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Publisher: Elsevier   (Total: 3181 journals)

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Showing 1 - 200 of 3181 Journals sorted alphabetically
Academic Pediatrics     Hybrid Journal   (Followers: 39, SJR: 1.655, CiteScore: 2)
Academic Radiology     Hybrid Journal   (Followers: 26, SJR: 1.015, CiteScore: 2)
Accident Analysis & Prevention     Partially Free   (Followers: 105, SJR: 1.462, CiteScore: 3)
Accounting Forum     Hybrid Journal   (Followers: 28, SJR: 0.932, CiteScore: 2)
Accounting, Organizations and Society     Hybrid Journal   (Followers: 42, SJR: 1.771, CiteScore: 3)
Achievements in the Life Sciences     Open Access   (Followers: 7)
Acta Anaesthesiologica Taiwanica     Open Access   (Followers: 6)
Acta Astronautica     Hybrid Journal   (Followers: 444, SJR: 0.758, CiteScore: 2)
Acta Automatica Sinica     Full-text available via subscription   (Followers: 2)
Acta Biomaterialia     Hybrid Journal   (Followers: 30, SJR: 1.967, CiteScore: 7)
Acta Colombiana de Cuidado Intensivo     Full-text available via subscription   (Followers: 3)
Acta de Investigación Psicológica     Open Access   (Followers: 3)
Acta Ecologica Sinica     Open Access   (Followers: 11, SJR: 0.18, CiteScore: 1)
Acta Histochemica     Hybrid Journal   (Followers: 5, SJR: 0.661, CiteScore: 2)
Acta Materialia     Hybrid Journal   (Followers: 319, SJR: 3.263, CiteScore: 6)
Acta Mathematica Scientia     Full-text available via subscription   (Followers: 5, SJR: 0.504, CiteScore: 1)
Acta Mechanica Solida Sinica     Full-text available via subscription   (Followers: 9, SJR: 0.542, CiteScore: 1)
Acta Oecologica     Hybrid Journal   (Followers: 12, SJR: 0.834, CiteScore: 2)
Acta Otorrinolaringologica (English Edition)     Full-text available via subscription  
Acta Otorrinolaringológica Española     Full-text available via subscription   (Followers: 2, SJR: 0.307, CiteScore: 0)
Acta Pharmaceutica Sinica B     Open Access   (Followers: 2, SJR: 1.793, CiteScore: 6)
Acta Poética     Open Access   (Followers: 4, SJR: 0.101, CiteScore: 0)
Acta Psychologica     Hybrid Journal   (Followers: 26, SJR: 1.331, CiteScore: 2)
Acta Sociológica     Open Access   (Followers: 1)
Acta Tropica     Hybrid Journal   (Followers: 6, SJR: 1.052, CiteScore: 2)
Acta Urológica Portuguesa     Open Access  
Actas Dermo-Sifiliograficas     Full-text available via subscription   (Followers: 3, SJR: 0.374, CiteScore: 1)
Actas Dermo-Sifiliográficas (English Edition)     Full-text available via subscription   (Followers: 2)
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 3, SJR: 0.344, CiteScore: 1)
Actas Urológicas Españolas (English Edition)     Full-text available via subscription   (Followers: 1)
Actualites Pharmaceutiques     Full-text available via subscription   (Followers: 7, SJR: 0.19, CiteScore: 0)
Actualites Pharmaceutiques Hospitalieres     Full-text available via subscription   (Followers: 3)
Acupuncture and Related Therapies     Hybrid Journal   (Followers: 8)
Acute Pain     Full-text available via subscription   (Followers: 15, SJR: 2.671, CiteScore: 5)
Ad Hoc Networks     Hybrid Journal   (Followers: 11, SJR: 0.53, CiteScore: 4)
Addictive Behaviors     Hybrid Journal   (Followers: 18, SJR: 1.29, CiteScore: 3)
Addictive Behaviors Reports     Open Access   (Followers: 9, SJR: 0.755, CiteScore: 2)
Additive Manufacturing     Hybrid Journal   (Followers: 11, SJR: 2.611, CiteScore: 8)
Additives for Polymers     Full-text available via subscription   (Followers: 23)
Advanced Drug Delivery Reviews     Hybrid Journal   (Followers: 188, SJR: 4.09, CiteScore: 13)
Advanced Engineering Informatics     Hybrid Journal   (Followers: 12, SJR: 1.167, CiteScore: 4)
Advanced Powder Technology     Hybrid Journal   (Followers: 17, SJR: 0.694, CiteScore: 3)
Advances in Accounting     Hybrid Journal   (Followers: 9, SJR: 0.277, CiteScore: 1)
Advances in Agronomy     Full-text available via subscription   (Followers: 17, SJR: 2.384, CiteScore: 5)
Advances in Anesthesia     Full-text available via subscription   (Followers: 30, SJR: 0.126, CiteScore: 0)
Advances in Antiviral Drug Design     Full-text available via subscription   (Followers: 2)
Advances in Applied Mathematics     Full-text available via subscription   (Followers: 12, SJR: 0.992, CiteScore: 1)
Advances in Applied Mechanics     Full-text available via subscription   (Followers: 12, SJR: 1.551, CiteScore: 4)
Advances in Applied Microbiology     Full-text available via subscription   (Followers: 24, SJR: 2.089, CiteScore: 5)
Advances In Atomic, Molecular, and Optical Physics     Full-text available via subscription   (Followers: 15, SJR: 0.572, CiteScore: 2)
Advances in Biological Regulation     Hybrid Journal   (Followers: 4, SJR: 2.61, CiteScore: 7)
Advances in Botanical Research     Full-text available via subscription   (Followers: 2, SJR: 0.686, CiteScore: 2)
Advances in Cancer Research     Full-text available via subscription   (Followers: 34, SJR: 3.043, CiteScore: 6)
Advances in Carbohydrate Chemistry and Biochemistry     Full-text available via subscription   (Followers: 9, SJR: 1.453, CiteScore: 2)
Advances in Catalysis     Full-text available via subscription   (Followers: 5, SJR: 1.992, CiteScore: 5)
Advances in Cell Aging and Gerontology     Full-text available via subscription   (Followers: 5)
Advances in Cellular and Molecular Biology of Membranes and Organelles     Full-text available via subscription   (Followers: 14)
Advances in Chemical Engineering     Full-text available via subscription   (Followers: 29, SJR: 0.156, CiteScore: 1)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 11, SJR: 0.713, CiteScore: 1)
Advances in Chronic Kidney Disease     Full-text available via subscription   (Followers: 10, SJR: 1.316, CiteScore: 2)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 26, SJR: 1.562, CiteScore: 3)
Advances in Colloid and Interface Science     Full-text available via subscription   (Followers: 20, SJR: 1.977, CiteScore: 8)
Advances in Computers     Full-text available via subscription   (Followers: 14, SJR: 0.205, CiteScore: 1)
Advances in Dermatology     Full-text available via subscription   (Followers: 15)
Advances in Developmental Biology     Full-text available via subscription   (Followers: 13)
Advances in Digestive Medicine     Open Access   (Followers: 12)
Advances in DNA Sequence-Specific Agents     Full-text available via subscription   (Followers: 7)
Advances in Drug Research     Full-text available via subscription   (Followers: 26)
Advances in Ecological Research     Full-text available via subscription   (Followers: 44, SJR: 2.524, CiteScore: 4)
Advances in Engineering Software     Hybrid Journal   (Followers: 29, SJR: 1.159, CiteScore: 4)
Advances in Experimental Biology     Full-text available via subscription   (Followers: 8)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 52, SJR: 5.39, CiteScore: 8)
Advances in Exploration Geophysics     Full-text available via subscription   (Followers: 1)
Advances in Fluorine Science     Full-text available via subscription   (Followers: 9)
Advances in Food and Nutrition Research     Full-text available via subscription   (Followers: 67, SJR: 0.591, CiteScore: 2)
Advances in Fuel Cells     Full-text available via subscription   (Followers: 17)
Advances in Genetics     Full-text available via subscription   (Followers: 21, SJR: 1.354, CiteScore: 4)
Advances in Genome Biology     Full-text available via subscription   (Followers: 11, SJR: 12.74, CiteScore: 13)
Advances in Geophysics     Full-text available via subscription   (Followers: 7, SJR: 1.193, CiteScore: 3)
Advances in Heat Transfer     Full-text available via subscription   (Followers: 26, SJR: 0.368, CiteScore: 1)
Advances in Heterocyclic Chemistry     Full-text available via subscription   (Followers: 11, SJR: 0.749, CiteScore: 3)
Advances in Human Factors/Ergonomics     Full-text available via subscription   (Followers: 26)
Advances in Imaging and Electron Physics     Full-text available via subscription   (Followers: 3, SJR: 0.193, CiteScore: 0)
Advances in Immunology     Full-text available via subscription   (Followers: 37, SJR: 4.433, CiteScore: 6)
Advances in Inorganic Chemistry     Full-text available via subscription   (Followers: 10, SJR: 1.163, CiteScore: 2)
Advances in Insect Physiology     Full-text available via subscription   (Followers: 2, SJR: 1.938, CiteScore: 3)
Advances in Integrative Medicine     Hybrid Journal   (Followers: 6, SJR: 0.176, CiteScore: 0)
Advances in Intl. Accounting     Full-text available via subscription   (Followers: 3)
Advances in Life Course Research     Hybrid Journal   (Followers: 9, SJR: 0.682, CiteScore: 2)
Advances in Lipobiology     Full-text available via subscription   (Followers: 1)
Advances in Magnetic and Optical Resonance     Full-text available via subscription   (Followers: 8)
Advances in Marine Biology     Full-text available via subscription   (Followers: 21, SJR: 0.88, CiteScore: 2)
Advances in Mathematics     Full-text available via subscription   (Followers: 15, SJR: 3.027, CiteScore: 2)
Advances in Medical Sciences     Hybrid Journal   (Followers: 8, SJR: 0.694, CiteScore: 2)
Advances in Medicinal Chemistry     Full-text available via subscription   (Followers: 6)
Advances in Microbial Physiology     Full-text available via subscription   (Followers: 5, SJR: 1.158, CiteScore: 3)
Advances in Molecular and Cell Biology     Full-text available via subscription   (Followers: 25)
Advances in Molecular and Cellular Endocrinology     Full-text available via subscription   (Followers: 8)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 7, SJR: 0.182, CiteScore: 0)
Advances in Nanoporous Materials     Full-text available via subscription   (Followers: 5)
Advances in Oncobiology     Full-text available via subscription   (Followers: 2)
Advances in Organ Biology     Full-text available via subscription   (Followers: 2)
Advances in Organometallic Chemistry     Full-text available via subscription   (Followers: 18, SJR: 1.875, CiteScore: 4)
Advances in Parallel Computing     Full-text available via subscription   (Followers: 7, SJR: 0.174, CiteScore: 0)
Advances in Parasitology     Full-text available via subscription   (Followers: 5, SJR: 1.579, CiteScore: 4)
Advances in Pediatrics     Full-text available via subscription   (Followers: 27, SJR: 0.461, CiteScore: 1)
Advances in Pharmaceutical Sciences     Full-text available via subscription   (Followers: 19)
Advances in Pharmacology     Full-text available via subscription   (Followers: 17, SJR: 1.536, CiteScore: 3)
Advances in Physical Organic Chemistry     Full-text available via subscription   (Followers: 9, SJR: 0.574, CiteScore: 1)
Advances in Phytomedicine     Full-text available via subscription  
Advances in Planar Lipid Bilayers and Liposomes     Full-text available via subscription   (Followers: 3, SJR: 0.109, CiteScore: 1)
Advances in Plant Biochemistry and Molecular Biology     Full-text available via subscription   (Followers: 10)
Advances in Plant Pathology     Full-text available via subscription   (Followers: 6)
Advances in Porous Media     Full-text available via subscription   (Followers: 5)
Advances in Protein Chemistry     Full-text available via subscription   (Followers: 19)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 20, SJR: 0.791, CiteScore: 2)
Advances in Psychology     Full-text available via subscription   (Followers: 68)
Advances in Quantum Chemistry     Full-text available via subscription   (Followers: 6, SJR: 0.371, CiteScore: 1)
Advances in Radiation Oncology     Open Access   (Followers: 2, SJR: 0.263, CiteScore: 1)
Advances in Small Animal Medicine and Surgery     Hybrid Journal   (Followers: 3, SJR: 0.101, CiteScore: 0)
Advances in Space Biology and Medicine     Full-text available via subscription   (Followers: 6)
Advances in Space Research     Full-text available via subscription   (Followers: 424, SJR: 0.569, CiteScore: 2)
Advances in Structural Biology     Full-text available via subscription   (Followers: 5)
Advances in Surgery     Full-text available via subscription   (Followers: 13, SJR: 0.555, CiteScore: 2)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 38, SJR: 2.208, CiteScore: 4)
Advances in Veterinary Medicine     Full-text available via subscription   (Followers: 20)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 15)
Advances in Virus Research     Full-text available via subscription   (Followers: 6, SJR: 2.262, CiteScore: 5)
Advances in Water Resources     Hybrid Journal   (Followers: 54, SJR: 1.551, CiteScore: 3)
Aeolian Research     Hybrid Journal   (Followers: 6, SJR: 1.117, CiteScore: 3)
Aerospace Science and Technology     Hybrid Journal   (Followers: 385, SJR: 0.796, CiteScore: 3)
AEU - Intl. J. of Electronics and Communications     Hybrid Journal   (Followers: 8, SJR: 0.42, CiteScore: 2)
African J. of Emergency Medicine     Open Access   (Followers: 6, SJR: 0.296, CiteScore: 0)
Ageing Research Reviews     Hybrid Journal   (Followers: 12, SJR: 3.671, CiteScore: 9)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 483, SJR: 1.238, CiteScore: 3)
Agri Gene     Hybrid Journal   (Followers: 1, SJR: 0.13, CiteScore: 0)
Agricultural and Forest Meteorology     Hybrid Journal   (Followers: 18, SJR: 1.818, CiteScore: 5)
Agricultural Systems     Hybrid Journal   (Followers: 32, SJR: 1.156, CiteScore: 4)
Agricultural Water Management     Hybrid Journal   (Followers: 45, SJR: 1.272, CiteScore: 3)
Agriculture and Agricultural Science Procedia     Open Access   (Followers: 4)
Agriculture and Natural Resources     Open Access   (Followers: 3)
Agriculture, Ecosystems & Environment     Hybrid Journal   (Followers: 58, SJR: 1.747, CiteScore: 4)
Ain Shams Engineering J.     Open Access   (Followers: 5, SJR: 0.589, CiteScore: 3)
Air Medical J.     Hybrid Journal   (Followers: 8, SJR: 0.26, CiteScore: 0)
AKCE Intl. J. of Graphs and Combinatorics     Open Access   (SJR: 0.19, CiteScore: 0)
Alcohol     Hybrid Journal   (Followers: 12, SJR: 1.153, CiteScore: 3)
Alcoholism and Drug Addiction     Open Access   (Followers: 12)
Alergologia Polska : Polish J. of Allergology     Full-text available via subscription   (Followers: 1)
Alexandria Engineering J.     Open Access   (Followers: 2, SJR: 0.604, CiteScore: 3)
Alexandria J. of Medicine     Open Access   (Followers: 1, SJR: 0.191, CiteScore: 1)
Algal Research     Partially Free   (Followers: 11, SJR: 1.142, CiteScore: 4)
Alkaloids: Chemical and Biological Perspectives     Full-text available via subscription   (Followers: 2)
Allergologia et Immunopathologia     Full-text available via subscription   (Followers: 1, SJR: 0.504, CiteScore: 1)
Allergology Intl.     Open Access   (Followers: 5, SJR: 1.148, CiteScore: 2)
Alpha Omegan     Full-text available via subscription   (SJR: 3.521, CiteScore: 6)
ALTER - European J. of Disability Research / Revue Européenne de Recherche sur le Handicap     Full-text available via subscription   (Followers: 11, SJR: 0.201, CiteScore: 1)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 54, SJR: 4.66, CiteScore: 10)
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring     Open Access   (Followers: 6, SJR: 1.796, CiteScore: 4)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 6, SJR: 1.108, CiteScore: 3)
Ambulatory Pediatrics     Hybrid Journal   (Followers: 5)
American Heart J.     Hybrid Journal   (Followers: 58, SJR: 3.267, CiteScore: 4)
American J. of Cardiology     Hybrid Journal   (Followers: 66, SJR: 1.93, CiteScore: 3)
American J. of Emergency Medicine     Hybrid Journal   (Followers: 47, SJR: 0.604, CiteScore: 1)
American J. of Geriatric Pharmacotherapy     Full-text available via subscription   (Followers: 13)
American J. of Geriatric Psychiatry     Hybrid Journal   (Followers: 14, SJR: 1.524, CiteScore: 3)
American J. of Human Genetics     Hybrid Journal   (Followers: 37, SJR: 7.45, CiteScore: 8)
American J. of Infection Control     Hybrid Journal   (Followers: 29, SJR: 1.062, CiteScore: 2)
American J. of Kidney Diseases     Hybrid Journal   (Followers: 36, SJR: 2.973, CiteScore: 4)
American J. of Medicine     Hybrid Journal   (Followers: 50)
American J. of Medicine Supplements     Full-text available via subscription   (Followers: 3, SJR: 1.967, CiteScore: 2)
American J. of Obstetrics and Gynecology     Hybrid Journal   (Followers: 266, SJR: 2.7, CiteScore: 4)
American J. of Ophthalmology     Hybrid Journal   (Followers: 66, SJR: 3.184, CiteScore: 4)
American J. of Ophthalmology Case Reports     Open Access   (Followers: 5, SJR: 0.265, CiteScore: 0)
American J. of Orthodontics and Dentofacial Orthopedics     Full-text available via subscription   (Followers: 6, SJR: 1.289, CiteScore: 1)
American J. of Otolaryngology     Hybrid Journal   (Followers: 25, SJR: 0.59, CiteScore: 1)
American J. of Pathology     Hybrid Journal   (Followers: 32, SJR: 2.139, CiteScore: 4)
American J. of Preventive Medicine     Hybrid Journal   (Followers: 28, SJR: 2.164, CiteScore: 4)
American J. of Surgery     Hybrid Journal   (Followers: 39, SJR: 1.141, CiteScore: 2)
American J. of the Medical Sciences     Hybrid Journal   (Followers: 12, SJR: 0.767, CiteScore: 1)
Ampersand : An Intl. J. of General and Applied Linguistics     Open Access   (Followers: 7)
Anaerobe     Hybrid Journal   (Followers: 4, SJR: 1.144, CiteScore: 3)
Anaesthesia & Intensive Care Medicine     Full-text available via subscription   (Followers: 67, SJR: 0.138, CiteScore: 0)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 25, SJR: 0.411, CiteScore: 1)
Anales de Cirugia Vascular     Full-text available via subscription   (Followers: 1)
Anales de Pediatría     Full-text available via subscription   (Followers: 3, SJR: 0.277, CiteScore: 0)
Anales de Pediatría (English Edition)     Full-text available via subscription  
Anales de Pediatría Continuada     Full-text available via subscription  
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 5, SJR: 4.849, CiteScore: 10)
Analytica Chimica Acta     Hybrid Journal   (Followers: 44, SJR: 1.512, CiteScore: 5)
Analytica Chimica Acta : X     Open Access  
Analytical Biochemistry     Hybrid Journal   (Followers: 211, SJR: 0.633, CiteScore: 2)
Analytical Chemistry Research     Open Access   (Followers: 13, SJR: 0.411, CiteScore: 2)
Analytical Spectroscopy Library     Full-text available via subscription   (Followers: 14)
Anesthésie & Réanimation     Full-text available via subscription   (Followers: 2)
Anesthesiology Clinics     Full-text available via subscription   (Followers: 25, SJR: 0.683, CiteScore: 2)
Angiología     Full-text available via subscription   (SJR: 0.121, CiteScore: 0)
Angiologia e Cirurgia Vascular     Open Access   (Followers: 1, SJR: 0.111, CiteScore: 0)
Animal Behaviour     Hybrid Journal   (Followers: 227, SJR: 1.58, CiteScore: 3)
Animal Feed Science and Technology     Hybrid Journal   (Followers: 7, SJR: 0.937, CiteScore: 2)
Animal Reproduction Science     Hybrid Journal   (Followers: 7, SJR: 0.704, CiteScore: 2)

