Biomedical subjects
M Aragüés
Publications and source records attributed to M Aragüés.
Subcutaneous lepromas as leprosy-type presentation.
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Sweet's syndrome on the area of postmastectomy lymphoedema.
BACKGROUND: Sweet's syndrome (SS) has been reported in association with many conditions, including malignancy, infections, autoimmune disorders, pregnancy and drugs. MATERIALS AND METHODS: We reviewed patients with SS-like lesions on the lymphoedema area seen in our department. Clinical manifestations, histopathologic characteristics, treatment and outcome data were recorded and analysed. RESULTS: We report seven women with a history of surgery for breast cancer with axillary lymphadenectomy. Six of them were on tamoxifen. All of them had various lesions consistent with SS localized predominantly on the limb affected by the postmastectomy lymphoedema, and on the ipsilateral chest, trunk and back. One of them presented bullous lesions. Three of the cases underwent spontaneous remission, two resolved with antibiotic therapy, one healed with corticosteroids, and one with corticosteroids plus antibiotic. CONCLUSIONS: Erythematous tender plaques on the area of postmastectomy lymphoedema could be considered an unusual manifestation of Sweet's syndrome. We have found only three similar cases in the literature. Although it is difficult to elucidate the pathogenesis of this entity, it has been suggested that it could be due to immune surveillance impairment.
C957T DRD2 polymorphism is associated with schizophrenia in Spanish patients.
OBJECTIVE: The objective was to confirm whether a homozygous genotype for the C957 allele of the C957T DRD2 gene single nucleotide polymorphism (SNP) is associated with schizophrenia in an independent study population. METHOD: We examined the genotypic distribution of this SNP in a set of clinically ascertained schizophrenic patients (n = 131) and age-matched control subjects (n = 364). Individuals were genotyped using automated analysis of fluorescently labeled PCR products. RESULTS: The distribution of grouped genotypes for the C957T DRD2 SNP (CC vs. CT, TT) showed that C homozygote genotype was over-represented in our patient sample when compared with control subjects. This difference reaches the statistical significance (chi(2) = 7.0; df = 1; P = 0.008; OR = 2.05; % CI 1.2-3.4). CONCLUSION: The findings of this study provide additional evidence that genetic variation at the DRD2 gene plays an important role in the vulnerability to schizophrenia.
IDRD2 TaqIA polymorphism is associated with urinary homovanillic acid levels in a sample of Spanish male alcoholic patients.
The TaqIA1 allele of the dopamine receptor gene D2 (DRD2) has been associated with alcoholism, as well as with other addictive behaviours. The exact nature of how the presence of this allele can be a vulnerability factor in the development of alcoholism remains unclear. In this study we found that the presence in the DRD2 genotype of the TaqIA1 allele in Spanish alcoholics is associated with higher levels of urine homovanillic acid (HVA) when compared to patients homozygous for the TaqIA2 allele. A sample of 142 Spanish male alcoholic patients was split into 2 groups on the basis of the presence or absence of the A1 allele in their genotype. The urine sample was analyzed by high performance liquid cromatography (HPLC), and the concentration of homovanillic acid (HVA), 5-hydroxyindoleacetic acid (5-HIAA) and vanilylmandelic acid (VMA) was determined. We found a statistical difference in the concentration of HVA between the groups, that suggests this polymorphism could be related to the variance of urine HVA levels.
Leucocytoclastic vasculitis, hepatitis C virus-associated mixed cryoglobulinaemia with biclonal gammopathy and Waldenstrom macroglobulinaemia.
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Allergic contact dermatitis from benzoyl peroxide transferred by a loving son.
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Cutaneous embolization of cardiac myxoma.
Atrial myxoma is the most common primary tumour of the heart. Skin manifestations in patients with a cardiac myxoma are frequent and may be due to cutaneous emboli, or may be specific findings as part of more complex syndromes. We present a 33-year-old-man with a history of episodes of pain in both legs and an ischaemic neurological event, who also had episodes of acral papular erythematous lesions on the legs and feet including the soles. The histological finding of dermal vessels occluded by a myxomatous material was the clue to the diagnosis of a cardiac myxoma. The diagnosis of this entity can be very difficult, because of the broad spectrum of clinical features; rarely the skin manifestations lead to the diagnosis of this tumour. The histological recognition of the myxomatous emboli is of vital importance for the diagnosis and treatment of this disease.
Massive scrotal calcinosis.
