 previously selected objectives were listed. We then applied the Delphi method to achieve consensus on which ones the respondents considered important or very important (score≥4 on a Likert scale). RESULTS Nineteen responses (33%) were received. On the second round of the Delphi process, 68 objectives achieved average scores of at least 4. The respondents emphasized that graduates should understand the structure and functions of the skin and know about bacterial, viral, and fungal skin infections, the most common sexually transmitted diseases (STDs), and the 4 main inflammatory dermatoses. Students should also learn about common complaints, such as itching and bald patches; the management of dermatologic emergencies; purpura and erythema nodosum as signs of internal disease; and the prevention of STDs and skin cancer. During clinical clerkships students should acquire the communication skills they will need to interview patients, write up a patient's medical history, and refer the patient to a specialist. CONCLUSIONS The AEDV's group of instructors have defined their recommendations on the core content that medical faculties should adopt for the undergraduate subject of dermatology in Spain.
Collapse
Affiliation(s)
| | - R M Pujol
- Universitat Autònoma de Barcelona, Barcelona, España
| | - C Ferrándiz
- Universitat Autònoma de Barcelona, Barcelona, España
| | - I Betlloch
- Universitad Miguel Hernández, Elche, Alicante, España
| | - R J Bosch
- Universitat de Málaga, Málaga, España
| | - V Fernández
- Universidad de Santiago de Compostela, Santiago de Compostela, España
| | - R M Martí
- Universitat de Lleida, Lleida, España
| | - L Requena
- Universidad Autónoma de Madrid, Madrid, España
| | | | - V Alegre
- Universidad de Valencia, Valencia, España
| | - J J Vilata
- Universidad de Valencia, Valencia, España
| | - N Vilar
- Universitat de Girona, Girona, España
| | - P Jaén
- Universidad de Alcalá de Henares, Madrid, España
| | - I Bielsa
- Universitat Autònoma de Barcelona, Barcelona, España
| | - I Querol
- Universidad de Zaragoza, Zaragoza, España
| | - T Azón
- Universitat Rovira i Virgili, Reus, Tarragona, España
| | - L Borrego
- Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, España
| | | | - M Alsina
- Universitat de Barcelona, Barcelona, España
| | - R M Díaz
- Universidad Alfonso X el Sabio, Madrid, España
| | - R Suarez
- Universidad Complutense de Madrid, Madrid, España
| | | | | | - T Estrach
- Universitat de Barcelona, Barcelona, España
| | | |
Collapse
|
8
|
Casanova JM, Sanmartín V, Martí RM, Morales JL, Soler J, Purroy F, Pujol R. Evaluación de las prácticas clínicas de Dermatología en el grado de Medicina. Actas Dermo-Sifiliográficas 2014; 105:459-68. [PMID: 23664251 DOI: 10.1016/j.ad.2012.12.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2012] [Revised: 11/11/2012] [Accepted: 12/16/2012] [Indexed: 11/16/2022] Open
Affiliation(s)
- J M Casanova
- Servicio de Dermatología, Hospital Universitario Arnau de Vilanova, Universitat de Lleida, Lleida, España.
