Malignant melanoma in Chile: different site distribution between private and state patients

BACKGROUND: The body site location of primary Malignant Melanoma (MM) has been correlated with prognosis and survival. Ethnic, genetics, sun exposure factors are related to the anatomical distribution of MM. Low and high socioeconomic strata in Chile differ in ethnic, genetic and cultural conditions. The purpose of this study was to analyze the anatomical MM distribution in the Chilean population in both strata searching for differences due to their ethno-genetic-cultural differences. Records of 1148 MM, 575cases from state hospitals (Low Socioeconomic Strata, LSS) and 573 cases from private clinics (High Socioeconomic Strata, HSS) were analyzed by body site. RESULTS: Females from LSS showed a higher number of MM in soles, cheeks, and around the eye area. Females from the HSS showed a higher number of MM in dorsal feet and dorsal hands. Males from LSS showed a higher number of MM in soles, around the eye area, and cheeks. However, males from HSS showed a higher number of MM in the trunk, and in the arms. Acral MM was significantly higher in LSS than in the HSS in both sexes. The Chilean population from the HSS and LSS showed differences in the distribution of MM by site. Furthermore, gender differences in the proportion of MM analyzed by anatomical site are observed in both strata. CONCLUSIONS: Results show evidence that differential genetics factors, sun exposure, or other environmental or cultural factors of both strata may account for these differences

Cutaneous Malignant Melanoma in Chile: Differences in Tumor Thickness and Overall Survival Between Patients From Public and Private Health Care Centers

Introduction: A low socioeconomic status (SES) is associated with lower survival rates in cutaneous malignant melanoma (CMM). In South America, there are few studies that analyze CMM data according to SES. Objectives: To determine the differences in microstaging and overall survival in CMM between public and private health care centers. Methods: Retrospective cohort study. Histopathological reports with a diagnosis of CMM from two public hospitals (PuH) and one private health care center (PrH) in Santiago from 2008 to 2018 were included. Patients’ death certificates were obtained to estimate overall survival. Results: 1014 MMC were found. The mean age was 58.6 ± 16.8 years and 59.9% corresponded to female patients. Of these, 33.9% received treatment at PuH and 66.1% at PrH. Patients from PuH had an increased risk of having an invasive CMM and a >1 mm thickness melanoma compared to PrH (OR 2.77 and 6.06, respectively). Patients with invasive CMM from the PuH were 6.29-fold more likely to die than a patient from the PrH. Conclusions: We observed a great disparity in tumor thickness between the socioeconomic sectors, reflecting a later detection and lower survival rate in PuH. Our results highlight a gap on which National Public Health should focus

Mastocitosis cutánea maculopapular infantil: reporte de un caso

Resumen: Objetivo: Reportar un caso de mastocitosis cutánea maculopapular de inicio en la infancia y realizar una revisión bibliográfica con énfasis en el diagnóstico, estudio, pronóstico y tratamiento. Caso clínico: Lactante de 14 meses que presentaba máculas de color marrón en tronco y extremidades, con signo de Darier positivo. Resultados: La biopsia resultó compatible con mastocitosis y se realizó estudio sanguíneo que descartó compromiso sistémico. Conclusiones: La mayoría de las mastocitosis cutáneas en niños tienen un excelente pronóstico y tienden a mejorar hacia la pubertad, realizándose un tratamiento conservador. Abstract: Objective: To report a case of childhood-onset maculopapular cutaneous mastocytosis and to conduct a literature review with emphasis on diagnosis, study, prognosis and treatment. Clinical case: A 14-month-old infant, who had brown macules on trunk and limbs, showing a positive Darier sign. Results: The biopsy was compatible with mastocytosis, and through a blood study we discarded any systemic involvement. Conclusion: The majority of cutaneous mastocytosis in children have an excellent prognosis and tend to improve in puberty, once a conservative treatment is prescribed. Palabras clave: Mastocitosis cutánea, urticaria pigmentosa, mastocitosis de inicio en la infancia, mastocitosis pediátrica, mastocitosis cutánea maculopapular, Keywords: Cutaneous mastocytosis, urticaria pigmentosa, childhood-onset mastocytosis, pediatric mastocytosis, maculopapular cutaneous mastocytosi

Subungual schwannoma with clinical, sonographic, and histologic correlation

We show an unusual presentation of a schwannoma that was located in the ungual bed of the left great toe. The clinical, color Doppler ultrasound imaging, and histologic findings are shown to illustrate the case. This type of neurogenic tumor and the ultrasound presurgical imaging support should be considered when dealing with subungual tumors of the foot

No clinical predictors of intraepithelial neoplasia in HIV-positive patients with external condilomata acuminata

To identify clinical parameters in association with human papilloma virus (HPV) genotypes and histopathology diagnosis in HIV-positive patients with external condylomata acuminata (ECA), 400 Chilean HIV-positive patients were included in the study. Forty-seven patients presented ECA. Clinical parameters and socio demographic data were recorded. Histopathology study and HPV linear array genotyping assay were performed. Intraepithelial neoplasia (IEN) grade 2 or 3 was found in 8.5% of patients, associated to HPV-16. Patients were mainly single, MSM, with history of sexually transmitted disease (STD), multiple sexual partners, receiving antiretroviral therapy and with recurrent lesions. All ECA were mainly perianal, grey or pink colored, exophytic with less than two years evolution. No clinical parameter could predict the development of high grade IEN in HIV patients with ECA. It seems necessary to perform biopsy and genotype all HIV positive patients with ECA