Pub Date : 2025-03-03DOI: 10.1016/j.ad.2025.02.023
J Angel-Baldo, S Podlipnik, A Azón, A Boada, A Arrieta, J Marcoval, C López-Sánchez, M- Sàbat, S Segura, D Bodet, N Curcó, D Lopez-Castillo, J Solà, M Quintana-Codina, C Baliu-Piqué, M Just-Sarobé, S Martín-Sala, J Malvehy, S Puig, C Carrera, R M Marti
Background: Acral melanoma is associated with poor prognosis. Studying the characteristics and prognosis of Caucasian patients is crucial to understand the distinct features of this tumor.
Objectives: To analyze the epidemiological, clinicopathological, and prognostic features of acral melanoma in Caucasian patients.
Methods: We conducted a retrospective, multicenter, cohort study of acral melanoma from a database across 20 hospitals from South Europe from January 2000 through December 2019.
Results: A total of 733 acral melanomas were identified (median age, 67.5 years; 95.2%, Caucasians; 77.5% of which were located on the feet). Overall, 77.5% of cases were invasive melanomas. Foot melanomas had a higher proportion of invasive cases (80.8% vs 69.8%; p = 0.003), stages III and IV at diagnosis (24.8% vs 11.7%; p < 0.001), thicker Breslow depth (2.8 mm vs 2.0 mm; p = 0.021) and a higher rate of positive sentinel lymph node biopsy (SLNB) (30.7% vs 15.7%; p = 0.012). Thicker Breslow depth and later age of onset were risk factors for melanoma-specific survival. Thicker Breslow depth and ulceration were independent prognostic factors of relapse-free survival. Melanoma location and histopathological subtype were not associated with worse prognosis. Recurrences were a common finding (27.7%), with distant metastases appearing earlier than locoregional recurrences (1.32 years [IQR, 1.12-1.87] vs 2.14 years [IQR, 1.68-2.70]; p = 0.015).
Conclusion: This study, the largest in a predominantly Caucasian population, underscores the unfavorable outcomes of acral melanoma. Foot melanomas exhibited delayed detection, increased invasiveness, thicker Breslow depth, increased SLNB involvement, and higher AJCC stages. The high recurrence rate and early distant metastases emphasise the critical role of intensive follow-up and routine imaging modalities to detect asymptomatic relapses.
{"title":"Acral melanoma in the Caucasian population: a comprehensive cohort study on epidemiological, clinicopathological, and prognostic features.","authors":"J Angel-Baldo, S Podlipnik, A Azón, A Boada, A Arrieta, J Marcoval, C López-Sánchez, M- Sàbat, S Segura, D Bodet, N Curcó, D Lopez-Castillo, J Solà, M Quintana-Codina, C Baliu-Piqué, M Just-Sarobé, S Martín-Sala, J Malvehy, S Puig, C Carrera, R M Marti","doi":"10.1016/j.ad.2025.02.023","DOIUrl":"https://doi.org/10.1016/j.ad.2025.02.023","url":null,"abstract":"<p><strong>Background: </strong>Acral melanoma is associated with poor prognosis. Studying the characteristics and prognosis of Caucasian patients is crucial to understand the distinct features of this tumor.</p><p><strong>Objectives: </strong>To analyze the epidemiological, clinicopathological, and prognostic features of acral melanoma in Caucasian patients.</p><p><strong>Methods: </strong>We conducted a retrospective, multicenter, cohort study of acral melanoma from a database across 20 hospitals from South Europe from January 2000 through December 2019.</p><p><strong>Results: </strong>A total of 733 acral melanomas were identified (median age, 67.5 years; 95.2%, Caucasians; 77.5% of which were located on the feet). Overall, 77.5% of cases were invasive melanomas. Foot melanomas had a higher proportion of invasive cases (80.8% vs 69.8%; p = 0.003), stages III and IV at diagnosis (24.8% vs 11.7%; p < 0.001), thicker Breslow depth (2.8 mm vs 2.0 mm; p = 0.021) and a higher rate of positive sentinel lymph node biopsy (SLNB) (30.7% vs 15.7%; p = 0.012). Thicker Breslow depth and later age of onset were risk factors for melanoma-specific survival. Thicker Breslow depth and ulceration were independent prognostic factors of relapse-free survival. Melanoma location and histopathological subtype were not associated with worse prognosis. Recurrences were a common finding (27.7%), with distant metastases appearing earlier than locoregional recurrences (1.32 years [IQR, 1.12-1.87] vs 2.14 years [IQR, 1.68-2.70]; p = 0.015).</p><p><strong>Conclusion: </strong>This study, the largest in a predominantly Caucasian population, underscores the unfavorable outcomes of acral melanoma. Foot melanomas exhibited delayed detection, increased invasiveness, thicker Breslow depth, increased SLNB involvement, and higher AJCC stages. The high recurrence rate and early distant metastases emphasise the critical role of intensive follow-up and routine imaging modalities to detect asymptomatic relapses.</p>","PeriodicalId":7173,"journal":{"name":"Actas dermo-sifiliograficas","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.ad.2023.08.022