| | - V Sanmartín
- Servicio de Dermatología, Hospital Universitario Arnau de Vilanova, Universitat de Lleida, Lleida, España
| | - R M Martí
- Servicio de Dermatología, Hospital Universitario Arnau de Vilanova, Universitat de Lleida, Lleida, España
| | - J L Morales
- Servicio de Medicina Interna, Hospital Universitari Arnau de Vilanova, Lleida, España
| | - J Soler
- Médico de Familia, Lleida, España
| | - F Purroy
- Servicio de Neurología, Hospital Universitario Arnau de Vilanova, Lleida, España
| | - R Pujol
- Servicio de Dermatología, Hospital Universitari del Mar, Barcelona, España
| |
Collapse
|
9
|
Aguayo RS, Baradad M, Soria X, Abal L, Sanmartín V, Egido R, Gallel P, Casanova JM, Martí RM. Unilateral milia-type intradermal tophi associated with underlying urate subcutaneous deposition: an uncommon cutaneous presentation of gout. Clin Exp Dermatol 2014; 38:622-5. [PMID: 23837935 DOI: 10.1111/ced.12084] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2012] [Indexed: 11/30/2022]
Abstract
Tophi develop during the most advanced clinical stage of gout, and are usually located on or around the joints. However, unusual skin features caused by intradermal and/or subcutaneous deposition of tophaceous material at locations other than articular regions have been reported. We present the case of a patient with a condition that has been recently termed 'miliarial gout'. which is only the second such case, to our knowledge. A 51-year-old woman, who had a chronic joint disease that had been diagnosed and treated as psoriatic arthritis, presented with multiple asymptomatic, yellowish-white, firm papules (1-3 mm in size) on erythematous areas on the outside of her left leg. On histological examination of a skin biopsy, uric acid crystals were seen in the dermis and subcutis. The patient also had a raised level of serum urate, consistent with a diagnosis of gout. Treatment with allopurinol led to rapid improvement. Intake of corticosteroids and diuretics was a possible triggering factor for the development of cutaneous tophi in this patient.
Collapse
Affiliation(s)
- R S Aguayo
- Department of Dermatology, University of Lleida, Lleida, Catalonia, Spain
| | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Ríos L, Nagore E, López JL, Redondo P, Martí RM, Fernández-de-Misa R, Soler B. Melanoma characteristics at diagnosis from the Spanish National Cutaneous Melanoma Registry: 15 years of experience. Actas Dermosifiliogr 2013; 104:789-99. [PMID: 23622931 DOI: 10.1016/j.ad.2013.02.003] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Revised: 02/08/2013] [Accepted: 02/13/2013] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The Spanish National Cutaneous Melanoma Registry (Registro Nacional de Melanoma Cutáneo [RNMC]) was created in 1997 to record the characteristics of melanoma at diagnosis. In this article, we describe the characteristics of these tumors at diagnosis. PATIENTS AND METHODS This was a cross-sectional observational study of prevalent and incident cases of melanoma for which initial biopsy results were available in the population-based RNMC. RESULTS The RNMC contains information on 14,039 patients. We analyzed the characteristics of 13,628 melanomas diagnosed between 1997 and 2011. In total, 56.5% of the patients studied were women and 43.5% were men. The mean age of the group was 57 years (95% CI, 56.4-57 years) while median age was 58 years. The most common tumor site was the trunk (37.1%), followed by the lower limbs (27.3%). The most frequent clinical-pathologic subtype was superficial spreading melanoma (n=7481, 62.6%), followed by nodular melanoma (n=2014, 16.8%). Localized disease was observed in 86.2% of cases (n=10,382), regional metastasis in 9.9% (n=1188), and distant metastasis in 3.9% (n=479). Independently of age at diagnosis, men had thicker tumors, more ulceration, higher lactate dehydrogenase levels, and a higher rate of metastasis than women (P<.001). CONCLUSIONS Based on our findings, melanoma prevention campaigns should primarily target men over 50 years old because they tend to develop thicker tumors and therefore have a worse prognosis.