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Similar Journals
Journal Cover
Actas Dermo-Sifiliográficas (English Edition)
Number of Followers: 2  
 
  Full-text available via subscription Subscription journal
ISSN (Print) 1578-2190
Published by Elsevier Homepage  [3181 journals]
  • Beaded Nodules on the Forearms
    • Abstract: Publication date: Available online 23 March 2019Source: Actas Dermo-Sifiliográficas (English Edition)Author(s): I. García Río, S. Heras Gonzalez, M.I. Martínez Gonzalez
       
  • Integral Facial Management of the Aesthetic Patient: The Skin Age
           Management Protocol
    • Abstract: Publication date: Available online 23 March 2019Source: Actas Dermo-Sifiliográficas (English Edition)Author(s): R. Ruiz-Rodriguez, A. Martin-GorgojoAbstractAesthetic dermatology offers many minimally invasive therapies that can help our patients age gracefully and discreetly. Because it is hard to systematize these treatments to make patients aware of the options they have for the area of the face they want to improve, at Clínica Dermatológica Internacional, we have developed the Skin Age Management (SAM) protocol. In this article, we describe this protocol designed to help doctors and patients to better understand and plan available treatments, underlining the advisability of combining techniques with the goal of achieving discreet changes to obtain what we consider to be optimum results, based on our experience at our center.ResumenLa dermatología estética hoy en día contempla múltiples tratamientos mínimamente invasivos que pueden ayudar a envejecer a nuestros pacientes con elegancia y discreción. Dado que puede resultar difícil sistematizarlos para que el paciente sea consciente de las posibilidades que tiene en función del área que quiere mejorar, desde Clínica Dermatológica Internacional hemos elaborado el protocolo Skin Age Management (SAM). En este artículo describimos este protocolo —dirigido a ayudar a médicos y pacientes a conocer mejor y planificar los tratamientos disponibles, que refuerza el mensaje de la idoneidad de la combinación de técnicas con la filosofía de lograr cambios discretos para obtener los resultados que consideramos óptimos—, basado en la experiencia de nuestro centro.
       
