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Resumen Introduccion El hemangioma infantil (HI) es el tumor mas frecuente de la infancia. Es un tumor benigno de origen vascular, que afecta a la edad pediatrica exclusivamente. La mayoria sigue un curso clinico benigno y se resuelve sin necesidad de tratamiento, aunque con frecuencia origina lesiones residuales una vez resuelto. El objetivo de este estudio fue realizar un estudio descriptivo de los HI evaluados en un hospital terciario, evaluar la incidencia de lesiones residuales y predecir los factores relacionados con el desarrollo de las mismas. Material y metodos Se realizo un estudio observacional retrospectivo recogiendo los HI de los que se disponia de imagenes clinicas evaluados en el Servicio de Dermatologia del Hospital Clinico Universitario de Valencia, en el periodo comprendido entre enero de 2009 y diciembre de 2017. Resultados La forma clinica de presentacion mas frecuente fue: 74,6% de sexo femenino, 73,1% lesion unica, edad media de aparicion de 1,5 meses, 63,3% con componente superficial, 83,3% focales, 51,1% localizados en la cabeza o el cuello, 80% ≤3 cm. Un 51,5% de los pacientes recibio tratamiento con propranolol, desarrollando alguna reaccion adversa en un 17,6% de los casos, fundamentalmente terrores nocturnos. Conclusiones Un 69,2% de los HI desarrollaron secuelas esteticas al involucionar. La invasion de la dermis superficial por la tumoracion, una menor edad de inicio y la ausencia de una lesion precursora al nacimiento se relacionaron de forma estadisticamente significativa con un mayor riesgo de secuela.

Successful management of toxic epidermal necrolysis (TEN) with tumor necrosis factor-α inhibitors has been described in adults, but few cases have been reported in children. To date, only four pediatric cases of TEN treated with infliximab and one with etanercept have been published. We present the case of an 8-year-old boy diagnosed with TEN induced by levetiracetam, successfully treated with etanercept, systemic corticosteroids, and intravenous immunoglobulin.

Buschke-Ollendorff syndrome (BOS) is a rare autosomal dominant genodermatosis caused by heterozygous mutations in LEMD3 and characterized by connective tissue nevi and sclerotic bone lesions known as osteopoikilosis. We report a family with three individuals affected by BOS, two of whom manifested clinical and histopathological peculiarities, presenting with a depressed indurated plaque as the main cutaneous manifestation instead of the classic connective tissue nevi. Notable elastorrhexis was present in both biopsies.

Angiokeratoma circumscriptum is the rarest variant of angiokeratoma. It usually affects females and it is characterized by dark-red to blue-black confluent papules or nodules on lower limbs in a segmental and unilateral distribution. We describe the clinical and histopathological findings in a patient with angiokeratoma circumscriptum and discuss the etiology, associations, diagnosis, differential diagnosis, and treatment.

We have read with great interest Dr Recalcati’s review about skin manifestations in COVID‐19 as it is the first report on this subject1. In a recent review on clinical characteristics of coronavirus disease 2019 in China, rash was observed in 0,2% of cases2. However, from the trained eyes of a dermatologist, this percentage may be higher.

Aplasia cutis congenita (ACC) associated with fetus papyraceus is a rare subtype of aplasia cutis categorized as type V in Frieden's classification. It is characterized by stellate lesions in a symmetrical distribution over the trunk and proximal extremities. Conservative treatment is recommended, but there is not a well-defined therapeutic protocol. We report the case of a type V ACC in a preterm male newborn with lesions on the trunk and scalp successfully treated with topical 1% silver sulfadiazine and petrolatum gauze with an excellent evolution. This case associates a severe affectation of the scalp which represents a rare variant of type V ACC.

El objetivo del presente artículo es el de caracterizar cómo se dinamiza el proceso de producción de textos expositivos en un taller de escritura para estudiantes de quinto grado de Básica primaria de la modalidad virtual. Se utilizó un enfoque metodológico cualitativo, ya que permitió comprender mejor la realidad social a partir de la lógica y el sentir de los participantes; y el diseño estuvo basado en la etnografía virtual, puesto que se centró en estudiar la cultura de una comunidad educativa virtual, analizar el contexto y los discursos que se produjeron entre los miembros, observando que sus vínculos estuvieron mediados por la tecnología. Se plantearon varios momentos, los cuales dieron claridad sobre los componentes del estudio. Los momentos fueron diseño y formulación de la propuesta; en el segundo, se definieron los participantes, informantes y las fuentes de datos con sus técnicas; en el tercero, se llevó a cabo el trabajo de campo para interpretar la problemática identificada; en el cuarto, la construcción del informe final que incluye análisis de los resultados, conclusiones y recomendaciones. Los resultados muestran el análisis e interpretación de algunas estrategias implementadas por la maestra durante el desarrollo del taller, las herramientas informáticas usadas, las actividades realizadas, la comunicación entre compañeros y estudiantes – docente, la producción de un tipo de texto (expositivo), teniendo en cuenta todo el proceso que se requiere para lograr hacerlo y así mejorar su competencia comunicativa.