Collapse
Affiliation(s)
- L Ríos
- Servicio de Dermatología, Hospital Ramón y Cajal, Madrid, España
| | | | | | | | | | | | | |
Collapse
|
11
|
Das A, Pushparaj C, Bahí N, Sorolla A, Herreros J, Pamplona R, Vilella R, Matias-Guiu X, Martí RM, Cantí C. Functional expression of voltage-gated calcium channels in human melanoma. Pigment Cell Melanoma Res 2012; 25:200-12. [PMID: 22260517 DOI: 10.1111/j.1755-148x.2012.00978.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The expression of voltage-gated calcium channels (VGCCs) has not been reported previously in melanoma cells in spite of increasing evidence of a role of VGCCs in tumorigenesis and tumour progression. To address this issue we have performed an extensive RT-PCR analysis of VGCC expression in human melanocytes and a range of melanoma cell lines and biopsies. In addition, we have tested the functional expression of these channels using Ca(2+) imaging techniques and examined their relevance for the viability and proliferation of the melanoma cells. Our results show that control melanocytes and melanoma cells express channel isoforms belonging to the Ca(v) 1 and Ca(v) 2 gene families. Importantly, the expression of low voltage-activated Ca(v) 3 (T-type) channels is restricted to melanoma. We have confirmed the function of T-type channels as mediators of constitutive Ca(2+) influx in melanoma cells. Finally, pharmacological and gene silencing approaches demonstrate a role for T-type channels in melanoma viability and proliferation. These results encourage the analysis of T-type VGCCs as targets for therapeutic intervention in melanoma tumorigenesis and/or tumour progression.
Collapse
Affiliation(s)
- A Das
- Laboratori d'Investigació, University of Lleida-IRBLleida, Lerida, Spain
| | | | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Martí RM, Sorolla A, Yeramian A. New therapeutic targets in melanoma. Actas Dermosifiliogr 2012; 103:579-90. [PMID: 22261672 DOI: 10.1016/j.ad.2011.08.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2011] [Revised: 06/25/2011] [Accepted: 08/10/2011] [Indexed: 01/07/2023] Open
Abstract
Research into molecular targets for drug development in melanoma is starting to bear fruit. Of the drugs tested to date in patients with metastatic melanoma, those that have yielded the best results are V600E BRAF inhibitors in melanomas carrying the V600E mutation; c-kit tyrosine kinase activity inhibitors in melanomas carrying c-kit mutations; and anti-cytotoxic T lymphocyte antigen 4 (CTLA-4) antibodies, which block the mechanisms involved in immune tolerance. Many problems have yet to be resolved in these areas, however, such as the rapid development of resistance to BRAF and c-kit inhibitors and the lack of biomarkers to predict treatment response in the case of CTLA-4 blockers. We review the results of targeted therapy with these and other drugs in metastatic melanoma and discuss what the future holds for this field.
Collapse
Affiliation(s)
- R M Martí
- Servicio de Dermatología, Hospital Universitari Arnau de Vilanova, Universitat de Lleida, IRBLLEIDA, Lleida, Spain.
| | | | | |
Collapse
|
13
|
Mangas C, Paradelo C, Puig S, Gallardo F, Marcoval J, Azon A, Bartralot R, Bel S, Bigatà X, Curcó N, Dalmau J, del Pozo LJ, Ferrándiz C, Formigón M, González A, Just M, Llambrich A, Llistosella E, Malvehy J, Martí RM, Nogués ME, Pedragosa R, Rocamora V, Sàbat M, Salleras M. [Initial evaluation, diagnosis, staging, treatment, and follow-up of patients with primary cutaneous malignant melanoma. Consensus statement of the Network of Catalan and Balearic Melanoma Centers]. Actas Dermosifiliogr 2010; 101:129-142. [PMID: 20223155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
The consensus statement on the management of primary cutaneous melanoma that we present here was based on selection, discussion, review, and comparison of recent literature (including national and international guidelines). The protocols for the diagnosis, treatment, and follow-up used in the hospital centers throughout Catalonia and the Balearic Isles belonging to the Network of Catalan and Balearic Melanoma Centers were also considered. The main objective of this statement was to present the overall management of melanoma patients typically used in our region at the present time. As such, the statement was not designed to be an obligatory protocol for health professionals caring for this group of patients, and neither can it nor should it be used for this purpose. Professionals reading the statement should not therefore consider it binding on their practice, and in no case can this text be used to guarantee or seek responsibility for a given medical opinion. The group of dermatologists who have signed this statement was created 3 years ago with the aim of making our authorities aware of the importance of this complex tumor, which, in comparison with other types of cancer, we believe does not receive sufficient attention in Spain. In addition, the regular meetings of the group have produced interesting proposals for collaboration in various epidemiological, clinical, and basic applied research projects on the subject of malignant melanoma in our society.
