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J Toribio

Publications and source records attributed to J Toribio.

At least 19 recordsLinked to original sources
PubMed2001

Sea-urchin granuloma: histologic profile. A pathologic study of 50 biopsies.

BACKGROUND: Sea-urchin granuloma is a chronic granulomatous skin lesion caused by injury with sea-urchin spines. Frequently these lesions occur on the hands and develop several months after the initial injury. Classified as an allergic foreign-body reaction, their most common histological pattern resembles sarcoid. The purpose of this study was to evaluate the light microscopic features of biopsies from lesions clinically diagnosed of sea-urchin granolomas. METHODS: We retrospectively reviewed 50 biopsy specimens corresponding to 35 patients with sea-urchin granulomas. These lesions were caused by injuries with the spines of the sea-urchin Paracentrotus lividus. Data were collected between 1990 and 1999 from patients in the seashore of Galicia (NW Atlantic coast, Spain). RESULTS: The cohort consisted of 35 patients (31 males, 4 females), with a median age of 35 years (range 14-60 years). The median duration of the disease was 7.5 months (range 2-60 months). We identified different histopathologic patterns. A granulomatous reaction was observed in 39 biopsies (78%). In 70% corresponding to 35 biopsies this granulomatous reaction was predominant. Foreign-body, sarcoidal, tuberculoid, necrobiotic and suppurative granulomas were identified. The remaining 15 biopsies (30%) showed a predominant inflammatory reaction with features of non-specific chronic inflammation or suppurative dermatitis. A panel of histopathologic features, including epidermal and dermal changes were evaluated. Presence of focal necrosis and microabscesses were common findings. In 50% of our specimens we found umbilication and/or perforation. Additional features included the presence of inclusion epidermoid cysts in four cases and squamous syringometaplasia in one case. CONCLUSIONS: Our observations suggest that sea-urchin granuloma span a wide morphologic spectrum. A granulomatous inflammatory reaction was predominant, with the foreign body and sarcoidal types the most frequent patterns. Other histopathologic patterns with non granulomatous inflammation can be noted. Some features, such as the frequency of perforation and the presence of necrobiotic granulomas have not previously been recognized in the literature.

Adolescent↗
PubMed2001

Identification of Mycobacterium marinum in sea-urchin granulomas.

BACKGROUND: Sea-urchin granuloma is a chronic granulomatous reaction arising after injury with sea-urchin spines. Classified as an allergic foreign-body type of granuloma, it is believed to be a delayed-type reaction to an as yet unidentified antigen. In a clinicopathological study, 50 biopsy specimens from 35 patients diagnosed as having sea-urchin granuloma caused by Paracentrotus lividus, we found different inflammatory patterns that in some cases suggested a mycobacterial infection. OBJECTIVES: To investigate and identify mycobacterial DNA in formalin-fixed and paraffin-embedded skin biopsy specimens diagnosed as sea-urchin granulomas. METHODS: A search combining polymerase chain reaction amplification using Mycobacterium genus-specific primers, and subsequent restriction enzyme analysis enabling identification to the species level, was performed in 41 samples. RESULTS: Amplification of a 924-bp DNA fragment encoding mycobacterial 16S rRNA gene was positive in eight biopsy specimens from seven patients (21%). M. marinum-specific restriction patterns were identified in three samples. CONCLUSIONS: Although further controlled studies are necessary, from these data it would appear that mycobacteria may play a pathogenic role in some cases of sea-urchin granuloma.

Adolescent↗
PubMed2001

Treatment of alpha1-antitrypsin-deficiency panniculitis with minocycline.

