Revistas
Revista:
CANCERS
ISSN:
2072-6694
Año:
2023
Vol.:
15
N°:
20
Págs.:
5037
The aim of this study is to compare the risk of local recurrence and metastases in patients with cSCC based on the presence or absence of prior sun exposure in the region of tumor development. A retrospective observational epidemiological study including 558 patients from January 2017 to December 2020 was conducted. Among the 463 patients with cSCC in highly sun-exposed areas, 73 (15.8%) were diagnosed with local recurrence versus only 7 of 95 patients (7.4%) in less sun-exposed areas. No differences were found in terms of metastasis between both groups. In regions with low sun exposure, the variables linked to a heightened risk of recurrence include tumor depth and the involvement of surgical margins. Our results suggest that highly sun-exposed areas could have a greater risk of developing local recurrence, conferring a worse prognosis for the patients. Background: The incidence of cutaneous squamous cell carcinoma (cSCC) is increasing over the years. Risk factors for local recurrence and metastasis have been widely studied in highly sun-exposed areas of the body but less data exist about less sun-exposed ones. The main objective of this study is to compare the risk of local recurrence and metastases in patients with cSCC in highly sun-exposed areas compared to cSCC in less sun-exposed areas. Material and methods: A retrospective observational study was carried out, including 558 patients with histopathologically confirmed cSCC at the Reina Sofia University Hospital (HURS), Cordoba, during the period from 1 January 2017 to 31 December 2020. Demographic, clinical and anatomopathological data were collected. Results: Local recurrence occurs more often in highly sun-exposed areas (15.8%) compared to less sun-exposed ones (7.4%) (p < 0.05). However, no differences in the rate of metastases in both groups were found. The presence of affected surgical margins and tumor thickness were identified as independent risk factors for cSCC in low sun-exposure areas. Conclusions: cSCC located in anatomical areas of high sun exposure presented a greater risk of developing local recurrence in our population, which could suggest that these tumors have worse prognosis than those that lie in areas that do not receive chronic sun exposure.
Revista:
JOURNAL OF CLINICAL MEDICINE
ISSN:
2077-0383
Año:
2023
Vol.:
12
N°:
24
Págs.:
7619 - *
Introduction: Cutaneous squamous cell carcinoma (cSCC) is the second most common cutaneous neoplasm, and its incidence is on the rise. While most cSCCs have an excellent prognosis, certain risk factors, especially immunosuppression, have been associated with higher rates of local recurrence (LR), metastasis, and poor prognosis. This study aims to assess the risk factors for LR and metastasis development in cSCC among solid organ transplant recipients (SOTRs) and compare these rates with those in immunocompetent patients. Materials and Methods: A retrospective observational study included cSCC cases from the University Hospital Reina Sofia in Cordoba, Spain, between 2002 and 2019. Demographic, clinical, and histopathological data were collected. Local recurrence and metastasis rates were analyzed, along with progression-free survival. Univariate analyses were performed to identify prognostic factors in SOTRs. Results: Among 849 cSCC cases, we found higher rates of local recurrence and metastasis in tumors developed by SOTRs compared to those in immunocompetent individuals. However, no significant differences in local recurrence, metastasis, or progression-free survival were observed between the two groups. Risk factors for adverse outcomes in SOTRs included tumor size > 2 cm, depth > 4 mm, and a higher Clark level. A total of 34.4% of SOTRs developed a second primary cSCC during the follow-up. Conclusions: In our study, cSCCs in SOTRs did not exhibit statistically significant differences in the rates of adverse outcomes compared to immunocompetent patients. The prognosis of cSCCs in SOTRs may be more related to other tumor-dependent risk factors than to the immunosuppression status itself. Future studies are needed to refine risk stratification and follow-up protocols to ensure the optimal management of high-risk cSCC cases, particularly among immunosuppressed patients.