Collapse
Affiliation(s)
- C Mangas
- Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Casanova JM, Baradad M, Soria X, Martí RM. [Use of www.dermatoweb.net to support undergraduate teaching of dermatology]. Actas Dermosifiliogr 2009; 100:866-874. [PMID: 20038363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
Dermatoweb is a website to aid undergraduate dermatology training. It includes the dermatology program of the Lerida Faculty of Medicine, and is based principally on clinical presentations, tables with the differential diagnosis of the 20 most common reasons for dermatologic consultation, about 200 clinical test cases to stimulate self-training, and a subject list with the 32 topics that make up the dermatology syllabus in many faculties of medicine. Thanks to this website, some of our students achieve high marks in dermatology despite hardly coming to classes. In addition, therapeutic guidelines for the common dermatoses can be found on the site, and an atlas with more than 5,300 photographs and almost 100 videos on the more common dermatological procedures; these can serve as a visual aid for family doctors, residents in dermatology in the initial years, and practicing dermatologists.
Collapse
Affiliation(s)
- J M Casanova
- Servicio de Dermatología, Hospital Universitari Arnau de Vilanova, Universitat de Lleida, Lleida, España.
| | | | | | | |
Collapse
|
15
|
Soria X, Sanmartín V, Martí RM, Baradad M, Casanova JM. [Erythema nodosum associated with inflammatory tinea capitis (kerion celsi)]. Actas Dermosifiliogr 2008; 99:319-321. [PMID: 18394416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
|
16
|
Casanova JM, Sanmartín V, Soria X, Baradad M, Martí RM, Font A. [Childhood dermatosis in a dermatology clinic of a general university hospital in Spain]. Actas Dermosifiliogr 2008; 99:111-118. [PMID: 18346432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Pediatric dermatology is a relatively new subspecialty for which few epidemiological studies are available. We aimed to determine the work load associated with this subspecialty and the most common presenting complaints among pediatric patients in the general dermatology clinic of our hospital. METHODS A descriptive study was performed based on hospital records to analyze patients aged 16 years or under seen in our department in 2005 and their diagnoses. RESULTS Pediatric dermatology accounts for 12.1 % of the work load in our department (1,329/10,998 patients were <or= 16 years old). By disease groups, tumors and infections were the most common diagnoses and accounted for 55.4 % of all cases. A long way behind was eczema (15.0 %) and diseases affecting hair follicles, nails, and sweat and sebaceous glands (8.8 %). The most common individual diagnosis was melanocytic nevus (19.8 %), followed by viral warts (12.1 %), atopic dermatitis (8.9 %), molluscum contagiosum (8.4 %), and acne (7.0 %). CONCLUSIONS In most developed countries, atopic dermatitis is the most common dermatologic disease in children. In our study, however, melanocytic nevus was the most common presenting complaint, reflecting perhaps that there are more children in Spain with multiple nevi due to overexposure to sunlight or because of concern about melanoma among the population. Another possibility is that Spain has fewer cases of atopic dermatitis than more industrialized countries in northern Europe. Measures to avoid exposure to sunlight and use of sunscreen should be promoted during infancy. This could help slow the increase of melanoma in the adult population.
Collapse
Affiliation(s)
- J M Casanova
- Servicio de Dermatología, Hospital Universitari Arnau de Vilanova de Lleida, Universitat de Lleida, España.
