Grupos Investigadores

Miembros del Grupo

Coordinador
Redondo Bellón, Pedro
(predondo@unav.es)
Investigadores
Leire
Aguado Gil
Francisco Javier
García Martinez
María Pilar
Gil Sánchez
Colaboradores
Ester
Moreno Artero
Irene
Palacios Álvarez

Líneas de Investigación

  • Cirugía de MOHS
  • Patogenia molecular del carcinoma basocelular
  • Tratamiento del carcinoma basocelular
  • Tratamiento quirúrgico del carcinoma epidermoide

Palabras Clave

  • Carcinoma basocelular
  • Carcinoma epidermoide
  • Expresión génica
  • Patogenia
  • Sonic hedgehog
  • Tratamiento

Publicaciones Científicas desde 2018

  • Autores: Redondo Bellón, Pedro (Autor de correspondencia)
    Revista: JOURNAL OF CLINICAL MEDICINE
    ISSN: 2077-0383 Vol.12 N° 16 2023 págs. 5399
    Resumen
    The forehead and temporal region are frequent areas of skin cancer development. After tumor removal, reconstruction must be performed, maintaining the frontal-temporal line of the scalp and symmetry of the eyebrows in an attempt to hide the scars within these marks or natural folds and wrinkles. Second wound healing and skin grafts generally do not produce an acceptable cosmetic result. When direct closure is not possible, the technique of choice is skin flaps. In the midfrontal line continuation of the glabella, there is a remnant of skin to be used as a donor area for local flaps; similarly, it occurs in the preauricular cheek, which can move toward the temple. In addition to the classic advancement and rotation flaps, the frontalis myocutaneous transposition flap is an excellent technique for closing defects which are wider than higher on the forehead. Its design is very versatile and can be performed between the two pupil lines at different heights depending on the location of the defect. On the other hand, the preauricular skin advancement flap with an infralobular Burow's triangle is also an excellent option for reconstructing tumors in the temporal area.
  • Autores: Redondo Bellón, Pedro (Autor de correspondencia); Barrio Barrio, Jesús; Salido Vallejo, Rafael; et al.
    Revista: JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY
    ISSN: 0926-9959 Vol.37 N° 4 2023 págs. e496 - e498
  • Autores: García Martinez, Francisco Javier (Autor de correspondencia); Estenaga-Pérez-de Albéniz, Á.
    Revista: MEDICINA CLINICA
    ISSN: 0025-7753 Vol.160 N° 8 2023 págs. 367 - 368
  • Autores: Estenaga Pérez de Albéniz, Ángela; Sánchez Lorenzo, María Luisa; Antoñanzas Pérez, Javier; et al.
    Revista: JOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT
    ISSN: 1610-0379 Vol.21 N° 7 2023 págs. 792 - 794
  • Autores: Montero-Vilchez, T. R.; Garces, J. A.; Rodríguez-Prieto, M.; et al.
    Revista: JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY
    ISSN: 0926-9959 Vol.37 N° 8 2023 págs. 1587 - 1594
    Resumen
    IntroductionThere is still a need to develop a simple algorithm to identify patients likely to need complex Mohs micrographic surgery (MMS) and optimize MMS schedule. The main objectives of this study are to identify factors associated with a complex MMS and develop a predictor model of the number of stages needed in surgery and the need for a complex closure. Materials and MethodsA nationwide prospective cohort study (REGESMOHS, the Spanish Mohs surgery registry) was conducted including all patients with a histological diagnosis of basal cell carcinoma (BCC). Factors related to three or more stages and a complex closure (that needing a flap and/or a graft) were explored and predictive models were constructed and validated to construct the REGESMOSH scale. ResultsA total of 5226 patients that underwent MMS were included in the REGESMOHS registry, with 4402 (84%) having a histological diagnosis of BCC. A total of 3689 (88.9%) surgeries only needed one or two stages and 460 (11.1%) required three or more stages. A model to predict the need for three or more stages included tumour dimension, immunosuppression, recurrence, location in risk areas, histological aggressiveness and previous surgery. Regarding the closure type, 1616 (38.8%) surgeries were closed using a non-complex closure technique and 2552 (61.2%) needed a complex closure. A model to predict the need for a complex closure included histological aggressiveness, evolution time, patient age, maximum tumour dimension and location. ConclusionWe present a model to predict MMS needing >= 3 stages and a complex closure based on epidemiological and clinical data validated in a large population (with real practice variability) including different centres that could be easily implemented in clinical practice. This model could be used to optimize surgery schedule and properly inform patients about the surgery duration.
  • Autores: Aitken, P. (Autor de correspondencia); Stanescu, I.; Boddington, L.; et al.
    Revista: BRITISH JOURNAL OF DERMATOLOGY
    ISSN: 0007-0963 Vol.189 N° 5 2023 págs. 520-530
    Resumen
    We carried out a phase II/III double-blind randomized placebo-controlled efficacy and safety trial of a novel rapamycin cream to treat facial angiofibromas. Topical rapamycin treatment improved the appearance of angiofibromas over a 26-week treatment period and was well tolerated. Background Facial angiofibromas (FAs) are a major feature of tuberous sclerosis complex (TSC). Topical rapamycin can successfully treat FAs. A new stabilized cream formulation that protects rapamycin from oxidation has been developed in 0.5% and 1% concentrations. Objectives To assess the efficacy and safety of a novel, stabilized topical rapamycin cream formulation. Methods This multicentre double-blind randomized placebo-controlled dose-response phase II/III study with a parallel design included participants aged 6-65 years with FAs of mild or moderate severity according to the Investigator's Global Assessment (IGA) scale. Participants were randomized to one of three treatment arms: topical rapamycin 0.5%, topical rapamycin 1% or placebo. Treatment was applied once daily for 26 weeks. Safety and efficacy measures were assessed at days 14, 56, 98, 140 and 182. The primary endpoint was the percentage of participants achieving IGA scores of 'clear' or 'almost clear' after 26 weeks of treatment. Secondary measures included Facial Angiofibroma Severity Index (FASI) and participant- and clinician-reported percentage-based improvement. Safety measures included the incidence of treatment-emergent adverse events and blood rapamycin concentration changes over time. Results Participants (n = 107) were randomized to receive either rapamycin 1% (n = 33), rapamycin 0.5% (n = 36) or placebo (n = 38). All treated participants were included in the final analysis. The percentage of participants with a two-grade IGA improvement was greater in the rapamycin 0.5% treatment group (11%) and rapamycin 1% group (9%) than in the placebo group (5%). However, this was not statistically significant [rapamycin 0.5%: odds ratio (OR) 1.71, 95% confidence interval (CI) 0.36-8.18 (P = 0.50); rapamycin 1%: OR 1.68, 95% CI 0.33-8.40 (P = 0.53)]. There was a statistically significant difference in the proportion of participants treated with rapamycin cream that achieved at least a one-grade improvement in IGA [rapamycin 0.5%: 56% (OR 4.73, 95% CI 1.59-14.10; P = 0.005); rapamycin 1%: 61% (OR 5.14, 95% CI 1.70-15.57; P = 0.004); placebo: 24%]. Skin adverse reactions were more common in patients following rapamycin application (64%) vs. placebo (29%). Conclusions Both rapamycin cream formulations (0.5% and 1%) were well tolerated, and either strength could lead to clinical benefit in the treatment of FA.
  • Autores: Marti-Marti, I. (Autor de correspondencia); Podlipnik, S.; Canueto, J.; et al.
