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Tejera-Vaquerizo A, Gómez-Tomás Á, Jaka A, Toll A, Del Río M, Ferrándiz-Pulido C, Fuente MJ, Carrasco C, Almazán-Fernández FM, Toledo-Pastrana T, Ferrer-Fuertes A, Ribero S, Avallone G, Cañueto J, Santos-Juanes J, Sanmartín O. Sentinel lymph node biopsy versus observation in high-risk cutaneous squamous cell carcinoma in immunosuppressed and immunocompetent patients: An inverse probability of treatment weighting study. J Eur Acad Dermatol Venereol 2024. [PMID: 38738666 DOI: 10.1111/jdv.20051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 02/28/2024] [Indexed: 05/14/2024]
Abstract
BACKGROUND The survival benefit of sentinel lymph node biopsy (SLNB) in immunocompetent and immunosuppressed patients with high-risk cutaneous squamous cell carcinoma (cSCC) has not been established. OBJECTIVE To determine whether SLNB improves disease-specific survival (DSS) in high-risk cSCC. Secondary objectives were to analyse disease-free survival, nodal recurrence-free survival and overall survival (OS). METHODS Multicentre, retrospective, observational cohort study comparing survival outcomes in immunosuppressed and immunocompetent patients treated with SLNB or watchful waiting. Inverse probability of treatment weighting was used to adjust for possible confounding effects. RESULTS We studied 638 tumours in immunocompetent patients (SLNB n = 42, observation n = 596) and 173 tumours in immunosuppressed patients (SLNB n = 28, observation n = 145). Overall, SLNB was positive in 15.7% of tumours. SLNB was associated with a reduced risk of nodal recurrence (NR) (hazard ratio [HR], 0.05 [95% CI, 0.01-0.43]; p = 0.006), disease specific mortality (HR, 0.17 [95% CI, 0.04-0.72]; p = 0.016) and all-cause mortality (HR, 0.33 [95% CI, 0.15-0.71]; p = 0.004) only in immunocompetent patients. CONCLUSIONS SLNB was associated with improvements in NR, DSS and OS in immunocompetent but not in immunosuppressed patients with high-risk cSCC.
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Affiliation(s)
- Antonio Tejera-Vaquerizo
- Cutaneous Oncology Unit, Hospital San Juan de Dios, Córdoba, Spain
- Dermatology Department, Instituto Dermatológico GlobalDerm, Palma del Río, Córdoba, Spain
| | - Álvaro Gómez-Tomás
- Dermatology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ane Jaka
- Dermatology Department, Hospital Universitari Germans Trials i Pujol, Institut d'Investigació GermansTrias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Agustín Toll
- Dermatology Department, Hospital Clínic de Barcelona, Universidad de Barcelona, Barcelona, Spain
| | - María Del Río
- Plastic Surgery Department, Hospital Universitari Germans Trials i Pujol, Institut d'Investigació GermansTrias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Carla Ferrándiz-Pulido
- Dermatology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - María J Fuente
- Dermatology Department, Hospital Universitari Germans Trials i Pujol, Institut d'Investigació GermansTrias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Cristian Carrasco
- Plastic Surgery Department, Hospital Universitari Germans Trials i Pujol, Institut d'Investigació GermansTrias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | | | - Tomás Toledo-Pastrana
- Dermatology Department, Hospital Quirón Salud Infanta Luisa, Hospital Quirón Salud Sagrado Corazón, Sevilla, Spain
| | | | - Simone Ribero
- Section of Dermatology, Medical Sciences Department, University of Turin, Turin, Italy
| | - Gianluca Avallone
- Section of Dermatology, Medical Sciences Department, University of Turin, Turin, Italy
| | - Javier Cañueto
- Dermatology Department, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | - Jorge Santos-Juanes
- Dermatology Department, Central Universitary Hospital of Asturias and Instituto de Investigación Sanitaria of Principado de Asturias, IUOPA, Oviedo University, Oviedo, Spain
| | - Onofre Sanmartín
- Dermatology Department, Instituto Valenciano de Oncología, Valencia, Spain
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Serrano C, Lazo M, Serrano A, Toledo-Pastrana T, Barros-Tornay R, Acha B. Clinically Inspired Skin Lesion Classification through the Detection of Dermoscopic Criteria for Basal Cell Carcinoma. J Imaging 2022; 8:jimaging8070197. [PMID: 35877641 PMCID: PMC9319034 DOI: 10.3390/jimaging8070197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/05/2022] [Accepted: 07/08/2022] [Indexed: 12/10/2022] Open
Abstract
