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Biomedical subjects

J A Martínez-Escribano

Publications and source records attributed to J A Martínez-Escribano.

11 recordsLinked to original sources

Cutaneous hyperpigmentation induced by omeprazole mimicking ashy dermatosis.

BACKGROUND: Omeprazole has been associated with multiple adverse effects including skin reactions but, to date, cutaneous hyperpigmentation has not been described as an adverse effect of this drug. OBSERVATIONS: We describe a case of a 52-year-old Caucasian woman who developed skin hyperpigmentation in the upper trunk, mimicking ashy dermatosis, 2 months after initiating omeprazole treatment. Histopathologic examination of a skin biopsy taken from a pigmented macule showed dermal macrophages containing golden-brown granules, which also displayed a sulphur peak on energy-dispersive X-ray microanalysis. High-performance liquid chromatography (HPLC) and mass spectrometry were also performed on the drug and on a biopsy specimen revealing the same chromatograms as well as the same mass spectra. CONCLUSIONS: According to our results, omeprazole itself may induce cutaneous pigmentation and, to our knowledge, this is the first report of this finding.

Anti-Ulcer Agents↗

Interleukin-10, interleukin-6 and interferon-gamma gene polymorphisms in melanoma patients.

The immune response against melanoma can be influenced by cytokines with potentially opposite effects on tumour cell growth, such as interleukin-10 (IL10), interleukin-6 (IL6) and interferon-gamma (IFNgamma). Our objective in this study was to investigate whether polymorphisms in the regulatory regions of IL10, IL6 and IFNgamma genes are associated with the development of primary cutaneous melanoma and/or the prognosis of this tumour. We studied genotypic variations at positions -1082, -819 and -592 in the IL10 promoter, -174 in the IL6 promoter and +874 in the IFNgamma intron 1 in 42 melanoma patients and 48 healthy controls. These two populations showed very similar genotypic frequencies for IL10, IL6 and IFNgamma gene polymorphisms. There was a significant increase in the prevalence of IL10 low expression genotypes, specially the ACC/ATA genotype, among patients with a poorer prognosis. In contrast, IL6 promoter and IFNgamma intron 1 gene polymorphisms did not correlate with melanoma prognosis. These data indicate that investigation of polymorphisms in the regulatory regions of IL10, IL6 and INFgamma genes does not seem to be useful for predicting the risk of development of primary cutaneous melanoma. However, IL10 low expression genotypes may be associated with a poorer outcome in melanoma patients.

Adult↗

Does injection distance of the radiocolloid modify lymphatic mapping in melanoma?

BACKGROUND: An important factor to be considered when performing lymphogammagraphy in melanoma patients is the adequate distance of injection of the radiopharmaceutical from the biopsy excision site or the primary lesion. OBJECTIVE: To test the reproducibility of lymphatic mapping in patients with primary cutaneous melanoma who had undergone narrow excisional biopsy by injecting a technetium marker at different distances from the biopsy scar. METHODS: After informed consent, two lymphoscintigraphies were performed on each of 19 melanoma patients, following narrow excisional biopsy. Four aliquots of the radiocolloid were intradermally injected in each procedure, surrounding the biopsy excision site at 1.5 and 0.5 cm, respectively. RESULTS: Both lymphoscintigraphies showed similar lymph channels and sentinel node(s). CONCLUSION: In melanoma patients who have undergone narrow excisional biopsy, lymphoscintigraphy marks with accuracy the sentinel node, at least when the radiopharmaceutical is injected at a distance of less than 1.5 cm from the limits of the biopsy scar.

Adult↗

Efficacy of lipectomy and liposuction in the treatment of multiple symmetric lipomatosis.

BACKGROUND: Multiple symmetric lipomatosis (MSL) is a rare disease characterized by enlarging, symmetric, nonencapsulated, fat deposits mainly on the neck and upper trunk. Liposuction and lipectomy, although palliative, are the treatments of choice, especially indicated when vital structures are compromised. OBJECTIVE: Our purpose was to evaluate the efficacy and safety of liposuction and lipectomy in the treatment of MSL. METHODS: We have examined two patients diagnosed with MSL who presented with symptoms derived from the compression of vascular, nervous, and/or respiratory tract structures. One was treated with lipectomy and the other with liposuction. RESULTS: A rapid resolution of the clinical symptoms was achieved with both therapies. The patient who was treated with lipectomy suffered from a compression of the left brachial plexus by scar tissue as an adverse effect, requiring a second surgical procedure. Liposuction only provoked a mild autoinvolutive hematoma in the other case. No clinical recurrences were observed at 3 and 2 years of follow-up respectively. CONCLUSIONS: We consider both lipectomy and liposuction as safe and effective techniques for the treatment of MSL patients. Although liposuction is usually associated with less adverse effects than lipectomy, location of the lipomas must be carefully considered before choosing one technique over another.

Adult↗

Dabska tumor developing within a preexisting vascular malformation.

Malignant endovascular papillary angioendothelioma, first described by Dabska in 1969, is a rare vascular tumor that primarily affects children and is characterized by papillary proliferations of endothelial cells into vessel lumens. We report a case of this rare neoplasm in a boy with angiomatosis who developed Kasabach-Merritt syndrome. The tumor evolved as an ulcerated lesion superficially within a previous vascular malformation on his buttock. A review of the literature is presented.

Adolescent↗

Acute exanthem and pancreatic panniculitis in a patient with primary HIV infection and haemophagocytic syndrome.

We report a patient with an acute infection with the human immunodeficiency virus (HIV), who initially presented due to a mononucleosis-like illness that included a rash on the upper trunk and limbs, and oral ulceration. The patient developed a haemophagocytic syndrome with severe systemic involvement. Three weeks after the initial presentation, lesions of a pancreatic panniculitis appeared on both legs.

Acute Disease↗

Subcutaneous nodules following treatment with aluminium-containing allergen extracts.

We describe two patients who developed multiple itching nodules following immunization with vaccines adsorbed on aluminium hydroxide. Both patients had been treated with vaccines for extrinsic asthma and rhinitis for 4 and 10 years respectively. The lesions were persistent and lasted for several years. Histopathological findings were those of a foreign body reaction. Aluminium was most probably involved in the pathogenesis of these lesions because its presence could be demonstrated in macrophages using energy-dispersive X-ray microanalysis. Although some symptomatic relief was achieved with topical corticosteroids and oral antihistamines, treatment was unsuccessful.

Adult↗