    Revista: JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY
    ISSN: 0190-9622 Vol.89 N° 1 2023 págs. 119 - 127
    Resumen
    Background: Satellitosis or in-transit metastasis (S-ITM) has clinical outcomes comparable to node-positivity in cutaneous squamous cell carcinoma (cSCC). There is a need to stratify the risk groups. Objective: To determine which prognostic factors of S-ITM confer an increased risk of relapse and cSCC-specific-death. Methods: A retrospective, multicenter cohort study. Patients with cSCC developing S-ITM were included. Multivariate competing risk analysis evaluated which factors were associated with relapse and specific death. Results: Of a total of 111 patients with cSCC and S-ITM, 86 patients were included for analysis. An S-ITM size of ¿20 mm, >5 S-ITM lesions, and a primary tumor deep invasion was associated with an increased cumulative incidence of relapse (subhazard ratio [SHR]: 2.89 [95% CI, 1.44-5.83; P = .003], 2.32 [95% CI, 1.13-4.77; P = .021], and 2.863 [95% CI, 1.25-6.55; P = .013]), respectively. Several >5 S-ITM lesions were also associated with an increased probability of specific death (SHR: 3.48 [95% CI, 1.18-10.2; P = .023]). Limitations: Retrospective study and heterogeneity of treatments. Conclusion: The size and the number of S-ITM lesions confer an increased risk of relapse and the number of S-ITM an increased risk of specific-death in patients with cSCC presenting with S-ITM. These results provide new prognostic information and can be considered in the staging guidelines.
  • Autores: Antoñanzas Pérez, Javier; Morelló Vicente, Ana; Garnacho-Saucedo, G. M.; et al.
    Revista: CANCERS
    ISSN: 2072-6694 Vol.15 N° 11 2023 págs. 3056
    Resumen
    Simple Summary: This study evaluates the occurrence of second primary neoplasms (SPNs) in individuals with a history of melanoma (MM) and identify factors that increase the risk in our population. A prospective cohort study was conducted, involving 529 MM survivors from January 2005 to August 2021. Among the 529 patients, 89 were diagnosed with SPNs, with 62 being skin tumors and 37 being solid organ tumors. The estimated probability of developing SPNs after MM diagnosis was found to increase over time, reaching 4.1% at 1 year, 11% at 5 years, and 19% at 10 years. Several factors were significantly associated with a higher risk of SPNs, including older age, primary MM location on the face or neck, and the histologic subtype of lentigo maligna MM. We conclude that individuals with primary MM located on the face and neck, as well as those with the histological subtype of lentigo maligna-MM, have a higher risk of developing SPNs. Age also independently influences the risk. Understanding these risk factors can assist in developing MM guidelines that provide specific follow-up recommendations for individuals at the highest risk. (1) Introduction: The association between melanoma (MM) and the occurrence of second primary neoplasms (SPNs) has been extensively studied, with reported incidence rates ranging from 1.5% to 20%. This study aims to evaluate the occurrence of SPNs in patients with a history of primary MM and to describe the factors that make the risk higher in our population. (2) Material and Methods: We conducted a prospective cohort study and calculated the incidence rates and relative risks (RR) for the development of different SPNs in 529 MM survivors from 1 January 2005 to 1 August 2021. Survival and mortality rates were obtained, and the Cox proportional hazards model was used to determine the demographic and MM-related factors that influence the overall risk. (3) Results: Among the 529 patients included, 89 were diagnosed with SPNs (29 prior to MM diagnosis, 11 synchronous, and 49 after MM), resulting in 62 skin tumors and 37 solid organ tumors. The estimated probability of developing SPNs after MM diagnosis was 4.1% at 1 year, 11% at 5 years, and 19% at 10 years. Older age, primary MM location on the face or neck, and histologic subtype of lentigo maligna mm were significantly associated with a higher risk of SPNs. (4) Conclusions: In our population, the risk of developing SPNs was higher in patients with primary MM located on the face and neck and with the histological subtype of lentigo maligna-MM. Age also independently influences the risk. Understanding these hazard factors can aid in the development of MM guidelines with specific follow-up recommendations for individuals with the highest risk.
  • Autores: Dill, P. E. (Autor de correspondencia); Bessis, D.; Guidi, B.; et al.
    Revista: JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY
    ISSN: 0190-9622 Vol.87 N° 6 2022 págs. 1448 - 1450
  • Autores: Salido Vallejo, Rafael (Autor de correspondencia); Sanz-Cabanillas, J. L.; Núñez Córdoba, Jorge María; et al.
    Revista: JOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT
    ISSN: 1610-0379 Vol.20 N° 1 2022 págs. 102 - 105
  • Autores: Oro-Ayude, M. (Autor de correspondencia); González-Sixto, B.; Sanmartín-Jiménez, O.; et al.
    Revista: JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY
    ISSN: 0926-9959 Vol.36 N° 1 2022 págs. e35 - e37
  • Autores: Ivars Lleó, Marta (Autor de correspondencia); Bernad, I.; Martínez-Menchón, T.; et al.
    Revista: INTERNATIONAL JOURNAL OF DERMATOLOGY
    ISSN: 0011-9059 Vol.61 N° 5 2022 págs. e193 - e194
  • Autores: Redondo Bellón, Pedro (Autor de correspondencia); Rodríguez Garijo, Nuria; Tomás Velázquez, Alejandra
    Revista: DERMATOLOGIC SURGERY
    ISSN: 1076-0512 Vol.48 N° 8 2022 págs. 867 - 869
  • Autores: Gracia-Darder, I. (Autor de correspondencia); Arean Cuns, Carolina; García Martinez, Francisco Javier
    Revista: JOURNAL OF ULTRASOUND
    ISSN: 1971-3495 Vol.25 N° 3 2022 págs. 729 - 732
    Resumen
    Eccrine spiradenoma is a rare, benign, adnexal skin tumor of the sweat gland. It is frequently solitary and presents as a small lesion in the dermal or the subcutaneous fat layer. Eccrine spiradenomas rarely progress to malignant transformation but they can relapse. Due to its rarity, there have been few reports about the sonographic appearances of eccrine spiradenoma. Sonographic findings were reported in a relapsing case of an eccrine spiradenoma, located in the deep dermal layers and hypodermis of the preauricular region in a middle-aged man. Ultrasound was very useful to suspect the relapse. Histology was correlated with the sonography and discussed the previously reported imaging findings of eccrine spiradenoma and other sweat gland tumors.
  • Autores: Ruiz-Salas, V. (Autor de correspondencia); Sanmartín-Jiménez, O.; Garcés, J. R.; et al.
    Revista: DERMATOLOGY
    ISSN: 1018-8665 Vol.238 N° 2 2022 págs. 320 - 328
    Resumen
    Background: Large prospective studies on the safety of Mohs micrographic (MMS) surgery are scarce, and most focus on a single type of surgical adverse event. Mid-term scar alterations and functional loss have not been described. Objectives: To describe the risk of MMS complications and the risk factors for them. Methods: A nationwide prospective cohort collected all adverse events on consecutive patients in 22 specialised centres. We used multilevel mixed-effects logistic regression to find out factors associated with adverse events. Results: 5,017 patients were included, with 14,421 patient-years of follow-up. 7.0% had some perioperative morbidity and 6.5% had mid-term and scar-related complications. The overall risk of complications was mainly associated with use of antiaggregant/anticoagulant and larger tumours, affecting deeper structures, not reaching a tumour-free border, and requiring complex repair. Age and outpatient setting were not linked to the incidence of adverse events. Risk factors for haemorrhage (0.9%) were therapy with antiaggregant/anticoagulants, tumour size, duration of surgery, and unfinished surgery. Wound necrosis (1.9%) and dehiscence (1.0%) were associated with larger defects and complex closures. Immunosuppression was only associated with an increased risk of necrosis. Surgeries reaching deeper structures, larger tumours and previous surgical treatments were associated with wound infection (0.9%). Aesthetic scar alterations (5.4%) were more common in younger patients, with larger tumours, in H-area, and in flap and complex closures. Risk factors for functional scar alterations (1.7%) were the need for general anaesthesia, larger tumours that had received previous surgery, and flaps or complex closures. Conclusions: MMS shows a low risk of complications. Most of the risk factors for complications were related to tumour size and depth, and the resulting need for complex surgery. Antiaggregant/anticoagulant intake was associated with a small increase in the risk of haemorrhage, that probably does not justify withdrawal. Age and outpatient setting were not linked to the risk of adverse events.