Revista:
JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY
ISSN:
0926-9959
Año:
2023
Vol.:
37
N°:
4
Págs.:
e496 - e498
Revista:
INTERNATIONAL JOURNAL OF DERMATOLOGY
ISSN:
0011-9059
Año:
2022
Vol.:
61
N°:
5
Págs.:
600 - 602
Revista:
JOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT
ISSN:
1610-0379
Año:
2022
Vol.:
20
N°:
12
Págs.:
1635 - 1635
Revista:
JOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT
ISSN:
1610-0379
Año:
2022
Vol.:
20
N°:
1
Págs.:
102 - 105
Autores:
Ferrándiz-Pulido, C. (Autor de correspondencia); Gómez-Tomás, A.; Llombart, B.; et al.
Revista:
JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY
ISSN:
0926-9959
Año:
2022
Vol.:
36
N°:
11
Págs.:
1991 - 2001
Background The proportion of Merkel cell carcinomas (MCCs) in solid-organ transplant recipients (SOTR) harbouring Merkel cell polyomavirus (MCPyV) is unknown, as are factors affecting their outcomes. Objective To describe clinicopathological features of MCC in SOTR, investigate the tumoral MCPyV-status and identify factors associated with tumour outcomes. Methods Retrospective, international, cohort-study. MCPyV-status was investigated by immunohistochemistry and polymerase chain reaction. Results A total of 30 SOTR and 44 consecutive immunocompetent patients with MCC were enrolled. SOTR were younger at diagnosis (69 vs. 78 years, P < 0.001). Thirty-three percent of SOTR MCCs were MCPyV-positive vs. 91% of immunocompetent MCCs (P = 0.001). Solid-organ transplantation was associated with an increased cumulative incidence of progression (SHR: 3.35 [1.57-7.14], P = 0.002), MCC-specific mortality (SHR: 2.55 [1.07-6.06], P = 0.034) and overall mortality (HR: 3.26 [1.54-6.9], P = 0.002). MCPyV-positivity and switching to an mTOR inhibitor (mTORi) after MCC diagnosis were associated with an increased incidence of progression (SHR: 4.3 [1.5-13], P = 0.008 and SHR: 3.6 [1.1-12], P = 0.032 respectively) in SOTR. Limitations Retrospective design and heterogeneity of SOTR cohort. Conclusions MCPyV appears to play a less prominent role in the aetiopathogenesis of MCC in SOTR. SOTR have a worse prognosis than their immunocompetent counterparts and switching to an mTORi after the diagnosis of MCC does not improve progression.
Revista:
INDIAN JOURNAL OF DERMATOLOGY VENEREOLOGY AND LEPROLOGY
ISSN:
0378-6323
Año:
2022
Vol.:
88
N°:
6
Págs.:
792 - 793
Revista:
INDIAN JOURNAL OF DERMATOLOGY VENEREOLOGY AND LEPROLOGY
ISSN:
0378-6323
Año:
2022
Vol.:
88
N°:
1
Págs.:
93 - 96
Revista:
DERMATOLOGIC THERAPY
ISSN:
1396-0296
Año:
2022
Vol.:
35
N°:
1
Págs.:
e15200
Revista:
INDIAN JOURNAL OF DERMATOLOGY VENEREOLOGY AND LEPROLOGY
ISSN:
0378-6323
Año:
2022
Vol.:
88
N°:
4
Págs.:
525 - 526
Revista:
JOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT
ISSN:
1610-0379
Año:
2022
Vol.:
20
N°:
12
Págs.:
1633 - 1635
Revista:
JAMA DERMATOLOGY
ISSN:
2168-6068
Año:
2022
Vol.:
158
N°:
12
Págs.:
1459 - 1460
Revista:
JAMA DERMATOLOGY
ISSN:
2168-6068
Año:
2022
Vol.:
158
N°:
7
Págs.:
832 - 834
This case report describes a Mediterranean HIV-negative man in his 60s with hypertension, osteoporosis, a history of flaccid paralysis after polio syndrome, and a 4-year history of progressive development of purplish, reddish cutaneous plaques and nodules limited to the lower limbs.
