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Biomedical subjects

L Requena

Publications and source records attributed to L Requena.

180 records · Page 10Linked to original sources

Periungual porocarcinoma.

We describe a patient who developed a porocarcinoma in the nail bed. His profession had exposed him to X-rays for many years, resulting in chronic radiodermatitis of several digits on both hands. He displayed an ulcer in the lateral nail fold of the right third digit which extended into the nail bed. The histology of the lesion was consistent with malignant eccrine poroma. Porocarcinoma has not been previously published in this location and this tumor must be considered in differential diagnosis of subungual malignant tumors.

Adenoma, Sweat Gland↗

Trichogenic trichoblastoma. An unusual neoplasm of hair germ.

Tumors of hair germ are a very rare group of primary cutaneous neoplasms that have been divided into two groups: epithelial and mesenchymal. Epithelial neoplasms of hair germ are further subdivided into those that are purely epithelial (trichoblastomas) and into epithelial neoplasms with mesenchymal components that may cause inductive changes toward the earliest phase of hair follicle differentiation (trichoblastic fibroma) or a more advanced and complete hair follicle formation (trichogenic trichoblastoma). We herein report an ulcerated trichogenic trichoblastoma whose epithelial and mesenchymal components recapitulated the formation of numerous primitive dermal papillae of the hair bulb because there were numerous strands of small polygonal epithelial cells that delimited areas of a dense and abundantly cellular connective tissue in a hair papilla-like pattern.

Adult↗

Verrucous trichoadenoma.

Two cases of verrucous trichoadenoma are reported. Clinically, both lesions were diagnosed as seborrheic keratoses, but histopathologically no areas of basaloid cell proliferation were seen in the numerous sections and there were many small, epidermoid cysts in the dermis which contained one or more vellous hairs. Some of these cysts expelled their horn material into the surface keratin layer in a "boiling pattern". We propose the term "verrucous trichoadenoma" for these tumors.

Aged↗

Simultaneous occurrence of junctional nevus and seborrheic keratosis.

A 45-year-old man presented with a pigmented lesion on his face. A clinical diagnosis of melanocytic nevus was made and the lesion was excised. Histopathologic examination showed a reticular seborrheic keratosis associated with a junctional nevus. We discuss the relation of nevocellular nevi with epidermal and adnexal tumors.

Cheek↗

Elastotic nodules of the ears.

A case of bilateral elastotic nodules of the ears is reported. This distinctive entity occurs on the ears in response to chronic actinic damage and is seen infrequently. Elastotic nodules of the ears may therefore be misdiagnosed clinically as basal cell carcinoma or some infiltrative process such as gout or amyloid. Although the lesions are usually found on the anthelix, they may also arise on the helix, and can then simulate chondrodermatitis nodularis helicis.

Diagnosis, Differential↗

Chemical warfare. Cutaneous lesions from mustard gas.

Cutaneous lesions of eight patients evacuated from the Iran-Iraq war zone are reported. The patients were exposed to mustard gas, and there was a spectrum of dermatologic lesions. In the mild cases only there was a sunburnlike erythema, but in the most severe cases this erythema was followed by large and disseminated bullae, which histologically showed a subepidermal location with full-thickness epidermal necrosis. The resorption of these blisters was followed by hyperpigmentation, which was more evident in the intertriginous areas. In these last cases there also were ocular, respiratory, and gastrointestinal manifestations. In the skin this mustard gas seems to act through a primary irritant mechanism and without allergic contact sensitization.

Adolescent↗

Malignant cutaneous mixed tumor. A new case with unusual clinical features.

We report the case of an ulcerated malignant cutaneous mixed tumor occurring on the nose of a 75-year-old woman. Malignant cutaneous mixed tumor (CMT) is a rare neoplasm. Of the 14 previously reported cases, 10 occurred on the extremities, three on the trunk, and one on the scalp. This contrasts with the benign CMT which is found mainly on the head and neck region, the nose being the most commonly affected site. Although eight of the cases of malignant CMT recurred and 10 metastasized, the primary lesion never ulcerated.

