Symmetrical pustulosis unfolds over systemic lupus erythematosus.

A review of terms used to define cutaneous squamous cell carcinoma with a poor prognosis.

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 standardizing the 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.

Diagnosis of Lung Cancer Due to a Complicated Abscess

Systematic review of BRAF/MEK inhibitors‐induced Severe Cutaneous Adverse Reactions (SCARs)

Severe cutaneous adverse reactions (SCARs) [Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), drug rash with eosinophilia and systemic syndrome (DRESS), acute generalized exanthematous pustulosis (AGEP), and generalized bullous fixed eruption (GBFE)] are severe drug reactions that often require hospitalization and could be fatal. BRAF and MEK inhibitors (BRAF/MEKi) are a standard of care in patients with BRAF-mutated metastatic melanomas. These agents are administered until disease progression or unacceptable toxicity occurs. This review has focus on BRAF/MEKi-induced SCARs. A systematic search of the following terms: 'vemurafenib', 'cobimetinib', 'dabrafenib', 'trametinib',…

Assessment of Acute Acral Lesions in a Case Series of Children and Adolescents During the COVID-19 Pandemic

Importance A novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has recently been identified as the cause of a pandemic called coronavirus disease 2019 (COVID-19). In this context, some associated skin diseases have been described. Cutaneous lesions referred to as acute acro-ischemia have been reported as a possible sign of COVID-19 in adolescents and children. Objective To evaluate the pathogenesis of these newly described acute acral lesions. Design, Setting, and Participants This prospective case series was conducted at La Fe University Hospital, a tertiary referral hospital in Valencia, Spain, between April 9 and April 15, 2020. Among 32 referred patien…

Pleomorphic cutaneous Rosai-Dorfman disease.

we report three cases of pure cutaneous Rosai-Dorfman disease (RDD) showing prominent nuclear pleomorphism. This unusual finding confers a worrisome appearance to these lesions, challenging their recognition and creating difficulty in the differential diagnosis with malignant neoplasms. This article is protected by copyright. All rights reserved.

Clinicopathological analysis of 1571 cutaneous malignant melanomas in Valencia, Spain: factors related to tumour thickness.

Epidemiological studies on cutaneous melanoma in Mediterranean countries are scarce. Our aim was to perform a descriptive analysis of melanoma cases diagnosed in Valencia, Spain, and to evaluate the relationship between Breslow thickness and some clinical features. A total of 1571 patients with histologically confirmed cutaneous malignant melanoma diagnosed at the two main referral melanoma centres were evaluated retrospectively. For each patient the following clinical and pathological characteristics were selected: age, gender, anatomic site, histogenetic type, Breslow thickness, presence of ulceration, the stage, and symptoms such as bleeding, changes in size and colour, altered sensation…

Pembrolizumab: a new Drug That Can Induce Exacerbations of Psoriasis.

Herpes vegetans of the vulva.

Antitumor effect of B16 melanoma cells genetically modified with the angiogenesis inhibitor rnasin.

The growth of new blood vessels is an essential condition for the development of tumors with a diameter greater than 1-2 mm and also for their metastatic dissemination. RNasin, the placental ribonuclease inhibitor, is known to have antiangiogenic activity through the inhibition of angiogenin and basic fibroblast growth factor. Nevertheless, the administration of the recombinant form of a protein poses several limitations; as a result, we have studied the antitumor effect of RNasin in a murine gene therapy model. RNasin cDNA was subcloned into the pcDNA3 expression vector, and the resulting recombinant plasmid was used to transfect the B16 murine melanoma cell line. An RNasin inverted constr…

Depth determination of skin cancers treated with superficial brachytherapy: ultrasound vs. histopathology

Purpose: The purpose of this study is to compare high frequency ultrasonography (HFUS) and histpathologic assessment done by punch biopsy in order to determine depth of basal cell carcinoma (BCC), in both superficial and nodular BCCs prior to brachytherapy treatment. Material and methods: This study includes 20 patients with 10 superficial and 10 nodular BCCs. First, punch biopsy was done to confirm the diagnosis and to measure tumour depth (Breslow rate). Subsequently, HFUS was done to measure tumour depth to search for correlation of these two techniques. Results: Neither clear tendency nor significance of the punch biopsy vs. HFUS depth determination is observed. Depth value differences …