Revista:
EUROPEAN JOURNAL OF DERMATOLOGY
ISSN:
1167-1122
Año:
2022
Vol.:
32
N°:
5
Págs.:
667 - 668
Revista:
INDIAN JOURNAL OF DERMATOLOGY
ISSN:
0019-5154
Año:
2021
Vol.:
66
N°:
5
Págs.:
576
Autores:
Tejera-Vaquerizo, A. (Autor de correspondencia); Paradela, S.; Toll, A.; et al.
Revista:
ACTA DERMATO-VENEREOLOGICA
ISSN:
0001-5555
Año:
2021
Vol.:
101
Págs.:
adv00525
The aim of this study was to compare tumour burden in patients who underwent surgery for melanoma and cutaneous squamous cell carcinoma during nationwide lockdown in Spain due to COVID-19 (for the period 14 March to 13 June 2020) and during the same dates in 2019 before the COVID-19 pandemic. In addition, associations between median tumour burden (Breslow thickness for melanoma and maximum clinical diameter for cutaneous squamous cell carcinoma) and demographic, clinical, and medical factors were analysed, building a multivariate linear regression model. During the 3 months of lockdown, there was a significant decrease in skin tumours operated on (41% decrease for melanoma (n = 352 vs n = 207) and 44% decrease for cutaneous squamous cell carcinoma (n = 770 vs n = 429)) compared with the previous year. The proportion of large skin tumours operated on increased. Fear of SARS-CoV-2 infection, with respect to family member/close contact, and detection of the lesion by the patient or doctor, were related to thicker melanomas; and fear of being diagnosed with cancer, and detection of the lesion by the patient or relatives, were related to larger size cutaneous squamous cell carcinoma. In conclusion, lockdown due to COVID-19 has resulted in a reduction in treatment of skin cancer.
Revista:
ARCHIVES OF DERMATOLOGICAL RESEARCH
ISSN:
0340-3696
Año:
2020
Vol.:
312
N°:
9
Págs.:
675 - 680
Conventional photodynamic therapy (cPDT) using red light is considered one of the most effective therapy option for the treatment of actinic keratosis (AK). The main disadvantage of cPDT is the pain experienced by the patients during illumination. Daylight PDT (dPDT) represents an effective and painless alternative. It can be speculated that a combination of both regimes combines their benefits. To compare the combination of cPDT and dPDT (combPDT) to dPDT alone in terms of effectiveness and safety. The study was developed as a single-centre, intraindividual, retrospective study. Each patient received one dPDT and a combPDT session with BF-200 ALA. Primary effectiveness endpoints included the reduction in the number of basal AK, percentage of patients with complete response (CR) and partial response (PR). Safety parameters evaluated were local skin response (LSR) and visual analogue scale (VAS). A total of 19 patients with 264 AK were evaluated 12 weeks after both PDT modalities. The area treated with combPDT showed a reduction in the number of AK lesions (82.7%) when compared to the dPDT-treated area (56.8%). Higher rates of CR (31.6% vs 15.8) and PR (63.2% vs 26.3%) were achieved in combPDT fields. Areas treated with combPDT showed enhanced local skin reactions (LSR) in comparison with dPDT-treated areas (6.4 vs.4.4, respectively). In combPDT-treated patients a moderate increase of the pain during illumination was observed when compared to dPDT (VAS: 3.4 vs 0.6). This study reports the first data set on the benefit of a direct combination of daylight and subsequent conventional red light illumination (combPDT) with BF-200 ALA. The combination approach achieved a significant increase in clearance rates of AK lesions, while pain was perceived as mild to moderate during red light illumination.