| | | | | | | | | | | |
Collapse
|
17
|
Campo A, Hausmann G, Martí RM, Estrach T, Grau JM, Porcel JM, Herrero C. [Complement activation products (C3a and C5b-9) as markers of activity of dermatomyositis. Comparison with usual biochemical parameters]. Actas Dermosifiliogr 2007; 98:403-14. [PMID: 17663930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023] Open
Abstract
INTRODUCTION Dermatomyositis (DM) is an autoimmune disease included in the group of idiopathic inflammatory myopathies. Markers of disease activity are needed for clinical control in order to facilitate adjustment of immunomodulatory therapy. We analyzed the relationship between complement activation products (CAP) and the activity of dermatomyositis and its usefulness in the follow-up of the disease and the prediction of recrudescences related to usual biochemical parameters. MATERIAL AND METHODS We studied 16 patients with DM that were followed periodically. In each appointment the degree of cutaneous and muscular activity was assessed and such disease activity was correlated with plasma levels of C3a and C5b-9, measured by ELISA. RESULTS Though we obtained certain correlation between disease activity and plasma levels of C3a and C5b-9, the strength of such correlation was not superior to that obtained by usual biochemical markers. C3a was shown to be the most sensitive marker (100 %) with a sufficient specificity (83.3 %) in the capability to predict recrudescences. CONCLUSIONS C3a and, to a lesser extent C5b-9, would be useful in the identification of patients with especially active DM as well as in predicting disease recrudescences. Nevertheless they are not superior to the rest of biochemical markers as indicators of current activity.
Collapse
Affiliation(s)
- A Campo
- Servicio de Dermatología, Hospital Clínic, Barcelona, España.
| | | | | | | | | | | | | |
Collapse
|
18
|
Casanova JM, Martí RM, Baradad M, Egido R, Mascaró JM. [Bart syndrome associated to lethal junctional epidermolysis bullosa (Herlitz form)]. Actas Dermosifiliogr 2007; 97:658-61. [PMID: 17173830 DOI: 10.1016/s0001-7310(06)73489-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
We present the case of a newborn with congenital absence of skin in the anterior part of the left leg that shortly after developed bulla and erosions in hands, feet, ears, buttocks and mouth. The cutaneous biopsy and ultrastructural and immunohistochemical studies showed a subepidermal bulla in the lamina lucida, absence of hemidesmosomes and marked decrease of laminin 5, thus establishing the diagnosis of Bart syndrome associated to the Herlitz form of lethal junctional epidermolysis bullosa. Bart syndrome consists of congenital and localized absence of skin, nail abnormalities and mucoc-cutaneous bullae. It is usually associated to dystrophic epidermolysis bullosa. The Herlitz form of junctional epidermolysis bullosa is a rare variant, usually lethal that is produced by mutations in the genes coding for the anchor protein laminin 5. To our knowledge this is the second case that reports an association between Bart syndrome and lethal junctional epidermolysis bullosa and the first in which the results of immunofluorescence mapping are published.
Collapse
Affiliation(s)
- J M Casanova
- Servicio de Dermatología, Hospital Universitari Arnau de Vilanova de Lleida, Spain.
| | | | | | | | | |
Collapse
|
19
|
Martí RM, Campo E, Bosch F, Palou J, Estrach T. Cutaneous lymphocyte-associated antigen (CLA) expression in a lymphoblastoid mantle cell lymphoma presenting with skin lesions. Comparison with other clinicopathologic presentations of mantle cell lymphoma. J Cutan Pathol 2001; 28:256-64. [PMID: 11401669 DOI: 10.1034/j.1600-0560.2001.028005256.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Cutaneous lymphocyte-associated antigen (CLA) is a lymphocyte homing receptor selectively expressed by T cells of the cutaneous immune system and their malignant counterpart, that is to say, cutaneous T-cell lymphomas. However it is absent in the vast mayority of other T-cell malignancies and B-cell lineage lymphomas irrespective on primary tumor site. METHODS Expression of CLA was investigated on six cases of mantle cell lymphoma (MCL) which differed in their histopathological subtype (typical or blastic) and their tendency to infiltrate skin and/or central nervous system (CNS). RESULTS CLA immunostaining on neoplastic cells was only observed in a 61-year-old female suffering from a lymphoblastoid MCL which clinically presented with specific skin lesions and further developped CNS disease. In this patient, coexpression of CLA with MCL markers (CD20 and CD5) was confirmed by conventional immunohistochemistry and double immunofluorescence studies. CONCLUSIONS To our knowledge, CLA immunoreactivity on B-cell lymphomas has not beeen previously reported. The expression of this skin-related adhesion molecule on malignant MCL cells could explain the clinical behavior of our case which presented and relapsed with cutaneous lesions. However, CLA seems not to be a MCL marker nor a CNS-related adhesion molecule. The authors review the clinical and histopathological characteristics of MCL-specific skin lesions and their diagnostic clues based on cell morphology, immunohistochemistry and molecular investigations.