N.M. Román Mendoza , R. Muñoz Martínez , I. Gonzalo González , F.J. Vicente Martín
{"title":"Chemsex y lesiones cutáneas tras la inyección de mefedrona. A propósito de 3 casos","authors":"N.M. Román Mendoza , R. Muñoz Martínez , I. Gonzalo González , F.J. Vicente Martín","doi":"10.1016/j.ad.2023.08.022","DOIUrl":"10.1016/j.ad.2023.08.022","url":null,"abstract":"","PeriodicalId":7173,"journal":{"name":"Actas dermo-sifiliograficas","volume":"116 3","pages":"Pages 323-325"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.ad.2024.12.006
S. Gomez-Martinez , J. Ibaceta Ayala , D. Morgado-Carrasco
Wood's light (WL) is a useful, economical and easy-to-learn diagnostic tool. Despite its advantages, the use of LW among dermatologists is limited. In porokeratosis, the “diamond necklace” sign has been described, corresponding to the white fluorescence of the hyperkeratotic scale. Subclinical morphea lesions are seen as well-defined dark macules. Among the pigmentary disorders, the bluish fluorescence of vitiligo, the increased contrast of epidermal melasma, and the follicular-centered red fluorescence of progressive macular hypomelanosis stand out. Regarding skin infections, erythrasma presents a coral red fluorescence; tinea versicolor, yellow-green fluorescence; Pseudomonas aeuriginosa, green fluorescence; and scabies, blue-white fluorescence in the acarine burrows. In skin cancer, LW has been used to delimit the surgical margins of both lentigo maligna and non-melanoma skin cancer, with variable results.
{"title":"[Translated article] Wood's Light in Inflammatory and Autoimmune Dermatoses, Infections and Skin Cancer","authors":"S. Gomez-Martinez , J. Ibaceta Ayala , D. Morgado-Carrasco","doi":"10.1016/j.ad.2024.12.006","DOIUrl":"10.1016/j.ad.2024.12.006","url":null,"abstract":"<div><div>Wood's light (WL) is a useful, economical and easy-to-learn diagnostic tool. Despite its advantages, the use of LW among dermatologists is limited. In porokeratosis, the “diamond necklace” sign has been described, corresponding to the white fluorescence of the hyperkeratotic scale. Subclinical morphea lesions are seen as well-defined dark macules. Among the pigmentary disorders, the bluish fluorescence of vitiligo, the increased contrast of epidermal melasma, and the follicular-centered red fluorescence of progressive macular hypomelanosis stand out. Regarding skin infections, erythrasma presents a coral red fluorescence; tinea versicolor, yellow-green fluorescence; <em>Pseudomonas aeuriginosa</em>, green fluorescence; and scabies, blue-white fluorescence in the acarine burrows. In skin cancer, LW has been used to delimit the surgical margins of both lentigo maligna and non-melanoma skin cancer, with variable results.</div></div>","PeriodicalId":7173,"journal":{"name":"Actas dermo-sifiliograficas","volume":"116 3","pages":"Pages T281-T290"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.ad.2024.07.017
E. Samaniego-González , S. Podlipnik , S. Ribero , E. Nagore , A. Boada , J. Cañueto , S. Paradela , B. de Unamuno , P. Rodríguez-Jiménez , S. Puig , J. Malvehy , C. Carrera , G. Roccuzzo , C. Requena , E. Manrique-Silva , N. Richarz , A. Ruiz-Villanueva , V. Traves , S. España-Fernández , R. Botella-Estrada , A. Tejera-Vaquerizo
Introduction
Complete lymph node dissection (CLND) was the standard practice for patients with melanoma and a positive sentinel lymph node biopsy (SLNB) until the results of 2 clinical trials published in 2016 and 2017 demonstrated that it did not improve melanoma-specific survival (MSS). However, it continues to be performed in some scenarios. No studies have ever been published on lymph node management after a positive SLNB in the routine clinical practice in our setting.