Revista:
JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY
ISSN:
0190-9622
Año:
2020
Vol.:
83
N°:
3
Págs.:
e203
Revista:
AMERICAN JOURNAL OF DERMATOPATHOLOGY
ISSN:
1533-0311
Año:
2020
Vol.:
42
N°:
5
Págs.:
356 - 359
Langerhans cell histiocytosis (LCH) is a rare proliferative disorder, more frequent in children, characterized by an abnormal accumulation of Langerhans cells admixed with eosinophils, lymphocytes, neutrophils, and macrophages. The clinical presentation is variable and depends on whether a single or multiple organs are affected. Skin lesions are common in LCH (40% of cases) and represent a frequent form of presentation (in up to 80% of cases). Cutaneous manifestations of LCH are highly variable, frequently presenting as crusted papules or scaly seborrheic-like lesions localized in the scalp. We report the first case of a localized acral sclerosing LCH, a new form of LCH. This case highlights the broad and surprising form of presentation of LCH which may be overlooked and can significantly delay its diagnosis. The development of systemic disease may occur months to years after the initial skin presentation. Prompt diagnosis and treatment may prevent progression to systemic disease, as documented in some cases.
Revista:
JOURNAL OF DERMATOLOGICAL TREATMENT
ISSN:
1471-1753
Año:
2018
Vol.:
29
N°:
4
Págs.:
393 - 399
Introduction: The aim of the study was to evaluate the results on effectiveness and safety of topical treatment for actinic keratosis (AK) with ingenol mebutate gel (IMG) in real-life conditions and to perform an analysis of the factors that may influence the treatment outcomes.Materials and methods: Retrospective study of patients with non-hyperkeratotic AK lesions prescribed with IMG in Spain according to clinical practice. Dermatologists reported the characteristics of patients and AK at baseline, and the findings observed up to 60d after treatment.Results and conclusions: A total of 260 treatments in 246 patients with a mean (SD) age 70.6 (10.4) years were reviewed. The number of clinically visible AK in the treated area decreased from 6.16 (3.02) to 1.22 (2.02) (p<.001) lesions with an average reduction of 84%. Univariate analysis showed higher reduction rates when IMG was applied in the face/scalp (p=.026), in women (p=.041), and in patients under 70years of age (p=.033). According to multivariate analysis, advanced age was associated with worse clearance rates (p=.038). However, besides statistical significance, we can conclude that gender (female) and age (under 70years-old) show a tendency to have better efficacy outcomes but without clinical relevance. Topical IMG was generally well tolerated and had positive cosmetic results after 60d. Age influences on IMG effectiveness for AK and LSRs were correlated with higher effectiveness ratios.
Autores:
Alcantara Reifs, C. M. (Autor de correspondencia); Salido-Vallejo, Rafael; Garnacho-Saucedo, G. M.; et al.
Revista:
ANAIS BRASILEIROS DE DERMATOLOGIA
ISSN:
1806-4841
Año:
2016
Vol.:
91
N°:
5
Págs.:
642 - 644
Sezary syndrome is a primary cutaneous T-cell lymphoma characterized by the triad of erythroderma, lymphadenopathy and circulating atypical cells. The emergence of new molecular targets has enabled the development of drugs such as alemtuzumab, an anti-CD52 monoclonal antibody, which has shown promising results in the treatment of this entity. We report the case of a 70-year-old male with refractory Sezary syndrome in whom treatment with alemtuzumab achieved an 80% skin lesion clearance with complete haematologic and radiologic response. The treatment was discontinued after 4 months due to adverse effects, with the patient showing a sustained response without disease progression after 13 months of follow-up.
Revista:
JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY
ISSN:
1468-3083
Año:
2016
Vol.:
30
N°:
7
Págs.:
1120 - 1124
BackgroundIntralesional methotrexate (MTX-il) has been used as neoadjuvant therapy for keratoacanthoma but has only been utilized in a few isolated cases of cutaneous squamous cell carcinoma as neoadjuvant therapy (cSCC).
ObjectivesThe objective of this study was to evaluate the effectiveness in clinical practice of presurgical MTX-il infiltration to reduce the size of the cSCC. Safety and the impact on subsequent reconstructive surgical techniques was also assessment.