Collapse
Affiliation(s)
- R M Martí
- Department of Dermatology, Hospital Clínic i Provincial de Barcelona, Barcelona, Spain.
| | | | | | | | | |
Collapse
|
20
|
Servitje O, Martí RM, Estrach T, Palou J, Gallardo F, Limón A, Romagosa V. Occurrence of Hodgkin's disease and cutaneous B-cell lymphoma in the same patient: a report of two cases. Eur J Dermatol 2000; 10:43-6. [PMID: 10694298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
The occurrence of Hodgkin's disease (HD) and non-Hodgkin's lymphoma (NHL) in the same patient is well known. The most frequent observation has been the development of large B cell lymphoma in patients affected with the nodular form of lymphocytic predominant HD. A less common situation is the development of NHL among patients successfully treated for HD. In such patients the second lymphoma has been thought to be related to the previous therapy or the immunodeficiency state that can accompany HD. Histologically, these NHL lymphomas often are intermediate to high grade and frequently extranodal. We report two patients successfully treated for HD who also developed NHL of the skin. Both patients presented with strikingly similar findings regarding to sex, age and subtype of HD. Clinical, histopathological and immunophenotypical findings were consistent with cutaneous low-grade B cell lymphoma of the marginal zone type. Both cases remain in complete remission of HD after standard therapy. In both patients the cutaneous lymphoma followed an indolent clinical course after a long follow-up period. This observation expands the spectrum of alterations possibly related to HD.
Collapse
Affiliation(s)
- O Servitje
- Department of Dermatology and Pathology, Hospital Princeps d'Espanya, CSUB. Feixa Llarga s/n L'Hospitalet de Llobregat, 08907 Barcelona, Spain.
| | | | | | | | | | | | | |
Collapse
|
21
|
Abstract
BACKGROUND The wide use of staging procedures, looking for visceral involvement in patients with cutaneous T-cell lymphoma (CTCL), is controversial, especially in the early stages. In this study, we analyzed the results of bone marrow biopsy and laparoscopy with liver biopsy in a series of 43 patients with CTCL. METHODS Clinicopathologic stages were established by a modification of the TNM system proposed in 1979. Results of staging procedures were correlated with blood cell counts and laboratory tests. The usefulness of the staging procedures was analyzed particularly in patients without clinical or biologic evidence of extracutaneous disease. RESULTS The patient's median age was 66 years; 35 patients were men and eight women. The clinicopathologic stages were as follows: T1: 3 cases; T2: 15; T3: 14; T4: 11; N0: 15; N1: 28; M0: 38; M1: 5; B0: 37; and B1: 6 cases. Internal lymph node disease, diagnosed by lymphangiography and/or abdominal scanning, was demonstrated in 37% of patients. Bone marrow infiltration was seen in 12% of patients and was the only form of visceral involvement. All liver biopsies were negative. Serum lactate dehydrogenase (LDH) levels were raised in patients with lymph node disease; it was the only laboratory test that correlated with extracutaneous involvement. Staging procedures changed three of the nine patients with a clinical T1-T2N0M0B0 stage (33%) to a more advanced stage. The abdominal lymph node evaluation allowed a reclassification from N0 to N1 in two of nine cases (22%); one of the remaining cases was reclassified from M0 to M1 on the basis of bone marrow biopsy results. CONCLUSIONS Our results indicate that bone marrow biopsy is a useful investigational procedure for determining extracutaneous disease in CTCL. Peritoneoscopy with liver biopsy rarely is informative; however, as our study does not include a very large number of patients, these preliminary conclusions must be confirmed in the future by including more cases.