Objectives
To determine the evolution of the indication for CLND in patients with a positive SLNB, as well as the characteristics associated with its performance.
Material and methods
We conducted a multicenter retrospective observational study with patients with skin melanoma and positive sentinel lymph nodes diagnosed from 2017 through 2022 at 8 Spanish centers and 1 Italian center.
Results
A total of 430 patients were included, 54% men, with 358 (75.1%) aged between 45 and 80 years. A total of 133 cases (31%) exhibited Breslow thickness > 4 mm, 206 cases (49.1%) were ulcerated, and in 213 cases (55.7%), lymph node metastasis was > 1 mm. Isolated lymphadenectomy or followed by adjuvant therapy was performed in 146 patients (34.1%). After multivariate logistic regression, the factors associated with the performance of CLND were the acral lentiginous melanoma histological subtype, lymph node metastasis size > 1 mm, extracapsular spread, and the participant hospital. Age > 80 years was inversely associated.
Conclusion
While the frequency of CLND in patients with melanoma and positive SLNB has decreased, the indication for systemic adjuvant therapy in these patients has increased. However, CLND is still indicated in patients with high-risk characteristics.
{"title":"Análisis multicéntrico del manejo quirúrgico y tratamiento adyuvante de los pacientes con melanoma y positividad en la biopsia selectiva del ganglio centinela","authors":"E. Samaniego-González , S. Podlipnik , S. Ribero , E. Nagore , A. Boada , J. Cañueto , S. Paradela , B. de Unamuno , P. Rodríguez-Jiménez , S. Puig , J. Malvehy , C. Carrera , G. Roccuzzo , C. Requena , E. Manrique-Silva , N. Richarz , A. Ruiz-Villanueva , V. Traves , S. España-Fernández , R. Botella-Estrada , A. Tejera-Vaquerizo","doi":"10.1016/j.ad.2024.07.017","DOIUrl":"10.1016/j.ad.2024.07.017","url":null,"abstract":"<div><h3>Introduction</h3><div>Complete lymph node dissection (CLND) was the standard practice for patients with melanoma and a positive sentinel lymph node biopsy (SLNB) until the results of 2 clinical trials published in 2016 and 2017 demonstrated that it did not improve melanoma-specific survival (MSS). However, it continues to be performed in some scenarios. No studies have ever been published on lymph node management after a positive SLNB in the routine clinical practice in our setting.</div></div><div><h3>Objectives</h3><div>To determine the evolution of the indication for CLND in patients with a positive SLNB, as well as the characteristics associated with its performance.</div></div><div><h3>Material and methods</h3><div>We conducted a multicenter retrospective observational study with patients with skin melanoma and positive sentinel lymph nodes diagnosed from 2017 through 2022 at 8 Spanish centers and 1 Italian center.</div></div><div><h3>Results</h3><div>A total of 430 patients were included, 54% men, with 358 (75.1%) aged between 45 and 80 years. A total of 133 cases (31%) exhibited Breslow thickness > 4<!--> <!-->mm, 206 cases (49.1%) were ulcerated, and in 213 cases (55.7%), lymph node metastasis was > 1<!--> <!-->mm. Isolated lymphadenectomy or followed by adjuvant therapy was performed in 146 patients (34.1%). After multivariate logistic regression, the factors associated with the performance of CLND were the acral lentiginous melanoma histological subtype, lymph node metastasis size > 1<!--> <!-->mm, extracapsular spread, and the participant hospital. Age > 80 years was inversely associated.</div></div><div><h3>Conclusion</h3><div>While the frequency of CLND in patients with melanoma and positive SLNB has decreased, the indication for systemic adjuvant therapy in these patients has increased. However, CLND is still indicated in patients with high-risk characteristics.</div></div>","PeriodicalId":7173,"journal":{"name":"Actas dermo-sifiliograficas","volume":"116 3","pages":"Pages 233-244"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.ad.2024.07.022
M.G. Baião Catorze , P.M. Leal Filipe
{"title":"Mohs Surgery: From Past to Present, Current State of the Art and Future Perspectives","authors":"M.G. Baião Catorze , P.M. Leal Filipe","doi":"10.1016/j.ad.2024.07.022","DOIUrl":"10.1016/j.ad.2024.07.022","url":null,"abstract":"","PeriodicalId":7173,"journal":{"name":"Actas dermo-sifiliograficas","volume":"116 3","pages":"Pages 207-209"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.ad.2024.12.015
A. Vicente , A. Pérez-Ferriols , A. Batalla , L. García-Fernandez , B. Pérez , N. Eiris , R. de Lucas , P. De La Cueva , J.M. Carrascosa
Justification and objectives
The Spanish Academy of Dermatology and Venereology (AEDV) Psoriasis and Pediatric Working Groups (PSW and PWG) have developed a set of recommendations for the management of pediatric psoriasis based on the best available evidence and experts’ opinion.