A small proportion of patients with alpha1-antitrypsin (alpha1AT) deficiency experience recurrent ulcerating panniculitis. Studies suggest that alpha1AT-deficiency panniculitis reflects an uncontrolled inflammatory process because of the serum's incapacity to neutralize proteolytic enzymes released by leukocytes in the skin. Dapsone is considered the treatment of choice for this entity, but it is limited by its side effects, especially hematologic ones. Tetracyclines have anticollagenase and anti-inflammatory activity and have been used successfully to treat this type of panniculitis. We report the case of a 42-year-old woman with recurrent alpha1AT-deficiency panniculitis who did not tolerate the side effects of dapsone or systemic corticosteroid. Minocycline treatment led to disappearance of lesions, and long-term administration prevented recurrences without evident negative side effects. We consider minocycline a safe treatment that allows control of alpha1AT-deficiency panniculitis.

Anti-Bacterial Agents↗
PubMed2000

A gene for hypotrichosis simplex of the scalp maps to chromosome 6p21.3.

Hypotrichosis simplex of the scalp (HSS) is an autosomal dominant form of isolated alopecia causing almost complete loss of scalp hair, with onset in childhood. After exclusion of candidate regions previously associated with hair-loss disorders, we performed a genomewide linkage analysis in two Danish families and localized the gene to chromosome 6p21.3. This was confirmed in a Spanish family, with a total LOD score of 11.97 for marker D6S1701 in all families. The combined haplotype data identify a critical interval of 14.9 cM between markers D6S276 and D6S1607. Localization of the locus for HSS to 6p21.3 is a first step toward identification of the gene. The gene will give important insights into the molecular and cellular basis of hair growth on the scalp.

Adolescent↗
PubMed2000

Cost-effectiveness analysis of interferon as adjuvant therapy in high-risk melanoma patients in Spain.

In the randomised clinical trial E1684, the administration of interferon (IFN) alpha-2b resulted in prolonged disease-free and overall survival in high-risk melanoma patients following surgical resection. However, and considering the cost and toxicity of IFN, the convenience of its widespread use should be evaluated. The aim of this study was to analyse the cost-effectiveness ratio of adjuvant therapy with IFN alpha-2b in melanoma patients versus an untreated control group. A Markov model was used to compare two hypothetical cohorts of 1000 patients aged 50 years, according to the clinical outcome of the E1684 study. The cohort of patients treated with IFN alpha-2b has an increased overall survival of 1.90 years during the patient's lifetime. The incremental discounted cost per life year gained of IFN versus observation is 9015 Euros according to the projection generated by the model. The sensitivity analysis demonstrated that changes in the most relevant study end-points do not modify the study outcome. In conclusion, in high-risk melanoma patients following surgical resection, the cost-effectiveness of IFN alpha-2b (at a dose of 20 MU/m2/day, 5 days per week for one month, followed by 10 MU/m2 TIW, up to one complete year of therapy) versus an untreated control group is within the limits established in health economics to determine if adoption of a new treatment is economically justified and is comparable with other interventions in which cost-effectiveness is acceptable to the National Health System.

Antineoplastic Agents↗
PubMed2000

Expression of growth hormone receptor in benign and malignant cutaneous proliferative entities.

The skin has the necessary elements to respond to growth hormone (GH) and suffers clinical changes in the pathological circumstances of excess and deficiency of GH. The GH has been involved in the development of different types of human neoplasms. Based on these data, we have studied the GH receptor (GHR) expression in acrochordons, seborrheic keratosis, melanocytic nevi, histiocytomas, squamous cell carcinomas, basal cell carcinomas, and malignant melanomas by means of the immunohistochemistry with the monoclonal antibody MAb 263. All the entities showed immunoreactivity for GHR. In the histiocytomas, the expression of GHR in the keratinocytes of the hyperplastic epidermis coating the lesion showed a strong nuclear pattern, but the non-hyperplastic epidermis of the edges of the histiocytomas expressed GHR with a cytoplasmic pattern. In the basal cell carcinoma and squamous cell carcinoma, the immunoreactivity was weaker than in normal skin. In the squamous cell carcinoma, the intensity of immunostaining correlated directly with the grade of cellular differentiation. In conclusion, the GH may be involved in the development of different kinds of cutaneous neoplasms, and the intracellular localization of GHR may imply a functional significance, at least in the histiocytomas.