  • Autores: Podlipnik, S.; Boada, A.; López-Estebaranz, J. L.; et al.
    Revista: CANCERS
    ISSN: 2072-6694 Vol.14 N° 4 2022 págs. 1060
    Resumen
    Simple Summary Many people with skin cancer will have their cancer come back. The 31-gene expression profile (31-GEP) test can help predict if a cancer has a low (Class 1) or high (Class 2) chance of returning. This study looked at 86 patients with early skin cancer to see how well the 31-GEP test predicted if their cancer would return. None of the patients with a Class 1 GEP result had their cancer return within 3 years, but one-fourth of patients with a Class 2 result did. This study showed that the 31-GEP test can help predict if a patient's skin cancer will return. Accurate risk prediction can help doctors make better treatment plans for patients with skin cancer. Background: Fifteen to forty percent of patients with localized cutaneous melanoma (CM) (stages I-II) will experience disease relapse. The 31-gene expression profile (31-GEP) uses gene expression data from the primary tumor in conjunction with clinicopathologic features to refine patient prognosis. The study's objective was to evaluate 31-GEP risk stratification for disease-free survival (DFS) in a previously published cohort with longer follow-up. Methods: Patients with stage IB-II CM (n = 86) were prospectively tested with the 31-GEP. Follow-up time increased from 2.2 to 3.9 years. Patient outcomes were compared using Kaplan-Meier and Cox regression analysis. Results: A Class 2B result was a significant predictor of 3-year DFS (hazard ratio (HR) 8.4, p = 0.008) in univariate analysis. The 31-GEP significantly stratified patients by risk of relapse (p = 0.005). A Class 2B result was associated with a lower 3-year DFS (75.0%) than a Class 1A result (100%). The 31-GEP had a high sensitivity (77.8%) and negative predictive value (95.0%). Conclusions: The 31-GEP is a significant predictor of disease relapse in patients with stage IB-II melanoma and accurately stratified patients by risk of relapse.
  • Autores: Antoñanzas Pérez, Javier; Rodríguez Garijo, Nuria (Autor de correspondencia); Estenaga Pérez de Albéniz, Ángela; et al.
    Revista: DERMATOLOGIC THERAPY
    ISSN: 1396-0296 Vol.35 N° 9 2022 págs. e15709
    Resumen
    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 cross-reactivity 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.
  • Autores: Miñano Medrano, R. (Autor de correspondencia); López Estebaranz, J. L.; Sanmartín-Jiménez, O.; et al.
    Revista: ACTAS DERMO-SIFILIOGRAFICAS
    ISSN: 0001-7310 Vol.113 N° 5 2022 págs. 451 - 458
    Resumen
    Objective: Patients with nonmelanoma skin cancer (NMSC)-ie, basal cell carcinoma (BCC) or squamous cell carcinoma (SCC)-have an increased risk of developing a second skin cancer. The aim of this study was to describe the frequency, incidence per 1000 person-years, and predictors of a second skin cancer in a cohort of patients with NMSC treated with Mohs micrographic surgery (MMS). Material and methods: Prospective study of a national cohort of patients with NMSC who underwent MMS at 22 Spanish hospitals between July 2013 and February 2020; case data were recorded in the REGESMOHS registry. The study variables included demographic characteristics, frequency and incidence per 1000 person-years of second skin cancers diagnosed during the study period, and risk factors identified using mixed-effects logistic regression. Results: We analyzed data for 4768 patients who underwent MMS; 4397 (92%) had BCC and 371 (8%) had SCC. Mean follow-up was 2.4 years. Overall, 1201 patients (25%) developed a second skin cancer during follow-up; 1013 of the tumors were BCCs (21%), 154 were SCCs (3%), and 20 were melanomas (0.4%). The incidence was 107 per 1000 person-years (95% CI, 101-113) for any cancer, 90 per 1000 person-years (95% CI, 85-96) for BCC, 14 (95% CI, 12-16) per 1000 person-years for SCC, and 2 (95% CI, 1-3) per 1000 person-years for melanoma. More men than women developed a subsequent skin cancer (738 [61%) vs 463 [39%]). The main risk factors were a history of multiple tumors before diagnosis (relative risk [RR], 4.6; 95% CI, 2.9-7.1), immunosuppression (RR, 2.1; 95% CI, 1.4-3.1), and mate sex (RR, 1.6; 95% CI, 1.4-1.9). Conclusion: Patients have an increased risk of developing a second tumor after MMS treatment of NMSC. Risk factors are a history of multiple tumors at diagnosis, immunosuppression, and male sex.
  • Autores: Nieto Benito, Lula María (Autor de correspondencia); Ciudad-Blanco, C.; Sanmartín-Jiménez, O.; et al.
    Revista: EXPERIMENTAL DERMATOLOGY
    ISSN: 0906-6705 Vol.30 N° 5 2021 págs. 717 - 722
    Resumen
    Characterization of patients, surgery procedures and the risk factors for dermatofibrosarcoma protuberans (DFSP) recurrences is poorly defined. In this study, we aimed to describe the demographics, tumor characteristics and interventions of DFSP treated with Mohs micrographic surgery (MSS) to determine the rate and risk factors for recurrence. Data were collected from REGESMOHS, a nationwide prospective cohort study of patients treated with MMS in Spain. From July 2013 to February 2020, 163 patients with DFSP who underwent MMS were included. DFSP was mostly located on trunk and extremities. Recurrent tumors had deeper tumor invasion and required higher number of MMS stages. Paraffin MMS was the most frequently used technique. Overall recurrence rate was 0.97 cases/100 person-years (95% IC = 0.36-2.57). No differences were found in epidemiological, tumor, surgery characteristics or surgical technique (frozen or paraffin MMS [p = 0.6641]) in terms of recurrence. Median follow-up time was 28.6 months with 414 patient-years of follow-up. In conclusion, we found an overall low recurrence rate of DFSP treated with MMS. None of the studied risk factors, including MMS techniques, was associated with higher risk for recurrence.
  • Autores: Palacios Álvarez, Irene; Riquelme-Mc Loughlin, C.; Curto-Barredo, L.; et al.
    Revista: JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY
    ISSN: 0190-9622 Vol.85 N° 2 2021 págs. 484 - 486
  • Autores: Estenaga Pérez de Albéniz, Ángela; Rodríguez Garijo, Nuria; Tomás Velázquez, Alejandra; et al.
    Revista: JOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT
    ISSN: 1610-0379 Vol.19 N° 4 2021 págs. 603 - 604
  • Autores: Estenaga Pérez de Albéniz, Ángela; Castañón Álvarez, Eduardo; García Martinez, Francisco Javier; et al.
    Revista: JOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT
    ISSN: 1610-0379 Vol.19 N° 3 2021 págs. 448 - 450
  • Autores: Querol Cisneros, Elena; Moreno Artero, Ester; Rodríguez Garijo, Nuria; et al.
    Revista: JOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT
    ISSN: 1610-0379 Vol.19 N° 2 2021 págs. 265 - 267
  • Autores: Tomás Velázquez, Alejandra (Autor de correspondencia); Rodríguez Garijo, Nuria; Redondo Bellón, Pedro
    Revista: ACTAS DERMO-SIFILIOGRAFICAS
    ISSN: 0001-7310 Vol.112 N° 10 2021 págs. 924 - 925
  • Autores: Tomás Velázquez, Alejandra (Autor de correspondencia); Medina Baquerizo, I.; Redondo Bellón, Pedro; et al.
    Revista: MEDICINA CLINICA
    ISSN: 0025-7753 Vol.156 N° 4 2021 págs. 203
  • Autores: Olmos-Alpiste, F.; Segura, S.; Tomás Velázquez, Alejandra; et al.