MethodsSingle, retrospective, observational study of two historical cohorts differentiated in time. Subjects included were diagnosed with infiltrating cSCC. Patients included in group-A received neoadjuvant MTX-il and patients included in group-B underwent scheduled surgery without prior infiltration. Univariate and multivariate analyses were performed.
ResultsGroup-A patients (n=43) showed an average reduction in the tumour area of 0.52cm(2), while in group-B (n=43), the area increased by 0.49cm(2). A multivariate linear regression analysis demonstrated that MTX-il was the only independent variable that significantly reduced the tumour size [mean 42.6% (95% CI: 31.17-54.03)]. Tumours 2cm in size required significantly a lower percentage of complex reconstructions (P=0.026). Lower lip tumours showed a higher reduction in group treated with MTX-il (P=0.045). The only complication observed was discomfort during methotrexate infiltration (60.47%).
Conclusions...
Autores:
Alcantara-Reifs, C. M. (Autor de correspondencia); Salido-Vallejo, Rafael; Garnacho-Saucedo, G.; et al.
Revista:
AMERICAN JOURNAL OF OTOLARYNGOLOGY
ISSN:
1532-818X
Año:
2016
Vol.:
37
N°:
3
Págs.:
251 - 254
Background: Phymatous rosacea is characterized by thickened skin and irregular surface contours as the result of variable combinations of fibrosis, sebaceous hyperplasia and lymphoedema. Otic phyma is rarely seen and has been rarely reported in the English literature.
Methods: We present another case of this uncommon condition, frequently misdiagnosed, maybe due to its underrecognition.
Results: Phymatous rosacea most commonly occurs on the nose, but may also develop on any sebaceous facial region, including the ears. Although it is a benign condition, there are significant morbidities associated with rosacea, and can even result in conductive deafness because of the obstruction of the external auditory canal.
Conclusions: The knowledge of this entity may be important for clinicians, especially dermatologists, ENT specialists and plastic surgeons, for an appropriate treatment and follow-up
Revista:
ACTAS DERMO-SIFILIOGRAFICAS
ISSN:
1578-2190
Año:
2014
Vol.:
105
N°:
6
Págs.:
558 - 568
Facial angiofibromas are hamartomatous growths that are closely associated with tuberous sclerosis complex and, in fact, they constitute one of the main diagnostic criteria for that disease. These lesions composed of blood vessels and fibrous tissue appear on the face at an early age. Since they have important physical and psychological repercussions for patients, several treatment options have been used to remove them or improve their appearance. However, the lack of treatment guidelines prevents us from developing a common protocol for patients with this condition. The present article aims to review the treatments for facial angiofibromas used to date and to propose a new evidence-based treatment protocol.
Revista:
CLINICAL AND EXPERIMENTAL DERMATOLOGY
ISSN:
1365-2230
Año:
2014
Vol.:
39
N°:
8
Págs.:
888 - 893
Background: Tuberous sclerosis complex (TSC) is an autosomal dominant neurocutaneous disorder characterized by the development of multisystem hamartomatous tumours. Topical sirolimus has recently been suggested as a potential treatment for TSC-associated facial angiofibroma (FA).
Aim: To validate a reproducible scale created for the assessment of clinical severity and treatment response in these patients.
Methods: We developed a new tool, the Facial Angiofibroma Severity Index (FASI) to evaluate the grade of erythema and the size and extent of FAs. In total, 30 different photographs of patients with TSC were shown to 56 dermatologists at each evaluation. Three evaluations using the same photographs but in a different random order were performed 1 week apart. Test and retest reliability and interobserver reproducibility were determined.
Results: There was good agreement between the investigators. Inter-rater reliability showed strong correlations (> 0.98; range 0.97-0.99) with inter-rater correlation coefficients (ICCs) for the FASI. The global estimated kappa coefficient for the degree of intra-rater agreement (test-retest) was 0.94 (range 0.91-0.97).
