Linear basal cell carcinoma of the lower eyelid: Reconstruction with a musculocutaneous transposition flap

Linear basal cell carcinoma (LBCC) is a rare morphologic variant of basal cell carcinoma. It is defined as a basal cell carcinoma that grows following a linear pattern, with a longitudinal diameter longer that its width. This entity was first reported by Lewis in 1985,1 and since then approximately 50 new cases have been described. LBCC characteristically spreads following relaxed skin tension lines, and the most frequent site is the lower eyelid. Currently, some controversy exists regarding the most appropriate surgical approach and reconstructive technique for LBCC. For this reason, we present 2 cases recently managed in our center

Angioedema severity and impact on quality of life: Chronic histaminergic angioedema versus chronic spontaneous urticaria

Histamine-mediated angioedema is the most frequent form of angioedema. It is classified as idiopathic histaminergic acquired angioedema (IH-AAE)1 when allergies and other causes have been excluded and a positive treatment response to antihistamines, corticosteroids, or omalizumab has been reported. Idiopathic histaminergic acquired angioedema may occur in isolation, when it is termed chronic histaminergic angioedema (CHA), or it may be associated with wheals in chronic spontaneous urticaria angioedema (CSU-AE). The term CHA is equivalent to IH-AAE and mast cell-mediated angioedema. However, this term reflects the chronic and recurrent course of the disease. Therefore, we propose that the term CHA be internationally discussed in the following guidelines. Chronic spontaneous urticaria is classically characterized by the presence of recurrent episodes of wheals (hives) with or without angioedema for at least 6 weeks.2 Chronic histaminergic angioedema is typically considered a subtype of CSU without wheals. However, a recent study3 found several features that differentiate CHA from CSU, which suggests that CHA is a separate entity. Quality of life (QoL) studies specifically for CHA patients have not been performed, and their QoL has been assessed only in the context of CSU-AE

Linear basal cell carcinoma of the lower eyelid: Reconstruction with a musculocutaneous transposition flap

Linear basal cell carcinoma (LBCC) is a rare morphologic variant of basal cell carcinoma. It is defined as a basal cell carcinoma that grows following a linear pattern, with a longitudinal diameter longer that its width. This entity was first reported by Lewis in 1985,1 and since then approximately 50 new cases have been described. LBCC characteristically spreads following relaxed skin tension lines, and the most frequent site is the lower eyelid. Currently, some controversy exists regarding the most appropriate surgical approach and reconstructive technique for LBCC. For this reason, we present 2 cases recently managed in our center

Apremilast in combination with botulinum toxin-A injection for recalcitrant Hailey-Hailey disease

Hailey–Hailey disease (HHD) is a rare genodermatosis caused by a mutation in the ATP2C1 gene, which codes for a calcium channel. This ionic alteration leads to a defective keratinocyte adhesion. Hailey–Hailey disease is characterized by recurrent flare-ups of vesicles and flaccid blisters in folds that have an impact on patients’ quality of life. The recurrent and refractory nature of this condition makes its treatment a challenge. Isolated cases have been reported describing controversial results after treatment with apremilast. Here we present a case of refractory HHD who experienced an excellent response after treatment with apremilast and botulinum toxin-A (BoNT) infiltrations

Apremilast in combination with botulinum toxin-A injection for recalcitrant Hailey-Hailey disease

Hailey–Hailey disease (HHD) is a rare genodermatosis caused by a mutation in the ATP2C1 gene, which codes for a calcium channel. This ionic alteration leads to a defective keratinocyte adhesion. Hailey–Hailey disease is characterized by recurrent flare-ups of vesicles and flaccid blisters in folds that have an impact on patients’ quality of life. The recurrent and refractory nature of this condition makes its treatment a challenge. Isolated cases have been reported describing controversial results after treatment with apremilast. Here we present a case of refractory HHD who experienced an excellent response after treatment with apremilast and botulinum toxin-A (BoNT) infiltrations

