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Ejc Supplements - EJC SUPPL. 01/2010; 8(3):173-173.
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ABSTRACT: The risk of multiple melanoma is estimated to be between 1 % and 8 %, with the majority of studies being carried out on North American populations. Our objective was to determine the risk and the clinical-pathological features of multiple primary melanoma in a Spanish Mediterranean population.
We performed a retrospective study of the medical records and the database of the Melanoma Unit of Hospital de Bellvitge, Barcelona, Spain, between 1988 and 2005.
We found 25 cases of multiple primary melanoma among 934 patients studied, representing a risk of 2.6 % in our population of melanoma patients. In 50 % of cases, the second melanoma appeared during the first year of follow-up. These subsequent lesions occurred at a different site from the initial lesion in 58 % of cases. In the majority of cases, lesions in a single patient showed similar cytological and architectural features. However, we did observe marked interindividual variability in the histology of multiple primary melanomas.
Although the risk of a second melanoma in our population appears to be lower than in North American populations, it is not negligible. Melanoma patients must therefore be followed up for life, not only for the risk of metastases but also for the risk of a new primary tumor. Complete examination of the skin must be performed at each visit.
Actas Dermo-Sifiliográficas 07/2009; 100(5):414-9.
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Actas Dermo-Sifiliográficas 01/2009; 99(10):812-3.
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ABSTRACT: The incidence of melanoma has increased more than that of any other type of malignant tumor. Our aim was to analyze the changes in incidence of cutaneous melanoma in recent years in a Mediterranean population.
Patients with melanoma diagnosed between 1988 and 2006 were included in the study. Data from the first half of this period were compared with data from the second half.
The number of in situ melanomas increased from 36/302 cases (11.92 %) in the first half of the period to 224/724 (30.94 %) in the second half. Melanomas measuring more than 4 mm increased from 29/302 cases (9.60 %) to 62/724 (8.56 %). The mean maximum thickness for the whole study period was 1.91 mm and was similar for both halves.
The increase in incidence of melanoma in our population was due mainly to an increase in incipient cases. The proportion of melanomas larger than 4 mm remained constant, although, in absolute terms, twice as many such melanomas were detected per year. We believe that campaigns for prevention and early detection must continue, and should focus in particular on the older population.
Actas Dermo-Sifiliográficas 08/2008; 99(6):464-8.
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Journal of the European Academy of Dermatology and Venereology 07/2008; 23(3):327-8. · 2.98 Impact Factor
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ABSTRACT: Subcutaneous sarcoidosis is a specific cutaneous lesion of systemic sarcoidosis that is rarely reported. Clinically, it is characterized by multiple, asymptomatic subcutaneous nodules mainly located on the forearms. Adverse effects of desensitization injections mostly consist of local transient reactions. Nodular lesions may also develop at the site of injection; these have been attributed to the aluminium hydroxide contained by many vaccines. We report a 49-year old woman with a history of two outbreaks of acute sarcoidosis (Löfgren syndrome) in 1994 and 1999, who developed lesions of subcutaneous sarcoidosis in the upper part of both arms, at the sites of desensitization injections for extrinsic asthma immunotherapy.
Clinical and Experimental Dermatology 04/2008; 33(2):132-4. · 1.20 Impact Factor
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Actas Dermo-Sifiliográficas 04/2008; 99(2):157-9.
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Actas Dermo-Sifiliográficas 07/2007; 98(5):374-5.
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ABSTRACT: Calciphylaxis is an uncommon disease characterized by calcification of dermal vessels that determines skin necrosis. Calciphylaxis has been almost exclusively reported in association with renal failure and altered phosphor-calcium metabolism. Only a few cases have been described in hyperparathyroidism, malignancies, and, recently, cirrhosis. We report a patient that developed calciphylaxis related to end-stage alcoholic cirrhosis, without any alteration in the phosphocalcic and parathyroid hormone metabolisms. Possible contributing factors were repeated albumin infusions and low levels of protein C and S.