Background and Objective. Skin cancer is the most common cancer worldwide. One of the most common non-melanoma tumors is basal cell carcinoma (BCC), which accounts for 75% of all skin cancers. There are many benign lesions that can be confused with these types of cancers, leading to unnecessary biopsies. In this paper, a new method to identify the different BCC dermoscopic patterns present in a skin lesion is presented. In addition, this information is applied to classify skin lesions into BCC and non-BCC. Methods. The proposed method combines the information provided by the original dermoscopic image, introduced in a convolutional neural network (CNN), with deep and handcrafted features extracted from color and texture analysis of the image. This color analysis is performed by transforming the image into a uniform color space and into a color appearance model. To demonstrate the validity of the method, a comparison between the classification obtained employing exclusively a CNN with the original image as input and the classification with additional color and texture features is presented. Furthermore, an exhaustive comparison of classification employing different color and texture measures derived from different color spaces is presented. Results. Results show that the classifier with additional color and texture features outperforms a CNN whose input is only the original image. Another important achievement is that a new color cooccurrence matrix, proposed in this paper, improves the results obtained with other texture measures. Finally, sensitivity of 0.99, specificity of 0.94 and accuracy of 0.97 are achieved when lesions are classified into BCC or non-BCC. Conclusions. To the best of our knowledge, this is the first time that a methodology to detect all the possible patterns that can be present in a BCC lesion is proposed. This detection leads to a clinically explainable classification into BCC and non-BCC lesions. In this sense, the classification of the proposed tool is based on the detection of the dermoscopic features that dermatologists employ for their diagnosis.
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Affiliation(s)
- Carmen Serrano
- Dpto. Teoría de la Señal y Comunicaciones, Universidad de Sevilla, Camino de los Descubrimientos s/n, 41092 Seville, Spain; (M.L.); (B.A.)
- Correspondence:
| | - Manuel Lazo
- Dpto. Teoría de la Señal y Comunicaciones, Universidad de Sevilla, Camino de los Descubrimientos s/n, 41092 Seville, Spain; (M.L.); (B.A.)
| | - Amalia Serrano
- Hospital Universitario Virgen Macarena, Calle Dr. Fedriani, 3, 41009 Seville, Spain;
| | - Tomás Toledo-Pastrana
- Hospitales Quironsalud Infanta Luisa y Sagrado Corazón, Calle San Jacinto, 87, 41010 Seville, Spain;
| | | | - Begoña Acha
- Dpto. Teoría de la Señal y Comunicaciones, Universidad de Sevilla, Camino de los Descubrimientos s/n, 41092 Seville, Spain; (M.L.); (B.A.)
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3
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Cordero-Ramos J, Barros-Tornay R, Toledo-Pastrana T, Ferrándiz L, Calleja-Hernández MÁ, Moreno-Ramírez D. Effectiveness and safety of topical 15% resorcinol in the management of mild-to-moderate hidradenitis suppurativa: A cohort study. J Dermatol 2022; 49:459-462. [PMID: 34984726 DOI: 10.1111/1346-8138.16275] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 11/20/2021] [Accepted: 11/29/2021] [Indexed: 12/01/2022]
Abstract
Antibiotics remain one of the main treatment alternatives in mild-to-moderate hidradenitis suppurativa. The use of topical 15% resorcinol reduces antibiotic pressure and the generation of resistance. However, knowledge on its efficacy and safety is limited. This single-center, prospective, follow-up cohort study evaluated topical 15% resorcinol every 12-h response at 16 weeks. Those individuals with mild-to-moderate hidradenitis suppurativa (Hurley I-II) who started treatment with topical resorcinol monotherapy between April 2019 and May 2020 were eligible for follow-up. The primary endpoint for effectiveness was the proportion of patients who achieved an overall clinical response (complete or partial response) at week 16, evaluated as intention-to-treat. Responses were measured according to the Hidradenitis Suppurativa Clinical Response index. Target lesion size was measured clinically and by ultrasonography. Quality of life was assessed through the Dermatology Life Quality Index (DLQI) questionnaire. Safety was measured by recording the adverse events reported during the follow-up period. A total of 32 patients were enrolled (mean age, 40.1 years [95% confidence interval, 35.7-44.4]; women, 20 [62.5%]; Hurley I, 17 [53.1%]). Under the intention-to-treat analysis, 68.8% (n = 22) of the patients achieved a clinical response. A ≥50% reduction in the size of the main lesion was observed in 56.3% of the patients (n = 18). Some 65.6% (n = 21) of the patients had a ≥50% reduction (improvement) in their baseline DLQI score. Fifty percent of patients who completed the follow-up period experienced adverse events, all of which were local, mild, and transient and did not lead to discontinuation of resorcinol. To conclude, in this cohort study, topical 15% resorcinol was shown to be effective for mild-to-moderate hidradenitis suppurativa and to have a positive impact on quality of life with an acceptable safety profile.