Acute parvovirus B19 infection: Analysis of 46 patients

Introduction: Parvovirus B19 (PVB19) infection has a high incidence and worldwide distribution. It has a broad clinical spectrum, with skin, joint and haematological manifestations being the most common. The objective of this study was to determine the epidemiology and clinical–analytical manifestations of acute PVB19 infection. Patients and methods: A retrospective study of patients with a positive IgM serology for PVB19 (10 years). Forty-six patients were included and their demographic, clinical and analytical characteristics were analyzed. Results: Primary infection was most prevalent in women (ratio 2.2:1) aged 41 (mean age). Joint involvement was the most common manifestation (65%). Skin abnormalities were observed in more than half of patients (24 cases): rash (28%), megalerythema (9%), “gloves and socks” involvement (6.5%), periflexural rash (4%) and oedema (4%). Anaemia was the main haematological alteration (35%). The symptoms were self-limiting and resolved in 1–2 weeks in most patients. Conclusions: Although there is a variable clinical spectrum, polyarthralgias and generalized maculopapular rash with fever and anaemia are the typical and most frequent manifestations of primary infection by PVB19 and are usually self-limiting.Introducción: La infección por parvovirus B19 (PVB19) tiene una incidencia elevada y distribución mundial. Su espectro clínico es amplio, destacando las manifestaciones cutáneas, articulares y hematológicas. El objetivo del presente estudio fue estudiar epidemiología y manifestaciones clínico-analíticas de la primoinfección por PVB19. Pacientes y método: Estudio retrospectivo (10 anos) ˜ de pacientes con serología IgM positiva para PVB19. Se incluyeron 46 pacientes y se estudiaron sus características demográficas, clínicas y analíticas. Resultados: La primoinfección fue más prevalente en mujeres (ratio 2,2:1), y en edad media de 41anos. ˜ La afectación articular fue la más frecuente (65%). En más de la mitad de los pacientes (24 casos) se observaron alteraciones cutáneas: exantema (28%), megaloeritema (9%), afectación «en guantes y calcetines» (6,5%), afectación periflexural (4%) y edema (4%). De entre las alteraciones hematológicas destacó la anemia (35%). El cuadro clínico se autolimitó en 1-2 semanas en la mayoría de los pacientes. Conclusiones: A pesar de que existe un espectro clínico variable, las poliartralgias y el exantema maculopapular generalizado junto con fiebre y anemia son las manifestaciones típicas y más frecuentes de la primoinfección por PVB19 y suelen autolimitarse

Generalized morphea following the COVID vaccine: A series of two patients and a bibliographic review

The appearance of morphea after vaccination has been reported to date as single and deep lesions that appear exactly at the site of the skin puncture. It was therefore postulated that the origin could be the trauma related to the injection. The aim of this article is to review the various hypotheses offered in the published literature about generalized morphea following vaccination. We present two cases of generalized morphea after COVID-19 vaccination and review the published literature on immune-related cutaneous reactions. As previously reported, antigenic crossreactivity between vaccine spike proteins and human tissues could cause certain immune-mediated diseases, including generalized morphea. Herein we report two cases of generalized morphea probably induced by the COVID-19 vaccine, given the temporal relationship with its administration. In summary, environmental factors such as vaccination against SARS-COV-2 could induce an immune system dysregulation, which would have an important role in the pathogenesis of morphea. We present two cases of generalized morphea probably induced by the COVID-19 vaccine, given the time elapsed between vaccination and the onset of the skin lesions

Popper’s Dermatitis: An Unusual Diagnostic Challenge

Volatile nitrites, and especially isobutyl nitrite or “Popper”, are popular drugs of abuse in Europe, mainly in men that have sex with men (MSM). Inhalation is the most common route of consumption, but direct contact with skin or muco- sal membranes has been associated with a local adverse event called “Popper’s dermatitis”. To date, just five cases have been reported, most of them on the face, but also on other parts of the body [1, 2]

Methotrexate-induced epidermal necrosis in a child with osteosarcoma

Methotrexate is a folic acid antagonist used to treat psoria-sis, rheumatoid arthritis and neoplasms. It is renally excreted unchanged, at levels of about 90% within 24 hours. Several risk factors for intoxication have been described, including folate deficiency, liver cirrhosis, renal failure or the use of me-dications such as sulfonamides, salicylate and nonsteroidal anti-inflammatory drugs. Adverse cutaneous reactions such as photosensitivity, alopecia, urticaria, mucositis, erythe-ma, desquamation, Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN) are well known. Methotrexate epidermal necrosis (MEN) should also be considered because of its severity, its similarity to TEN and the importance of rapidly administering appropriate treatment. Some cases of MEN have been reported in psoriasis patients, in whom the occurrence with an underlying skin disease has been found to be more common

Cocaine-induced pyoderma gangrenosum-like lesions

Cocaine consumption is increasing at an alarming rate. This drug produces euphoria, anorexia, increased alertness and diminished sleep requirements. It is estimated that up to 80 % of cocaine is contaminated with levamisole, a substance which may potentiate the drug’s chemical effects [ 1 ] . Multiple mucocutaneous manifestations have been associated with cocaine use [ 2 ] , including cocaine-induced pyoderma gangre-nosum (CIPG), cocaine-induced midline destructive lesions (CIMDL) and retiform purpura (RP). We present three cases of cocaine abuse with skin lesions compatible with PG, and review the epidemiological, clinical, histopathological and immunological characteristics of CIPG and RP. We suggest that these two conditions are more closely related than previously thought. Additionally, in our opinion, no specific immunological or histological profile would be indicative of levamisole toxicity