Psoriasis moderada-grave en pacientes pediátricos y jóvenes: experiencia en el registro BIOBADADERM

Resumen {0>El debut de la psoriasis en la edad pediatrica, aunque generalmente leve, puede requerir tratamiento sistemico en las formas moderadas o graves de la enfermedad. Childhood-onset psoriasis generally follows an indolent course but patients with moderate or severe disease may require systemic treatment. El objetivo de este trabajo es analizar la frecuencia relativa, las caracteristicas de los pacientes, el tratamiento empleado y los eventos adversos (EA) observados a partir del registro BIOBADADERM en ninos y jovenes con psoriasis moderada-grave. The aim of this study was to determine the relative proportion of children and young people aged up to 21 years with moderate to severe ps…

Changing Trends in Drug Prescription and Causes of Treatment Discontinuation of First Biologic Over Ten Years in Psoriasis in the Spanish Biobadaderm Registry

Background and objectives: Current psoriasis guidelines do not usually include recommendations about first line classical or biologic treatment. The objectives of this study were: to describe shifts in the prescription of the first biological treatment, and to compare treatment withdrawal and rates of adverse events over ten years. Material and methods: Biobadaderm registry was analyzed to describe: first biological prescription in bio-naive patients, adverse events rate and reasons for drug withdrawal comparing three periods of time (2008-2010, 2011-2014, 2015-2018). Results: Anti-TNF drugs were the most prescribed biological drug from 2008 to 2010. Ustekinumab has become the most prescrib…

Long-term safety of nine systemic medications for psoriasis: A cohort study using the Spanish Registry of Adverse Events for Biological Therapy in Dermatological Diseases (BIOBADADERM) Registry.

Background: Registry studies broadly describing the safety of systemic drugs in psoriasis are needed. Objective: To describe the safety findings of the systemic drugs acitretin, adalimumab, apremilast, cyclosporine, etanercept, infliximab, methotrexate, secukinumab, and ustekinumab used for the treatment of moderate to severe psoriasis in patients included in the Spanish Registry of Adverse Events for Biological Therapy in Dermatological Diseases (BIOBADADERM) Registry. Methods: The incidence rate ratio (IRR) and adjusted IRR (including propensity scores) of identified adverse events for each drug, using methotrexate as reference, were determined by means of a prospective cohort. Results: O…

Pembrolizumab, un nuevo fármaco capaz de inducir un brote psoriasis

Study of the immunophenotype of the inflammatory cells in melanomas with regression and halo nevi.

Abstract The pathogenesis and prognostic implications of regression in melanoma are not well understood. It has traditionally been considered an immunologically mediated phenomenon. Improvement in the knowledge of the mechanisms that lead to regression may prove to be of great value in an era in which treatments oriented to the augmentation of the host's immunity against melanoma have demonstrated excellent clinical results. This study was designed to improve the understanding of the mechanisms underlying melanoma regression and the differences between similar situations in benign melanocytic nevus. The study sample consisted of 77 lesions: 62 melanomas and 15 halo nevi. The following marke…

Primary cutaneous lymphomas in children: A prospective study from the Spanish Academy of Dermatology and Venereology (AEDV) Primary Cutaneous Lymphoma Registry.

