DERMATOLOGY

Author: GARCIA ALMAGRO DOMINGO.
Year: 2004.
University: COMPLUTENSE DE MADRID [www.ucm.es].
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: V.COMPLUTENSE. FACULTAD DE MEDICINA.

Summary: Assumptions: Cutaneous leishmaniasis is in the Toledo Area Sanitary, a hipoendemia maintained over tiempo.Su mild morbidity, and polymorphism evolution commonly benign clinical hinder their knowledge. Objectives: Verification of hipoendemia its mapping and habitat that is developed, clinical characteristics, development of the same over the period studied, possible seasonal nature of the disease, histological study of biopsies, peculiarities of patients with coinfection Leishmania- HIV, and treatment of patients studied. Materials and Methods: A retrospective study of 131 patients with cutaneous leishmaniasis, documented in amastigotes smears (7 cases) and / or biopsy (124 cases) between January 1991 and March 2004.Datos collected: age, sex, number and location injuries, year and month consultation year and month likely to bite, clinic injuries, epithelioid granuloma formation, co-infection with HIV, treatment and location of resisdencia patient. Results and conclusions: It confirms the existence of the hipoendemia, peri, zoonotic, which is the dog reservoir, located in the northeastern part of Toledo, particularly in relation to the course of the river Tagus, Guadarrama, and that continues to callously area hipoendémica southern Madrid.Como peculiarities presents greater involvement of adults (average age of 49.58 years) of female predominance 3 / 2, while women tambiuén are older (average age of male 39.55 years and 56.4 years for women). Minor predominance of head injuries, particularly in varones.4 injuries mucous three in immunocompetent and HIV, which insists on implementing the designation "button East or Leishmaniadis Skin inoculation mucosa. "endemia is staying with a decline between 1994 and 2000, and a subsequent rebound, there is still not enough valorable.No seasonality in the activity of flebotomos.El treatment of choice in cases not complicated, is the antimoniato meglumine intralesional.Existe an underreporting of which must rethink the mechanisms of meglumine intralesional.Existe a subdeclacración that should rethink the mechanisms of coordination between the echelon of care and epidemiological teams. Keywords: Cutaneous leishmaniasis, Button Middle mucosal inoculation, zoonoses, endemic, Toledo.

Author: BARTRALOT SOLER RAMÓN.
Year: 2005.
University: AUTÓNOMA DE BARCELONA [www.uab.es].
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: UNIVERSIDAD AUTÓNOMA DE BARCELONA.

Summary: INTRODUCTION The Mycobacterial atypical skin infections occur by inoculation external extension to the skin from a serious infection or Hematogenous dissemination of a systemic infection. Most skin infections by these microorganisms appear in tabular form nonspecific. Only two infections that are considered specific kind: granuloma of the tanks or pools due to Mycobacterium marinum, and Buruli ulcer, caused by Mycobacterium ulcerans. OBJECTIVE define patterns of clinical and pathological skin infections by atypical mycobacteria. METHODS Through the study of 51 patients with atypical mycobacterial infections were analyzed clinical and histological features. The results were compared between immunocompetent and immunocompromised patients, as well as the published literature by searching Medline. The group of immunosuppressed distinguished 2 subgroups: skin infection isolated and disseminated infection affecting the skin. RESULTS in immunosuppressed patients, the number of injuries was significantly higher. Also in this group was found more frequently abscesses and ulcers and lesions elementary. The species responsible and immunocompetent were different from those found in immunocompromised. It identified several patterns of skin infection: lesions with distribution linfocutánea or esporotricoide, injuries not linfocutáneas in areas with previous trauma, folliculitis and fornuculosis in the lower extremities and widespread injuries in the extremities in immunosuppressed patients. In patients with disseminated infection, were observed 2 additional patterns: localized lesions and skin -mucosas widespread injuries. CONCLUSIONS Skin manifestation of Mycobacterial infections can be grouped, according to criteria such as type of skin lesions and the immune status of patients, fairly uniform pattern.