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Affiliation(s)
- Jaime Cordero-Ramos
- Hospital Pharmacy Unit, University Hospital Virgen Macarena, Seville, Spain.,Department of Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Seville, Seville, Spain
| | | | | | - Lara Ferrándiz
- Dermatology Unit, University Hospital Virgen Macarena, Seville, Spain
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Català A, Muñoz-Santos C, Galván-Casas C, Roncero Riesco M, Revilla Nebreda D, Solá-Truyols A, Giavedoni P, Llamas-Velasco M, González-Cruz C, Cubiró X, Ruíz-Villaverde R, Gómez-Armayones S, Gil Mateo MP, Pesqué D, Marcantonio O, Fernández-Nieto D, Romaní J, Iglesias Pena N, Carnero Gonzalez L, Tercedor-Sanchez J, Carretero G, Masat-Ticó T, Rodríguez-Jiménez P, Gimenez-Arnau AM, Utrera-Busquets M, Vargas Laguna E, Angulo Menéndez AG, San Juan Lasser E, Iglesias-Sancho M, Alonso Naranjo L, Hiltun I, Cutillas Marco E, Polimon Olabarrieta I, Marinero Escobedo S, García-Navarro X, Calderón Gutiérrez MJ, Baeza-Hernández G, Bou Camps L, Toledo-Pastrana T, Guilabert A. Cutaneous reactions after SARS-COV-2 vaccination: A cross-sectional Spanish nationwide study of 405 cases. Br J Dermatol 2021; 186:142-152. [PMID: 34254291 PMCID: PMC8444756 DOI: 10.1111/bjd.20639] [Citation(s) in RCA: 145] [Impact Index Per Article: 48.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/05/2021] [Accepted: 07/10/2021] [Indexed: 11/30/2022]
Abstract
Background Cutaneous reactions after severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) vaccines are poorly characterized. Objective To describe and classify cutaneous reactions after SARS‐CoV‐2 vaccination. Methods A nationwide Spanish cross‐sectional study was conducted. We included patients with cutaneous reactions within 21 days of any dose of the approved vaccines at the time of the study. After a face‐to‐face visit with a dermatologist, information on cutaneous reactions was collected via an online professional survey and clinical photographs were sent by email. Investigators searched for consensus on clinical patterns and classification. Results From 16 February to 15 May 2021, we collected 405 reactions after vaccination with the BNT162b2 (Pfizer‐BioNTech; 40·2%), mRNA‐1273 (Moderna; 36·3%) and AZD1222 (AstraZeneca; 23·5%) vaccines. Mean patient age was 50·7 years and 80·2% were female. Cutaneous reactions were classified as injection site (‘COVID arm’, 32·1%), urticaria (14·6%), morbilliform (8·9%), papulovesicular (6·4%), pityriasis rosea‐like (4·9%) and purpuric (4%) reactions. Varicella zoster and herpes simplex virus reactivations accounted for 13·8% of reactions. The COVID arm was almost exclusive to women (95·4%). The most reported reactions in each vaccine group were COVID arm (mRNA‐1273, Moderna, 61·9%), varicella zoster virus reactivation (BNT162b2, Pfizer‐BioNTech, 17·2%) and urticaria (AZD1222, AstraZeneca, 21·1%). Most reactions to the mRNA‐1273 (Moderna) vaccine were described in women (90·5%). Eighty reactions (21%) were classified as severe/very severe and 81% required treatment. Conclusions Cutaneous reactions after SARS‐CoV‐2 vaccination are heterogeneous. Most are mild‐to‐moderate and self‐limiting, although severe/very severe reactions are reported. Knowledge of these reactions during mass vaccination may help healthcare professionals and reassure patients. What is already known about this topic?In clinical trials, COVID‐19 vaccines were associated with cutaneous adverse events, especially local injection site reactions. Previous descriptions of cutaneous reactions beyond the injection site were case reports or mostly reported by non‐dermatologists and lacked clinical images.
