Cutaneous manifestations of spondyloarthritis

Spondyloarthritis comprises a group of inflammatory rheumatic disorders with a genetic predisposition involving multiple genes that interact with environmental factors. The skin manifestations of spondyloarthritis are diverse, particularly psoriatic arthritis related to the overexpression of inflammatory cytokines such as TNF, IL-6, IL-12, IL-2 and IFN-g; this psoriatic dermatitis is a common skin feature of spondyloarthritis. Spondyloarthritis mainly affects the spine, sacroiliac joints, ligaments and other tissues. Psoriatic lesions are erythematous plaques covered with silvery whitish scales distributed on the scalp, elbows, knees, trunk and gluteus creases, and the fingernails are frequently involved. Individuals with reactive arthritis and Crohn’s disease may exhibit psoriasiform dermatitis and other manifestations including ocular inflammation, oral ulceration, erythema nodosum and/or thrombophlebitis. In the case of reactive arthritis, male patients may exhibit circinate balanitis and keratoderma blennorrhagica. In summary, dermatological manifestations of spondyloarthritis represent clinical clues and a unique scenario to explore the related pathophysiology and therapeutic approaches

Clinical and Dermoscopic Features of the Scalp in 31 Patients with Dermatomyositis

Scalp involvement is not directly evaluated in patients with dermatomyositis (DM). Therefore, the exact frequency of scalp dermatomyositis (SDM) and its clinical and trichoscopic characteristics have been poorly described. The aim of this study was to determine the frequency and clinical and dermoscopic features of SDM in patients diagnosed with DM. We performed a descriptive prospective, cross-sectional observational study that included all patients diagnosed with DM at a Mexican academic institute over the course of a year. Twenty-four out of 31 patients with DM had scalp involvement at clinical examination, with a prevalence of 77.4%. SDM was clinically characterized by erythema in all cases, scales in 20 (83.3%) patients, nonscarring alopecia in 21 (87.5%) patients, pruritus in 17 (70.8%) patients, and poikiloderma of the scalp in 16 (51.6%) patients. Twenty-eight patients were evaluated by trichoscopy. The most consistent finding was the presence of enlarged capillaries, found in 20 (71.4%) cases, followed by peripilar casts (57.1%) and tufting and interfollicular scales in 14 (50%) cases. Twenty-two patients also had positive nail fold capillaroscopic features similar to those observed by trichoscopy. The simple size was limited. Scalp involvement and alopecia are common in patients with DM, and trichoscopy shows features similar to those found at capillaroscopy. Trichoscopy is a very important tool for diagnosis of scalp involvement in patients with DM

Acral and multicentric pigmented Bowen's disease in HIV-Positive patients: Report on two unusual cases

In situ squamous cell carcinoma of the skin (SCCis or Bowen's disease) is a common intraepidermal cutaneous malignancy with a low invasive potential. Acral Bowen's disease is usually solitary, but multiple acral SCCis have been reported. Pigmented Bowen's disease is typically unilesional and characterized by a hyperpigmented plaque with a velvety of keratotic surface, which can eventually simulate melanoma clinically. We describe two HIV-positive patients who presented with multiple pigmented SCCis involving the distal extremities. In patients with immunosuppression, the presence of multiple and hyperpigmented verrucae that clinically do not respond to adequate treatment should raise the differential diagnosis of SCC in situ

Oral and cutaneous lymphomas other than mycosis fungoides and sézary syndrome in a mexican cohort: Recategorization and evaluation of international geographical disparities

Background: Nonmycosis fungoides/Sézary syndrome (non-MF/SS) primary cutaneous lymphomas (PCL) are currently categorized under the 2005-World Health Organization/European Organization for Research and Treatment of Cancer (WHO-EORTC) classification for PCL. These differ in behavior from secondary cutaneous lymphomas (SCL) and to lymphomas limited to the oral cavity (primary oral lymphomas [POL]) both categorized under the 2016-WHO classification for lymphoid neoplasms. Aims: This study aims to report the first series of non-MF/SS PCL, SCL, and POL in a Mexican cohort, examine the applicability of current classification systems and compare our findings with those from foreign cohorts. Materials and Methods: Eighteen non-MF/SS PCL, four SCL, and two POL with available tissue for morphology and immunophenotypic assessment were reclassified according to the 2005-WHO/EORTC and 2016-WHO classifications. Results: Non-MF/SS PCLs were primarily of T-cell origin (61%) where CD30+ lymphoproliferative disorders predominated, followed by Epstein–Barr virus-induced lymphomas, and peripheral T-cell lymphomas, not otherwise specified. Primary cutaneous B-cell lymphomas (BCL) were primarily of follicle center cell origin followed by postgerminal lymphomas of the diffuse large BCL variety. Conclusions: Most non-MF/SS PCL, SCL, and POL can be adequately categorized according to the 2005-WHO/EORTC and 2016-WHO classification systems, even when dealing with clinically atypical cases. The relative frequencies in our cohort hold closer similarities to Asian registries than from those of Europe/USA, supporting the concept of individual and/or racial susceptibility, and the notion of geographical variances in the rate of lymphomas. In particular, such disparity may arise from viral-induced lymphomas which might show partial geographical restriction

Spectroscopic and Imaging Characteristics of Pigmented Non-Melanoma Skin Cancer and Melanoma in Patients with Skin Phototypes III and IV

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