Background/Objectives Primary cutaneous lymphomas are rare in pediatric patients. The clinical and histopathological manifestations may differ from those in adults. Due to their low frequency and the insidious clinical picture, the diagnosis is usually delayed. The Spanish Primary Cutaneous Lymphoma Registry was initiated in 2016 as a multicenter registry that would allow better insight into the epidemiological, clinical, histopathological, and treatment response characteristics of patients with primary cutaneous lymphomas. Methods We conducted a prospective observational cohort study of primary cutaneous lymphomas in pediatric patients participating in the Spanish Academy of Dermatology an…

Guía de práctica clínica de melanoma de la Academia Española de Dermatología y Venereología

Resumen: El diagnóstico y tratamiento del melanoma en atención especializada es un campo en el que se han producido numerosos cambios. El objetivo de esta guía es ofrecer a los dermatólogos españoles una referencia para resolver las dudas clínicas más frecuentes basándose en la evidencia actual. Para la realización de esta guía se escogió a miembros del Grupo Español de Dermato-Oncología y Cirugía con experiencia en el tratamiento de estos tumores y con interés en participar en la elaboración de la guía. Se hizo una adaptación de las guías de práctica clínica existentes mediante el método ADAPTE: inicialmente se resumió el proceso de atención y se elaboraron las preguntas clínicas relevante…

Diagnóstico de cáncer de pulmón a raíz de un «absceso» complicado

Hiperplasia gingival inducida por nifedipino

Incidence of severe COVID-19 outcomes in psoriatic patients treated with systemic therapies during the pandemic: A Biobadaderm cohort analysis

Toxische epidermale Nekrolyse mit schwerer hepatischer Beteiligung

The association between dermoscopic features and BRAF mutational status in cutaneous melanoma: Significance of the blue-white veil.

Background: The genetic basis of melanoma affects its clinicopathologic characteristics and increasingly influences its management. B-Raf proto-oncogene, serine/threonine kinase gene (BRAF)-mutated melanoma may present with specific dermoscopic features. Objectives: To identify the dermoscopic features associated with BRAF mutation in cutaneous melanoma and to evaluate a model capable of predicting BRAF mutations on the basis of dermoscopic and clinicopathologic features that are easily accessible in normal clinical practice. Methods: A prospective, cross-sectional, observational, and descriptive study was performed. A total of 93 cutaneous melanomas with dermoscopic images from 93 patients…

Erfolgreiche Imatinib‐Therapie einer mit dem myeloproliferativen hypereosinophilen Syndrom mit PDGFRA ‐Rearrangement assoziierten lymphomatoiden Papulose

Sonidegib en el tratamiento del carcinoma basocelular localmente avanzado

Resumen: Sonidegib es un inhibidor del receptor transmembrana Smoothened (SMO), de la vía de señalización de Hedgehog, indicado para el tratamiento del carcinoma basocelular localmente avanzado (CBCla), no susceptible a cirugía curativa ni a radioterapia. Sonidegib ha demostrado su eficacia y seguridad en pacientes con CBCla en el ensayo de fase II (BOLT), donde el 61% (IC 95%: 48; 72) de los pacientes tratados con 200 mg de sonidegib tuvo una respuesta objetiva al tratamiento, con un tiempo medio hasta la respuesta de cuatro meses. La mediana de duración de respuesta fue de 26,1 meses y la mediana de supervivencia libre de progresión fue de 22,1 meses. Los eventos adversos más frecuentes f…

Accuracy of SCORTEN and ABCD‐10 to predict mortality and the influence of renal function in Stevens–Johnson syndrome/toxic epidermal necrolysis

Epidermal necrolysis (EN) compromises a spectrum of life-threatening dermatoses (Stevens-Johnson Syndrome [SJS], overlap syndrome and toxic epidermal necrolysis [TEN]). Currently, no active therapeutic regimen with unequivocal benefit exists for SJS/TEN. SCORTEN is the widely-used prognostic scale specific for SJS/TEN. Nevertheless, a new prognostic scale, the ABCD-10, has been recently proposed. In this context, acute renal failure (ARF) seems to be an important comorbidity that could influence prognosis in SJS/TEN patients more than it is assumed by these two scales. Our objectives were to compare the accuracy of the SCORTEN and ABCD-10 scales in predicting the mortality in SJS/TEN, and t…