Journal of the European Academy of Dermatology and Venereology 06/2006; 20(5):599-601. · 2.98 Impact Factor
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ABSTRACT: Subcutaneous sarcoidosis is a specific cutaneous lesion of sarcoidosis that is rarely reported.
Our purpose was to analyse the clinicopathological features of 10 patients with subcutaneous sarcoidosis and its relationship with the systemic features of the disease.
The patients with systemic sarcoidosis, diagnosed from 1974 to 2002 at a university hospital in Barcelona, Spain, who developed subcutaneous involvement, were included in the study. The diagnosis of systemic sarcoidosis was made according to conventional criteria. All the patients were monitored prospectively at the sarcoidosis clinic of the hospital. Skin biopsies were performed when granulomatous cutaneous involvement was suspected clinically.
Granulomatous cutaneous involvement was demonstrated in 85 of 480 patients with systemic sarcoidosis. In 10 of these 85 patients subcutaneous sarcoidosis was diagnosed (11.8%). The lesions were most frequently located in the extremities, involving the forearms in nine patients. Indurated linear bands from the elbow to the hand were observed in five patients. In all of our patients the subcutaneous nodules appeared at the beginning of the disease. In six patients, the nodules remitted spontaneously in less than 2 years. In two cases foreign particles were detected under polarized light.
Subcutaneous sarcoidosis is a quite uniform clinicopathological entity usually appearing at the beginning of the disease. It usually heralds forms of sarcoidosis with nonsevere systemic involvement and is not associated with chronic fibrotic disease.
British Journal of Dermatology 11/2005; 153(4):790-4. · 3.67 Impact Factor
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ABSTRACT: Cutaneous necrosis is an infrequent complication of coumarin therapy. Skin necrosis has usually been reported in patients with congenital protein C deficiency or, less commonly, protein S deficiency. However, this complication may also occur with acquired and transient protein C and/or S deficiency. In coumarin therapy there is a relatively hypercoagulable state at the start of treatment, and most lesions appear between the third and sixth days. We describe a 75-year-old man receiving coumarin therapy (acenocumarol) for 7 years who was given a nonsteroidal anti-inflammatory agent (diclofenac) for a pain in his knee. Two days later, his renal function deteriorated and skin necrosis became evident. Biopsy showed histological changes consistent with coumarin-induced necrosis. Protein C and S levels were normal. We concluded that in our patient acute renal insufficiency aggravated by diclofenac treatment probably associated with an inadvertent withdrawal could have been the precipitating factor for transient protein C deficiency.
British Journal of Dermatology 09/2004; 151(2):502-4. · 3.67 Impact Factor
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ABSTRACT: To assess the presence of foreign material in the granulomatous cutaneous lesions of patients with systemic sarcoidosis.
Observational study reevaluating histological specimens at a university referral hospital.
Sixty-five patients diagnosed as having sarcoidosis who developed granulomatous cutaneous involvement.
To detect the presence of polarizable foreign particles in cutaneous biopsy specimens and to evaluate the association with clinical features of the patients.
Granulomatous cutaneous involvement was demonstrated in 65 (15.3%) of 425 patients with systemic sarcoidosis. In 14 (22%) of the 65 patients, the cutaneous biopsy specimen showed foreign particles in polarized light. The skin lesions corresponded to 3 different clinical patterns: an admixture of papules and infiltration of previously undetected minute scars (n = 6); scar sarcoidosis (n = 4); and subcutaneous nodules (n = 4). The lesions were located most frequently in the extremities, involving the knees in 10 patients.
The presence of polarizable foreign body material in granulomatous cutaneous lesions is not infrequent in patients with systemic sarcoidosis. Inoculation of foreign matter from a previous inapparent minor trauma may induce granuloma formation in individuals with sarcoidosis.
