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Acral melanocytic nevi are relatively frequent in the palmoplantar location. In congenital nevi various characteristic dermoscopic patterns have been described, such as reticular and globular patterns, brown pigmented areas, and areas with peripilar depigmentation. However, there are few reports on the dermoscopic pattern of acral congenital nevi. The homogeneous blue pattern is typical of blue nevus and is not typical of acral localization and metastasis of cutaneous melanoma. However, this pattern should be considered characteristic of acral congenital nevus.

Osteoma cutis, a rare benign condition characterized by the presence of osseous nodules are composed of lamellar bone with osteocytes in the center and osteoclasts in the external area, in the reticular layer of the skin. Osteoma cutis can be either primary, arising de novo in healthy skin, or secondary, developing in association with pre-existing neoplastic or inflammatory skin lesions. We present a 25-year-old man with plaque-like osteoma cutis.

We report the case of a primary cutaneous melanoma with acantholytic-like changes in a 61-year-old man. Clinical and immunohistochemic features were similar to those of other superficial spreading with vertical growth melanomas. Histologically, intraepidermal and suprabasal bullous spaces were filled by isolated tumor cells, simulating acantholytic blisters. These findings could be explained by the presence of inflammation-related extracellular fluid. Two other cases with suprabasal discohesive atypical melanocytes have recently been described. We report the first case of malignant melanoma with an intense and diffuse pattern of dyscohesion, resembling acantholysis. Recognition of this histologic pattern in malignant melanoma is important to avoid a misdiagnosis.

A 77-year-old healthy woman presented with an isolated exophytic lesion of the scalp for 4 years, which had grown progressively. On exam, there was a 4 cm, firm erythematous and lobulated tumor with telangiectasias on the scalp. The rest of her cutaneous exam was normal. No lymphadenopathy was appreciated. A solitary cylindroma was diagnosed by biopsy.

Background and Objectives: The relationship between androgenetic alopecia and cardiovascular disease has been studied by some authors in the past, although the results of epidemiological studies have been variable. The objective of this study was to determine the prevalence of metabolic syndrome and carotid arteriosclerosis in patients with early-onset androgenetic alopecia., Patients and Methods: Seventy men were studied, 35 with diagnosis of early-onset (before 35 years of age) androgenetic alopecia and 35 control subjects who consulted for other skin conditions. In both groups, the criteria for metabolic syndrome according to the Adult Treatment Panel-III were studied (obesity, triglycerides, high-density lipoprotein cholesterol, systolic and diastolic blood pressure, and blood glucose), presence of atheromatous plaques, and carotid intima-media thickness using Doppler ultrasonography. Other cardiovascular risk factors, hormones, and acute-phase reactants were also analyzed., Results: Criteria for metabolic syndrome were met by 57.1% of the patients with androgenetic alopecia compared to 14.3% of the controls (P<0001). Thirty-four percent of the patients with androgenetic alopecia had atheromatous plaques compared to 8.6% of the controls (P=.018). In an independent correlation analysis, abdominal obesity, systolic blood pressure, triglycerides, and blood glucose levels were significantly greater among patients with androgenetic alopecia. Testosterone and sex hormone binding globulin levels were similar in the 2 groups whereas insulin and aldosterone levels were higher in patients with androgenetic alopecia (P<05)., Conclusions: The high frequency of metabolic syndrome and carotid atheromatous plaques in patients with androgenetic alopecia suggests cardiovascular screening should be done to enable early detection of individuals at risk and initiation of preventive treatment before cardiovascular disease becomes established.

Background: Few studies have analysed the relationship between androgenetic alopecia (AGA) in women and cardiovascular disease. There is reported to be an elevated prevalence of hypertension among men with AGA, and it has been proposed that both phenomena may be explained by the presence of hyperaldosteronism. However, no data on blood pressure (BP) and aldosterone levels in women with AGA have been published to date., Objectives: The objective of this study was to evaluate aldosterone levels and the presence of systolic and diastolic hypertension in women with early-onset AGA and in healthy controls., Patients and Methods: This case-control study included 40 women with AGA and 40 healthy controls from the Department of Dermatology of San Cecilio Hospital, Granada, Spain., Results: Patients with AGA showed significantly higher systolic BP values (139.43 vs. 107.80 mmHg; P < 0.0001), diastolic BP values (87.65 vs. 67.48 mmHg; P < 0.0001) and aldosterone levels (249.55 vs. 155.14 pg mL(-1); P = 0.002) vs. controls, respectively. A positive correlation between aldosterone levels and systolic and diastolic BP values is described., Conclusions: A higher prevalence of hypertension in women with AGA has been found. The elevated aldosterone values in these patients may contribute, alongside other mechanisms, to the development of AGA and may also explain the higher prevalence of hypertension. BP screening of women with AGA will permit earlier diagnosis of an unsuspected hypertension and initiation of appropriate treatment.