Collapse
Affiliation(s)
- R M Martí
- Department of Dermatology, Hospital Clínic i Provincial de Barcelona, Spain
| | | | | | | | | | | | | |
Collapse
|
22
|
Abstract
Oral mucous membrane involvement occurs uncommonly in mycosis fungoides and reports of it are scarce. We present two patients with severe involvement of the oral mucous membranes.
Collapse
Affiliation(s)
- A Vicente
- Department of Dermatology, Hospital Clínico, University of Barcelona, Faculty of Medicine, Spain
| | | | | | | | | | | |
Collapse
|
23
|
Abstract
Influence of clinicopathologic data on survival was analyzed in 43 patients with cutaneous T-cell lymphoma. The median age was 66 years; 35 were male and eight female. The extent of the disease, established according to a modification of the TNM system, was as follows: T1, three patients; T2, 15; T3, 14; T4, 11; N0, 15; N1, 28; M0, 38; M1, 5; B0, 37; and B1, six. The first treatment applied after staging was skin-limited therapy in seven patients and different regimens of systemic chemotherapy in 29. Seven patients received no treatment or only topical corticosteroids and tars. Median follow-up was 26 months. Nineteen patients died, with a median survival of 36.3 months. The prognostic value of age, sex, delay of diagnosis and staging, pruritus, number of sites of clinically enlarged lymph nodes, results of staging and TNM classification, erythrocyte sedimentation rate, peripheral blood cell count, liver function tests, serum lactate dehydrogenase levels, protein electrophoresis, presence of epidermotropism, thickness of cutaneous infiltrate, blastic cell percentage, mitotic index, cellular density, cutaneous eosinophilia, and follicular mucinosis was studied. Multivariate analysis (proportional hazard model with covariates) indicated that the major prognostic factors in patients with cutaneous T-cell lymphoma are as follows: (1) in a clinical model, the T category of TNM classification and the serum lactate dehydrogenase value; and (2) in a clinicopathologic model, the T category of TNM classification and the thickness of cutaneous infiltrate (measured in 10(-1) mm from the granular layer to the lower limit of the infiltrate) of the clinically thickest lesion.
Collapse
Affiliation(s)
- R M Martí
- Department of Dermatology, Hospital Clínic i Provincial of Barcelona, Spain
| | | | | | | |
Collapse
|
24
|
Vilalta A, Molgó M, Martí RM, Mascaró JM. Free laminar thin band graft--a surgical therapeutic variant in the treatment of leg ulcers. J Dermatol Surg Oncol 1987; 13:1344-7. [PMID: 3316335 DOI: 10.1111/j.1524-4725.1987.tb03580.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
For the past 2 years, we have been using a surgical technique for the treatment of leg ulcers caused by chronic venous insufficiency. This consists of a type of graft biologically and technically intermediate between Reverdin and Thiersh's types. We have named it the "free laminar thin band graft." In contrast to the Thiersh graft, this simple surgical technique requires little equipment, and it can be done quickly and easily as an office procedure, with little risk to the patient. In addition, it is a low cost procedure. In our experience with this technique, healing time is shorter and lesions recur later than with the Reverdin graft. The authors describe the surgical method and report a clinical case.
Collapse
Affiliation(s)
- A Vilalta
- Department of Dermatology, University of Barcelona, Spain
| | | | | | | |
Collapse
|
25
|
Abstract
A case of a primary cutaneous lymphoplasmacytic lymphoma synthesizing IgG lambda chains is reported. Immunohistochemical studies were done with the use of antihuman immunoglobulin antisera and monoclonal antibodies against T cell antigens. These studies reveal an unusual pattern of immunoglobulin production (IgG lambda chains) and an important population of accessory cells (T cells and Langerhans cells).
Collapse
|