    Revista: JOURNAL OF DERMATOLOGY
    ISSN: 0385-2407 Vol.48 N° 3 2021 págs. 380 - 384
    Resumen
    Colony-stimulating factor 1 receptor (CSF1R) inhibitors represent a new class of immune-modulatory drugs, mostly investigated in clinical trials in different malignant neoplasms. Four patients, diagnosed with recurrent or advanced malignant neoplasm and treated with a combination of anti-programmed death ligand 1 and anti-CSF1R monoclonal antibodies, developed an asymptomatic cutaneous eruption characterized by an ill-defined pseudoedematous to waxy diffuse infiltration with a reticular cobblestone-like pattern. Histopathological examination revealed diffuse mucin deposition involving the superficial and mid-dermis with fragmented and scattered elastic fibers. The exact pathogenic mechanisms implicated in the development of mucin deposits in patients treated with CSF1R inhibitors remain to be elucidated. A reduced degradation and clearance of components of the extracellular matrix by macrophages secondary to CSF1 pathway inhibition may be hypothesized. Shredding and fragmentation of elastic fibers may be a result of the increased accumulation of mucopolysaccharides. This observation illustrates the new spectrum of skin-related toxicities secondary to new targeting therapies. This may contribute to a better understanding of the underlying pathogenic mechanisms in skin diseases characterized by a persistent dermal glycosaminoglycan deposition.
  • Autores: Tomás Velázquez, Alejandra (Autor de correspondencia); Redondo Bellón, Pedro
    Revista: ACTAS DERMO-SIFILIOGRAFICAS
    ISSN: 0001-7310 Vol.112 N° 2 2021 págs. 171 - 175
    Resumen
    Upper-lip reconstruction after Mohs micrographic surgery is challenging for dermatologic surgeons. We describe a series of 15 patients (7 men and 8 women; mean age, 65.6 years) with skin cancer on the upper lip treated with Mohs surgery: 10 were basal cell carcinomas, 2 were melanomas, and 3 were squamous cell carcinomas. The resulting defects measured between 3 and 7.6 cm. We used island flaps to reconstruct the defects in all cases, hiding the incisions in the nasolabial fold, at the line where the skin meets the vermillion border of the lip, and in the relaxed skin tension lines. We explain key aspects of the surgeries and design of the reconstructions, with emphasis on the importance of occasionally sacrificing small areas of healthy skin. Cosmetic and functional outcomes were satisfactory in all patients, and there were no postsurgical complications. (C) 2020 AEDV. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license
  • Autores: García Martinez, Francisco Javier (Autor de correspondencia); Azorín, D.; Duat Rodríguez, A.; et al.
    Revista: JOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT
    ISSN: 1610-0379 Vol.19 N° 1 2021 págs. 73 - 80
    Resumen
    Background and objective: Clinicopathological features of cutaneous neurofibromas presenting as large irregularly shaped congenital cafe-au-lait macules (CALM) in Neurofibromatosis type 1 (NF1) patients have not been well characterized. We aimed to analyze the histopathological findings of large "atypical" CALM in children with NF1. Patients and Methods: this retrospective observational study we analyzed histopathological and immunostaining features of 21 biopsy specimens from 18 large hyperpigmented macules with irregular borders with or without hypertrichosis present during the first months of life in NF1 diagnosed children. Results: Of the 21 biopsies, ten showed a diffuse neurofibroma pattern and four exhibited characteristics of plexiform neurofibroma (PNF). In twelve specimens we observed groups of fusiform cells arranged linearly mimicking a small caliber nerve trunk with abnormal morphology. Repeated biopsies from two of these lesions performed at different ages showed transformation to a plexiform pattern. An increased interstitial cellularity was observed in 17 samples that was more evident around eccrine glands in 16 or accompanying hair follicles and vascular structures in twelve samples. All these cells had immunoreactivity for S100-protein, CD68 and were Melan-A positive in 15 samples. Conclusion: Clinicopathological findings of congenital cutaneous neurofibromas provide early diagnostic clues of NF1 with high relevance for monitoring of these patients.
  • Autores: García Martinez, Francisco Javier (Autor de correspondencia); de Cabo Francés, F.
    Revista: JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY
    ISSN: 0190-9622 Vol.88 N° 4 2021 págs. e163 - e164
  • Autores: Tomás Velázquez, Alejandra (Autor de correspondencia); Sanmartín-Jiménez, O.; Garcés, J. R.; et al.
    Revista: ACTA DERMATO-VENEREOLOGICA
    ISSN: 0001-5555 Vol.101 N° 11 2021 págs. adv00602
    Resumen
    Randomized studies to assess the efficacy of Mohs micrographic surgery in basal cell and squamous cell carcinomas are limited by methodological and ethical issues and a lack of long follow-up periods. This study presents the real-life results of a nationwide 7-years cohort on basal cell carcinoma and squamous cell carcinoma treated with Mohs micrographic surgery. A prospective cohort was conducted in 22 Spanish centres (from July 2013 to February 2020) and a multivariate analysis, including characteristics of patients, tumours, surgeries and follow-up, was performed. A total of 4,402 patients followed up for 12,111 patientyears for basal cell carcinoma, and 371 patients with 915 patient-years of follow-up for squamous cell carcinoma were recruited. Risk factors for recurrence included age, non-primary tumours and more stages or unfinished surgeries for both tumours, and immunosuppression for squamous cell carcinoma. Incidence rates of recurrence were 1.3 per 100 person-years for basal cell carcinoma (95% confidence interval 1.1-1.5) and 4.5 for squamous cell carcinoma (95% confidence interval 3.3-6.1), being constant over time (0-5 years). In conclusion, follow-up strategies should be equally intense for at least the first 5 years, with special attention paid to squamous cell carcinoma (especially in immunosuppressed patients), elderly patients, non-primary tumours, and those procedures requiring more stages, or unfinished surgeries.
  • Autores: García Martinez, Francisco Javier (Autor de correspondencia); Rull, E. V.; Salgado-Boquete, L.; et al.
    Revista: JOURNAL OF DERMATOLOGICAL TREATMENT
    ISSN: 0954-6634 Vol.32 N° 3 2021 págs. 286-290
    Resumen
    Background and objectives: Hidradenitis suppurativa (HS) is a chronic inflammatory disease of the follicular unit characterized by recurrent, painful, skin lesions including inflammatory nodules, abscesses, tunnels, and mutilating scarring. Intralesional corticosteroids injection (ICI) for HS has received little attention in the scientific literature. We evaluate the clinical response of ICI in acute and chronic HS lesions and aim to identify new applications of ultrasound-assisted procedures in HS management. Patients and methods: An observational, retrospective, multicenter study of HS patients treated with ICI was conducted from January 1 to August 1, 2015. We collected 98 HS patients. A total of 135 individual lesions were infiltrated, including non-inflammatory nodules, inflammatory nodules abscesses and fistulous tracts. Results: Complete response was reached in 95 lesions (70.37%), 34 showed partial response (25.19%) and 6 (4.44%) were non-response. A total of 105 individual lesions underwent sonographic scan before ICI. Conclusion: Clinical experience supported the use of ICI for individual lesions. Our results showed that ICI is a useful treatment to control in acute and recalcitrant HS lesions. Response rates improve significantly if lesions are previously evaluated with HFUS.
  • Autores: Ceballos Rodríguez, María del Carmen; Redondo Bellón, Pedro; Tomás Velázquez, Alejandra; et al.