  • Telomerase Expression in a Series of Melanocytic Neoplasms
    • Abstract: Publication date: Available online 21 March 2019Source: Actas Dermo-Sifiliográficas (English Edition)Author(s): De Unamuno Bustos B, Sahuquillo Torralba A, Moles Poveda P, Pérez Simó G, Simarro Farinos J, Llavador Ros M, Palanca Suela S, Botella Estrada RAbstractBackground and objectivesTelomerase is an enzyme involved in maintaining the length of telomeres and cell senescence. Numerous studies have shown that in more than 90% of malignant tumors telomerase activity is detected.Material and methodsRetrospective observational study in a series of 85 cases of primary melanomas, 12 metastatic melanomas, and 22 melanocytic nevi. We used the monoclonal antibody hTERT (human telomerase reverse transcriptase, Rockland) to assess telomerase activity. The SPSS software package was used to analyze data.ResultsTelomerase expression was present in all the melanocytic neoplasms analyzed. Expression was heterogenous and moderate or high in the melanomas. In contrast, expression was homogeneous and lower in the nevi. Heterogeneous expression was associated with rapid melanoma growth (P = .028), a Breslow thickness of more than 4 mm (P = .004), mitosis (P = .032), and mutations in the TERT gene (P = .002). Activity was less intense in intradermal nevi, and more intense in compound and dysplastic nevi (P = .054).ConclusionsTelomerase expression is found in all melanocytic neoplasms but is higher in melanomas than in nevi. A heterogeneous pattern of expression in melanomas is associated with more aggressive tumors.ResumenIntroducción y objetivosLa telomerasa es una enzima implicada en el mantenimiento de los telómeros y la senescencia celular. Numerosos estudios han demostrado que en más del 90% de las neoplasias malignas se detecta actividad telomerásica. El objetivo del presente estudio es analizar la expresión de telomerasa por inmunohistoquímica en una serie de neoplasias melanocíticas.Material y métodosEstudio observacional retrospectivo realizado en una serie de 85 melanomas primarios, 12 metastásicos y 22 nevus melanocíticos. La expresión de telomerasa se analizó empleando el anticuerpo monoclonal hTERT (Rockland). El análisis de los datos se realizó con el programa SPSS.ResultadosEn todas las neoplasias melanocíticas analizadas se demostró expresión de telomerasa. En el caso de los melanomas predominó el patrón de expresión heterogéneo, y la expresión moderada o intensa. En los nevus resultó más frecuente una expresión homogénea con intensidad leve. El patrón de expresión heterogéneo se asoció a los melanomas de rápido crecimiento (p = 0,028), con Breslow> 4 mm (p = 0,004), con mitosis (p = 0,032), y con mutaciones en el gen TERT (p = 0,002). En el caso de los nevus, la intensidad fue menor en los nevus intradérmicos, seguidos de los compuestos y de los diplásicos (p = 0,054).ConclusionesLa expresión de telomerasa está presente en la totalidad de las neoplasias melanocíticas, con mayor expresión en los melanomas que en los nevus. En el caso de los melanomas, la expresión de forma heterogénea se asocia a un fenotipo de mayor agresividad.
       
  • Unilateral Erosive and Oozing Lesion of the Nipple
    • Abstract: Publication date: Available online 13 March 2019Source: Actas Dermo-Sifiliográficas (English Edition)Author(s): A. Marcos-Pinto, L. Soares-Almeida, J. Borges-Costa
       
  • Photodynamic Therapy in the Treatment of Cutaneous Leishmaniasis
    • Abstract: Publication date: Available online 12 March 2019Source: Actas Dermo-Sifiliográficas (English Edition)Author(s): L. Sainz-Gaspar, E. Rosón, J. Llovo, H. Vázquez-Veiga
       
  • Effectiveness of 904 nm Gallium-Arsenide Diode Laser in Treatment of Oral
           Lichen Planus: Report of 2 Cases
    • Abstract: Publication date: Available online 11 March 2019Source: Actas Dermo-Sifiliográficas (English Edition)Author(s): P.T. Bhattacharya, K. Patil, M.V. Guledgud
       
  • An Analysis of Drug Survival, Effectiveness, and Safety in Moderate to
           Severe Psoriasis Treated With Ustekinumab: An Observational Study of 69
           Patients in Routine Clinical Practice
    • Abstract: Publication date: Available online 11 March 2019Source: Actas Dermo-Sifiliográficas (English Edition)Author(s): I. Salgüero Fernández, M. Hospital Gil, M. Sigüenza Sanz, G. Roustan Gullón
       
  • Azathioprine in the Treatment of Severe Pediatric Atopic Dermatitis:
           Experience in a Referral Hospital in Spain
    • Abstract: Publication date: Available online 9 March 2019Source: Actas Dermo-Sifiliográficas (English Edition)Author(s): A. Vicente Villa
       
  • Ultrasound Morphology of Stiff Skin Syndrome with Clinical and
           Histological Correlation
    • Abstract: Publication date: Available online 9 March 2019Source: Actas Dermo-Sifiliográficas (English Edition)Author(s): V. Kaplan, C. Bolte, I. Sazunic, X. Wortsman
       
  • Good News on Adjuvant Therapy for Advanced Cutaneous Melanoma
    • Abstract: Publication date: Available online 8 March 2019Source: Actas Dermo-Sifiliográficas (English Edition)Author(s): D. Morgado-Carrasco, F. Terc, S.S. Ertekin, L. Ferrandiz
       
  • Derm Dotting: A New Technique That Improves Diagnostic Precision in the
           Evaluation of Skin Lesions
    • Abstract: Publication date: Available online 8 March 2019Source: Actas Dermo-Sifiliográficas (English Edition)Author(s): J.A. Moreno Romero, N. Pérez Muñoz, A. Campoy Sánchez, M. Urbano Carrillo, M.T. Fernández FiguerasDermoscopy has improved diagnostic precision in the clinical evaluation of complex skin lesions by helping to pinpoint small clinically suspicious areas that are not visible to the naked eye but require histopathologic examination. Derm dotting is a new technique for selectively marking areas of interest to ensure they are examined under a microscope. Left unmarked, suspicious areas might not appear in routinely prepared cross sections or might be difficult to correlate with dermoscopic images. In vivo or ex vivo derm dotting involves the application of nail polish, which, unlike stains, leaves tissues unaltered. Dots can be placed by the dermatologist or laboratory staff during macroscopic preparation of the sample. Derm dotting is a simple, inexpensive technique that any dermatopathology laboratory can quickly adopt to improve diagnostic precision through better dermoscopic–histologic correlation.ResumenLa dermatoscopia ha aumentado la precisión en el diagnóstico clínico de lesiones cutáneas complejas. Es una herramienta que permite identificar pequeñas áreas de sospecha, no apreciables a simple vista y que requieren examen histopatológico específico. El derm dotting es un método de marcaje selectivo de zonas de interés para asegurar que estos focos son estudiados microscópicamente, puesto que por su pequeño tamaño podrían no aparecer en las secciones de rutina o ser difíciles de correlacionar con la imagen dermatoscópica. Combina la dermatoscopia in vivo o ex vivo con la aplicación de esmalte ungueal. A diferencia de los colorantes usuales, el uso de esmalte ungueal no altera la histología. Puede ser aplicado por parte del dermatólogo o durante el procesamiento macroscópico en el laboratorio. El derm dotting es una técnica novedosa, sencilla y económica, que puede implementarse rápidamente en cualquier Laboratorio de Dermatopatología. Mejora la precisión diagnóstica ya que traslada los hallazgos dermatoscópicos al estudio histológico.Graphical abstractGraphical abstract for this article
       
  • Recurrent Perimenstrual Vesicles Inside the Ear: A Rare Presentation
    • Abstract: Publication date: Available online 8 March 2019Source: Actas Dermo-Sifiliográficas (English Edition)Author(s): V. Zawar, M. Pawar, S. Kumavat
       
  • Infarcted Giant Skin Tag
    • Abstract: Publication date: Available online 8 March 2019Source: Actas Dermo-Sifiliográficas (English Edition)Author(s): E.C. López-Jiménez, R. Ruiz-Rodríguez, I. Sánchez-Carpintero
       
  • Allergic Contact Dermatitis to Kojic Acid
    • Abstract: Publication date: Available online 8 March 2019Source: Actas Dermo-Sifiliográficas (English Edition)Author(s): A. Tejera-Vaquerizo, J. García-Gavín
       
  • Telltale Hairs
    • Abstract: Publication date: Available online 8 March 2019Source: Actas Dermo-Sifiliográficas (English Edition)Author(s): S. Sánchez-Pérez, C. Torres-Sánchez, V. Alonso-Usero
       
  • Adverse Hair Reactions to New Targeted Therapies for Cancer
    • Abstract: Publication date: Available online 4 March 2019Source: Actas Dermo-Sifiliográficas (English Edition)Author(s): J.F. Mir-Bonafé, D. Saceda-Corralo, S. Vañó-GalvánThe advent of immune targeted therapies for cancer has radically changed the treatment and prognosis of many cancers. These drugs are called targeted therapies because they target specific pathophysiological mechanisms of cancer. This paradigm shift in cancer treatment, however, has resulted in new adverse dermatologic effects involving both the skin and its appendages. In the case of hair, targeted drugs can cause immune alterations and changes in hair growth, color, and shape. Because most targeted therapies are new, there is no single document describing all these adverse effects. We performed an exhaustive review of the literature to characterize adverse hair effects associated with the use of targeted therapies.ResumenLas nuevas terapias inmunológicas dirigidas contra el cáncer han supuesto un cambio radical en el tratamiento y el pronóstico de muchas neoplasias. Estos medicamentos se dirigen de manera mucho más específica contra los mecanismos fisiopatogénicos del cáncer, por lo que adquieren el sobrenombre de «terapias diana». Este cambio de paradigma ha supuesto la aparición de nuevos efectos adversos dermatológicos, que afectan tanto la piel como sus anejos. Los efectos adversos en el pelo pueden manifestarse en alteraciones de su ciclo, forma, color o inmunología. Debido a que son tratamientos nuevos en su mayoría y no existe un documento que englobe todos estos efectos adversos, hemos realizado una exhaustiva revisión bibliográfica para caracterizar de manera concreta cuáles son los efectos adversos tricológicos que pueden inducir cada uno de estos fármacos.Graphical abstractGraphical abstract for this article
       