Adult↗
PubMed2000

Solitary cutaneous metastasis on the buttock: a disclosing sign of pancreatic adenocarcinoma.

A 48-year-old man, previously healthy and asymptomatic, showed a unique skin lesion located on the right buttock. The histopathological study of the lesion disclosed an adenocarcinoma metastatic to the skin. The primary tumour was found at the head of the pancreas, and was confirmed by biopsy. Six months after the beginning of treatment with Gemcitabine the patient is still asymptomatic, and the cutaneous lesion has disappeared. Carcinomas of the pancreas represent less than 5% of human malignant neoplasms, skin involvement is rare, and metastasis generally multiple and situated in the periumbilical area. To our knowledge, very few patients have been reported with a solitary cutaneous lesion disclosing a pancreatic adenocarcinoma. The atypical location, the absence of related symptoms or analytical disorders, and the good progress of the patient make this case especially interesting.

Adenocarcinoma↗
PubMed2000

Case Reports. Pityriasis amiantacea as manifestation of tinea capitis due to Microsporum canis.

We report three patients, two infants and an adult, in whom their tinea capitis clinically appeared as pityriasis amiantacea. The mycological studies showed infection due to Microsporum canis in all cases. Correct diagnosis as well as adequate antimycotic chemotherapy of this atypical manifestation of tinea capitis remain a challenge to the clinician. Epidemiological aspects must be regarded also.

Adult↗
PubMed2000

Three cases of type 2 segmental manifestation of multiple glomus tumors: association with linear multiple trichilemmal cysts in a patient.

We report 3 cases of congenital multiple glomus tumors seen during the last 5 years. One of them showed autosomal dominant inheritance with male-to-male transmission. The remaining patients had no family history of similar lesions. The clinical and histopathological aspects of our patients support the recently described type 2 segmental manifestation of multiple glomus tumors. One of the cases showed associated multiple and giant trichilemmal cysts with a linear distribution in the scalp.

Adult↗
PubMed2000

Blastoid NK cell leukemia/lymphoma with cutaneous involvement.

Malignant neoplasms from natural killer (NK) cells are characterized by their positivity for CD56 and absence of monoclonal TCR gene rearrangement. Recently, they have been classified into four main types (nasal and nasal-type NK cell lymphoma, aggressive NK cell leukemia/lymphoma, and blastoid NK cell leukemia/lymphoma), based on clinical features, racial predisposition, presence of azurophilic granules, immunophenotype and association with Epstein-Barr virus (EBV) infection. A 72-year-old Caucasian man presented with a malignant neoplasm comprised of blastoid cells without azurophilic granules in the Giemsa stain, with positivity for CD2, CD4, HLA-DR, CD45 and CD56, and negativity for CD3 (surface and cytoplasmic) and CD5. In situ hybridization for EBV and PCR analysis of rearrangement of the T cell receptor gene were negative. Based on these results, a diagnosis of blastoid NK cell lymphoma was made. In this case the first clinical manifestations were the cutaneous lesions, and, although the disease was already advanced at the diagnosis, the patient responded completely to the treatment and remains asymptomatic 14 months after diagnosis.

Aged↗
PubMed2000

Unilateral psoriasis: a case individualized by means of involucrin.

Several authors have questioned the existence of unilateral (linear) psoriasis. These authors have suggested that the condition is actually an inflammatory linear verrucous epidermal nevus, or the result of an isomorphic effect on a pre-existing epidermal nevus. We report the case of a 25-year-old man, with no relevant personal or family history, who presented with a number of pruritic, punctiform erythematosquamous lesions that were linearly distributed over the left side of the body. Clinical examination and results of histopathologic and histochemical studies indicated unilateral psoriasis. Our findings confirm that involucrin immunohistochemistry can be a useful diagnostic tool in cases of this type. Treatment with keratolytics and topical calcipotriol led to a significant, but only temporary, improvement.

Adult↗