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Biomedical subjects

L Requena

Publications and source records attributed to L Requena.

At least 19 recordsLinked to original sources
PubMed2005

Imiquimod 5% cream for the treatment of superficial basal cell carcinoma: results from a randomized vehicle-controlled phase III study in Europe.

BACKGROUND: Imiquimod is an immune response modifier that acts through toll-like receptor 7 to induce cytokine production and a subsequent innate and adaptive cell-mediated immune response. Clinical studies have demonstrated clinical and histological clearance of superficial basal cell carcinoma (sBCC) after treatment with imiquimod 5% cream. OBJECTIVES: To evaluate the safety and clinical efficacy of imiquimod (Aldaratrade mark; 3M Pharmaceuticals, St Paul, MN, U.S.A.) 5% cream for the treatment of sBCC in a multicentre, randomized, parallel, vehicle-controlled, double-blind, phase III clinical study conducted at 26 centres in Europe. METHODS: Subjects who had at least one histologically confirmed sBCC tumour were randomized to apply imiquimod or vehicle cream to the target tumour once daily, seven times per week (7 x/week) for 6 weeks. The target tumour location was identified with an indelible ink mark before treatment initiation. The treated tumour site was clinically assessed for treatment response at 12 weeks post-treatment and was then excised for histological evaluation. Efficacy assessments included the composite response rates (proportion of subjects with clinical and histological clearance) and response rates solely based on histology (proportion of subjects with histological clearance). Safety assessments, which included adverse events and scoring of local skin reactions (LSRs), were carried out throughout the study. RESULTS: In total, 166 subjects were enrolled in this study. For the intent-to-treat dataset, there was a statistically significant difference between imiquimod and vehicle groups for both composite clearance rates (clinical and histological assessments) and histological clearance rates. Composite clearance was demonstrated in 77% and 6% of subjects treated with imiquimod and vehicle cream, respectively. Histological clearance was demonstrated in 80% and 6% of subjects treated with imiquimod and vehicle cream, respectively. The most frequently reported safety findings were investigator-assessed LSRs and spontaneous reports by subjects of application site reactions, which occurred more frequently in the imiquimod group than in the vehicle group. CONCLUSIONS: Imiquimod 5% cream administered 7 x/week for 6 weeks is a safe and effective treatment for sBCC when compared with vehicle cream.

Adult↗
PubMed2004

[Circumscribed acral hypokeratosis].

Circumscribed acral hypokeratosis is a rare chronic disorder of cornification that occurs predominantly in women. Lesions are solitary and do not respond to any local conservative treatment. They have to be differentiated by biopsy from other non-healing lesions and tumors in acral skin. Clinically lesions appear as sharply circumscribed reddish macules. The histologic hallmark is a circumscribed loss of the entire stratum corneum, which can be best demonstrated at the border of the lesion as a contrast to the perilesional broad stratum corneum typical for acral sites.

Aged↗
PubMed2003

'Eruptive syringoma': a misnomer for a reactive eccrine gland ductal proliferation?

BACKGROUND: Syringomas have traditionally been categorized as benign neoplasms of the eccrine gland ductal epithelium. However, the variety of clinical presentations reported in the literature and some cases recently observed by the authors cast doubt upon the neoplastic nature of eruptive syringomas. Our goal is to challenge the traditional notion that eruptive syringomas are neoplastic lesions. RESULTS: We observed two patients who presented with an eczematous process, which resolved leaving residual lesions. Biopsies of the late lesions showed features of eccrine syringoma. Yet a biopsy obtained from an incipient lesion in one of the cases showed a lymphocytic inflammatory reaction of the superficial portion of the eccrine duct resulting in tortuous hyperplastic changes. CONCLUSION: Based on our observations, some of the so-called 'eruptive syringoma' may represent a hyperplastic response of the eccrine duct to an inflammatory reaction rather than a true adnexal neoplasm. We proposed the term 'syringomatous dermatitis' for such cases.

Adult↗
PubMed2003

Epithelioid angiosarcoma of the breast involving the skin: a highly aggressive neoplasm readily mistaken for mammary carcinoma.