  • Progressive skin ulcers in extremities
    • Abstract: Publication date: Available online 4 March 2019Source: Actas Dermo-Sifiliográficas (English Edition)Author(s): S. Castillo-Loaiza, C.J. Díaz, L.F. Cardenas
       
  • Medical Photography: Much Work Remains for Dermatologists
    • Abstract: Publication date: March 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 2Author(s): R. Taberner
       
  • Circumscribed Palmar Hypokeratosis: Treatment with Cryotherapy
    • Abstract: Publication date: March 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 2Author(s): J. Boix-Vilanova, M.C. Montis-Palos, A. Giacaman, E. Antón-Valentí
       
  • Usefulness of Reflectance Confocal Microscopy For in Vivo Diagnosis of
           Sebomatricomas
    • Abstract: Publication date: March 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 2Author(s): S. Burillo-Martínez, R. Gamo, F. Pinedo, J.L. López-Estebaranz
       
  • Nail Psoriasis Treated With Certolizumab Pegol in Patients With Psoriatic
           Arthritis: Preliminary Observation
    • Abstract: Publication date: March 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 2Author(s): M. Mazzeo, A. Dattola, M.V. Cannizzaro, L. Bianchi
       
  • Cutaneous Langerhans Cell Histiocytosis Presenting in Adulthood
    • Abstract: Publication date: March 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 2Author(s): M.A. Flores-Terry, J.L. Sanz-Trenado, M. García-Arpa, M.P. Cortina-de la Calle
       
  • An Unusual Presentation of Cutaneous Leishmaniasis: The Role of Skin
           Ultrasound
    • Abstract: Publication date: March 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 2Author(s): E. Rojas Mora, A. Garrido Ríos, B. Echeverría García, J. Borbujo
       
  • Tuberous Sclerosis Complex Associated with Hemihypertrophy and Combined
           Vascular Malformations
    • Abstract: Publication date: March 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 2Author(s): M.Á. Flores-Terry, A. Alegre-Sánchez, P. Boixeda, J.C. López-Gutiérrez
       
  • Pseudolymphomatous Granuloma Annulare: A Little-Known Variant
    • Abstract: Publication date: March 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 2Author(s): M. Llamas-Velasco, A. Urquina-Renke, A. Pérez-Plaza, J. Fraga
       
  • Syphilitic Alopecia of the Eyebrows and Eyelashes
    • Abstract: Publication date: March 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 2Author(s): P. García-Montero, J.B. Repiso-Jiménez, C. García-Harana
       
  • Extensive Vulvar Melanosis
    • Abstract: Publication date: March 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 2Author(s): P. García-Montero, L. Padilla-España, J. Bosco Repiso-Jiménez
       
  • What Should We Use' Recommendations on Appropriate Gloves for
           Dermatologic Surgery
    • Abstract: Publication date: March 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 2Author(s): X. Bosch-Amate, D. Morgado-Carrasco, J. Riera-Monroig, J. Ferrando
       
  • A Refractory Periungual Lesion
    • Abstract: Publication date: March 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 2Author(s): J. Boix-Vilanova, N. Izquierdo-Herce, L.J. del Pozo
       
  • Frontal Tumor That Increased in Size With the Valsalva Maneuver
    • Abstract: Publication date: March 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 2Author(s): A. Catalán Griffiths, F. Alfagueme Roldán, I. Salgüero Fernández, M.G. Ragusa
       
  • Postirradiation Morphea in Patients With Breast Cancer: Possible
           Association With Other Autoimmune Diseases
    • Abstract: Publication date: March 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 2Author(s): A. Diago, B. Llombart, C. Requena, O. Sanmartín, C. GuillénAbstractPostirradiation morphea is an uncommon entity that has been mostly described in women with breast cancer. The increasing use of radiotherapy to treat breast cancer and the clinical similarities between morphea and other conditions, such as radiodermatitis, postirradiation fibrosis, and tumor recurrence, highlights the need for dermatologists to be familiar with this entity. We present a series of 6 women with a mean age of 64.2 years and a mean latency of 9.5 years between radiotherapy for breast cancer and onset of morphea. Four of the patients had a history of autoimmune disease: rheumatoid arthritis, Sjögren syndrome, vitiligo, and Crohn disease. No specific risk factors for postirradiation morphea have been identified to date, although it would appear that a history of autoimmune disease could be associated with an increased risk of morphea in patients treated with radiation therapy.ResumenLa morfea postradioterapia es una entidad poco frecuente descrita mayoritariamente en mujeres con cáncer de mama. El uso creciente de la radioterapia en el tratamiento del cáncer de mama, así como la similitud clínica de la morfea con otros cuadros tales como la radiodermitis, la fibrosis postradiación o la recidiva tumoral, obligan al dermatólogo al conocimiento de esta entidad. Presentamos una serie de 6 mujeres, con una media de edad de 64,2 años y un tiempo medio de latencia entre la radioterapia y la morfea de 9,5 años. Cuatro de las 6 pacientes presentaban algún trastorno de base autoinmune (artritis reumatoide, síndrome de Sjögren, vitíligo y enfermedad de Crohn) entre sus antecedentes. Hasta el momento actual no se han encontrado factores de riesgo que predispongan al desarrollo de morfea tras el tratamiento con radioterapia, si bien parece que presentar algún trastorno de base autoinmune puede condicionar la aparición de morfea en pacientes tratados con radioterapia.
       
  • Referral of Patients to Dermatology and Teledermatology Consultations in
           Spain. DIADERM Study
    • Abstract: Publication date: March 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 2Author(s): G. González-López, M.Á. Descalzo-Gallego, S. Arias-Santiago, A. Molina-Leyva, Y. Gilaberte, P. Fernández-Crehuet, H. Husein-El Ahmed, A. Viera-Ramírez, P. Fernández-Peñas, R. Taberner, I. García-Doval, A. Buendía-Eisman, Agustín Buendía, Pablo Fernández-Crehuet, Husein Husein-ElAhmed, Jesús Vega, Agustín Viera, José Manuel Carrascosa, Marta Ferrán, Enrique GómezAbstractBackground and objectivesUnderstanding the origin and referral routes of patients seen in teledermatology and in-person dermatology consultations in Spain is of interest from the perspective of health care management. The objective of this study was to describe the referral routes and the frequency and characteristics of teledermatology consultations in Spain.Material and methodsWe performed a descriptive cross-sectional study of data collected over 6 days from the DIADERM study sample, which included the outpatients diagnosed by 80 Spanish dermatologists, selected by means of stratified random sampling. We studied the source and destination of patients based on funding, type of consultation, and age of the patients. We reported the frequency of teledermatology consultations, their origin and destination, type of funding, age of the patients, and most common diagnoses, and compared them with the same characteristics for in-person consultations.ResultsIn private consultations, most patients were direct clients, whereas the most frequent source in public consultations was primary care and the dermatologist. Sixty-six percent of patients were referred to dermatology and 27% were discharged. No differences in these percentages were found between public and private consultations. The ratio of follow-up to initial visits was 0.8 for public consultations and 0.2 for private consultations. Teledermatology accounts for 1% of consultations. Eighty percent of these come from primary care and 17% are direct visits. Thirty-three percent of these visits are referred to primary care —a greater proportion than in in-person consultations. Galicia, Andalusia, and Catalonia are the regions with the highest percentage of consultations.ConclusionsThe results suggest that dermatologists in Spain have a considerable ability to resolve cases. Teledermatology accounts for a small percentage of consultations and access to these consultations is direct in a large percentage of cases.ResumenAntecedentes y objetivosEl conocimiento de las rutas de origen y derivación de los pacientes atendidos en consulta dermatológica presencial y de teledermatología en España tiene interés desde el punto de vista de la gestión sanitaria. El objetivo de este estudio es describir las rutas de derivación y la frecuencia y características de la teledermatología en España.Material y métodosEstudio transversal descriptivo sobre la muestra del estudio DIADERM, que recogió la actividad de 80 dermatólogos españoles, seleccionados mediante muestreo aleatorio estratificado, durante 6 días. Se estudiaron el origen y destino de los pacientes en función de la financiación, el tipo de consulta y la edad de los pacientes. Se describió la frecuencia de las consultas por teledermatología, su origen y destino, el tipo de financiación, la edad de los pacientes y los diagnósticos más frecuentes, comparándolos con la consulta presencial.ResultadosEl origen más frecuente en la consulta privada es el directo, mientras que en la pública es la atención primaria y el propio dermatólogo. Un 66% de los pacientes se derivan a dermatología y un 27% son dados de alta. No existen diferencias en estos porcentajes entre consulta pública y privada. El índice sucesivas/primeras fue de 0,8 para la consulta pública y de 0,2 para la privada. La teledermatología representa un 1% de las consultas. El 80% procede de atención primaria y el 17% tiene origen directo. Se deriva a atención primaria el 33%, en mayor proporción que en consulta presencial. Galicia, Andalucía y Cataluña son las regiones donde representa un mayor porcentaje de consultas.ConclusionesLos resultados sugieren una alta capacidad resolutiva de las consultas de dermatología en España. La teledermatología representa un porcentaje pequeño de las consultas, y el acceso a ella se da en un porcentaje relevante de pacientes por vía directa.
       
