Rapid Improvement of Palmoplantar Psoriasis after Cessation of Smoking

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¿Cuánta carga asistencial suponen las dermatosispediátricas en la actividad ambulatoria en ladermatología espa˜nola? Resultados del muestreoaleatorio nacional DIADERM

Un total de 20.097 diagnósticos fueron efectuados en pacientes menores de18 a˜nos, lo que supone un 12% del total de los codificados en DIADERM. Las infecciones víri-cas, el acné y la dermatitis atópica fueron los diagnósticos más comunes (43,9% de todos losdiagnósticos). No se observaron diferencias estadísticamente significativas en la proporción dediagnósticos atendidos en las consultas monográficas frente a las generales, así como en losregistrados en el ámbito público frente al privado. Tampoco las hubo en los diagnósticos enfunción de la época de la encuesta (enero y mayo).Conclusiones: La atención a pacientes pediátricos por parte de dermatólogos en Espa˜na suponeuna proporción significativa de la actividad habitual. Estos datos nos permiten descubrir áreasde mejora en la comunicación y la formación de los pediatras de atención primaria, comola necesidad del refuerzo de actividades formativas dirigidas al mejor tratamiento de acné ylesiones pigmentadas (y manejo básico de la dermatoscopia) en este ámbito asistencial.SurveyAbstractBackground: Visits for skin conditions are very common in pediatric primary care, and many ofthe patients seen in outpatient dermatology clinics are children or adolescents. Little, however,has been published about the true prevalence of these visits or about their characteristics.Material and methods: Observational cross-sectional study of diagnoses made in outpatientdermatology clinics during 2 data-collection periods in the anonymous DIADERM National Ran-dom Survey of dermatologists across Spain. All entries with an International Classification ofDiseases, Tenth Revision code related to dermatology in the 2 periods (84 diagnoses) were collec-ted for patients younger than 18 years and classified into 14 categories to facilitate analysisand comparison.Results: In total, the search found 20 097 diagnoses made in patients younger than 18 years (12%of all coded diagnoses in the DIADERM database). Viral infections, acne, and atopic dermatitiswere the most common, accounting for 43.9% of all diagnoses. No significant differences wereobserved in the proportions of diagnoses in the respective caseloads of specialist vs. generaldermatology clinics or public vs. private clinics. Seasonal differences in diagnoses (January vs.May) were also nonsignificant.Conclusions: Pediatric care accounts for a significant proportion of the dermatologist’s caseloadin Spain. Our findings are useful for identifying opportunities for improving communication andtraining in pediatric primary care and for designing training focused on the optimal treatmentof acne and pigmented lesions (with instruction on basic dermoscopy use) in these settings.El estudio DIADERM fue promovido por la Fundación Piel Sanade la AEDV, que recibió ayuda económica de Novarti

Pyoderma gangrenosum developing over an arteriovenous fistula scar

A 47-year-old man was admitted to our hospital for a radiocephalic arteriovenous fistula (AVF) in the right arm for dialytic treatment. His past medical history included Wegener granulomatosis diagnosed 8 years previously and chronic kidney disease for which he was receiving kidney replacement therapy in the form of haemodialysis for 7 years. Twenty-four hours after the operation, the patient complained of pain, fever, general discomfort and inflammation in the surgical area. He was admitted to hospital for monitoring and observation. The AVF was dismounted and ligatured and the aneurysmatic area removed and debrided. Response was positive for the first 24 h

Vogt-Koyanagi-Harada disease, a rare entity in Spain: the challenge of worldwide immigration and globalization

Vogt–Koyanagi–Harada disease is rare, mediated by autoimmune melanocyte inflammation and facilitated by genetic predisposition[1-3]. The main clinical features include uveitis, meningitis, tinnitus and sensorineural deafness, and skin and hair depigmentation. It usually develops in four consecutive stages: prodromal, acute uveitic, convalescent, and chronic or recurrent[4]. In view of the first two stages, the differential diagnosis takes into account uveo-meningeal syndromes. Treatment is based on high dose corticosteroids. We present the case of a 14-year-old girl admitted to hospital with fever, progressive uveo-meningeal symptoms, and sensorineural hearing loss. After work-up, the final diagnosis of Vogt–Koyanagi–Harada disease was made

Carcinoma basocelular: relación entre factores externos y características clínico-histológicas, causas de retraso diagnóstico y de extirpación incompleta

Tesis Univ. Granada. Departamento de Medicin

Sclerodermiform basal cell carcinoma: how much can we rely on dermatoscopy to differentiate from non-aggressive basal cell carcinomas? Analysis of 1256 cases.

The behaviour of each basal cell carcinoma is known to be different according to the histological growth pattern. Among these aggressive lesions, sclerodermiform basal cell carcinomas are the most common type. This is a challenging-to-treat lesion due to its deep tissue invasion, rapid growth, risk of metastasis and overall poor prognosis if not diagnosed in early stages. To investigate if sclerodermiform basal cell carcinomas are diagnosed later compared to non-sclerodermiform basal cell carcinoma Method: All lesions excised from 2000 to 2010 were included. A pathologist classified the lesions in two cohorts: one with specimens of non-aggressive basal cell carcinoma (superficial, nodular and pigmented), and other with sclerodermiform basal cell carcinoma. For each lesion, we collected patient's information from digital medical records regarding: gender, age when first attending the clinic and the tumor location. 1256 lesions were included, out of which 296 (23.6%) corresponded to sclerodermiform basal cell carcinoma, whereas 960 (76.4%) were non-aggressive subtypes of basal cell carcinoma. The age of diagnosis was: 72.78±12.31 years for sclerodermiform basal cell and 69.26±13.87 years for non-aggressive basal cell carcinoma (P retrospective design. The diagnostic accuracy and primary clinic conjecture of sclerodermiform basal cell carcinomas is quite low compared to other forms of basal cell carcinoma such as nodular, superficial and pigmented. The dermoscopic vascular patterns, which is the basis for the diagnosis of non-melanocytic nonpigmented skin tumors, may not be particularly useful in identifying sclerodermiform basal cell carcinomas in early stages. As a distinct entity, sclerodermiform basal cell carcinomas show a lack of early diagnosis compared to less-aggressive subtypes of BCC, and thus, more accurate diagnostic tools apart from dermatoscopy are required to reach the goal of early-stage diagnosis of sclerodermiform basal cell carcinomas

Úlcera genital aguda asociada a eritema nudoso. ¿Cuál debería ser la primera sospecha?

A 66-year-old woman presented to our department with a 9-month history of ulcers located in her genital region. She had a two-year history of repeated oral aphthae and erythema nodosum. Use of acyclovir treatment did not lead to good response.A 66-year-old woman presented to our department with a 9-months history of ulcers located in genital region. She had a 2-year history of repeated oral aphthae and erythema nodosum. Use of acyclovir treatment did not lead to good response