BackgroundPigmented lesions on acral sites are common; clinical differentiation of nevi
and early melanoma can be challenging. In these cases, dermoscopy can
provide a more accurate diagnosis. Most dermoscopic patterns on acral skin
have been described in Asian and European populations, while there are few
studies in Latin American populations.ObjectivesTo determine the frequency of pigmented lesions in volar skin and their
dermoscopic patterns in a Mexican population. Methods: An observational,
descriptive, cross-sectional study was performed in Hispanic patients with
the presence of at least one pigmented lesion on acral skin. Clinical and
dermoscopic images were obtained. These were subsequently evaluated
independently by two dermatologists trained and experienced in
dermoscopy.ResultsA total of 582 pigmented lesions on volar skin were diagnosed in 321
patients. Overall, prevalence of acral pigmented lesions on volar skin was
6.8%. For both observers, parallel furrows were the most frequent pattern
described, but for observer 2, a lattice-like pattern was prevalent on the
toes and a homogeneous pattern on the sides of the feet. There was lower
inter-observer agreement, with a kappa index of 0.144.Study limitationsThe lesions were not biopsied, so clinical-histological correlation could not
be performed. The study did not correlate dermoscopic patterns with age.Conclusions.As previously reported by other authors, parallel furrows were the most
frequently found dermoscopic pattern on palmoplantar skin.
The cholelithiasis is a common pathology, however, if left untreated may cause a gallbladder perforation (GBP). This complication can include local or generalized biliary spillage, or a fistulous communication to an adjacent organ. We report a case of a patient with cholecystopleural fistula in a 71-year-old male. Complicated cholelithiasis presented fistulous GBP into the right pleura cavity, progressing into an empyema. The diagnosis was made preoperatively with computed tomography, and the patient was treated with a laparoscopic cholecystectomy, thoracostomy tube, and a biliopleural fistulectomy. The postsurgical outcome was satisfactory, with uneventful follow-up 3 weeks after.
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