Methodology
The methodology of nominal groups was followed, with help from a scoping review. A coordinator was designated, and a group of experts was selected based on their experience and knowledge on the management of psoriasis. The coordinator defined both the objectives and the key points of the document. Then, with help from a documentalist, a systematic literature review was conducted across Medline, Embase and Cochrane Library until May 2023. Systematic literature reviews, meta-analyses, and observational studies were included. National and international clinical practice guidelines and consensus documents were reviewed. With this information, the coordinator proposed preliminary recommendations that were discussed and modified in a nominal group meeting with all experts. After several review processes, which included an external review, the final document was generated.
Results
Practical recommendations on the evaluation and management of patients with pediatric psoriasis are presented in association with other AEDV documents. The evaluation of the pediatric patient, the definition of the therapeutic objectives, the criteria for indication and selection of treatment are addressed. Practical issues such as therapeutic failure, response maintenance, comorbidity and risk management are also included.
{"title":"[Translated article] Consensus Statement From the Spanish Academy of Dermatology and Venereology (AEDV) Psoriasis Working Group (SWG) and Pediatric Working Group (PWG) on the Management of Pediatric Psoriasis","authors":"A. Vicente , A. Pérez-Ferriols , A. Batalla , L. García-Fernandez , B. Pérez , N. Eiris , R. de Lucas , P. De La Cueva , J.M. Carrascosa","doi":"10.1016/j.ad.2024.12.015","DOIUrl":"10.1016/j.ad.2024.12.015","url":null,"abstract":"<div><h3>Justification and objectives</h3><div>The Spanish Academy of Dermatology and Venereology (AEDV) Psoriasis and Pediatric Working Groups (PSW and PWG) have developed a set of recommendations for the management of pediatric psoriasis based on the best available evidence and experts’ opinion.</div></div><div><h3>Methodology</h3><div>The methodology of nominal groups was followed, with help from a scoping review. A coordinator was designated, and a group of experts was selected based on their experience and knowledge on the management of psoriasis. The coordinator defined both the objectives and the key points of the document. Then, with help from a documentalist, a systematic literature review was conducted across Medline, Embase and Cochrane Library until May 2023. Systematic literature reviews, meta-analyses, and observational studies were included. National and international clinical practice guidelines and consensus documents were reviewed. With this information, the coordinator proposed preliminary recommendations that were discussed and modified in a nominal group meeting with all experts. After several review processes, which included an external review, the final document was generated.</div></div><div><h3>Results</h3><div>Practical recommendations on the evaluation and management of patients with pediatric psoriasis are presented in association with other AEDV documents. The evaluation of the pediatric patient, the definition of the therapeutic objectives, the criteria for indication and selection of treatment are addressed. Practical issues such as therapeutic failure, response maintenance, comorbidity and risk management are also included.</div></div>","PeriodicalId":7173,"journal":{"name":"Actas dermo-sifiliograficas","volume":"116 3","pages":"Pages T254-T280"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.ad.2024.12.010
R. García Castro, C. Manzanas Yustas, L. Núñez Hipólito, I. Alcaraz León
{"title":"[Translated article] Use of Micrografts for Postsurgical Wound Reconstruction: A 21-Case Series","authors":"R. García Castro, C. Manzanas Yustas, L. Núñez Hipólito, I. Alcaraz León","doi":"10.1016/j.ad.2024.12.010","DOIUrl":"10.1016/j.ad.2024.12.010","url":null,"abstract":"","PeriodicalId":7173,"journal":{"name":"Actas dermo-sifiliograficas","volume":"116 3","pages":"Pages T313-T315"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.ad.2023.08.017
A. Soto-Moreno , P. Díaz-Calvillo , S. Arias-Santiago
{"title":"Síndrome de Kounis, mastocitos más allá de la piel","authors":"A. Soto-Moreno , P. Díaz-Calvillo , S. Arias-Santiago","doi":"10.1016/j.ad.2023.08.017","DOIUrl":"10.1016/j.ad.2023.08.017","url":null,"abstract":"","PeriodicalId":7173,"journal":{"name":"Actas dermo-sifiliograficas","volume":"116 3","pages":"Pages 305-306"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140329515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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