Conclusions: The FASI is a valid and reliable tool for measuring the clinical severity of TSC-associated FAs, which can be applied in clinical practice to evaluate the response to treatment in these patients.
Revista:
REVISTA IBEROAMERICANA DE MICOLOGIA
ISSN:
1130-1406
Año:
2014
Vol.:
31
N°:
2
Págs.:
149 - 151
Background: Phaeohyphomycosis can be caused by a number of different species, being the most common Alternaria alternata and Alternaria infectoria. The biggest risk factor for the development of the infection is immunosuppression.
Aims: We present the case of a 64-year-old male renal transplant patient who came to hospital for presenting a tumour in the Achilles region which had been gradually growing in size.
Methods: A skin biopsy was taken for histological study and culture of fungi and mycobacteria. Blood tests and imaging studies were performed.
Results: Histopathology study and cultures identified A. infectoria as the causal agent. Imaging studies ruled out internal foci of infection. The lesion was surgically removed with no signs of recurrence after 24 months of follow-up.
Conclusions: There are no treatment guidelines at present for cutaneous and subcutaneous Alternaria spp. infections. Various systemic antifungals have been used, either in combination with surgical removal or alone, with varying results. Surgery alone could be useful in the treatment of solitary, localised lesions in transplant patients in whom there are difficulties in controlling immunosuppression.
Revista:
JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY
ISSN:
0926-9959
Año:
2012
Vol.:
26
N°:
10
Págs.:
1315 - 1318
Background: Tuberous sclerosis complex (TSC) is an autosomal dominant neurocutaneous disorder characterized by the development of multisystem hamartomatous tumours. Facial angiofibroma appears in up to 80% of patients and has a considerable psychological impact. Various invasive procedures have been used, although they show limited effectiveness and potential adverse effects.
Objectives: To evaluate the sustained clinical benefits and safety profile of topical sirolimus applied to treat facial angiofibromas.
Methods: This study was a non-blinded, uncontrolled case-series comprising 10 patients with TSC-associated facial angiofibroma that was treated with 0.4% sirolimus ointment 3 times a week for 9 months. Patients were clinically evaluated at baseline and at 6, 12, 24 and 36 weeks. Plasma levels of sirolimus were determined.
Results: A sustained improvement was observed in erythema and in the size and extension of the lesions as early as the first weeks of treatment. Sirolimus plasma levels remained below detection limits (0.3 ng/mL) in all cases. The formula was well-tolerated with no local or systemic adverse effects.
Conclusions: Topical sirolimus seems to be an effective and safe medical alternative to surgery or laser-based treatments in patients with TSC-associated facial angiofibromas.
Nacionales y Regionales
Título:
Estudio prospectivo aleatorizado y controlado de eficacia a largo plazo del láser CO2 en pacientes con enfermedad de Hailey-Hailey. Valoración del cambio de expresión génica.
Código de expediente:
PID2020-114340RA-I00
Investigador principal:
Leyre Aguado Gil
Financiador:
AGENCIA ESTATAL DE INVESTIGACION
Convocatoria:
2020 AEI PROYECTOS I+D+i (incluye Generación del conocimiento y Retos investigación)
Fecha de inicio:
01/09/2021
Fecha fin:
31/08/2024
Importe concedido:
84.700,00€
Otros fondos:
-
Título:
Plataforma para la Identificación de TCR Específicos de Antígenos Tumorales para la Inmunoterapia de Tumores Sólidos (PITAGORAS)
Código de expediente:
0011-1411-2023-000107
Investigador principal:
Ascensión López Díaz de Cerio
Financiador:
GOBIERNO DE NAVARRA
Convocatoria:
2023 GN PROYECTOS ESTRATEGICOS DE I+D 2023-2026
Fecha de inicio:
01/07/2023
Fecha fin:
31/12/2025
Importe concedido:
474.228,40€
Otros fondos:
-