  • Survey on Private Dermatology Practice Characteristics and Fees in Spain
           in 2018
    • Abstract: Publication date: March 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 2Author(s): A. Martin-Gorgojo, I. García-Doval, E. del Río de la TorreAbstractBackground and objectivePer-visit fees and the characteristics of private practice in dermatology have been studied very little, at least in Spain. This study aims to describe how dermatologists in private practice in Spain provide services, collect payment, promote their services, and establish fees. We also analyze differences by region, age, and sex.Materials and methodsWe performed a descriptive, cross-sectional study based on an online questionnaire with a total of 31 questions aimed exclusively at dermatologists in private practice in Spain. The questionnaire was open for responses from May 17 to June 5, 2018. The data were analyzed by comparing region, sex, and age.ResultsA total of 234 questionnaires were returned, with equal numbers of male and female respondents and proportional numbers in terms of the regional sections of the Spanish Academy of Dermatology and Venereology (AEDV). Some differences were found for region, age, and sex. The fees of female dermatologists were consistently lower, even after adjusting for confounding factors by means of regression models.ConclusionsWe have described the characteristics of private dermatology practice in Spain. Charging of lower fees by female dermatologists requires more detailed study, probably using qualitative research techniques.ResumenAntecedentes y objetivoLas tarifas por acto médico y los hábitos de asistencia privada de los dermatólogos apenas han sido objeto de estudio, al menos en nuestro entorno inmediato. Con el presente trabajo pretendemos describir hábitos de prestación de servicios, medios de cobro, promoción y fijación de tarifas de los dermatólogos que realizan asistencia privada en España. Secundariamente, buscamos analizar las diferencias por sección territorial, edad y sexo.Materiales y métodosEstudio descriptivo transversal a partir de un cuestionario on-line con un total de 31 preguntas dirigido exclusivamente a dermatólogos con asistencia privada en España, abierto a respuestas del 17 de mayo al 5 de junio de 2018. Los datos fueron analizados comparando por sección territorial, sexo y edad.ResultadosSe recibió un total de 234 respuestas, paritarias en cuanto a sexo y proporcionadas en cuanto a las secciones territoriales de la Academia Española de Dermatología y Venereología (AEDV). Pudieron constatarse algunas diferencias por sección territorial, edad y sexo. Destacaban las tarifas sistemáticamente menores de las dermatólogas, incluso tras ajustar por factores de confusión mediante modelos de regresión.ConclusionesQuedan descritas características de la asistencia privada en Dermatología en España. El hecho de que haya tarifas más baratas entre las dermatólogas requiere de un estudio más detallado, probablemente mediante técnicas de investigación cualitativa.
       
  • Patient Attitudes to Medical Photography: Study of a Spanish Population at
           the Pius Hospital de Valls in Tarragona, Spain
    • Abstract: Publication date: March 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 2Author(s): P. Pasquali, M. Hernandez, C. Pasquali, K. FernandezIntroductionMedical photography is a noninvasive technique used for diagnostic, monitoring, and educational purposes. It is important to understand the patient's attitude to all or part of their body being photographed. The objective of this study was to analyze the attitudes of patients towards medical photography at a district hospital in Tarragona, Spain.MethodologyThis exploratory study used a questionnaire to evaluate attitudes to medical photography among outpatients at Pius Hospital de Valls. The questionnaire explored the patients’ beliefs about the usefulness of medical photography, the circumstances in which they would agree to be photographed and by whom, as well as their prior experience of medical photography. They were also asked whether they would authorize the use of photography and, if not, to explain their motives.ResultsThe questionnaire was completed by 134 patients. The results showed that patients had a clearly positive attitude to being photographed for medical purposes (94.8%), treatment follow-up (88.1%), and consultation of their case with other physicians (86.6%). Acceptance was 88.8% if the lesion was malignant and 85.1% if it was extensive. For facial lesions, only 78.4% were willing to be photographed and in the case of genitals the percentage fell to 70.2%. Most patients (95.5%) would agree to being photographed by their doctor. The rate of acceptance was 66.4% in the case of a nurse, 64.9% for another doctor, and 21.6% for a professional photographer.ConclusionsOur study revealed that patients have a positive attitude to being photographed for medical purposes, particularly when they have a malignant lesion, when the photograph is taken by their specialist, and when they cannot be identified.ResumenIntroducciónLa fotografía médica es una técnica de imagen no invasiva que se utiliza con fines diagnósticos, de monitoreo y educativos. Es importante conocer la actitud del paciente hacia ser fotografiado, en su totalidad o en parte de su cuerpo. El objetivo de este estudio es analizar la actitud de los pacientes del Pius Hospital de Valls hacia la fotografía médica.MetodologíaEste estudio exploratorio evaluó, a partir de un cuestionario, la actitud de los pacientes que asistieron a consultas externas del Hospital Pius de Valls (España) respecto a ser fotografiados. Las preguntas estaban relacionadas con creencias en torno a la utilidad de la fotografía médica, circunstancias bajo las cuales se autorizaría ser fotografiado y a manos de quién, experiencia con la fotografía médica, intención de autorizar la fotografía y motivos para no autorizarla.ResultadosEl cuestionario fue respondido por 134 pacientes. Los resultados mostraron una actitud claramente positiva hacia ser fotografiado con fines médicos (94,8%), por seguimiento de tratamiento (88,1%) y consulta del caso con otros médicos (86,6%). El 88,8% aceptaría ser fotografiado si la lesión es maligna y el 85,1% si es extensa. Para lesiones en el rostro, solamente el 78,4% lo permitiría; en los genitales el porcentaje es aún menor (70,2%). El 95,5% estaría dispuesto a dejarse fotografiar si es el mismo médico quien la hace, si es el enfermero (66,4%), otro médico (64,9%) o un fotógrafo profesional (21,6%).ConclusionesNuestro estudio muestra una actitud positiva hacia ser fotografiado con fines médicos, siempre que el fotógrafo sea el médico tratante, en lesiones malignas y en áreas no identificables.Graphical abstractGraphical abstract for this article
       
  • An Update on the Treatment and Management of Cellulitis
    • Abstract: Publication date: March 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 2Author(s): E. Ortiz-Lazo, C. Arriagada-Egnen, C. Poehls, M. Concha-RogazyCellulitis and erysipelas are local soft tissue infections that occur following the entry of bacteria through a disrupted skin barrier. These infections are relatively common and early diagnosis is essential to treatment success. As dermatologists, we need to be familiar with the clinical presentation, diagnosis, and treatment of these infections. In this article, we provide a review of the literature and update on clinical manifestations, predisposing factors, microbiology, diagnosis, treatment, and complications. We also review the current situation in Chile.ResumenLa celulitis y la erisipela son infecciones localizadas de partes blandas que se desarrollan como resultado de la entrada de bacterias a través de una barrera cutánea alterada. Es una entidad de presentación relativamente frecuente y su diagnóstico precoz es clave para el tratamiento oportuno del paciente, por lo que debemos estar instruidos en su clínica, diagnóstico y alternativas de tratamiento. En este trabajo, se realiza una revisión de la literatura y actualización en el tema que incluye: manifestaciones clínicas, factores predisponentes, microbiología, diagnóstico, tratamiento y complicaciones. Además, se realiza una revisión de la situación bacteriológica actual en Chile.Graphical abstractGraphical abstract for this article
       
  • Update on Topical Treatments for Psoriasis: The Role of Calcipotriol Plus
           Betamethasone Dipropionate Aerosol Foam
    • Abstract: Publication date: March 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 2Author(s): L. Puig, G. CarreteroTopical agents are the first-line treatment for mild and moderate psoriasis, but factors such as frequency of administration, organoleptic properties, and the limited short term results can reduce treatment adherence and effectiveness.Innovations in topical treatments are linked not only to the discovery of new molecules, but also to the reformulation of existing active ingredients based on improvements to administration, organoleptic properties, bioavailability, and ease of use. Calcipotriol and betamethasone dipropionate aerosol foam is a new formulation in which the active ingredients are dissolved in a mixture of volatile propellants that evaporate quickly, leaving a supersaturated solution of calcipotriol and betamethasone dipropionate that enhances penetration into the epidermis.In this article, we take a look at the new calcipotriol and betamethasone dipropionate aerosol formulation and briefly review the main evidence supporting the use of topical treatments for psoriasis.ResumenLos agentes tópicos representan la primera línea de tratamiento para la psoriasis leve y moderada. Sin embargo, factores como la frecuencia de administración, las características organolépticas o los resultados limitados a corto plazo pueden disminuir la adherencia al tratamiento y su efectividad.Las innovaciones en los tratamientos tópicos se basan en descubrir nuevas moléculas, pero también en la reformulación de principios activos ya conocidos, mejorando su administración, características organolépticas, biodisponibilidad y comodidad de uso. La espuma en aerosol de calcipotriol y dipropionato de betametasona es una nueva formulación donde los principios activos están disueltos en una mezcla de propelentes volátiles que se evaporan rápidamente dejando una solución sobresaturada de calcipotriol y dipropionato de betametasona, que aumenta la penetración de los fármacos en la epidermis.En este artículo se hace un breve repaso de las principales evidencias sobre los tratamientos tópicos disponibles para la psoriasis y de la nueva formulación en espuma de calcipotriol y dipropionato de betametasona.Graphical abstractGraphical abstract for this article
       
  • Consensus Statement on the Psychological Needs of Patients With Chronic
           Inflammatory Skin Diseases
    • Abstract: Publication date: March 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 2Author(s): M. Ribera, S. Ros, B. Madrid, R. Ruiz-Villaverde, F. Rebollo, S. Gómez, E. Loza, G. CarreteroAbstractObjectiveTo establish recommendations to determine, identify, and manage the psychological and emotional needs of patients with chronic inflammatory skin diseases in clinical practice.MethodsA guided discussion was held at meeting of a nominal group of expert dermatologists and psychologists on the psychological and emotional needs of patients with chronic inflammatory skin diseases, how to manage these cases, and which referral criteria to employ. Based on the results of the discussion, and with the aid of a patient focus group and a review of the literature, a master document was drawn up with recommendations for discussion. A Delphi survey was circulated among a larger group of dermatologists and psychologists to assess the level of agreement with the recommendations.ResultsTen recommendations were established and can be summarized as follows: explore the psychological sphere of the patients with open questions at the time of diagnosis and during the course of the disease; provide patients with clear explanations that address their concerns and inform them of the existence of patient associations; investigate symptoms of anxiety and depression and, if confirmed by means of a Hospital Anxiety and Depression score (HADS) of 11 or greater, consider referral to a mental-health specialist; and, during visits, create a climate of trust, empathize with patients, agree goals and treatment options with them, and motivate them to adhere to those treatments.ConclusionsThese recommendations may help health care professionals address psychological and emotional aspects of their patients in daily clinical practice.ResumenObjetivoEstablecer recomendaciones para conocer, identificar y manejar las necesidades psicológicas y emocionales de los pacientes con enfermedades inflamatorias crónicas dermatológicas en la práctica clínica habitual.MétodosEn una reunión de grupo nominal con expertos dermatólogos y psicólogos, se realizó una discusión guiada sobre las necesidades psicológicas y emocionales de estos pacientes, cómo abordarlas, y cuáles serían los criterios de derivación apropiados. A partir de todo ello, con la ayuda de un grupo focal de pacientes y de una revisión de la literatura, se preparó un documento matriz con las recomendaciones para su discusión, así como una encuesta tipo Delphi para evaluar el grado de acuerdo con las mismas, que se hizo extensiva a más dermatólogos y psicólogos.ResultadosSe establecieron 10 recomendaciones que podrían resumirse en las siguientes: explore la esfera psicológica de los pacientes con preguntas abiertas tanto en el momento del diagnóstico como durante el curso de la enfermedad. Dele explicaciones claras adaptadas a sus preocupaciones e infórmele de la existencia de asociaciones de pacientes. Explore si existen síntomas de ansiedad y depresión, y si se confirman mediantes una puntuación de 11 o más en la Hospital Anxiety and Depression Scale (HADS), valore una derivación a un especialista en salud mental. En las visitas, genere un clima de confianza, empatice con el paciente, consensúe con él los objetivos y opciones terapéuticas, y motívele para conseguir una buena adherencia.ConclusionesEstas recomendaciones pueden servir a los profesionales sanitarios para que aborden de forma abierta y natural aspectos psicológicos y emocionales del paciente en la consulta diaria.
       