BACKGROUND: Angiosarcomas are malignant neoplasms of endothelial cells. Angiosarcoma of the breast is a rare neoplasm that behaves in a highly malignant fashion. It must be differentiated from benign vascular proliferations and from mammary carcinoma. METHODS: We report on a 49-year-old-woman who presented with a large mass involving the left breast. RESULTS: The lesion had an erythematoviolaceous hue and livedoid pattern at the periphery. Histopathologic study showed an epithelioid malignant neoplasm, and immunohistochemical studies demonstrated that neoplastic cells expressed immunoreactivity for endothelial cell markers. CONCLUSIONS: A diagnosis of epithelioid angiosarcoma of the breast was established. The patient was treated with radical mastectomy, but she refused any other additional therapy.

Antigens, CD34↗
PubMed2002

[Diffuse dermal angiomatosis].

Diffuse dermal angiomatosis (DDA) is a benign, acquired vascular proliferation characterized by painful, poorly circumscribed, livid-erythematous plaques with frequent central ulceration. The clinical features are reminiscent of reactive angioendotheliomatosis or embolia cutis medicamentosa. Histologically, a dense diffuse network of regular capillary vessels throughout the dermis is seen. Endothelial atypia, atypical mitoses or signs of vasculitis are missing. A 43-year-old woman developed a bizarre brownish-livid rapidly growing lesion of DDA 8 centimeters above a surgical scar, shortly after removal of 20 kilograms of fatty tissue from the lower abdominal wall. DDA regressed spontaneously within 12 weeks, and has not recurred over 4 years of follow-up.

Abdominal Wall↗
PubMed2002

[Invisible dermatosis].

The microscopically "invisible dermatoses" comprise a heterogeneous plethora of skin disorders which are characterized by a stunning discrepancy between the classical clinical findings and very discrete histological alterations suggesting "normal skin." Methods and strategies for the correct histopathological diagnosis of seemingly normal skin are discussed.

Diagnosis, Differential↗
PubMed2002

Cutaneous metastases from Ewing's sarcoma: report of two cases.

Ewing's sarcoma is a malignant osseous neoplasm that affects mostly children and young adult males. Clinically, the neoplasm presents with oedema, swelling, and pain of the involved area. Histopathologically, Ewing's sarcoma consists of solid sheets of small round cells, with vesicular nuclei and scant cytoplasm, arranged in irregular masses separated by strands of fibrous tissue, with areas of necrosis en masse intermingled with intratumoural haemorrhage. Ewing's sarcoma is an extremely aggressive neoplasm and metastases to sites such as lung, pleura, other bones, central nervous system, liver, and regional lymph nodes frequently develop in early stages of the disease. Surprisingly, despite the highly aggressive biological behaviour of this neoplasm, cutaneous metastases from Ewing's sarcoma are very uncommon. We report two patients with Ewing's sarcoma of the bone who developed cutaneous metastases. As in other internal malignancies, the onset of cutaneous metastases in patients with Ewing's sarcoma indicates a poor prognosis.

Adult↗
PubMed2002

Drug eruption secondary to aciclovir with recall phenomenon in a dermatome previously affected by herpes zoster.

Classically, recall dermatitis refers to chemotherapy-induced reactivation of skin damage caused by radiotherapy months, or even years, earlier. The concept of recall dermatitis has now been extended to include radiation recall dermatitis induced by other drugs, ultraviolet radiation, extravasation of drugs, and allergic contact dermatitis. We now describe recall dermatitis along the residual cutaneous lesions of a previous thoracic herpes zoster in a patient who developed a drug eruption after oral administration of aciclovir. The most striking feature consisted of confluent linear erythema along the dermatomes previously involved by the herpes zoster episode. Histopathologic study demonstrated small foci of spongiosis, vacuolar changes involving the basal layer of the epidermis and single necrotic keratinocytes scattered within the epidermis. The papillary dermis appeared oedematous and with dilated blood capillaries surrounded by a sparse inflammatory infiltrate composed mainly of lymphocytes. Serial sections failed to demonstrate cytologic changes of herpes varicella zoster infection. We interpreted this case as an example of recall dermatitis because the widespread cutaneous eruption secondary to aciclovir was more intense in skin previously compromised by herpes varicella zoster infection. To the best of our knowledge, recall dermatitis has not been described before at the site of previous involvement by herpes zoster.