Sonidegib in the Treatment of Locally Advanced Basal Cell Carcinoma

Sonidegib is an antagonist of the transmembrane protein Smoothened in the Hedgehog signaling pathway. It is indicated for the treatment of locally advanced basal cell carcinoma (BCC) that is not amenable to curative surgery or radiotherapy. Sonidegib's efficacy and safety were demonstrated in the phase 2 BOLT trial, where 61% (95% CI, 48-72%) of patients with locally advanced BCC treated with sonidegib 200 mg achieved an objective response to treatment with a mean time to response of 4 months. The median duration of response was 26.1 months and the median progression-free survival was 22.1 months. The most common adverse events were muscle spasms (54.4%), hair loss (49.4%), and loss of tast…

Cambios en las tendencias de la prescripción y causas de la interrupción en los tratamientos biológicos indicados en la psoriasis durante los primeros 10 años. Datos obtenidos del registro español Biobadaderm

Resumen Antecedentes y objetivos Las guias sobre el tratamiento de la psoriasis habitualmente no incluyen las recomendaciones acerca de cual debe ser la primera linea de tratamiento sistemico o biologico. Los objetivos de este estudio fueron describir las tendencias en la prescripcion del primer farmaco biologico y comparar la retirada de los farmacos y las tasas de efectos adversos a lo largo de los 10 anos de seguimiento. Material y metodos Se utilizo el registro Biobadaderm para determinar cual fue el primer farmaco biologico indicado en pacientes con psoriasis naive para biologicos, asi como cual es la tasa de efectos adversos y los motivos de suspension de los farmacos. Los resultados …

A randomized, intraindividual, non-inferiority, Phase III study comparing daylight photodynamic therapy with BF-200 ALA gel and MAL cream for the treatment of actinic keratosis.

Abstract Background The most effective treatment modality for actinic keratosis (AK) is photodynamic therapy (PDT). Major obstacles of PDT are the need of a special illumination device and pain accompanying the illumination. These issues may be overcome by replacing an artificial high‐power light source with natural daylight for more extended illumination at lower light doses. Objective To determine whether BF‐200 ALA (a nanoemulsion gel containing 7.8% 5‐aminolaevulinic acid) is non‐inferior to MAL (a cream containing 16% methyl‐aminolaevulinate) in the treatment of mild‐to‐moderate AK with daylight PDT (dPDT). Non‐inferiority of the primary efficacy variable (total lesion clearance rate p…

Comment on ‘Two cases of COVID‐19 presenting with a clinical picture resembling chilblains: first report from the Middle East’: pernio unrelated to COVID‐19

Ampollas por coma. Una clave para el diagnóstico neurológico

Acute Necrotic Plaque in an Immunocompromised Host.

Urticaria multiforme, un simulador de «eritema multiforme»

Accuracy of SCORTEN to predict the prognosis of Stevens‐Johnson syndrome/toxic epidermal necrolysis: a systematic review and meta‐analysis

BACKGROUND The SCORTEN score is a specific predictor of the probability of death for patients diagnosed with Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN). OBJECTIVES To evaluate the overall accuracy of SCORTEN and the influence of several moderators such as age, sex, geographical region and age of the study. METHODS A systematic search was performed on MEDLINE, The Cochrane Library, EMBASE, SCOPUS and Web of Knowledge, with no restriction on language (last update 5 February 2019 for all databases). Original studies on the use of SCORTEN were eligible. The standardized mortality ratio (SMR), defined as the quotient between the number of deaths observed and the number expec…

Systemic therapies for Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: a SCORTEN-based systematic review and meta-analysis.

Background The SCORTEN score is a specific predictor of mortality for patients with Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN). There is little evidence in support of the common immunomodulating therapies for SJS/TEN. Objectives To systematically assess the effectiveness of several therapies for SJS/TEN through the SCORTEN score. Methods Databases were searched for original studies on the use of SCORTEN. Six meta-analyses were carried out on patients with SJS/TEN who received supportive care only or in combination with immunomodulating drugs: corticosteroids, cyclosporine, etanercept, immunoglobulins or a combination of corticosteroids with immunoglobulins. A multivaria…

A case of cefditoren‐induced Acute Generalized Exanthematous Pustulosis during COVID‐19 pandemics. Severe Cutaneous Adverse Reactions (SCARs) are an issue

Abstract We read with interest the article by Recalcati et al. about the report of cutaneous manifestations in COVID‐19 patients. We would like to highlight that some potentially severe manifestations in these patients are not directly related to the coronavirus but to the medications administered.