  • Teledermatology: A Tool to Bridge the Gap Between Primary and Specialized
           Care
    • Abstract: Publication date: March 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 2Author(s): G. Romero-Aguilera, J.A. Garrido-Martin
       
  • Fees and Payment-Collection Habits in Private Dermatology in Spain
    • Abstract: Publication date: March 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 2Author(s): A. Tejera-Vaquerizo
       
  • Paradoxical Arthritis Due to Ixekizumab in a Patient With Plaque Psoriasis
    • Abstract: Publication date: Available online 1 March 2019Source: Actas Dermo-Sifiliográficas (English Edition)Author(s): D. Vidal, S. Ros, D. Reina
       
  • Usefulness of 2% Topical Diltiazem in Chondrodermatitis Nodularis Helicis:
           A Report of 2 Cases
    • Abstract: Publication date: Available online 28 February 2019Source: Actas Dermo-Sifiliográficas (English Edition)Author(s): A. de Quintana-Sancho, L. Carnero-González, R. González-Pérez, M. Drake-Monfort
       
  • Multiple Eruptive Dermatofibromas in a Patient Treated With Brentuximab
           Vedotin
    • Abstract: Publication date: Available online 28 February 2019Source: Actas Dermo-Sifiliográficas (English Edition)Author(s): P. Giavedoni, A. Combalia, R. Pigem, J.M. Mascaró
       
  • Coexistence of Tumid Lupus Erythematosus and Discoid Lupus Erythematosus
    • Abstract: Publication date: Available online 26 February 2019Source: Actas Dermo-Sifiliográficas (English Edition)Author(s): I. Abadías-Granado, J. Sánchez-Bernal, F. Felipo-Berlanga, M. Ara-Martín
       
  • Fast-Growing Occipital Tumor
    • Abstract: Publication date: Available online 23 February 2019Source: Actas Dermo-Sifiliográficas (English Edition)Author(s): E. Varas-Meis, C. Prada-García, P. Fernández-Canga, M.Á. Rodriguez-Prieto
       
  • Epidemiology of Psoriasis. A Population-Based Study
    • Abstract: Publication date: Available online 10 February 2019Source: Actas Dermo-Sifiliográficas (English Edition)Author(s): J.M. Fernández-Armenteros, X. Gómez-Arbonés, M. Buti-Solé, A. Betriu-Bars, V. Sanmartin-Novell, M. Ortega-Bravo, M. Martínez-Alonso, J.M. Casanova-SeumaAbstractBackground and objectivesPsoriasis is a chronic immunoinflammatory skin disease very frequent in the western world. Several authors have tried to calculate its prevalence in different regions, although most of them obtained the data from surveys and there are few publications from Mediterranean areas.The objective of our study was to analyze the prevalence and severity of psoriasis in Lleida (a northeastern region in Spain), identify age and sex specific differences and compare our results with other European series.Materials and methodsA joint database of primary care medicine and the dermatology department was obtained from the entire province of Lleida with epidemiological data and psoriasis diagnosis and treatment codification.ResultsA corrected database was obtained with 398,701 individuals and 6,868 of them (1.72%) were coded with the diagnosis of psoriasis. The prevalence was significantly higher in men than in women (1.88% vs 1.56%, OR = 1.21, 95% CI: 1.15-1.27). The highest prevalence of psoriasis was found in the 61-70 years group (2.90%) and psoriasis in population under 18 years of age was 0.30%. In our sample, 7.27% of the patients were classified as moderate-severe psoriasis (499/6,868).ConclusionThis study reports the prevalence and severity of psoriasis in a large Mediterranean region sample, obtaining the information through a electronic database. This study reveals a lower prevalence of psoriasis compared to other European countries, and the proportion of severe psoriasis (based on treatment criteria) is lower than in other studies. We emphasize that these differences could probably due to genetic background, life style and diet.ResumenAntecedentes y objetivoLa psoriasis es una enfermedad inmunoinflamatoria crónica de la piel muy frecuente en el mundo occidental. Muchos autores han intentado calcular su prevalencia en diversas regiones, aunque en la mayoría de los casos esta se ha obtenido mediante encuestas y existen escasas publicaciones procedentes del área mediterránea.El objetivo de nuestro estudio era analizar la prevalencia y severidad de la psoriasis en Lleida (región del noreste de España), identificar diferencias en edad y sexo, y comparar nuestros resultados con otras series europeas.Materiales y métodosSe obtuvo una base de datos conjunta entre medicina primaria y el departamento de dermatología de toda la provincia de Lleida con datos epidemiológicos, diagnóstico de psoriasis y codificación de tratamiento.ResultadosLa base de datos final comprendía a 398.701 individuos y 6.868 de ellos (1,72%) fueron codificados con el diagnóstico de psoriasis. La prevalencia de psoriasis fue significativamente mayor en hombres que en mujeres (1,88 vs. 1,56%; OR = 1,21; IC 95%: 1,15-1,27). La prevalencia más alta de psoriasis se encontró en el grupo de edad de los 61-70 años (2,90%) y la prevalencia de psoriasis en menores de 18 años fue del 0,30%. En nuestra población, el 7,27% de los pacientes fueron clasificados como psoriasis moderada-severa (499/6.868).ConclusionesEste estudio reporta la prevalencia y severidad de la psoriasis en una muestra amplia de una región mediterránea, obteniendo la información mediante una base de datos electrónica. Además, se evidencia una prevalencia menor de psoriasis comparada con otros países europeos y una proporción de psoriasis severa (basado en criterios de tratamiento) menor que en otros estudios. Estas diferencias podrían deberse a factores genéticos, estilo de vida y dieta.
       
  • Quality of Life in Patients with Cutaneous T-Cell Lymphoma
    • Abstract: Publication date: Available online 31 January 2019Source: Actas Dermo-Sifiliográficas (English Edition)Author(s): P. Martín-Carrasco, M. Morillo-Andújar, M. Sendín-Martín, J. Conejo-Mir
       
  • Role of Magnetic Resonance Image in Children with Lumbosacral and Perineal
           Hemangiomas: Case Reports and Review of the Literature
    • Abstract: Publication date: Available online 22 January 2019Source: Actas Dermo-Sifiliográficas (English Edition)Author(s): D. Subiabre-Ferrer, A. García-Rabasco, N. Correa-González, J.M. Ortiz-Salvador, M. Barreda-SolanaCutaneous hemangiomas are the most frequent benign tumors in children. When they affect the lumbar and perineal area some cases can be associated with an occult spinal dysraphism. The management of these hemangiomas lack consensus. We report 3 cases of children with lumbosacral and perineal hemangiomas with magnetic resonance image abnormalities and we review the literature to find out the type and timing of tests that should be performed to complete the study in these patients. Ultrasound is typically requested as young as possible, as this imaging technique is not possible 11 the posterior spinal elements have ossified. MRI is the gold standard for diagnosing occult spinal dysraphism. According to the literature, the mean age for MRI screening should be around 6 months, when the fat formation in the filum terminale is expanded. In our opinion, an MRI scan should be performed at 6 months of age in every children with lumbar or perineal hemangioma regardless the lesion size, neurological symptoms or the ultrasound results.ResumenLos hemangiomas infantiles son los tumores benignos más frecuentes en la población pediátrica. Cuando afectan al área lumbar y perineal, algunos casos pueden asociarse a alguna malformación subyacente como una disrafia espinal oculta. El manejo de estos hemangiomas carece de consenso. Describimos 3 casos de niños con hemangiomas lumbosacros y perineales con anomalías en la resonancia magnética y revisamos la literatura para valorar qué pruebas y en qué momento se deben realizar para completar el estudio en estos pacientes. Por lo general, se solicita una ecografía lo más precozmente posible, ya que esta técnica no es posible realizarla una vez que los elementos espinales posteriores se han osificado, lo que generalmente ocurre a los 6 meses de edad. La resonancia magnética es la prueba de referencia para diagnosticar una disrafia espinal oculta. De acuerdo con la literatura, la edad media para este examen debe ser alrededor de los 6 meses, cuando la formación de grasa en el filum terminale se ha visto incrementada. En nuestra opinión, se debería realizar una resonancia magnética a los 6 meses de edad en todos los niños con hemangioma lumbar o perineal, independientemente del tamaño de la lesión, la ausencia de síntomas neurológicos o los resultados de la ecografía.Graphical abstractGraphical abstract for this article
       
  • Allergic Contact Dermatitis Due to Chlorhexidine in 2 Pediatric Patient
    • Abstract: Publication date: January–February 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 1Author(s): S. Córdoba, T. Sanz-Sánchez, E. Mohedano-Vicente, J. Borbujo
       
  • Treatment of a Refractory Venous Ulcer With Terminal Interruption of the
           Reflux Source
    • Abstract: Publication date: January–February 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 1Author(s): M. Mendieta-Eckert, J.L. Azpiazu-Macho, N. Landa-Gundin
       
  • Milia: An Uncommon Reaction to Photodynamic Therapy
    • Abstract: Publication date: January–February 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 1Author(s): V. Flores-Climente, J. Dalmau, L. Puig
       
  • Extragenital Lichen Sclerosus Induced by Radiotherapy
    • Abstract: Publication date: January–February 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 1Author(s): M. Bonfill-Ortí, L. Martínez-Molina, R.M. Penín, J. Marcoval
       
  • Allergic Contact Dermatitis Due to Methyl Glucose Dioleate in a Balm Cream
    • Abstract: Publication date: January–February 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 1Author(s): T. Sanz-Sánchez, R.M. Díaz-Díaz, C. Garrido Gutiérrez, V. Leis Dosil
       
  • Dermatomyositis-like Eruption in a Woman Treated With Hydroxyurea
    • Abstract: Publication date: January–February 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 1Author(s): E. Moreno-Artero, J.J. Paricio, J. Antoñanzas, A. España
       
  • Mastocytosis With Associated Essential Thrombocythemia
    • Abstract: Publication date: January–February 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 1Author(s): J. Marcoval
       
  • Advanced-Stage Thymoma Associating Multiple Paraneoplastic Syndromes with
           Good Response to Oral Corticosteroids and Topical Tacrolimus
    • Abstract: Publication date: January–February 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 1Author(s): S. Sánchez-Pérez, C. Monteagudo-Castro, J.M. Martín-Hernández, M.D. Ramón-Quiles
       
  • Granulocyte Colony-Stimulating Factor (G-Csf)–Producing Giant Squamous
           Cell Carcinoma of the Scrotum
    • Abstract: Publication date: January–February 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 1Author(s): M. Takako, K. Yasunobu, Y. Toshiyuki
       