    Revista: JOURNAL OF PEDIATRIC SURGERY
    ISSN: 0022-3468 Vol.56 N° 11 2021 págs. 2113 - 2117
    Resumen
    Purpose: The aim of this study was to evaluate the outcomes, complications and psychosocial impact of surgical treatment of giant congenital melanocytic nevus (GCMN). Methods: Patients with surgically treated GCMN who attended our clinic between May 2014 and May 2018 were included. Patient demographics and data on the characteristics of the nevus, surgical treatment, and the psychosocial impact (including C-DLQI/DLQI questionnaires) were collected. Results: One hundred thirty-six patients were included (median age 9 years). Mean age at first surgery was 34 (+/- 61.45) months; 5.53 (+/- 3.69) surgical interventions were necessary to completely excise the nevus. The expanded skin flap was the preferred surgical technique in most locations. Complications were common but not severe. Of the patients studied, 70.4% reported that the surgery had a minor impact on their quality of life (QoL). Patients and caregivers stated that surgical treatment should begin as soon as possible, even in cases where early treatment did not have an impact on their QoL nor on their satisfaction with the surgery (p < 0.05). The lower the patient age at first surgery, the higher the surgeon's satisfaction (p < 0.01). Conclusions: Surgical treatment is a safe option for management of GCMN, and has a low impact on QoL. Patients, caregivers, and surgeons agree that the treatment should begin as soon as possible. This is the largest single-center study evaluating surgical treatment in GCMN patients and its psychosocial impact, and the first to take into account the patient, caregivers and dermatologists opinion of surgical results.
  • Autores: Pastushenko, I.; Mauri, F.; Song, Y.; et al.
    Revista: NATURE
    ISSN: 0028-0836 Vol.589 2021 págs. 488 - 455
    Resumen
    FAT1, which encodes a protocadherin, is one ofthe most frequently mutated genes in human cancers(1-5). However, the role and the molecular mechanisms by which FAT1 mutations control tumour initiation and progression are poorly understood. Here, using mouse models of skin squamous cell carcinoma and lung tumours, we found that deletion of Fat1 acceleratestumour initiation and malignant progression and promotes a hybrid epithelial-to-mesenchymal transition (EMT) phenotype. We also found this hybrid EMT state in FAT1-mutated human squamous cell carcinomas. Skin squamous cell carcinomas in which Fat1 was deleted presented increased tumour stemness and spontaneous metastasis. We performed transcriptional and chromatin profiling combined with proteomic analyses and mechanistic studies, which revealed that loss of function of FAT1 activates a CAMK2-CD44-SRC axis that promotes YAP1 nuclear translocation and ZEB1 expression that stimulates the mesenchymal state. This loss of function also inactivates EZH2, promotingSOX2expression, which sustains the epithelial state. Our comprehensive analysis identified drug resistance and vulnerabilities in FAT1-deficient tumours, which have important implications for cancer therapy. Our studies reveal that, in mouse and human squamous cell carcinoma, loss of function of FAT1 promotes tumour initiation, progression, invasiveness, stemness and metastasis through the induction of a hybrid EMT state.
  • Autores: García Castaño, A.; Muñoz Couselo, E.; Soria, A.; et al.
    Revista: ANNALS OF ONCOLOGY
    ISSN: 0923-7534 Vol.32 N° Supl. 5 2021 págs. S884 - S884
  • Autores: Canueto, J. (Autor de correspondencia); Tejera-Vaquerizo, A.; Redondo Bellón, Pedro; et al.
    Revista: ACTAS DERMO-SIFILIOGRAFICAS
    ISSN: 0001-7310 Vol.111 N° 4 2020 págs. 281 - 290
    Resumen
    Cutaneous squamous cell carcinoma (cSCC) is the second most common cancer in humans and its incidence is both underestimated and on the rise. cSCC is referred to in the literature as high-risk cSCC, locally advanced cSCC, metastatic cSCC, advanced cSCC, and aggressive cSCC. These terms can give rise to confusion and are not always well defined. In this review, we aim to clarify the concepts underlying these terms with a view to standardizingthe description of this tumor, something we believe is necessary in light of the new drugs that have been approved or are in development for cSCC.
  • Autores: Tomás Velázquez, Alejandra; López Gutiérrez, J. C.; Ceballos Rodríguez, María del Carmen; et al.
    Revista: JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY
    ISSN: 0190-9622 Vol.83 N° 1 2020 págs. 222 - 224
  • Autores: Tomás Velázquez, Alejandra (Autor de correspondencia); Rodríguez Garijo, Nuria; Moreno Artero, Ester; et al.
    Revista: JOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT
    ISSN: 1610-0379 Vol.18 N° 9 2020 págs. 1028 - 1030
  • Autores: Salido Vallejo, Rafael (Autor de correspondencia); Redondo Bellón, Pedro
    Revista: JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY
    ISSN: 0190-9622 Vol.83 N° 3 2020 págs. e203
  • Autores: Ivars Lleó, Marta (Autor de correspondencia); López-Gutiérrez, Juan Carlos; Martinez González, Victor; et al.
    Revista: JOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT
    ISSN: 1610-0379 Vol.18 N° 12 2020 págs. 1511-1514
  • Autores: Tomás Velázquez, Alejandra; Redondo Bellón, Pedro (Autor de correspondencia)
    Revista: JOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT
    ISSN: 1610-0379 Vol.18 N° 5 2020 págs. 512 - 515
    Resumen
    Various techniques have been described for the reconstruction of surgical defects of the upper lip after skin cancer. Here, we propose a technique for reconstructing medium or large defects located at the junction of the nasogenian and nasolabial folds with a hatchet flap. We report on three patients treated with this technique, describing the surgical procedure and some interesting caveats. Two patients reconstructed with direct closure in this location are described in order to emphasize the better aesthetic result achieved with the hatchet flap, especially in terms of symmetry. While direct closure tends to decrease the ipsilateral nasolabial fold, the hatchet flap extends the scar to the fold below the commissure in a natural wrinkle, becoming symmetrical and much less noticeable after a few months. We conclude that the hatchet flap is technically easy and rapidly implemented for defects in the apical triangle of the upper lip, and achieves better results in terms of facial symmetry than direct closure.
  • Autores: Tomás Velázquez, Alejandra (Autor de correspondencia); Moreno Artero, Ester; Aguado Gil, Leire
    Revista: MEDICINA CLINICA
    ISSN: 0025-7753 Vol.154 N° 5 2020 págs. 198
  • Autores: Querol Cisneros, Elena; García Martinez, Francisco Javier; Redondo Bellón, Pedro (Autor de correspondencia)
    Revista: JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY
    ISSN: 0926-9959 Vol.34 N° 3 2020 págs. 619 - 623
    Resumen
    Background Reconstruction of large auricular defects with full-thickness skin grafts (FTSG) is a commonly reported option, but less attention has focused on the advantages and indications of using split-thickness skin grafts (STSG) in the ear. Objective We sought to report our experience using STSG for repair of defects located on the auricular concave surfaces, highlighting the utility of choosing the adjacent hairy skin as donor site. Methods We performed a retrospective review of all Mohs micrographic defects on the auricular concave surfaces repaired with STSG obtained from the adjacent hairy skin, between January 2017 and July 2018 at our institution. Results A total of 16 patients with defects on the auricular concavities resulting from removal of non-melanoma skin cancer were reconstructed with STSG taken from the adjacent hairy skin. Only one patient experienced partial graft failure and no other complications were observed after 6-month follow-up. Conclusion Split-thickness skin grafts are suitable for reconstructing concave areas in the ear, providing good cosmetic results with a simple, cost-effective and easily reproducible technique. Choosing the adjacent hairy skin as a donor area shortens the operative and postoperative time, and allows the procedure to be performed in a single surgical field.
  • Autores: Alvarez, P.; García Martinez, Francisco Javier; Poveda, I.; et al.
