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Intravascular lymphoma is a rare subtype of extranodal diffuse large B-cell lymphoma characterized by clonal proliferation of lymphocytes inside of small and medium caliber vessels. Its incidence is estimated at one case per million. The clinical picture is very variable, but frequently has skin and central nervous system involvement. It is diagnosed by demonstrating pathological blood vessel infiltration by lymphoma cells. We report a 44 years old male presenting with fever, malaise and erythematous lesions in the abdominal wall. An abdominal wall biopsy showed dilated vascular vessels with atypical cells in their lumen, compatible with large B-cell intravascular lymphoma. He was treated with rituximab, cyclophosphamide, adriamycin, vincristine and prednisone and an autologous hematopoietic stem cell transplantation, achieving a complete remission that has lasted two years.

Bullous pemphigoid is an autoimmune dermatosis characterized by deposition of immunoglobulin G (IgG) and/or complement along basement membrane zone. The lesions of bullous pemphigoid are tense blisters on trunk and extremities, oral lesions are unusual. Figurate erythema includes some dermatologic pictures characterized by annular and polycyclic lesions. Figurate erythema can be confused with erythema gyratum repens, dermatosis associated statistically to malignant neoplasias. The objective for reporting this case is to inform the simultaneous association between bullous pemphigoid and figurate erythema in 83 year old man without underlying malignancy.

The cases of three children diagnosed with baboon syndrome are described, being defined by the appearance of dermatological lesions, with characteristic distribution and morphology, as a result of having been in contact with mercury. Other substances have been described associated with the appearance of this syndrome; however their pathogenis is not completely known, and it has been suggested that it could be another form of contact dermatitis. Diagnosis is based on patient clinical history and physical examination and there is no specific treatment.

With the coming of the biological therapies, long-term maintained control of psoriasis is becoming a reality and means a significant improvement in the quality of life in some patients with persistent clearing of the disease. This result was difficult to obtain previously. Efalizumab, a recombinant IgG1 anti-CD11a antibody approved for the treatment of psoriasis in moderate-to-severe chronic plaques, has an excellent safety profile and its therapeutic results in the clinical practice have surpassed the expectations based on the clinical trials. At 12 weeks of treatment (when its efficacy should be evaluated), a PASI 75 response can be expected in 35 to 40% of the patients and a PASI 50 response in two thirds of them. This degree of improvement may be maintained and may even increase in 80% of the patients, making it possible to achieve an almost complete clearing in more than 40% of the patients who continue the treatment over several years. Localized, transitory exacerbations may appear, especially in the beginning of the treatment, but these can generally be managed in combination with another treatment. There may also be generalized inflammatory outbreaks, especially in patients with scarce or null response, who require treatment with a rapid effect systemic drug at the onset. This is because they may be a prelude to the development of rebounds, that may acquire an erythrodermic or pustular morphology or be accompanied by arthritis, and which tend to appear after the sudden withdrawal of the drug. An adequate selection of the patients may maximize the possibilities of success. Patients without arthritis and with stable, extensive and non-inflammatory forms of the disease tend to be the best candidates. Special attention should be given to the administration of systemic agents in transition regimes when efalizumab is introduced or withdrawn. The clinical criteria is fundamental to optimize the therapeutic results with efalizumab, that may be an attractive challenge but may also be an especially satisfactory therapeutic option when long-term control is the disease is proposed.

Aim: To determine the prevalence of oral lesions in a HIV+ group of patients, related to CD4 cell count and viral load in a Venezuelan population., Materials and Methods: In the present study, we evaluated 75 HIV+ adult patients, attended at the Center of Infectious Diseases, at the Faculty of Dentistry, Central University of Venezuela. Each patient was clinically examined for detection of oral mucosal lesions. In addition, CD4 cell count was determined by flow cytometry, as well as viral load by RT-PCR (Amplicor HIV-RNA, TM test 1.5, Roche)., Results: 85% (64/75) of HIV/AIDS patients showed associated HIV lesions. Oral Candidiasis constituted the most common lesion representing a 61% (39/64), followed by Oral Hairy Leukoplakia 53% (34/64); Oral Leukoplakia 34% (22/64), Melanic Hyperpigmentation 38% (18/64); Papilloma 13 (6/64), Lineal Gingival Erythema 8% (5/64); Aphtous Recurrent Stomatitis 5% (4/64) and Kaposi's Sarcoma 5% (3/64). Only one case of the following lesions were represented by Non Hodgkin Lymphoma, Multifocal Epithelial Hyperplasia, Recurrent Herpes, Histoplasmosis and Molluscum Contagiosum. The patients with a viral load of 30.000 copies/mm3 exhibited oral lesions related with HIV, independent of CD4 cell count, although patients with CD4+ levels of 200 cel/mm3 were more susceptible to develop these lesions., Conclusions: The most common oral lesion was Oral Candidiasis followed by Oral Hairy Leukoplakia, Oral Leukoplakia and Melanic Hyperpigmentation. A high viral load was strongly associated to the oral lesions occurrence independently of CD4+ cell count.

