Background: The aetiology of contact dermatitis, a common inflammatory skin disorder, is often complex and multifactorial. Objectives: To describe the characteristics of patients with contact dermatitis who also have concomitant atopic dermatitis or psoriasis. Methods: Between 2000 and 2011, adult patients with chronic contact dermatitis (six months or more), which also had concomitant atopic dermatitis or psoriasis, were recruited for a descriptive retrospective study in a tertiary care Spanish hospital. Univariate and multivariate analyses were used for the analysis of the collected data. Results: 76 patients with atopic dermatitis and 130 with psoriasis were recruited. The most frequent site of contact dermatitis in both groups was the hands. The most frequent clinically relevant allergen in both groups was nickel sulphate. According to multivariate logistic regression, a statistically significant association was found between facial contact dermatitis and atopic dermatitis (adjusted OR 0.2 95% CI: 0.05-0.8; P = 0.022). No differences were found between the groups for patch test results (adjusted OR 0.6 CI 95%: 0.3-1.3; P = 0.194). Conclusions: Although the number of patients was limited, our results provide valuable insight on the behaviour of contact dermatitis in patients with atopic dermatitis and with psoriasis. Facial contact dermatitis was positively associated with atopic dermatitis. No differences were found with respect to rates of contact hypersensitivity or positivity to different allergens.
The term craniofacial hyperhidrosis (HH) refers to HH that affects the face and/or scalp. Few studies have focused on this specific location, and even fewer distinguish between the two areas. Our study aims are to describe the clinical characteristics of patients with craniofacial HH, specifying whether the condition affects the scalp, face or both, and to compare these cases with those recorded at other locations. As secondary objectives, we determine the effectiveness and adverse effects of oral oxybutynin (OOx), and assess patients' adherence to treatment. This prospective observational study was carried out with respect to the period 2007‐2019. All patients diagnosed with HH of the scalp and/or face and who were treated with OOx at our HH unit were included in the study group. Of 292 patients treated with OOx, 97 (33.2%) had craniofacial HH. Of these, 4 (4.1%) presented HH exclusively on the scalp, 56 (57.7%) exclusively on the face and 37 (38.1%) in both locations. The patients in the latter category (compared with those with exclusively facial HH) were significantly older than the others, had a later onset of HH, a greater frequency of secondary HH, less simultaneous involvement of the classical areas of primary focal HH (the palms, soles, and armpits) and greater generalized HH and of the trunk. No significant differences were observed between the three locations (face, scalp, or both) regarding the efficacy and side effects of OOx. The patients with exclusively facial HH presented greater adherence to treatment.
same site of VX while the other manifestations were controlled on the above regimen. Verruciform xanthoma is an uncommon benign tumor, which arises on the oral mucosa. Extramucosal lesions are rare. It was first described by WG Shafer as a benign neoplasm of the keratinocytes. 1 It is characterized by warty, hyperkeratotic growth. It usually occurs on the mucosal surfaces (oral cavity mostly). However, other nonoral mucosal surfaces have been reported which include the penis, esophagus, and vulva. 2 It has been reported with squamous cell carcinoma (SCC), recessive dystrophic epidermolysis bullosa (RBED), discoid lupus, and in healthy individuals. 3,4 Surgical excision is the treatment of choice with a risk of recurrence as in our patient. Histologically, it is characterized by verrucous epidermal hyperplasia and foamy histiocytic infiltrate in the connective tissue of papillary dermis with elongated rete ridges. The xanthoma cells show PAS-positive granules. 1 The pathogenesis of VX remains unknown. In chronic inflammation, the epithelial cells are damaged and entrapped in the papillary dermis leading to the accumulation of foamy cells. 5 Other reported association is HPV infection. 5 Extramucosal VX is a rare benign neoplasm, and its association with underlying inflammatory conditions is rarely reported in the literature. The patient presented here is the second reported case in association with discoid lupus.
Background Melanoma mortality rates are stabilizing and in certain regions and age groups are trending down. Although there are some studies that predict melanoma mortality in other countries, there are currently no studies that predict mortality in Spain in the coming years. The main aim of this study is to calculate melanoma mortality projections in Spain for the period 2019-2043.Methods This is a population-based ecological study that utilized information from the Spanish National Statistics Institute. Analysis included deaths as a result of cutaneous melanoma in Spain in the period 1979-2018, and data was analyzed according to gender and age group. Projections were made until 2043 in five-year periods, calculated in Nordpred (within the R software). Results Our estimates predict that in the period 2019-2043, there will be 30,477.9 deaths from melanoma in Spain, with the age group of >85 years being the group with the highest number of deaths. The expected average annual death rate for melanoma in both genders for the period 2019-2043 is 1,269.9 deaths / year. The predicted age-standardized mortality rates varied between 4.62/100.000 inhabitants in the 2019-2023 period and 3.94/ 100.000 inhabitants in the 2039-2043 period.Conclusions Overall mortality rate and age-standardized melanoma death rates in older people of both genders will increase in the coming years in Spain, while rates in younger people will stabilize or decrease progressively. In the coming years, prevention efforts should focus on the young, but the emphasis should also be on educating the elderly in early detection of melanoma.
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