    Revista: DERMATOLOGY
    ISSN: 1018-8665 Vol.236 N° 1 2020 págs. 46 - 51
    Resumen
    Background: There is little evidence on the use of intralesional triamcinolone (ILT) for managing fistulous tracts in hidradenitis suppurativa (HS). Objective: To assess the clinical and ultrasound response to ILT for single fistulous lesions in HS patients. Methods: A prospective open-label study was conducted to assess response to ILT (40 mg/mL) for fistulous tracts in HS. Consecutive patients (Hurley II stage exclusively) presenting to our department were recruited from August 2016 to August 2018. They received a single injection of ILT as the sole treatment. Lesions were assessed clinically and by ultrasound at baseline and 90 days. Results: Of the 53 included HS patients with fistulous tracts, 36 (67.9%) were women, 30 (56.6%) were smokers, and 36 (67.9%) were obese or overweight (body mass index >= 25). Median Sartorius score was 9.0 (IQR 9.0-36.0), and median duration of the lesion treated was 6 months (IQR 3.0-12.0). Fistulous tracts were injected with 0.5 mL triamcinolone 40 mg/mL. Seven patients were lost to follow-up. At 90 days, 20 (43.5%) lesions showed clinical and ultrasound resolution, 13 (28.3%) showed only clinical resolution while persisting on ultrasound, and 13 (28.3%) persisted both clinically and on ultrasound. Mean clinical size decreased from 17.0 to 5.1 mm (p < 0.0001), while mean length on ultrasound decreased from 16.0 to 8.6 mm (p < 0.0001). Limitations: Small sample size and no control group. Conclusions: Our study suggests that ILT is beneficial for small fistulous tracts in HS.
  • Autores: Bernad Alonso, Isabel; Aguado Gil, Leire; Núñez Córdoba, Jorge María; et al.
    Revista: EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY. JOURNAL
    ISSN: 1468-3083 Vol.34 N° 7 2020 págs. 1464 - 1470
    Resumen
    Background: Organ transplant recipients (OTR) have a higher risk of actinic keratosis (AK) and keratinocyte carcinomas (KC). There are no clinical trials assessing the effectiveness of daylight photodynamic therapy (DPDT) to prevent new AK and KC in OTR. Objectives: To determine whether repeated treatments of field cancerization with DPDT are effective in preventing new AK and KC in OTR. Methods: A randomized, intra-subject controlled, evaluator-blind, split-face and/or scalp trial, from April 2016 to October 2018. Participants were OTR older than 18 years, 1-year posttransplant, with at least 5 AK on each hemi-face/hemi-scalp. One side received six field treatments with DPDT: two sessions 15 days apart at baseline, two at 3 months and two at 9 months after baseline. Control side received lesion-directed treatment with cryotherapy (double freeze-thaw) at baseline, 3 and 9 months. Total number of lesions (AK and KC) at 21 months, number of new AK and KC at 3, 9, 15 and 21 months and treatment preferences were analysed. Results: Of 24 men included, 23 were analysed at 3 months; and 21, at 9, 15 and 21 months. Mean (SD) age was 69.8 years (9.2). The total number of lesions at 21 months was 4.7 (4.3) for DPDT and 5.8 (5.0) for control side; P = 0.09. DPDT showed significantly lower means [SD] of new lesions compared to control side at 3 months (4.2 [3.4] vs. 6.8 [4.8]; P < 0.001), 9 months (3.0 [3.3] vs. 4.3 [3.4]; P = 0.04) and 15 months (3.0 [4.6] vs. 4.8 [5.0]; P = 0.02), and non-significant at 21 months (3.7 [3.5] vs. 5.0 [4.5]; P = 0.06). Most participants preferred DPDT. Conclusion: DPDT showed potential effectiveness in preventing new AK and KC in OTR by consecutive treatments of field cancerization. The preference for DPDT could facilitate adherence to the long-term treatment necessary in these patients.
  • Autores: Vilchez-Marquez, F. (Autor de correspondencia); Borregon-Nofuentes, P.; Barchino-Ortiz, L.; et al.
    Revista: ACTAS DERMO-SIFILIOGRAFICAS
    ISSN: 0001-7310 Vol.111 N° 4 2020 págs. 291 - 299
    Resumen
    Background and objective: Basal cell carcinoma (BCC) is the most common skin cancer in the general population. BCC is managed in a variety of ways, and available international guidelines are difficult to put into practice in Spain. This guideline aims to improve the management of BCC based on current evidence and provide a point of reference for Spanish dermatologists. Material and methods: Members of the Spanish Oncologic Dermatology and Surgery Group (GEDOC) with experience treating BCC were invited to participate in drafting this guideline. The drafters used the ADAPTE collaboration process to develop the new guideline based on existing ones, first summarizing the care pathway and posing relevant clinical questions. They then searched for guidelines, assessed them with the AGREEII (Appraisal of Guidelines for Research and Evaluation) tool, and searched the selected guidelines for answers to the clinical questions. Finally, the recommendations were drafted and submitted for external review. Results: The highest-scoring guidelines were from the Association of Dermatologists, the National Comprehensive Cancer Network, the European Dermatology Forum, and the European Academy of Dermatology and Venereology. A total of 11 clinical questions were answered. Conclusions: This new guideline answers the working group's clinical questions about the routine management of BCC in Spain. It provides dermatologists with a tool they can use for decision-making while taking into consideration the resources available and patient preferences.
  • Autores: Rodriguez-Jimenez, P. (Autor de correspondencia); Jimenez, Y. D.; Reolid, A. ; et al.
    Revista: INTERNATIONAL JOURNAL OF DERMATOLOGY
    ISSN: 0011-9059 Vol.59 N° 3 2020 págs. 321 - 325
    Resumen
    Background The use of Mohs micrographic surgery (MMS) for rare cutaneous tumors is poorly defined. We aim to describe the demographics, tumor presentation and topography, surgery characteristics and complications of MMS for rare cutaneous tumors in a national registry. Methods Prospective cohort study of patients treated with MMS in Spain between July 2013 and June 2018. The inclusion criteria were patients with cutaneous tumors with final diagnosis different from basal cell carcinoma, squamous cell carcinoma, dermatofibrosarcoma protuberans, or any kind of melanoma. Results Five thousand and ninety patients were recorded in the registry, from which only 73 tumors (1.4%) fulfilled the inclusion criteria: atypical fibroxanthoma (18), microcystic adnexal carcinoma (10), extramammary Paget's disease (7), Merkel cell carcinoma (5), dermatofibroma (4), trichilemmal carcinoma (4), desmoplastic trichoepithelioma (4), sebaceous carcinoma (3), leiomyosarcoma (2), porocarcinoma (2), angiosarcoma (2), trichoblastoma (1), superficial acral fibromyxoma (1), and others (10). No intra-surgery morbidity was registered. Postsurgery complications appeared in six patients (9%) and were considered mild. Median follow-up time was 0.9 years during which three Merkel cell carcinomas, one angiosarcoma, one microcystic adnexal carcinoma, and four others recurred (12.3%). Conclusion This national registry shows that rare cutaneous tumors represent a negligible part of the total MMS performed in our country with a low complication rate.
  • Autores: Palacios Álvarez, Irene; Bueno, E. ; Fernandez-Lopez, E. ; et al.
    Revista: JOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT
    ISSN: 1610-0379 Vol.17 N° 2 2019 págs. 197 - 200
  • Autores: Tomás Velázquez, Alejandra (Autor de correspondencia); Moreno Artero, Ester; Abengozar Muela, Marta; et al.
    Revista: ACTAS DERMO-SIFILIOGRAFICAS
    ISSN: 0001-7310 Vol.110 N° 8 2019 págs. 702 - 704
  • Autores: Moreno Artero, Ester; Paricio Martínez, José Joaquín; Antonanzas, J.; et al.
    Revista: ACTAS DERMO-SIFILIOGRAFICAS
    ISSN: 0001-7310 Vol.110 N° 1 2019 págs. 64 - 67
  • Autores: Redondo Bellón, Pedro (Autor de correspondencia)
    Revista: ACTAS DERMO-SIFILIOGRAFICAS
    ISSN: 0001-7310 Vol.110 N° 1 2019 págs. 2
  • Autores: Tomás Velázquez, Alejandra (Autor de correspondencia); Panadero Meseguer, Pablo; Aguado Gil, Leire
    Revista: ATENCION PRIMARIA
    ISSN: 0212-6567 Vol.51 N° 10 2019 págs. 654 - 655
  • Autores: Redondo Bellón, Pedro (Autor de correspondencia)
    Revista: ACTAS DERMO-SIFILIOGRAFICAS
    ISSN: 0001-7310 Vol.110 N° 1 2019 págs. 2 - 2
  • Autores: Moreno Artero, Ester; Rodríguez Garijo, Nuria; Tomás Velázquez, Alejandra; et al.