What does this study add?We describe and classify a large, representative sample of patients with unexplained skin manifestations after COVID‐19 vaccination, using consensus to define associated morphological patterns. We describe six morphological reaction patterns and herpesvirus reactivations, and their association with demographic factors and the medical record, and provide illustrations to allow for easy recognition.
Linked Comment: V. Bataille and S. Puig. Br J Dermatol 2022; 186:15. Plain language summary available online
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Affiliation(s)
- A Català
- Servicio de Dermatología. Hospital Clínic, Barcelona, Spain
| | - C Muñoz-Santos
- Servicio de Dermatología. Hospital General de Granollers, Barcelona, Spain
| | - C Galván-Casas
- Servicio de Dermatología. Hospital Universitario de Móstoles, Madrid, Spain
| | - M Roncero Riesco
- Servicio de Dermatología. Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | - D Revilla Nebreda
- Servicio de Dermatología. Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | - A Solá-Truyols
- Servicio de Dermatología. Hospital Universitario Son Llatzer, Mallorca, Spain
| | - P Giavedoni
- Servicio de Dermatología. Hospital Clínic, Barcelona, Spain
| | - M Llamas-Velasco
- Servicio de Dermatología. Hospital Universitario de La Princesa, Madrid, Spain
| | - C González-Cruz
- Servicio de Dermatología. Hospital, Universitari Vall D'Hebron, Barcelona, Spain
| | - X Cubiró
- Servicio de Dermatología. Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - R Ruíz-Villaverde
- Servicio de Dermatología. Hospital Universitario San Cecilio, Granada, Spain
| | | | - M P Gil Mateo
- Servicio de Dermatología. Hospital General de La Palma. Santa Cruz de Tenerife, Spain
| | - D Pesqué
- Servicio de Dermatología. Hospital del Mar. IMIM, Universitat Autònoma, Barcelona, Spain
| | - O Marcantonio
- Servicio de Dermatología. Hospital del Mar. IMIM, Universitat Autònoma, Barcelona, Spain
| | | | - J Romaní
- Servicio de Dermatología, Parc Taulí Hospital Universitari. Sabadell, Barcelona, Spain
| | - N Iglesias Pena
- Servicio de Dermatología. Hospital, Universitario Lucus Augusti, Lugo, Spain
| | | | | | - G Carretero
- Servicio de Dermatología.Hospital Universitario Gran Canaria Doctor Negrín, Las Palmas Gran Canaria, Spain
| | - T Masat-Ticó
- CAP Cardedeu. Institut Català de la Salut, Barcelona, Spain
| | - P Rodríguez-Jiménez
- Servicio de Dermatología. Hospital Universitario de La Princesa, Madrid, Spain
| | - A M Gimenez-Arnau
- Servicio de Dermatología. Hospital del Mar. IMIM, Universitat Autònoma, Barcelona, Spain
| | - M Utrera-Busquets
- Servicio de Dermatología. Hospital Comarcal Infanta Elena, Huelva, Spain
| | - E Vargas Laguna
- Servicio de Dermatología. Hospital, Universitario Severo Ochoa, Madrid, Spain
| | - A G Angulo Menéndez
- Servicio de Dermatología. Serveis Medics Penedés Vilanova i la Geltrú, Barcelona, Spain
| | | | - M Iglesias-Sancho
- Servicio de Dermatología. Hospital, Universitari Sagrat Cor, Barcelona, Spain
| | - L Alonso Naranjo
- Servicio de Dermatología. Hospital Universitario de Toledo, Toledo, Spain
| | - I Hiltun
- Servicio de Dermatología, Complejo Hospitalario de Navarra, Navarra, Spain
| | - E Cutillas Marco
- Servicio de Dermatología. Hospital General, Universitario Reina Sofia, Murcia, Spain
| | | | | | - X García-Navarro
- Servicio de Dermatología. Consorci Sanitari Alt Penedès-Garraf, Barcelona, Spain
| | | | - G Baeza-Hernández
- Servicio de Dermatología. Hospital Universitario de Fuenlabrada, Madrid, Spain
| | | | | | - A Guilabert
- Servicio de Dermatología. Hospital General de Granollers, Barcelona, Spain
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Ríos-Viñuela E, Bernia E, Toledo-Pastrana T, Requena C, Diago A, Serra-Guillén C, Llombart B, Traves V, Nagore E, Guillén C, Sanmartin O. Localized Injection-site Toxic Erythema of Chemotherapy: An Under-recognized Acquaintance Revisited. Acta Derm Venereol 2021; 101:adv00429. [PMID: 33734421 DOI: 10.2340/00015555-3791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Elisa Ríos-Viñuela
- Department of Dermatology, Instituto Valenciano de Oncología, ES-46009 Valencia, Spain. E-mail:
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Padilla-España L, Toledo-Pastrana T, Fernández-Orland A, Ferrándiz-Pulido L. Electrochemotherapy With Intravenous Bleomycin in the Treatment of Unresectable Merkel Cell Carcinoma. Actas Dermosifiliogr (Engl Ed) 2018; 110:687-688. [PMID: 30126606 DOI: 10.1016/j.ad.2018.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 06/29/2018] [Accepted: 07/02/2018] [Indexed: 10/28/2022] Open
Affiliation(s)
- L Padilla-España
- Unidad de Gestión Clínica de Dermatología, Hospital Universitario Virgen Macarena, Sevilla, España.