Archives of Dermatology 05/2001; 137(4):427-30. · 3.89 Impact Factor
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ABSTRACT: Metastatic progression in ductal breast carcinomas are related to apoptosis in primary tumors. Frameshift mutations in a single-repeat sequence within the coding region (G)8 of the pro-apoptotic Bax gene have been related to microsatellite instability (MSI) and progression of some carcinomas and lymphomas. The aim of this study was to explore whether the extended lifespan of breast cancer cells can also be triggered by Bax mutation in ductal-breast carcinomas, and whether breast cancer cell MSI is related to the loss of apoptosis. For this purpose we studied frameshift mutations of a microsatellite (G)8 in the third exon of the Bax gene in a series of 105 ductal breast carcinomas, at T1 and T2-3 stages, 45 of which had lymph node metastasis. We analyzed MSI in five sequences of DNA isolated from normal and tumor tissue samples taken from 86 patients, and we explored the relationship between MSI and tumor apoptosis status. Bax mutation was not present in ductal breast carcinomas. MSI (two or more markers altered) was detected in 11.6% of tumors. Loss of apoptosis occurred in 80% (8/10) tumors with MSI, versus 17.8% of tumors without MSI (chi2 test, p = 0.0004), independently of Bax protein expression. We conclude that frameshift mutations of a microsatellite (G)8 of the Bax gene are not critical for the loss of apoptosis in breast cancer, and that loss of apoptosis may be a consequence of overexpression of anti-apoptotic protein Bcl-2 or Bcl-xL. Moreover, MSI in breast carcinomas might be the cause of loss of an apoptotic pathway that is not induced by frameshift mutations of a microsatellite (G)8 of the Bax gene.
Breast Cancer Research and Treatment 02/2001; 65(2):171-7. · 4.43 Impact Factor
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ABSTRACT: We have examined whether the extended life span of cells induced by Bcl-2 in T(1) ductal breast carcinomas might favor the acquisition and accumulation of genetic alterations that induce lymph node metastases. We analyzed the expression of c-Myc, c-erbB-2 and epidermal growth factor receptor by immuno-histochemistry in a group of 142 T(1) (<2 cm) ductal breast carcinomas embedded in paraffin, previously studied for p53 mutation and Bcl-2 over-expression. We also measured the apoptotic status and estimated the excess risk (pOR) for lymph node metastasis according to the number of accumulated oncogene alterations and Bcl-2 and p53 expression. The linear relationship between number of oncogene alterations and presence of lymph node metastasis was statistically significant in Bcl-2-positive tumors (trend test, p = 0.03), p53-mutated tumors (trend test, p = 0.08) and tumors with loss of apoptosis (trend test, p = 0.08). Very large associations (pOR > 12) between the number of oncogene alterations and lymph node metastasis were observed among Bcl-2-positive tumors that showed increased loss of apoptosis (trend test, p = 0.03). Furthermore, in p53-negative tumors, a strong linear association was found between the number of oncogene alterations and risk of lymph node metastasis among Bcl-2-positive tumors (trend test, p = 0.03). In human T(1) ductal breast carcinoma, over-expression of Bcl-2 along with loss of apoptosis might render breast cancer cells susceptible to the acquisition of additional genetic lesions related to disease progression among p53-negative tumors. Thus, in breast cancer, there are at least 2 pathways to progression: Bcl-2- and p53-dependent mechanisms.
International Journal of Cancer 03/2000; 89(2):142-7. · 5.44 Impact Factor
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British Journal of Dermatology 03/2000; 142(2):380-2. · 3.67 Impact Factor
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ABSTRACT: A significant proportion of multiple sclerosis patients develop cutaneous reactions by interferon beta 1b (IFN-beta). The am of this study was to describe clinically and histologically the cutaneous reactions by IFN-beta.
A series of 92 patients with multiple sclerosis in treatment with IFN-beta was followed. Cutaneous biopsy was performed in cases with persistent lesions.
9 out of 92 patients presented eritematous plaques, 4 cutaneous ulcers and 1 sclerodermiform plaques. Vascular thrombosis was demonstrated in 2 cases.