  • Torus Palatinus
    • Abstract: Publication date: January–February 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 1Author(s): E. Rozas-Pérez, C. Bravo, E. Rozas-Muñoz
       
  • Scratch-Induced Lesions…Without the Scratching
    • Abstract: Publication date: January–February 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 1Author(s): J.L. Ramírez-Bellver, A. Alegre-Sánchez
       
  • Immunotherapy for Advanced Skin Cancer
    • Abstract: Publication date: January–February 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 1Author(s): D. Morgado-Carrasco, F. Terc, S.S. Ertekin, L. Ferrandiz
       
  • Recurrent Facial Edema
    • Abstract: Publication date: January–February 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 1Author(s): J. Sabater Abad, C. Lloret Ruiz, E. Quecedo Estébanez
       
  • Erythematous Papules on the Dorsum of the Hand
    • Abstract: Publication date: January–February 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 1Author(s): C. Maldonado Seral, C. Gómez de Castro, B. Vivanco Allende
       
  • Recessive Dystrophic Epidermolysis Bullosa and Pregnancy
    • Abstract: Publication date: January–February 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 1Author(s): F. Boria, R. Maseda, M. Martín-Cameán, M. De la Calle, R. de LucasDystrophic epidermolysis bullosa is a rare inherited disease caused by mutations in the COL7A1 gene. Its recessive variant (recessive dystrophic epidermolysis bullosa) is characterized by the absence or considerably reduced expression of type VII collagen, which leads to marked fragility of the skin and mucous membranes and subsequent blister formation, whether spontaneously or following minimal injury. There have been very few reports of this disease in pregnant women.We present 2 cases of pregnant women with recessive dystrophic epidermolysis bullosa managed in our High-Risk Pregnancy Unit at Hospital Universitario La Paz, Madrid, Spain. Both patients underwent full-term cesarean delivery, with no further complications for mother or child.Although recessive dystrophic epidermolysis bullosa increases the risk of maternal complications, a patient is not advised against pregnancy. With adequate monitoring, these patients can fulfil their desire to become mothers.ResumenLa epidermólisis bullosa distrófica es una enfermedad hereditaria rara debida a mutaciones del gen COL7A1. Su variante recesiva (EBDR) se caracteriza por una marcada disminución o ausencia completa de colágeno tipo VII (C7), que da lugar a una marcada fragilidad de la piel y las mucosas, desencadenando la formación de ampollas de forma espontánea o en respuesta a mínimos traumatismos. Son muy pocos los casos descritos en la literatura de esta enfermedad en embarazadas.Exponemos 2 casos de gestantes, ambas afectadas de EBDR, y su manejo en nuestra Unidad de Obstetricia de Alto Riesgo del Hospital Universitario La Paz. En ambos casos se realizó una cesárea a término, finalizando la gestación sin complicaciones mayores para la madre o el feto.A pesar de relacionarse con un mayor número de complicaciones maternas, la EBDR no representa una contraindicación para la gestación, y con un control adecuado, estas pacientes pueden ver su deseo genésico cumplido.Graphical abstractGraphical abstract for this article
       
  • Granulomatous Reaction in a Patient With Metastatic Melanoma Treated With
           Ipilimumab: First Case Reported With Isolated Cutaneous Findings
    • Abstract: Publication date: January–February 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 1Author(s): J. Cervantes, A. Rosen, L. Dehesa, G. Dickinson, J. Alonso-LlamazaresAbstractGranulomatous sarcoidosis-like reactions affecting multiple organ systems at one time have infrequently been described within weeks to months after initiation of Ipilimumab. We present the first case of a 67-year-old man with isolated cutaneous granulomatous reaction involving the trunk, extremities, and face after eighteen months of treatment with ipilimumab for metastatic melanoma. This case documents the eruption of isolated cutaneous granulomatous reaction as a late treatment-related adverse effect of ipilimumab, highlighting the importance of adequate, prolonged follow-up.ResumenLas reacciones granulomatosas «sarcoidosis-like» secundarias a ipilimumab afectarán simultáneamente a múltiples órganos y característicamente se presentarán semanas o meses después de haber iniciado el tratamiento. Paciente varón de 67 años, quien consulta por reacción cutánea granulomatosa a nivel de tronco, extremidades y rostro. Esta se presentó 18 meses después de haber iniciado tratamiento con ipilimumab, medicamento pautado por el diagnóstico de un melanoma metastásico. Reportamos reacción granulomatosa de presentación exclusivamente cutánea, como efecto adverso medicamentoso tardío secundario al tratamiento con ipilimumab. Así mismo resaltamos la necesidad de realizar en los pacientes tratados con ipilimumab un seguimiento prolongado.
       
  • The Super Shaving Technique to Correct the Trapdoor Effect in Nasal Flaps
    • Abstract: Publication date: January–February 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 1Author(s): J. Correa, J. Magliano, I. Peres, C. BazzanoAbstractIntroduction and objectivesThe trapdoor effect is a possible complication in flap reconstructions, particularly those involving the face. It consists of a bulging, elevated deformity that appears 3 weeks after the intervention. To date there has been no consensus on how the trapdoor effect should be treated. The aim of this article is to report on our experience with this defect and describe how we use the ‘super shaving’ technique to resolve the trapdoor effect in nasal flaps.Material and methodsWe performed a retrospective, descriptive study of 10 patients who developed a bulging deformity of a nasal flap that was treated surgically with the super shaving technique. We also report on postoperative management.ResultsThe median age of the 10 patients was 67.7 years and they all developed a bulging transposition flap in the nasal area after conventional or Mohs micrographic surgery. The complication occurred approximately 5 weeks after surgery and healing time was 4 weeks. There were no major postoperative complications and the outcome was of low aesthetic significance compared with the bulging flap. All the patients stated they were very satisfied with the aesthetic outcome.ConclusionsIn our opinion, the super shaving technique is a fast, effective, simple, and cheap outpatient procedure that offers excellent aesthetic results.ResumenIntroducción y objetivosEl efecto en trampilla o trapdoor es una complicación posible en un colgajo cuando se utiliza especialmente en la zona facial. Consta de una deformidad elevada y abultada, que comienza 3 semanas después de la intervención, y hasta la fecha no existe consenso en su tratamiento. Es por ello que presentamos nuestra experiencia en esta afección, destacando la técnica de afeitado profundo o super shaving para la resolución del efecto en trampilla de colgajos nasales.Materiales y métodosEstudio retrospectivo y descriptivo de 10 pacientes que desarrollaron un abultamiento posterior a un cierre mediante colgajo en la zona nasal, que fueron resueltos quirúrgicamente a través de la técnica de super shaving y su manejo postoperatorio.ResultadosLa edad mediana de los 10 pacientes operados fue 67,7 años, y todos ellos presentaron abultamiento de colgajo de trasposición del área nasal, posterior a una cirugía micrográfica de Mohs o cirugía convencional. El tiempo de aparición de la complicación fue de aproximadamente 5 semanas, y el de cicatrización fue de 4 semanas. Ningún paciente presentó complicaciones mayores en el postoperatorio, y la cicatriz tuvo una incidencia estética baja comparada con el abultamiento. Todos los pacientes refirieron estar muy satisfechos con el resultado estético.ConclusionesConsideramos que la técnica de super shaving es rápida, efectiva, simple, de bajo costo, se practica de manera ambulatoria, y ofrece resultados estéticamente excelentes para resolver este defecto.
       
  • Screening for Body Dysmorphic Disorders in Acne Patients: A Pilot Study
    • Abstract: Publication date: January–February 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 1Author(s): S.E. Marron, T. Gracia-Cazaña, A. Miranda-Sivelo, S. Lamas-Diaz, L. Tomas-AragonesAbstractIntroductionBody dysmorphic disorder (BDD) is a mental health condition that is difficult to diagnose; it can cause a great deal of suffering, and treatment is often complex and challenging.Material and methodThe study population comprised 81 consecutive dermatology out-patients who met the inclusion criteria for participation. Participants were treated at hospitals in both urban (Zaragoza) and rural areas (Alcañiz). The project was based on a prospective and observational pilot study. Assessment instruments used: Cook's Acne Grading Scale and Body Dysmorphic Disorder Questionnaire (BDDQ) (Spanish translation).Possible cases of BDD were identified by means of 2 criteria: 1) A positive result in the BDDQ (4 positive points and a negative exclusion question); and, 2) A Cook's Acne Grading Score that reflected non-noticeable/mild lesions (the most stringent criteria) or moderate lesions (least stringent criteria)ResultsThe age range of the patients was from 13 to 43 years old. The average age was 19 with a standard deviation of 6.2. Of the 81 participants, 54.3% were women. 61.7% were seen in a rural hospital (Alcañiz Hospital) and 38.3% in an urban one (University Hospital of Zaragoza). When more restrictive criteria regarding the seriousness of the condition were applied (only patients with mild acne), the BDDQ screening resulted in a positive BDD prevalence rate of 8.6% (7 patients); if the criteria were less restrictive (including patients with moderate lesions), the rate was 14.8% (12 patients).DiscusionPatients who screened positive for BDD reported spending an average of 2 hours a day thinking and worrying about their appearance. These results highlight the importance of screening for possible cases of BDD in order to follow up these patients and recommend they be seen by a mental health specialist to confirm the diagnose and offer treatment for the disorder. BDD has a serious and negative impact on the lives of those affected.ResumenIntroducciónEl trastorno dismórfico corporal (TDC) es una enfermedad mental difícil de diagnosticar; puede causar una gran cantidad de sufrimiento, y el tratamiento a menudo es complejo y desafiante.Material y métodoLa población de estudio comprendía 81 pacientes ambulatorios dermatológicos consecutivos que cumplían los criterios de inclusión para la participación. Fueron tratados en hospitales en zonas urbanas (Zaragoza) y rurales (Alcañiz). Es un estudio piloto prospectivo y observacional. Se utilizaron como instrumentos de evaluación: a) La escala de gradación del acné de Cook y b) El Cuestionario de Trastorno Dismórfico Corporal (Body Dysmorphic Disorder Questionnaire, BDDQ) (traducción al español). Los posibles casos de TDC se identificaron mediante 2 criterios: 1) Un resultado positivo en el BDDQ (4 puntos positivos y una pregunta de exclusión negativa); y 2) Escala de gradación del acné de Cook que reflejó lesiones no perceptibles/leves (los criterios más estrictos) o lesiones moderadas (criterios menos estrictos)ResultadosEl rango de edad de los pacientes era de 13 a 43 años. La edad promedio fue 19 con una desviación estándar de 6,2. De los 81 participantes, el 54,3% eran mujeres y el 45,7% eran hombres. El 61,7% vivía en el área rural cubierta por el hospital de Alcañiz y el 38,3% era del área urbana atendida por el Hospital Universitario de Zaragoza. Cuando se aplicaron criterios más restrictivos con respecto a la gravedad de la afección (solo los pacientes con acné leve), el proceso de detección de BDDQ resultó en una tasa de prevalencia de TDC del 8,6% (7 pacientes); si los criterios fueron menos restrictivos (incluidos los pacientes con lesiones moderadas), la tasa fue del 14,8% (12 pacientes).DiscusiónVale la pena recordar que los pacientes con TDC que participaron en este estudio pasan un promedio de 2 h al día pensando y preocupándose por su apariencia. Este hecho es un recordatorio de la importancia de diagnosticar y tratar correctamente el TDC ya que la afección claramente tiene un impacto serio y negativo en las vidas de los afectados.
       
