Tepescohuite is an extract obtained from the bark of the Mimosa tenuiflora tree and is used as an empirical treatment in wounds for its healing and antiseptic properties. Venous leg ulcers (VLUs) are a common health care problem in most countries with a high rate of morbidity. The standard of care is moist interactive healing and compression; however, the ideal topical treatment is yet to be established. This study is designed to evaluate the effectiveness and safety of M. tenuiflora cortex extract (MTC-2G) in the treatment of VLUs in an Interdisciplinary Wound and Ostomy Care Center (IWOCC). A randomised, placebo-controlled, double blind clinical trial was conducted to compare the use of a hydrogel containing MTC-2G with the hydrogel alone in VLUs. The study included all patients with venous ulcers referred to the IWOCC. Laboratory tests and tissue biopsies were performed at the beginning and at the end of the study. The patients were instructed to daily cleansing followed by topical application of the hydrogel and compression. Forty-one patients were included, 22 patients received the MTC-2G and 19 patients received the hydrogel only. Of the 41 patients, 32 completed the study, 18 in the experimental arm and 14 in the control group, 19 were women and 13 men. The mean age of the subjects was 60 years. The mean time from presentation was 38 months. The mean surface reduction was 6·29 cm(2) [confidence interval (IC) 95%: 3·28-9·29] (P = 0·0001) in the MTC-2G group and 5·85 cm(2) (95% CI: 3·58-8·12) (P = 0·001) in the hydrogel group. There was no significant difference between the groups (P = 0·815). No changes in the laboratory parameters were noted. In the histology, there were not any differences between groups either. A hydrogel containing MTC-2G was not superior to a hydrogel alone in the treatment of VLUs.
Background: Most patients with oral mucosal melanoma have had a mucosal hyper pigmented area for months or even years before the diagnosis, it is important to consider the differential diagnosis of mucosal melanoma, which in many cases is a difficult diagnosis and because of the aggressive biological behavior of mucosal melanoma it is important to do a quick diagnosis. Main observation:A 40-year-old Mexican male patient, presented with a lesion on the lower right half of the lip covering almost the entire vermillion border, 1 mm below the white roll. The lesion was a 1.5 x 4 cm pigmented macule with asymmetric and irregular borders and colors. Dermoscopy showed a multi component pattern. An incision biopsy was performed under the impression of mucosal melanoma. The pathologic report described a Clark I vermillion edge mucosal melanoma in situ. Conclusions:This case had confounding clinical signs that could have misguided the clinician. But dermoscopy proved to be useful when suspecting a malignant lesion, which prompted a biopsy and a correct diagnosis. (J Dermatol Case Rep. 2012; 6(1): 1-4) A case of oral mucosal melanoma. Clinical and dermoscopic correlation.Tamar Hajar-Serviansky, Daniela Gutierrez-Mendoza, Iris L. Galvan, Lorena Lammoglia-Ordiales, Adalberto Mosqueda-Taylor, Maria de Lourdes Hernandez-Cázares, Sonia Toussaint-Caire Dermatology Division, Hospital General "Dr. Manuel Gea González", Mexico City, Mexico. IntroductionThere are many lesions that present with an increase in oral mucosal pigmentation, with an intrinsic and extrinsic origin. Since most patients with oral mucosal melanoma have had a mucosal hyper pigmented area for months or even years before the diagnosis, it is important to consider the differential diagnosis of mucosal melanoma. Case ReportA 40-year-old Mexican male patient, Fitzpatrick's skin type III, presented with a lesion on the lower right half of the lip covering almost the entire vermillion border, 1 mm below the white roll. The lesion was a 1.5 x 4 cm pigmented macule with asymmetric and irregular borders and colors. The white roll had an infiltrated area that was slightly elevated and deformed with grouped vesicles and erythema (Fig. 1).According to the patient, the lesion had always been present, and was confident the elevation and erythema were in the hard palate and upper alveolar ridge. Jaw, retromolar, trigone, and floor of the mouth were involved in 3 cases (8.57%); 3 melanomas (8.57%) were detected in the labial mucosa and 2 (5.71%) on buccal/vestibular mucosa. Only 1 case (2.86%) was diagnosed on the lateral border of tongue, and in 1 case (2.86%), they could not identify the site of the lesion. 7The biological behavior of mucosal melanoma notoriously differs from the one shown in case of skin melanomas. Likely reasons are late diagnosis and treatment; anatomic differences in location, a greater blood and lymphatic flow in mucosa, easing its spread and differences in its genetic profile. For the above, in general, it has a bad prognosis with a 5-ye...
Purpose:The objective of the study is to compare the frequency of Demodex on the eyelash follicle of patients with rosacea and referents without rosacea or ophthalmological disorders.Methods:This is a comparative, open, observational, and cross-sectional study that included 41 patients diagnosed with rosacea and 41 referents without rosacea diagnosis or ophthalmic alterations. The individuals underwent a slit-lamp examination in which two eyelashes per eyelid were removed with fine forceps. The presence of Demodex was sought by direct visualization under a light microscope. The results were expressed as “positive” when at least one mite on one lash was found and “negative” when no mite was identified. Chi-square test was used to compare the presence of mites in both groups.Results:Eighty-two study individuals (45 females and 37 males) were included, of which 41 patients were diagnosed with rosacea and 41 were without rosacea or ophthalmic alterations. The average mean age was 37 years with a minimum of 19 and a maximum of 87 years. Of the 41 patients with rosacea, 31 had erythematotelangiectatic rosacea and 10 had papulopustular rosacea. There were no patients with phymatous or ocular rosacea. The presence of Demodex was found in 32 patients: 24 patients with rosacea diagnosis (16 of the erythematotelangiectatic subtype and 8 of papulopustular subtype) and 8 patients without rosacea or ophthalmic alterations (P ≤ 0.001).Conclusion:Rosacea was found to be a statistically significant risk factor for Demodex infestation in eyelashes, irrespective of age and sex, with a higher prevalence in papulopustular variety.
Infundibulocystic basal cell carcinoma is a rare variant. It was first described in 1987 and proposed as a new basal cell carcinoma (BCC) subtype by Ackerman and Walsh in 1990. Dermoscopy is a noninvasive diagnostic technique that allows prompt identification of many types of BCC. However, dermoscopic findings for the infundibulocystic variant have not been reported. In our patient the dermoscopic findings were maple leaf-like areas in the periphery of the tumor, multiple scattered blue-gray dots and globules, short, fine telangiectasia and chrysalis or white-shiny streaks. All these structures had an underlying anatomopathological correlation.Conclusion:According to our case report, dermoscopy findings may aid to clearly diagnose this unusual BCC variant with proper histopathological correlation.
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