Cutaneous metastases from signet ring cell gastric carcinoma are uncommon. A 69-year-old man presented with a 15-day history of an asymptomatic indurated scar-like lesion. The biopsy revealed an infiltrating signet ring cell carcinoma consistent with gastric metastasis. Gastroscopy and biopsy showed gastric carcinoma with signet ring cells; subsequent computed tomography revealed metastatic nodules in the liver, mesentery, and retroperitoneal and peripancreatic lymph nodes. A review of the 10 cases of cutaneous metastasis from signet ring cell carcinoma in the literature revealed that cutaneous metastases of gastric origin usually appear at earlier ages than in our patient and that the primary tumor is unknown at the time of skin biopsy in 64 percent of cases. The present report describes the unusual clinical-diagnostic sequence of a patient diagnosed with cutaneous metastasis before detection of his gastric carcinoma.

Background: Ultraviolet radiation is the main risk factor for skin cancer. Changes in lifestyle over recent decades have led to greater exposure to ultraviolet radiation; this phenomenon, coupled with aging of the population, increases the risk of developing skin cancer. Our objective was to analyze the trends in the incidence of skin cancer worldwide, in Europe,and in Spain during the period 1978 to 2002., Material and Methods: Both skin cancer incidence and trends were investigated during the period 1978 to 2002 using the publication Cancer Incidence in Five Continents., Results: The incidence of cutaneous melanoma increased progressively throughout the period, with higher rates among women. The highest incidence was found in Australia. In Spain, the standardized rates of melanoma had tripled in both sexes by the end of the study period. The incidence of non melanoma skin cancer (NMSC) increased throughout the study period, with higher rates among men.The highest incidences were found in Australia, Brazil, and among the European inhabitants of Zimbabwe. Within Spain, the standardized rates of NMSC doubled or tripled in both sexes by the end of the study period., Conclusion: The rise in the incidence of skin cancer leads us to conclude that measures of primary prevention are failing or insufficient, or that it is still too soon to evaluate their efficacy. There are certain limitations to this study, such as the fact that it was impossible to analyze the most recent period, from 2003 to 2007, and that cancer registries are not available for all populations.

Background: Multiple eccrine hidrocystomas of de upper lip are bening cystic lesions that are associated with a chronic course. It is reported in the literature as a rare pathology., Case Report: We describe the case of a 60-year-old woman who was referred to the dermatology department for presenting multiple lesions translucent papular asymptomic two years of evolution on the upper lip. Increase in size in summer and physical exercise, improving winter., Conclusion: To make the diagnosis of multiple eccrine hidrocystomas is necessary clinical and histopathological findings, taking different lines of treatment.

Syringocystoadenoma papilliferum is a benign adnexal tumor usually located in head and neck that occurs during childhood or adolescence. A case of a syringocystoadema papilliferum associated with apocrine hydrocystoma and verruca is presented. It is unusual to see the occurrence of three histopathologic types of tumors coexisting in one cutaneous lesion.

Background: There is reported to be an elevated prevalence of hypertension among patients with androgenetic alopecia (AGA), and it has been proposed that both phenomena may be explained by the presence of hyperaldosteronism. However, no data on aldosterone levels in patients with AGA have been published to date., Objectives: The objective of this pilot study was to evaluate aldosterone levels and the presence of hypertension in patients with AGA and in healthy controls., Methods: This case-control study included 40 patients with AGA and 40 healthy controls from the Dermatology Department of San Cecilio Hospital, Granada, Spain., Results: Patients with AGA showed significantly higher systolic blood pressure values (136.23 vs. 124.10 mmHg, P = 0.01) and aldosterone levels (197.35 vs. 133.71 pg mL(-1), P = 0.007) vs. controls., Conclusion: The elevated aldosterone values in these patients may contribute, together with other mechanisms, to the development of AGA and may also explain the higher prevalence of hypertension. Blood pressure screening of patients with AGA will permit earlier diagnosis of an unknown hypertension and initiation of appropriate treatment.