  • Medical Malpractice Issues in Dermatology: Clinical Safety and the
           Dermatologist
    • Abstract: Publication date: January–February 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 1Author(s): J. Arimany Manso, C. Martin Fumadó, J.M. Mascaró BallesterClinical safety and medical liability are first-order concerns in today's medical practice. It is important to understand the circumstances under which medical acts fail to live up to the accepted standard of care and to recognize the impact that malpractice claims have on physicians. Practitioners must also grasp the concept of medical error, studying malpractice claims in order to identify the areas where improvement is needed. The risk of accusations of malpractice in dermatology is comparatively low, both in Spain and worldwide. However, a great variety of clinical scenarios in dermatology can potentially give rise to a claim, and malignant melanoma is most susceptible to risk. Dermatologists should know which actions during clinical consultation merit particular attention and care. Clinical practice carries inherent risk of malpractice claims, but taking certain recommended precautions can prevent them.ResumenLa seguridad clínica y la responsabilidad profesional médica son hoy en día preocupaciones de primer orden en el ejercicio de la medicina. Interesa la valoración de las circunstancias en las que el ejercicio de la medicina no se ajusta a la lex artis, así como el impacto de las reclamaciones sobre los facultativos. Debe existir además un aprendizaje del error médico, identificando, mediante el estudio de reclamaciones, áreas específicas de mejora. La dermatología es una especialidad con bajo riesgo de reclamación a nivel internacional y también en nuestro contexto. Gran variedad de circunstancias clínicas dan lugar a reclamaciones por praxis médica en dermatología, y entre ellas destaca la actuación en caso de melanoma cutáneo maligno. Por otro lado, existen riesgos potenciales en las consultas de dermatología que merecen especial atención. El quehacer clínico está sujeto a un riesgo inherente de reclamación y por tanto son necesarias una serie de recomendaciones para prevenirlas.Graphical abstractGraphical abstract for this article
       
  • Psoriasis and Depression: The Role of Inflammation
    • Abstract: Publication date: January–February 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 1Author(s): S. González-Parra, E. DaudénAbstractPsoriasis is a chronic, systemic inflammatory disorder with multiple comorbidities.The most common comorbidities are mental disorders, especially depression, which can interact negatively with psoriasis to produce a dangerous vicious circle. Depression in psoriasis has traditionally been explained as a response to psychosocial factors and impaired quality of life.However, a new hypothesis linking depression and psoriasis through chronic inflammation offers insights that should help us to understand and treat these diseases. In this approach, new drugs and lifestyle have an important role.ResumenLa psoriasis es un proceso inflamatorio crónico y sistémico con múltiples comorbilidades. Entre las más frecuentes se encuentran las enfermedades mentales y en especial la depresión, con la que interrelacionan negativamente llegando a producir un peligroso círculo vicioso. Clásicamente se ha explicado la depresión de los pacientes con psoriasis como reactiva a factores psicosociales y el deterioro en la calidad de vida. Sin embargo, la asociación de estas dos patologías a través del proceso inflamatorio crónico ofrece una nueva hipótesis para su comprensión y tratamiento. Este enfoque incide en nuevos fármacos y la importancia del estilo de vida.
       
  • Leiomyosarcoma and Pleomorphic Dermal Sarcoma: Guidelines for Diagnosis
           and Treatment
    • Abstract: Publication date: January–February 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 1Author(s): B. Llombart, C. Serra-Guillén, C. Requena, M. Alsina, D. Morgado-Carrasco, I. Machado, O. SanmartínThere are 3 types of leiomyosarcoma of the skin: dermal, subcutaneous, and metastatic cutaneous. Dermal leiomyosarcoma arises from smooth muscle fibers in arrector pili muscles, genital dartos muscles, and the nipple-areola complex. It is an intermediate-grade tumor associated with a tendency for local recurrence (24%) and low metastatic potential (4%). Subcutaneous leiomyosarcoma originates from smooth muscle in blood vessel walls and has higher rates of local recurrence (37%) and metastasis (43%).Plemorphic dermal sarcoma typically affects elderly patients and arises in sun-exposed areas (e.g., the scalp). Its histologic and immunohistochemical characteristics are similar to those of atypical fibroxanthoma, but it is more aggressive (metastasis rate of 10%-20%). Histologically, it can be distinguished from atypical fibroxanthoma by the observation of subcutaneous tissue invasion, perineural invasion, and foci of necrosis.ResumenEl leiomiosarcoma de la piel se clasifica en tres grupos: dérmico, hipodérmico y cutáneo metastásico. El dérmico se origina de las fibras musculares lisas del músculo erector del pelo, dartos genital o de la areola mamaria. Se considera un tumor de malignidad intermedia, con tendencia a la recidiva local (24%) y un bajo riesgo de metástasis (4%). El leiomiosarcoma hipodérmico se origina de las paredes musculares de los vasos, y se caracteriza por presentar una mayor tasa de recidiva local (37%) y metástasis (43%).El sarcoma pelomórfico dérmico aparece habitualmente en pacientes ancianos y se localiza característicamente en zonas de piel fotoexpuesta (cuero cabelludo). Comparte características histológicas e inmunohistoquímicas con el fibroxantoma atípico, pero con un comportamiento más agresivo (metástasis en el 10-20%). Los criterios histológicos que lo diferencian son la infiltración del tejido celular subcutáneo, la infiltración perineural y la presencia de focos de necrosis.Graphical abstractGraphical abstract for this article
       
  • Is the Current Classification of Urethritis as Gonococcal or Nongonoccal
           Becoming Obsolete'
    • Abstract: Publication date: January–February 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 1Author(s): V.M. Leis-Dosil
       
  • Correction of Trapdoor Effect Following Nasal Pyramid Reconstruction With
           a Transposition Flap
    • Abstract: Publication date: January–February 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 1Author(s): P. Redondo
       
  • Skin, Body Dysmorphic Disorder, and Other Syndromes
    • Abstract: Publication date: January–February 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 1Author(s): C. Martínez-González
       
  • Dilated Cardiomyopathy in a Child with Recessive Dystrophic Epidermolysis
           Bullosa
    • Abstract: Publication date: January–February 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 1Author(s): A. Imbernón-Moya, R. Maseda-Pedrero, M. Feito, R. de Lucas
       
  • Progesterone Autoimmune Dermatitis Responding to Ulipristal Acetate
    • Abstract: Publication date: January–February 2019Source: Actas Dermo-Sifiliográficas (English Edition), Volume 110, Issue 1Author(s): S. Oscoz-Jaime, M. Larrea-García, M.J. Mitxelena-Eceiza, N. Abián-Franco
       
  • Daylight Photodynamic Therapy in the Treatment of Actinic Keratosis in
           Carriers of Oculocutaneous Albinism: Report of Three Cases
    • Abstract: Publication date: Available online 13 December 2018Source: Actas Dermo-Sifiliográficas (English Edition)Author(s): L.E. Garcia Galvão, R. Tomaz, H. de Sá Gonçalves
       
  • Reverse Isotopic Phenomenon in Drug Reaction with Eosinophilia and
           Systemic Symptoms
    • Abstract: Publication date: Available online 15 October 2018Source: Actas Dermo-Sifiliográficas (English Edition)Author(s): M. Adil, Syed Suhail Amin, R. Dinesh Raj, Hera Tabassum
       
  • Clinical, Dermoscopic and Histologic Features of Recurrent Cutaneous
           Eosinophilic Vasculitis Cases
    • Abstract: Publication date: Available online 20 September 2018Source: Actas Dermo-Sifiliográficas (English Edition)Author(s): E.G. Quijano-Gomero, M.J.M. Rodríguez-Zúñiga, M.E. Sanz-Montero, D. Durand-BuseAbstractPrimary recurrent cutaneous eosinophilic vasculitis is a rare condition characterized by pruritic, erythematous, purpuric plaques associated to edema. We compared and analyze the clinical, dermoscopic and histological features of the disease in 4 patients from our hospital and 13 patients published in the literature. Seventeen patients were included, with a median age of 56 yo, a median duration of disease of 6 months. Lesions were most frequently generalized (47%) or localized in lower limbs (41%). The most frequent features were purpuric color (71%), local edema (65%), necrotizing vasculitis (94%) and eosinophil infiltration (100%) in histology. Most of the patients (82.4%) were given oral steroids with a median dose of 30 mg. Primary recurrent cutaneous eosinophilic vasculitis might be an infra-diagnosed condition. The analysis of the patients allowed us to propose diagnostic criteria for the definition of this disease. We suggest a therapeutic strategy with high-potency steroids and dapsone, which might be considered as first-line treatment.ResumenLa vasculitis eosinofílica recurrente cutánea primaria es una enfermedad rara, caracterizada por placas purpúricas, eritematosas y pruriginosas asociadas a edema. Comparamos y analizamos las características clínicas, dermatoscópicas e histológicas de la enfermedad en 4 pacientes de nuestro hospital y en 13 casos de pacientes publicados previamente. Se incluyeron 17 pacientes, con una mediana de edad de 56 años, y una mediana de duración de la enfermedad de 6 meses. En la mayoría de los casos las lesiones fueron generalizadas (47%) o localizadas en los miembros inferiores (41%). Las características histológicas más frecuentes fueron: color purpúrico (71%), edema local (65%), vasculitis necrosante (94%) e infiltración eosinofílica (100%). La mayoría de los pacientes (82,4%) recibió esteroides orales (mediana de la dosis de 30 mg). La vasculitis eosinofílica recurrente cutánea primaria podría ser una entidad clínica infradiagnosticada. El análisis de los pacientes nos permitió proponer algunos criterios diagnósticos para su definición. Recomendamos una estrategia terapéutica con esteroides de alta potencia y dapsona, pudiéndose considerar como el tratamiento de primera línea.
       
  • Diagnostic Pitfalls: Pseudomelanocytic Nests in the Setting of Lichenoid
           Inflammation
    • Abstract: Publication date: Available online 12 June 2018Source: Actas Dermo-Sifiliográficas (English Edition)Author(s): D. McClanahan, S. Choudhary, J. Zahniser, J. Ho
       
 
 
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