| | - T Toledo-Pastrana
- Unidad de Gestión Clínica de Dermatología, Hospital Universitario Virgen Macarena, Sevilla, España
| | - A Fernández-Orland
- Unidad de Gestión Clínica de Dermatología, Hospital Universitario Virgen Macarena, Sevilla, España
| | - L Ferrándiz-Pulido
- Unidad de Gestión Clínica de Dermatología, Hospital Universitario Virgen Macarena, Sevilla, España
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Ferrándiz L, Morales-Conde M, Fernández-Orland A, Martín-Gutiérrez FJ, Raya-Maldonado J, Toledo-Pastrana T, Moreno-Ramírez D. Teledermatology-driven topical therapy of actinic keratosis: a comparative study of clinical effectiveness and compliance. J Eur Acad Dermatol Venereol 2018; 32:2149-2152. [PMID: 29797670 DOI: 10.1111/jdv.15085] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 05/03/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND Teledermatology (TD) provides efficient care for skin cancer patients. OBJECTIVE To compare the clinical effectiveness of imiquimod 5% for the treatment of AK with in-person care and through TD. METHODS Longitudinal prospective controlled study including patients with single AK diagnosed and treated at face-to-face visits (FTF group) or through teledermatology (TD group) with imiquimod 5% cream. The main outcome measures assessed were the complete and global response percentage (CR and GR) under per-protocol (PP) and intention-to-treat (ITT) analysis. RESULTS A total of 157 patients were enrolled (FTF = 75, TD = 82). PP analysis showed CR in 66.7% of FTF patients and 65.6% in TD patients (P > 0.05). The ITT yielded CR in 64.0% and 51.2% in FTF visits and TD, respectively (P = 0.073). The analysis showed an advantage of FTF care against TD in achieving GR (84.0% vs. 70.7%; P = 0.036). Facial location and local adverse reactions were the only explanatory factors of complete response in the ITT approach. Treatment completion was found in 90.7% and 72.0% in the FTF and TD groups, respectively (P = 0.004). CONCLUSIONS Improvements in patient counselling at the primary care centre are needed before the implementation of TD as a routine methodology for the management of AK.
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Affiliation(s)
- L Ferrándiz
- Dermatology Unit & Teledermatology Network, Hospital Universitario Virgen, Macarena, Sevilla, Spain
| | - M Morales-Conde
- Dermatology Unit & Teledermatology Network, Hospital Universitario Virgen, Macarena, Sevilla, Spain
| | - A Fernández-Orland
- Dermatology Unit & Teledermatology Network, Hospital Universitario Virgen, Macarena, Sevilla, Spain
| | - F J Martín-Gutiérrez
- Dermatology Unit & Teledermatology Network, Hospital Universitario Virgen, Macarena, Sevilla, Spain
| | - J Raya-Maldonado
- Dermatology Unit & Teledermatology Network, Hospital Universitario Virgen, Macarena, Sevilla, Spain
| | - T Toledo-Pastrana
- Dermatology Unit & Teledermatology Network, Hospital Universitario Virgen, Macarena, Sevilla, Spain
| | - D Moreno-Ramírez
- Dermatology Unit & Teledermatology Network, Hospital Universitario Virgen, Macarena, Sevilla, Spain
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Toledo-Pastrana T, Rodríguez Pérez I, Eguino Gorrochategui P. Malignant Blue Nevus: A Challenge for Dermatologists and Dermatopathologists. Actas Dermosifiliogr (Engl Ed) 2017; 109:181-183. [PMID: 28963027 DOI: 10.1016/j.ad.2017.02.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 02/18/2017] [Indexed: 11/25/2022] Open
Affiliation(s)
- T Toledo-Pastrana
- Dermatology Department, Donostia University Hospital, San Sebastián, Spain.