Keratoacanthoma centrifugum marginatum (KCM) is a rare variant of keratoacanthoma (KA), characterized by progressive peripheral growth, and usually devoid of deep invasion. Different systemic (oral retinoids) or topical treatments have been reported, but there is not a well-defined therapeutic protocol. We report the case of a KCM developing after photodynamic therapy (PDT) on the right leg of a 64-year-old woman. It was treated successfully with oral acitretin combined with topical 5-Fluorouracil + salicylic acid for 5 months. This is the first case of KCM developing after PDT and successfully treated with oral retinoid combined with topical treatment.

The current situation is looked at from the perspectives of the different actors, in terms of commitment to finding a solution and to carrying on funding when change appears distant. The attitude of the different actors to the standard durable solutions is examined; international humanitarian agencies have long favoured local integration as a sustainable solution, one which the Royal Thai Government (RTG) implacably opposes. Resettlement has had some effect, but there is a question mark over its continued operation, and it has not reduced camp size, because new arrivals have replaced those who have gone. Gradually, there is an acceptance among most actors, including long-term donors, that voluntary repatriation must be at the heart of any sustainable solution; the challenge remains how to make Myanmar feel like a safe place of return for those who have fled, and for those born in the camps who have no memory of Myanmar.

The current levels of support within the settlements are assessed from the perspective of the displaced persons. In general, despite differences in approach from different actors, and the RTG’s stated policy of confinement and restriction of movement and access to services that might encourage local integration, the displaced persons themselves feel they have been well supported in terms of basic food, shelter, education and healthcare. However, problems resulting from long confinement are starting to impact, in terms of loss of self-confidence and self-reliance. There are also signs that funding is slowing down, partly related to the economic crisis in Europe and North America. Women, in particular, have experienced some disadvantage as a result of the way agencies and the RTG have supported traditional, male-dominated administration of the camps. There is consensus amongst all actors that change is needed now.

The root cause of this issue remains unresolved; the conflict within Myanmar. At the same time, there are signs of change in Myanmar, with the release of Aung San SuuKyi and the increasing engagement of ASEAN and the wider international community. Donors and funders are urged to maintain their support for now, and to increase pressure through trade and other links to make Myanmar a safe place for repatriation. The agencies are encouraged to continue moving from emergency response to developmental programmes, including within Myanmar. Collaboration on solutions, such as CCSDPT/UNHCR’s 5-year plan, is encouraged as long as all options are considered, not just local integration. The RTG must continue to be flexible, and to see strategies to encourage self-reliance of the displaced persons as preparation for eventual repatriation of the majority once Myanmar is free of conflict.

Generally, the displaced persons themselves are relatively contented with the way they have been treated in the settlements by all the various stakeholders. They have found relative safety and security, and have access to basic life requirements such as food and shelter and, increasingly, to education, health care and other services. However, the displaced persons are in limbo, and have been for a long time in some cases, and lack hope and motivation, leading to increasing social and community issues in the shelters. For the donors, the issue has become a strain on resources, and a peripheral issue in world affairs. For the UN agencies and NGOs, with no solutions in sight, this protracted situation has taxed resources and patience. For the RTG, also, there are more major issues to attend to. All parties have different perspectives, and communication between them is poor. The RTG’s approach has been more flexible in practice than is its policy, but it has been unable to agree a solution with the other actors.

The funding of the humanitarian and developmental programmes with the displaced people is examined in more detail, including how bodies such as UNHCR receive their funding. The relationship between the RTG and international actors is explored, looking in particular at the different perspectives that exist and how these have made joined-up policy and practice more difficult. The relationship between NGOs and other actors is also reviewed, and between them and the RTG, showing that communication has been a weakness. The 5-year strategic plan of CCSDPT/UNHCR is evaluated in terms of its scope and likelihood of success; it fails to put forward a solution based on a combination of the durable solutions. The relationship of actors with the RTG remains a barrier, in terms of culture and understanding of each others’ perspectives.