BACKGROUND: Scrotal calcinosis is a benign entity characterized by the appearance of calcific masses within the dermis of scrotal skin. Its pathogenesis has not been fully elucidated. OBJECTIVE: A 36-year-old man with massive scrotal calcinosis is described. Our aim was to perform a histologic examination of the surgical piece with subsequent closure of the defect achieving satisfactory cosmetic results. METHODS: Case report and literature review. RESULTS: Histologic studies of multiple nodules showed no epithelial lining and one calcified epidermal cyst. Subtotal excision of the scrotal wall was performed with excellent results. CONCLUSION: Even though the pathogenic mechanism of this entity is still unclear, our findings support the theory of dystrophic calcification of epidermoid cysts. Surgical treatment is the only definitive treatment. Subtotal excision of the scrotal wall in cases of massive calcinosis may be performed with good results.
Widespread biphasic amyloidosis: response to acitretin.
We report a patient who presented with an intensely pruritic rash, with hyperpigmentation of the whole back and multiple hyperpigmented and hyperkeratotic papules over his forearms and lower extremities. Histologically, he showed deposits of amyloid that reacted positively with monoclonal antibodies against cytokeratins. The lesions were resistant to antihistamines and corticosteroids. Treatment with oral acitretin was started and great improvement of the lesion was noted; the patient became asymptomatic. We review the literature on the effect of retinoids in cutaneous amyloidosis.
Water-induced pruritus in haematologically controlled polycythaemia vera: response to phototherapy.
BACKGROUND: Water-induced pruritus is characterized by the development of intense and widespread itching after contact with water at any temperature and without observable skin lesions. Around 40-52% of patients with polycythaemia vera (PV) have water-induced pruritus, and more than 20% of the patients continue with symptoms despite an adequate control of the underlying disease. The aetiology is unknown and treatment is often unsuccessful. We report a patient with a haematologically controlled polycythaemia vera and water-induced pruritus that responded to phototherapy. METHODS: An 83-year-old woman with haematologically controlled PV referred with intense water-induced pruritus without cutaneous lesions. Topical emollients and oral antihistamines were unsatisfactory and so phototherapy treatment (90% UVA/10% UVB) three times a week was commenced. RESULTS: Improvement was visible after 1 month and at the end of 3 months the pruritus had disappeared and treatment was stopped. CONCLUSION: It is considered that the successful treatment in this patient is due to the UVB radiation.
Flare-up reaction of pseudoephedrine baboon syndrome after positive patch test.
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Lichen sclerosus et atrophicus in sclerodermatous chronic graft-versus-host disease.
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Allergic contact dermatitis from common ivy confirmed with stored allergens.
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Porokeratotic eccrine ostial and dermal duct nevus of late onset: more frequent than previously suggested?
We describe the case of a 10-year-old boy with a porokeratotic eccrine ostial and dermal duct nevus (PEODDN) of late onset. The patient had an 8-year history of multiple keratotic papules on the dorsal surface, and multiple yellowish pitting lesions on the plantar surface of the right foot. Light-microscopic studies of both lesions showed multiple cornoid lamella-like parakeratotic columns, which exclusively arose over eccrine sweat ducts in which the acrosyringium was dilated. Although PEODDN is considered to be a congenital hamartoma of eccrine origin, a review of the literature showed us that the frequency of a late-onset variant may be as high as 26%.
Malignant melanoma appearing in a seborrhoeic keratosis.
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Cutaneous meningioma underlying congenital localized hypertrichosis.
A 28-year-old man had a circumscribed hypertrichotic area on the left lumbar region since birth. A biopsy specimen showed numerous normal-appearing hair follicles and arrector pili muscles. In the subcutaneous layer a mass of dense collagenous connective tissue formed the background in which ill-defined foci of meningothelial cells in nests and pseudovascular spaces were seen. Collagenous structures (pseudopsammoma bodies), some of which showed calcification (psammoma bodies), were also seen. A diagnosis of cutaneous meningioma was made.
Keratosis punctata of the palmar creases: case report and prevalence study in Caucasians.
Keratosis punctata of the palmar creases (KPPC) is a variant of keratosis punctata of palms and soles in which lesions are confined to palmar creases. We present a patient with KPPC and study the prevalence of the disease in Caucasians. The survey included 1,001 white patients, that were examined for palmar lesions. We could not find any case that fulfilled the diagnostic criteria for KPPC. We conclude that KPPC is a rare disease among Caucasians but rather common in the black race.