| | - I Rodríguez Pérez
- Pathology Department, Donostia University Hospital, San Sebastián, Spain
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Russo F, Linares M, Iglesias ME, Martínez-Amo JL, Cabo F, Tercedor J, Costa-Vieira R, Toledo-Pastrana T, Ródenas JM, Leis V. Reconstruction Techniques of Choice for the Facial Cosmetic Units. Actas Dermosifiliogr 2017; 108:729-737. [PMID: 28666523 DOI: 10.1016/j.ad.2017.02.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Revised: 02/21/2017] [Accepted: 02/24/2017] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND AND OBJECTIVES A broad range of skin flaps can be used to repair facial surgical defects after the excision of a tumor. The aim of our study was to develop a practical guideline covering the most useful skin grafts for each of the distinct facial cosmetic units. MATERIAL AND METHODS This was a multicenter study in which 10 dermatologists with extensive experience in reconstructive surgery chose their preferred technique for each cosmetic unit. The choice of flaps was based on personal experience, taking into account factors such as suitability of the reconstruction technique for the specific defect, the final cosmetic result, surgical difficulty, and risk of complications. Each dermatologist proposed 2 flaps in order of preference for each cosmetic subunit. A score of 10 was given to the first flap and a score of 5 to the second. RESULTS The total score obtained for each of the options proposed by the participating dermatologists was used to draw up a list of the 3 best grafts for each site. There was notable unanimity of criteria among most of the dermatologists for reconstructive techniques such as the glabellar flap for defects of the medial canthus of the eye, the bilateral advancement flag flap or H flap for the forehead, the rotary door flap for the auricle of the ear, the Mustarde flap for the infraorbital cheek, the O-Z rotation flap for the scalp, the Tenzel flap for the lower eyelid, and the island flap for the upper lip. CONCLUSIONS The results of this study will be useful as a practical guide to choosing the best reconstruction technique for each of the facial cosmetic units.
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Affiliation(s)
- F Russo
- Servicio de Dermatología, Hospital Punta de Europa, Algeciras, Cádiz, España.
| | - M Linares
- Servicio de Dermatología, Hospital Puerta del Mar, Cádiz, España
| | - M E Iglesias
- Servicio de Dermatología, Complejo Hospitalario de Navarra, Pamplona, España
| | - J L Martínez-Amo
- Servicio de Dermatología, Hospital de Poniente, El Ejido, Almería, España
| | - F Cabo
- Servicio de Dermatología, Complexo Hospitalario Universitario de Ourense, Orense, España
| | - J Tercedor
- Servicio de Dermatología, Complejo Hospitalario de Granada, Granada, España
| | - R Costa-Vieira
- Servicio de Dermatología, Centro Hospitalario e Universitário de Coimbra, Coimbra, Portugal
| | - T Toledo-Pastrana
- Servicio de Dermatología. Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España
| | - J M Ródenas
- Servicio de Dermatología, Hospital General Universitario Morales Meseguer, Murcia, España
| | - V Leis
- Servicio de Dermatología, Hospital Infanta Sofía, San Sebastián de los Reyes, Madrid, España
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Moreno-Ramirez D, Toledo-Pastrana T, Rios-Martin JJ, Ferrándiz L. Surgical removal of a noninvoluting congenital hemangioma using a modified sub-brow flap. JAAD Case Rep 2016; 2:199-201. [PMID: 27274536 PMCID: PMC4885147 DOI: 10.1016/j.jdcr.2016.03.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- David Moreno-Ramirez
- Medical & Surgical Dermatology Unit, University Hospital Virgen Macarena, Seville, Spain
- Correspondence to: David Moreno-Ramirez, PhD, Dermatology Unit, University Hospital Virgen Macarena, Avda. Dr. Fedriani s/n 41009 Seville, Spain.Dermatology UnitUniversity Hospital Virgen MacarenaAvda. Dr. Fedriani s/nSeville41009Spain
| | - Tomás Toledo-Pastrana
- Medical & Surgical Dermatology Unit, University Hospital Virgen Macarena, Seville, Spain
| | | | - Lara Ferrándiz
- Medical & Surgical Dermatology Unit, University Hospital Virgen Macarena, Seville, Spain