Glucagonoma is a rare pancreatic tumor that is usually associated with a syndrome that includes diabetes, anemia, weight loss and skin lesions in the form of necrolytic migratory erythema. We present the case of a patient with malignant glucagonoma treated with surgery and octreotide, which manifested with skin lesions. The discussion will review the physiopathology, other causes of necrolytic erythema, diagnosis and differential diagnosis and treatment.

Objective: In relatively few cases have perinatal factors been included as risk factors for allergy development. Delivery has not been considered as a possible influential factor in allergy development. To identify risk factors in allergy development, we have included erythema toxicum neonatorum (ETN)., Patients and Methods: We have prospectively studied 356 newborns that were followed for a period of two years. Characteristics of the delivery, such as the pregnancy, instrumental delivery, circular cord, ETN, number of vesicles, day of presentation, season of birth, maternal and cord blood IgE levels and cord blood eosinophils and the development allergies during the two year follow-up period were included., Results: ETN was seen in 25.3% of the children. The histopathology study of vesicles showed eosinophils. There was a significant difference between males and females (61.9% versus 38.1%, respectively). Cord blood IgE levels were not related to ETN, except in situations of allergy from 0.9 IU in cord blood or from 20 IU at six months of age (p < 0.05)., Conclusions: ETN is related to delivery characteristics, instrumental, circulars, amniotic alteration or fall in arterial pH < 7.24. In 84.2% of allergy manifestations during the first two years of life, ETN or a low pH was seen at birth, with atopic dermatitis being those that displayed ETN (85.7%).

Frey's syndrome is distinguished by the appearing of erythema, sensation of hotness, sometimes pain, and transpiration discharge in the preauricular and temporal area when ingestion stars. We present an eleven month old child with this pathology and we review the etiology and clinic manifestations of this syndrome.

A case of reticular erythematous mucinosis of histology and atypical localization in a patient with breast cancer, is presented. This patient had a history of benign tumors of muscular origin localized in uterus and stomach. We focus on the rareness of this syndrome and its association with other tumors, a point not shown in the literature.

In 1964 Sweet described a new syndrome, characterized by the association of fever, neutrophilic leukocytosis, erythematous plaque affecting the extremities, neck and face, with histologically verified polymorphonuclear perivascular dermal infiltrates and a rapid response to corticosteroids. Although some 100 cases have since then been described the pathogenesis remains obscure. We present two cases which showed all criteria for Sweet's syndrome, in which the initial presentation of acute onset with fever, multiple skin lesions and especially the poor general state on one, made use at first think of an infectious process such as staphylococcal or gonococcal sepsis, in which case diagnosis must be differential. Only when the causal agent is known and an early skin biopsy is done can correct diagnosis and treatment be established.

The authors report the case of a patient showing simultaneously actinic reticuloid (AR) and pigmented exuberant conjunctivitis (PEC), which are frequently encountered separately in the highlands of Bolivia. This pathological association could be in favour of the actinic origin of PEC, whereas for RA this origin is quite obvious. The main characteristics of PEC are described, insisting on differentiation with spring conjunctivitis. As a consequence of this association and the observation of other similar cases of PEC in the course of other photodermatoses, the authors are led to consider PEC as the only extra-cutaneous alteration up to now, and one more feature in the clinical picture of photodermatoses of altitude.

A 65 year old male with Hodgkins disease, and generalised figurate Erythema, which during his period of hospitalisation migrated and became much more evident, disappearing after initial therapy. Diagnosed as "Erythema gyratum repens" reported by Gammel, an uncommon form of paraneoplasic migrant figurate Erythema, we review the 33 previous cases of this process, and find that, although 30 were related to other processes.