In patients with multiple sclerosis treated with IFN-beta the persistent skin lesions are more frequent in female patients. Generally is not necessary to stop the treatment.
Medicina Clínica 11/1999; 113(12):447-8. · 1.38 Impact Factor
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ABSTRACT: The overexpression of Bcl-2, an anti-apoptotic oncogene, identifies human T1 breast cancer patients who have an increased risk of lymph-node metastasis. We examined in these patients (n = 142) whether the c-Myc oncogene influences metastatic progression in conjunction or not with Bcl-2 expression and the loss of apoptosis in tumors. The association between Bcl-2 and lymph-node metastasis was only significant when c-Myc was concomitantly expressed (chi2 test, p = 0.008). Moreover, very large associations (pOR = 6.4) between c-Myc and lymph-node metastasis were observed among Bcl-2 positive tumors and tumors with loss of apoptosis (pOR = 8.4). In contrast, the metastatic advantage linked to Bcl-2 was decreased (pOR = 2) when c-Myc was not coexpressed. It is concluded that the synergism between Bcl-2 and c-Myc oncogenes may promote metastasis in breast tumors, linked to loss of apoptosis.
Breast Cancer Research and Treatment 04/1999; 54(1):39-45. · 4.43 Impact Factor
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ABSTRACT: Diffuse plane xanthoma (DPX) usually has been described in association with a reticuloendothelial disease. However, the incidence of an underlying disease and its relation to clinical and histopathologic features have not been previously described.
We describe the clinicopathologic features of a series of patients with DPX.
Eight patients with DPX were diagnosed and studied between 1987 and 1996.
Three of the 8 patients had a reticuloendothelial disease (benign monoclonal gammopathy in 2 and chronic myelomonocytic leukemia in 1). These 3 patients had larger cutaneous lesions and involvement of trunk and extremities. Histologic examination showed only foamy macrophages in 2 of the 8 patients. The remainder exhibited macrophages, foamy histiocytes, lymphocytes, and Touton cells.
The incidence of underlying disease associated with DPX seems to be lower than expected. However, patients with DPX should be observed for the potential occurrence of an associated condition.
Journal of the American Academy of Dermatology 10/1998; 39(3):439-42. · 3.99 Impact Factor
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ABSTRACT: Carcinoma of the prostate gland is the second most frequent malignancy in males, accounting for 17% of cancer in men; between a third and one-half of these patients will have distant metastases at onset, but rarely cutaneous. We now report a case of prostatic adenocarcinoma with such metastases involving the right nipple and periareolar skin, overlying an area of hormone-induced gynaecomastia.
Clinical and Experimental Dermatology 06/1998; 23(3):119-20. · 1.20 Impact Factor
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ABSTRACT: Expression of the death-related proteins (DRPs) Bcl-2, Bax, Bcl-x and Bak that regulate cell survival and death was examined using immuno-histochemical methods in a group of 142 T1 (<2 cm) ductal breast carcinomas. Immunostaining results were correlated with loss of apoptosis and clinicopathological parameters such as histological grade (HG) and lymph node involvement. Expression of anti-apoptotic proteins Bcl-2 and Bcl-x was found in 57.0% and 62.75% of tumors, respectively. Bcl-2 expression, but not Bcl-x expression, was related to loss of apoptosis. Expression of the apoptotic proteins Bax and Bak was present in 58% of Bcl-2-negative tumors and associated significantly with an increase in apoptosis. Expression of these DRPs was associated significantly with the HG of the tumors: Bcl-2 and Bak expression was predominant in HG I/II tumors, whereas expression of Bcl-xL and Bax was commonly observed in HG III tumors, as occurs for p53 over-expression. Our results suggest that the loss or gain of apoptosis is regulated tightly in T1 breast carcinomas through the expression of different effectors along with tumor cell differentiation.
International Journal of Cancer 04/1998; 79(2):103-10. · 5.44 Impact Factor