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Rivas-Tolosa N, Ortiz-Brugués A, Toledo-Pastrana T, Baradad M, Traves V, Soriano V, Sanmartín V, Requena C, Martí R, Nagore E. Local cryosurgery and imiquimod: A successful combination for the treatment of locoregional cutaneous metastasis of melanoma: A case series. J Dermatol 2015; 43:553-6. [PMID: 26660713 DOI: 10.1111/1346-8138.13197] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 09/25/2015] [Indexed: 11/30/2022]
Abstract
Locoregional cutaneous metastases of melanoma (LCMM) represent a therapeutic challenge. Many treatment options are available with varying results. The combination of cryotherapy and imiquimod, two treatments with a possible synergistic effect, has not yet been described for treating this disease. In this paper, we aimed to show the response of LCMM to cryotherapy combined with topical imiquimod 5%. A retrospective review of 20 patients diagnosed with LCMM and treated with cryotherapy combined with topical imiquimod 5% between November 2000 and May 2014 at three institutions was performed. The locoregional cutaneous response was evaluated. After a mean of five sessions, 13 patients (65%) responded to treatment, eight (40%) of these completely and five (25%) partially. Systemic disease progressed in 16 (80%) patients. Cryotherapy followed by topical imiquimod 5% is simple to apply, has minimal adverse effects and provides response rates similar to other, more complex treatment options.
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Affiliation(s)
- Nancy Rivas-Tolosa
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| | | | | | - Manel Baradad
- Department of Dermatology, Hospital Universitario Arnau de Vilanova, Lleida, Spain
| | - Víctor Traves
- Department of Pathology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Virtudes Soriano
- Department of Medical Oncology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Verónica Sanmartín
- Department of Dermatology, Hospital Universitario Arnau de Vilanova, Lleida, Spain
| | - Celia Requena
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Rosa Martí
- Department of Dermatology, Hospital Universitario Arnau de Vilanova, Lleida, Spain
| | - Eduardo Nagore
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
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Toledo-Pastrana T, Sánchez J, Domínguez-Castellano Á. Tumoraciones cutáneas vasculares eruptivas en un varón de 45 años de edad. Rev Clin Esp 2014; 214:e115. [DOI: 10.1016/j.rce.2014.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Accepted: 08/15/2014] [Indexed: 10/24/2022]
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Toledo-Pastrana T, Zapata-López Á, Michán-Doña A. Exudado uretral y afectación mucocutánea. Rev Clin Esp 2014; 214:e91-2. [DOI: 10.1016/j.rce.2014.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Accepted: 04/06/2014] [Indexed: 11/17/2022]
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Toledo-Pastrana T, Hernández MJG, Camacho Martínez FM. Perifollicular erythema as a trichoscopy sign of progression in frontal fibrosing alopecia. Int J Trichology 2014; 5:151-3. [PMID: 24574696 PMCID: PMC3927175 DOI: 10.4103/0974-7753.125616] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Frontal fibrosing alopecia (FFA) in an entity characterized by the recession of the frontotemporal hairline (FTHL) with alopecic scarring change. In recent years there are numerous articles discussing the usefulness of dermoscopy for the clinical diagnosis of different types of scarring alopecia. MATERIALS AND METHODS We value 79 patients diagnosed with FFA, evaluating some trichoscopical findings described as typical for FFA: Absence of follicular opening, follicular hyperkeratosis, follicular plugs and erythema. RESULTS In a population of 79 women, 100% showed no follicular opening, 72.1% follicular hyperkeratosis, 66.3% perifollicular erythema and 44.8% follicular plugs. Thus, 100% of patients had at least one of the dermoscopic elements described as suggestive of FFA, 53% two of them, 45% three and 27%, all those elements. Perifollicular erythema was present in 95% of cases in which the disease was active. CONCLUSIONS We consider that the presence of perifollicular erythema will be a direct marker of FFA activity.
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