Acyclovir↗
PubMed2001

Epithelioid blue naevus of the genital mucosa: report of four cases.

Epithelioid blue naevi are an unusual cytological variant of blue naevus that have been recently described mostly in patients with the Carney complex, although they may also occur in isolation. This variant of blue naevus is composed of melanin-laden polygonal epithelioid melanocytes situated within the dermis. The neoplastic cells show no maturation with progressive depth of dermal infiltration and, in contrast with the usual stromal changes in blue naevi, epithelioid blue naevi exhibit no dermal fibrosis. We describe four cases of epithelioid blue naevus located on the genital mucosa in four patients with no evidence of the Carney complex. Three male patients showed an epithelioid blue naevus on the mucosa of the glans penis and a female patient had a lesion of the right labium minoris. Histopathologically, the lesions consisted of entirely intradermal melanocytic naevi composed mostly of heavily pigmented epithelioid melanocytes involving the dermis of the genital mucosa. Immunohistochemically, in all cases, epithelioid melanocytes expressed immunoreactivity for S-100 protein, HMB-45, Melan-A and MiTF antibodies.

Adult↗
PubMed2001

Malignant spiradenoma: report of two cases and literature review.

Spiradenoma is a benign skin adnexal neoplasm that usually appears as a solitary nodule in any area of the body. There have been only 33 reports on malignant transformation of a benign eccrine spiradenoma since the first description by Dabska in 1972. Most cases have originated on a long-standing cutaneous lesion. These tumors can behave in an aggressive fashion, and some have led to the patient's death. We report 2 new cases of this rare neoplasm affecting 2 men, 92 and 72 years of age, comment on the clinical and pathologic features of our cases, and review the literature concerning this lesion.

Adenoma, Sweat Gland↗
PubMed2001

Panniculitis. Part II. Mostly lobular panniculitis.

UNLABELLED: The second part of our review of panniculitis summarizes the clinicopathologic features of the mostly lobular panniculitides. Erythema induratum of Bazin (nodular vasculitis) represents the most common variant of lobular panniculitis with vasculitis, although controversy persists about the nature of the involved vessels. Mostly lobular panniculitides without vasculitis comprise a series of disparate disorders. These include sclerosing panniculitis that results from chronic venous insufficiency of the lower extremities; panniculitis with calcification of the vessel walls such as calciphylaxis and oxalosis; and inflammatory diseases with crystals within the adipocytes such as sclerema neonatorum, subcutaneous fat necrosis of the newborn, and poststeroid panniculitis. Connective tissue diseases, such as systemic lupus erythematosus and dermatomyositis, pancreatic diseases, and alpha(1)-antitrypsin deficiency may also show a mostly lobular panniculitis with characteristic histopathologic features. Lobular panniculitis may also be an expression of infections, trauma, or factitial causes involving the subcutaneous fat. Lipoatrophy refers to a loss of subcutaneous fat due to a previous inflammatory process involving the subcutis, and it may be the late-stage lesion of several types of panniculitis. In contrast, lipodystrophy means an absence of subcutaneous fat with no evidence of inflammation and often the process is associated with endocrinologic, metabolic, or autoimmune diseases. Finally, cytophagic histiocytic panniculitis is the term that has been used to describe two different processes: one is inflammatory, a lobular panniculitis, and the other one is neoplastic, a subcutaneous T-cell lymphoma. The only common feature of these two different processes is the presence of cytophagocytosis in the lesions. (J Am Acad Dermatol 2001;45:325-61.) LEARNING OBJECTIVE: At the completion of this learning activity, participants should be familiar with the pathogenesis, clinical manifestations, histopathologic findings, and treatment options for the most frequent variants of the lobular panniculitides.

Humans↗