    Revista: PIEL
    ISSN: 0213-9251 Vol.34 N° 3 2019 págs. 175-179
  • Autores: Moreno Artero, Ester; Paricio Martínez, José Joaquín; Antoñanzas, J.; et al.
    Revista: ACTAS DERMO-SIFILIOGRAFICAS
    ISSN: 0001-7310 Vol.110 N° 1 2019 págs. 64 - 67
  • Autores: Podlipnik, S. (Autor de correspondencia); Carrera, C.; Boada, A. ; et al.
    Revista: JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY
    ISSN: 0926-9959 Vol.33 N° 5 2019 págs. 857 - 862
    Resumen
    Background The clinical and pathological features of primary melanoma are not sufficiently sensitive to accurately predict which patients are at a greater risk of relapse. Recently, a 31-gene expression profile (DecisionDx-Melanoma) test has shown promising results. Objectives To evaluate the early prognostic performance of a genetic signature in a multicentre prospectively evaluated cohort. Methods Inclusion of patients with AJCC stages IB and II conducted between April 2015 and December 2016. All patients were followed up prospectively to assess their risk of relapse. Prognostic performance of this test was evaluated individually and later combined with the AJCC staging system. Prognostic accuracy of disease-free survival was determined using Kaplan-Meier curves and Cox regression analysis. Results of the gene expression profile test were designated as Class 1 (low risk) and Class 2 (high risk). Results Median follow-up time was 26 months (IQR 22-30). The gene expression profile test was performed with 86 patients; seven had developed metastasis (8.1%) and all of them were in the Class 2 group, representing 21.2% of this group. Gene expression profile was an independent prognostic factor for relapse as indicated by multivariate Cox regression analysis, adjusted for AJCC stages and age. Conclusions This prospective multicentre cohort study, performed in a Spanish Caucasian cohort, shows that this 31gene expression profile test could correctly identify patients at early AJCC stages who are at greater risk of relapse. We believe that gene expression profile in combination with the AJCC staging system could well improve the detection of patients who need intensive surveillance and optimize follow-up strategies.
  • Autores: de Lucas, R. (Autor de correspondencia); Garcia-Millan, C.; Perez-Davo, A. ; et al.
    Revista: CHILDREN
    ISSN: 2227-9067 Vol.6 N° 2 2019 págs. 17
    Resumen
    Atopic dermatitis (AD) is a chronic cutaneous inflammatory disorder, characterized by skin barrier disruption. Dermacare is a new cosmetic formulation, which enhances moisturization, reinforces and repairs the skin barrier, and prevents cutaneous microbiota imbalance. To demonstrate its safety and efficacy, a prospective, open-label, and multicenter study was carried out on patients diagnosed with mild to moderate AD. Transepidermal water loss (TEWL), clinical severity, Desquamation Index, Patient/Investigator Global Assessments, quality of life index, and tolerance were assessed. Adverse events were recorded. Daily application of the new treatment was well tolerated, and adverse events were absent. After 14 days, TEWL showed a 36.7% significant decrease (p = 0.035). At the end of the 28-day treatment, the Desquamation Index showed a reduction in 70% of patients; Eczema Area and Severity Index were reduced by 70.4% (p = 0.002); and skin irritation showed a significant reduction (p = 0.024). Likewise, Patient and Investigator Global Assessments reported a significant improvement in conditions and an overall global worsening when patients restarted their normal treatment. Parent's Index of Quality of Life Index significantly increased by 36.4% (p < 0.05) with Dermacare. In conclusion, a regular use of this new formulation can reduce the risk of relapse and extend the steroid-free treatment periods.
  • Autores: Moreno Artero, Ester; Rodríguez Garijo, Nuria; Tomás Velázquez, Alejandra; et al.
    Revista: PIEL
    ISSN: 0213-9251 Vol.34 N° 3 2019 págs. 175 - 179
  • Autores: Aguado Gil, Leire; Bernad Alonso, Isabel; Núñez Córdoba, Jorge María; et al.
    Revista: JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY
    ISSN: 0190-9622 Vol.81 N° 4 2019 págs. AB137
  • Autores: Querol Cisneros, Elena; Moreno Artero, Ester; Rodríguez Garijo, Nuria; et al.
    Revista: JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY
    ISSN: 0190-9622 Vol.81 N° 4 2019 págs. AB290
  • Autores: Palacios Álvarez, Irene (Autor de correspondencia); Gonzalez-Sarmiento, R.; Fernandez-Lopez, E.
    Revista: ACTAS DERMO-SIFILIOGRAFICAS
    ISSN: 0001-7310 Vol.109 N° 3 2018 págs. 207 - 217
    Resumen
    Gorlin syndrome is a rare autosomal dominant disease caused by mutations in the sonic hedgehog signaling pathway. Of particular importance is the PTCH1 gene. The disease is characterized by the development of multiple basal cell carcinomas at young ages. These tumors may present with other skin manifestations such as palmoplantar pits and with extracutaneous manifestations such as odontogenic keratocysts and medulloblastoma. Although the dermatologist may be key for recognizing clinical suspicion of the syndrome, a multidisciplinary team is usually necessary for diagnosis, treatment, and follow-up. Skin treatment may be complicated due to the large number of basal cell carcinomas and the extent of involvement. In recent years, new drugs that inhibit targets in the sonic hedgehog pathway have been developed. Although these agents appear promising options for patients with Gorlin syndrome, their efficacy is limited by adverse effects and the development of resistance. (C) 2017 AEDV. Published by Elsevier Espana, S.L.U. All rights reserved.
  • Autores: Moreno Artero, Ester; Querol Cisneros, Elena; Rodríguez Garijo, Nuria; et al.
    Revista: JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY
    ISSN: 0926-9959 Vol.32 N° 9 2018 págs. 1420 - 1426
    Resumen
    Cocaine is an alkaloid extracted from the leaves of the Erythroxylum coca plant that emerged in the 1970s as a fashionable drug among members of certain social backgrounds. Cocaine abuse is a problem of current interest, which is mostly hidden and underdiagnosed, but dramatically widespread among all socio-economic strata, and with an incidence which is increasing at an alarming rate. There are 1.5 million cocaine consumers in the USA. In Spain, the prevalence of consumption among the population between 15 and 65 years old is higher, reaching 3.1%. Because of this, it seems important to understand and recognize all the mucocutaneous manifestations of cocaine abuse which have been reported in the literature to clarify and to help dermatologists in their daily practice. In this article, we describe the principal mucocutaneous manifestations of cocaine abuse and we review isolated case reports which have been published in the literature. Because the dermatologist may deal with an unknown problem as well as with an already well-known history of cocaine abuse, it seems logical to separate the mucocutaneous manifestations into those which are frequent and highly suggestive, such as those caused by vascular injury, damage to mucosal membranes, infectious diseases or neutrophilic dermatosis, especially when suffered by young people and in consonance with other systemic manifestations and, those which have been reported in the literature as isolated case reports. We also summarize the main aspects of its pathogeny, principal pharmacodynamic and pharmacokinetic characteristics, and diagnostic tools.
  • Autores: Moreno Artero, Ester; Querol Cisneros, Elena; Rodríguez Garijo, Nuria; et al.
    Revista: JOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT
    ISSN: 1610-0379 Vol.16 N° 6 2018 págs. 763 - 768
  • Autores: Ivars Lleó, Marta; Moreno Artero, Ester; Idoate Gastearena, Miguel Ángel; et al.
    Revista: JOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT
    ISSN: 1610-0379 Vol.16 N° 8 2018 págs. 1036 - 1038
  • Autores: Palacios Álvarez, Irene (Autor de correspondencia); Simal-Gomez, G.; Mas-Vidal, A.; et al.