Aged↗

[Two HHV8-related illnesses in a HIV-negative patient: Kaposi's sarcoma and multicentric Castleman's disease. Response to treatment with Rituximab and CHOP].

Human herpes virus 8 (HHV8) was discovered in 1994 in the biopsy of a Kaposi's sarcoma in a patient with AIDS. Since then it has been identified in all variants of Kaposi's sarcoma and in another two rare disorders: multicentric Castleman's disease and primary body-cavity based lymphomas. The case discusses a 68 year old, HIV-negative male patient, presenting Kaposi's sarcoma for one year and being monitored by dermatology, who presented for weakness, anorexia and fever. On examination, he was found to have adenitis of the lymph nodes in his neck, underarm and groin. A biopsy on one of the swellings led to findings characteristic of multicentric plasma cell variant Castleman's disease. Blood tests for HHV8 and HIV were carried out, resulting positive and negative respectively (IgG anti-HHV8 positive, title 1/640, indirect immunofluorescence). PCR amplification showed HHV8 in peripheral blood. Patient received 8 cycles of CHOP and rituximab, leading to complete disappearance of the adenitis and general symptoms, with no worsening of his Kaposi's sarcoma. Patient remained in complete remission for 10 months after treatment. This paper discusses the case of a HIV-, HHV8+ patient, diagnosed with classic Kaposi's sarcoma, who developed multicentric plasma cell variant Castleman's disease. The coincidence of two or more HHV8-related illnesses in a HIV-negative patient has rarely been described in medical literature. Treatment with rituximab combined with CHOP chemotherapy was effective in this case, and no worsening of the patient's KS was observed.

Aged↗

[Nosocomial fungemias in a general hospital. Epidemiology and prognostic factors. Prospective study 1993-1998].

BACKGROUND: Nosocomial fungemias are infections with a high mortality rate. In last years the incidence of these infections has increased probably because of the growing population of immunocompromised patients who undergo aggressive diagnostic and therapeutic techniques. OBJECTIVE: To know the epidemiologic characteristics, risk factors, clinical features and prognosis of fungemia. PATIENTS AND METHODS: We prospectively evaluated all the patients with proven fungemia in our center during a 5 year-period. After finishing antifungal treatment a minimum follow-up of 1 month was carried out. Fungal isolation and identification were performed by standard tests. RESULTS: During the period of study we evaluated 81 patients with an episode of nosocomial fungemia. Global incidence was 0,9 episodes per thousand admitted patients. Candida albicans was the more frequently isolated species (n=53), followed by C. parapsilosis (n=11), C. tropicalis (n=6) and C. glabrata (n=5). Most of the patients had a central intravenous line and were on parenteral nutrition therapy. All of them previously received at least one course of broad-spectrum antibiotics. Overall mortality was 49,6%. A worst prognosis was significantly associated with: age over 65 years, surgical procedures during present admission, leucocytosis, shock, and delay in antifungal treatment. CONCLUSIONS: Fungal bloodstream infection incidence is high in our environment. It is associated with a high mortality rate, specially in patients in whom the beginning of antifungal treatment was delayed. A higher clinical suspicion index may improve the poor outcome in these patients.

Adolescent↗

A new case of hairy elbows syndrome (Hypertrichosis cubiti).

Hypertrichosis cubiti, also named hairy elbows syndrome (HES), is an uncommon variety of congenital, circumscribed hypertrichosis in which a remarkable amount of long vellus hair is localized on the extensor surfaces of the upper extremities. Usually, this condition appears in infancy, increases during early childhood, and regresses spontaneously at puberty. The mode of inheritance is not elucidated, and the condition presents in a sporadic or familial form. In most patients HES is not associated with any other physical abnormalities, although short stature and other developmental disorders have been described in some. An 8-year-old girl affected with HES is reported. The literature on this subject is reviewed, and some clinical and etiopathogenic aspects are discussed.

Aging↗