Epigenetic activation of a cryptic TBC1D16 transcript enhances melanoma progression by targeting EGFR

Metastasis is respoMetastasis is responsible for most cancer-related deaths, and, among common tumor types, melanoma is one with great potential to metastasize. Here we study the contribution of epigenetic changes to the dissemination process by analyzing the changes that occur at the DNA methylation level between primary cancer cells and metastases. We found a hypomethylation event that reactivates a cryptic transcript of the Rab GTPase activating protein TBC1D16 (TBC1D16-47 kDa; referred to hereafter as TBC1D16-47KD) to be a characteristic feature of the metastatic cascade. This short isoform of TBC1D16 exacerbates melanoma growth and metastasis both in vitro and in vivo. By combining imm…

Atrophic dermatofibrosarcoma protuberans with the fusion gene COL1A1-PDGFB

Urticaria multiforme, an "erythema multiforme" simulator.

Coma blisters. A key to neurological diagnosis

Toxic epidermal necrolysis with severe hepatic involvement.

Successful treatment with imatinib of lymphomatoid papulosis associated with myeloproliferative hypereosinophilic syndrome with PDGFRA rearrangement

El angioma centinela, metástasis cutánea de carcinoma renal de células claras

Folliculotropic Mycosis Fungoides With Flexural Eruptive Cysts and Comedones in a 14-Year-Old Boy

Clinical Practice Guideline on Melanoma From the Spanish Academy of Dermatology and Venereology (AEDV)

El diagnóstico y tratamiento del melanoma en atención especializada es un campo en el que se han producido numerosos cambios. El objetivo de esta guía es ofrecer a los dermatólogos españoles una referencia para resolver las dudas clínicas más frecuentes basándose en la evidencia actual. Para la realización de esta guía se escogió a miembros del Grupo Español de Dermato-Oncología y Cirugía con experiencia en el tratamiento de estos tumores y con interés en participar en la elaboración de la guía. Se hizo una adaptación de las guías de práctica clínica existentes mediante el método ADAPTE: inicialmente se resumió el proceso de atención y se elaboraron las preguntas clínicas relevantes. Se sel…

Fitofotodermatosis por «mojitos», la otra enfermedad de «lime»

Vulvar and areolar fixed drug eruption

Revisión de los términos que definen un carcinoma epidermoide cutáneo asociado a mal pronóstico

Resumen El carcinoma epidermoide cutaneo (CEC) es el segundo tumor mas frecuente en humanos y tiene una incidencia creciente e infraestimada. En la literatura nos encontramos con terminos como CEC de alto riesgo, CEC localmente avanzado, CEC metastasico, CEC avanzado y CEC agresivo, que pueden dar lugar a confusion y que en algunas ocasiones no se encuentran del todo bien definidos. En esta revision pretendemos aclarar estos conceptos con la idea de lograr homogeneidad en su descripcion, algo que parece necesario a la luz de los nuevos farmacos aprobados y en desarrollo para este tumor.

Infectious pubic plaque

Correlation of histologic regression in primary melanoma with sentinel node status.

Importance The influence of regression on the status of the sentinel node (SN) is controversial. In many centers, the presence of regression in thin melanomas supports the performance of an SN biopsy. Objective To identify whether regression in primary melanoma has any influence on SN involvement. Design, Setting, and Participants Retrospective study of melanomas with a Breslow thickness greater than 0.75 mm and undergoing SN biopsy from January 1, 2003, through December 31, 2010, at Instituto Valenciano de Oncologia, which receives melanoma patients from regional hospitals and dermatology practices. Only cases with paraffin blocks or histologic slides representative of the primary tumor an…