    Revista: JOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT
    ISSN: 1610-0379 Vol.16 N° 5 2018 págs. 611 - 613
  • Autores: Querol Cisneros, Elena; Redondo Bellón, Pedro (Autor de correspondencia)
    Revista: JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY
    ISSN: 0190-9622 Vol.78 N° 6 2018 págs. E145 - E147
  • Autores: Ruiz-Salas, V. (Autor de correspondencia); Garcés, J. R.; Alonso-Alonso, T. ; et al.
    Revista: ACTAS DERMO-SIFILIOGRAFICAS
    ISSN: 0001-7310 Vol.109 N° 4 2018 págs. 346 - 350
    Resumen
    Background: Regesmohs registry is a nationwide registry including patients evaluated for Mohs surgery in 17 Spanish centres since July 2013. Given that Mohs surgery is the therapy with best results for high risk basal cell carcinoma (BCC) and other skin tumours, we wanted to describe the reasons that lead to some patients being excluded from this therapy and the alternative treatments that they received. These data may be useful to avoid excluding patients for Mohs surgery use, to estimate the healthcare demand of these patients and the demand for Hedgehog inhibitors therapy in this group. Objective: To describe patients excluded for Mohs surgery after pre-surgical assessment, and the treatments that they received. Methods: Regesmohs includes all consecutive patients assessed for Mohs surgery in the participating centres, collecting data on patient characteristics, intervention, and short and long-term results. Patients excluded for Mohs surgery after pre-surgical evaluation were described. Results: 3011 patients were included in Regesmohs from July 2013 to October 2016. In 85, Mohs surgery was not performed as they were considered inadequate candidates. 67 had BCC. Reasons for exclusion were: medical contraindication (27.1%, n=23) low-risk tumour in (18.8%, n=16) and giant tumour and bone invasion (15.3%, n=13). Only 1 patient (1.2%) showed lymph node involvement and no patients had visceral metastases. Of the 85 excluded patients, 29 (34.1%) were treated with conventional surgery, 24 (28.3%) with radiotherapy, 4 (4.7%) with inhibitors of the Hedgehog pathway (only indicated for BCC), and 2 (2.4%) received palliative care. We had no follow-up data on 14 patients (16.5%). CONCLUSION: Medical comorbidities were the most common reason for withholding Mohs surgery. Withholding therapy on the basis of distant extension is uncommon. Most excluded patients received simpler therapies: conventional surgery or radiotherapy, with hedgehog inhibitors being a new option. Copyright (C) 2017 AEDV. Published by Elsevier Espana, S.L.U. All rights reserved.
  • Autores: Rodríguez Garijo, Nuria; Redondo Bellón, Pedro
    Revista: JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY
    ISSN: 0190-9622 Vol.7 2018 págs. 633 - 635
  • Autores: Querol Cisneros, Elena; Redondo Bellón, Pedro (Autor de correspondencia)
    Revista: JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY
    ISSN: 0190-9622 Vol.78 N° 6 2018 págs. e145 - e147
  • Autores: Tomas-Velazquez, A.; Redondo Bellón, Pedro (Autor de correspondencia)
    Revista: JAMA DERMATOLOGY
    ISSN: 2168-6068 Vol.154 N° 6 2018 págs. 708 - 711
  • Autores: Ivars Lleó, Marta; Moreno Artero, Ester; Idoate Gastearena, Miguel Ángel; et al.
    Revista: JOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT
    ISSN: 1610-0379 Vol.16 N° 8 2018 págs. 1036-1038
  • Autores: Jimenez, Y. D. (Autor de correspondencia); Camarero-Mulas, C.; Sanmartin-Jimenez, O.; et al.
    Revista: INTERNATIONAL JOURNAL OF DERMATOLOGY
    ISSN: 0011-9059 Vol.57 N° 11 2018 págs. 1375 - 1381
    Resumen
    BackgroundThe two main tumors treated with Mohs micrographic surgery (MMS) are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). There are no studies analyzing whether MMS is different when treating these two types of tumors. ObjectiveWe aim to compare the characteristics of the patients, the tumors, and MMS, and first-year follow-up of MMS in BCC and SCC. MethodsREGESMOHS is a prospective cohort study of patients treated with MMS. The participating centers are 19 Spanish hospitals where at least one MMS is performed per week. Data on characteristics of the patients, tumors, and surgery were recorded. The follow-up was done with two visits: the first visit within 1 month after surgery and the second one within the first year. ResultsFrom July 2013 to April 2017, a total of 2,669 patients who underwent MMS were included in the registry. Of them, 2,448 (93%) were diagnosed with BCC, and 181 (7%) were diagnosed with SCC. Patients with SCC were older than those with BCC (median age 73 years vs. 68 years) and presented immunosuppression more frequently. The tumor size was significantly larger in the SCC group. Regarding surgery, deeper invasion was more frequent in SCC, resulting in larger defects. Despite this, SCC did not require more stages to get clear margins or more time in the operating room. Incomplete Mohs was more frequent in the SCC group (6%) than in the BCC group (2%). The incidence of perioperative complications was higher when treating SCC. There were more relapses in the first-year follow-up in the SCC group. ConclusionThere are significant differences when comparing MMS in BCC and SCC. Knowledge of these differences can help to prepare the patient and plan the surgery, optimizing results.
  • Autores: Moreno-Ramirez, D. (Autor de correspondencia); Boada, A. ; Ferrandiz, L. ; et al.
    Revista: ACTAS DERMO-SIFILIOGRAFICAS
    ISSN: 0001-7310 Vol.109 N° 5 2018 págs. 390 - 398
    Resumen
    Recent publication of the results of clinical trials in which lymph node dissection was not associated with any survival benefit in patients with sentinel node metastasis makes it necessary to reconsider the treatment of patients with melanoma. This article provides an update on the available evidence on the diverse factors (routes of metastatic spread, predictors, adjuvant therapy, etc.) that must be considered when treating patients with sentinel node-positive melanoma. The authors propose a decision-making algorithm for use in this clinical setting. The current evidence no longer supports lymph node dissection in patients with Low-risk sentinel node metastasis (sentinel node tumor load <= 1 mm). (C) 2018 AEDV. Published by Elsevier Espana, S.L.U. All rights reserved.
  • Autores: Camarero-Mulas, C (Autor de correspondencia); Delgado Jiménez, Y; Sanmartín-Jiménez, O; et al.
    Revista: JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY
    ISSN: 0926-9959 Vol.32 N° 1 2018 págs. 108 - 112
    Resumen
    Background: The elderly population is increasing and more patients in this group undergo Mohs micrographic surgery (MMS). The few publications investigating MMS in elderly people conclude that it is a safe procedure; however, these are single-centre studies without a comparison group. Objective: To compare the characteristics of patients, tumours, MMS and 1-year follow-up in patients younger than 80 years, with patients older than 80 years at the time of surgery. Methods: Data was analysed from REGESMOHS, a prospective cohort study of patients treated with MMS. The participating centres were 19 Spanish hospitals where at least one MMS is performed per week. Data on characteristics of the patient, tumour and surgery were recorded. Follow-up data were collected from two visits; the first within 1 month postsurgery and the second within the first year. Results: From July 2013 to October 2016, 2575 patients that underwent MMS were included in the registry. Of them, 1942 (75.4%) were aged <80 years and 633 (24.6%) were ¿80 years old. In the elderly, the tumour size was significantly higher with a higher proportion of squamous cell carcinoma. Regarding surgery, elderly more commonly had tumours with deeper invasion and required a higher number of Mohs surgery stages, leaving larger defects and requiring more time in the operating room. Despite this, the incidence of postoperative complications was the same in both groups (7%) and there were no significant differences in proportion of relapses in the first-year follow-up. Conclusion: The risk of short-term complications and relapses were similar in elderly and younger groups. MMS is a safe procedure in the elderly.
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