Author: CARRASCOSA CARRILLO MANUEL.
Year: 2005.
University: BARCELONA [www.ub.es].
Place of defense: UNIVERSITAT AUTÒNOMA DE BARCELONA.
Place of preparation: UNIVERSITAT AUTÓNOMA DE BARCELONA.

Author: TOLL ABELLÓ AGUSTÍN.
Year: 2005.
University: BARCELONA [www.ub.es].
Place of defense: FACULTAT DE MEDICINA.
Place of preparation: FACULTAT DE MEDICINA.

Author: CORBALÁN VÉLEZ ANTONIO RAÚL.
Year: 2005.
University: ZARAGOZA [www.unizar.es].
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: UNIVERSIDAD DE ZARAGOZA.

Summary: The number of cases reported of squamous cell carcinoma (EC) clear cell is low, despite what we believe is a common event to observe clear cell in the EC in clinical practice. We believe that the cells could indicate clear differentiation adnexal and could be cytopathic effects of human papilloma virus (HPV). We studied 369 EC, which subsequently exclude 120, removed for a period of 5 years in the district hospital of Orihuela (Alicante). There differentiation adnexal in 19 cases, which were considered as a separate subgroup. Note 96 EC with more than 25% of clear cell, 7 cases with more than 75%. There are more cells in tumors not clear emerging and those that stem from Bowen's Disease (EB). We describe 2 patterns histology, a pattern of clear cell around pearls corneas CE it relates to Keratosis Actínica as injury prior to the observation of indirect signs of HPV in infundíbulos pilosos and other histological pattern of EC with clear cell differentiation that simulates adnexal and it relates to EB as a prior injury. In almost all of our cases there was intense elastosis sun, which lead a major chronic sun damage. We have also seen signs histological indirect attributable to HPV in almost all studied and EC cells such as those seen in the disease of Epidermodysplasia Verruciformee (EV cells) in 33 EC (14.7%). Often seen clear cell in the EC, while only a small percentage has a lot of clear cell. The development of clear cell in the EC would be a continuous process that requires time, and that only appear in the EC more or less developed emerging. The observation cell clear in the EC suggests that may exist differentiation adnexal: however, in most cases it is clear infiltrating cells with EB adnexal structures prior differentiation and simulating adnexal. In a small percentage of cases (7.6% in our study) does exist adnexal differentiation, it should be discarded through various histological and immunohistochemical approaches. Highlights differentiation adnexal type sebáceo-apocrino that could be associated with a poor prognosis, clinical (describe 12 carcinomas with this differentiation, 9 of them could be considered porocarcinomas sebo-apocrinos). Moreover, the histological pattern described as clear cell around pearls corneas, we practically ruled there adnexal differentiation. The observation of indirect signs of HPV in almost all EC surveyed support the potential role of HPV in oncogénesis CE. EV cells could be the result of cytopathic effects of certain subtypes of HPV (such as HPV-5 or HPV-8), and may be linked to immunosuppression. Based on immunosuppression caused by chronic sun exposure, the elderly or both, almost all our cases could be associated with immunosuppression, or at least localized skin.

Author: GALAN GUTIERREZ MANUEL.
Year: 2006.
University: CÓRDOBA [www.uco.es].
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA.

Summary: The retinoids have an important role as therapeutic agents. Since the introduction of the isotretinoina for treating acne and Cystic disorders of the querantinización more than 20 years ago, retinoids have been employed on a growing extra skin diseases and prevention or treatment of malignancies. Its use may be associated with a number of side effects, among which teratogenicity, and those musculoskeletal manifestations, unfortunately, it is not clear his action at the level of bone mineralization and the impact that could have such an effect . In this paper we study a total of 77 patients aged comprendías between 14 and 27 years, employing isotretinoina as treatment of their acne. We investigated the bone mineral density of these patients, evaluating the differences appeared along this while they were in therapy and at the end of it. Similarly, it also appeared determined alterations in the metabolism fosfo-cálcico and associated with treatment. In conclusion was not found that there was a significant decrease in bone mineral density of patients investigated, and changes in metabolism fosfo-cálcio were mild and transient. Therefore, we conclude that isotretinoina used in the treatment of acne, the dose and duration set for the same, not to a decline in bone mineralization maintain its excellent results in improving this table.