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Background: Merkel cell carcinoma (MCC) is a malignant skin cancer with a 5-year survival rate of approximately 50%. Knowledge of MCC has increased in recent years mostly due to improved diagnosis techniques. In Spain there is lack of information regarding the incidence and tumour characteristics, and the treatment approaches are not standardised. The objective of this study was to provide information of the clinical and epidemiological characteristics of MCC patients in Spain. Methods: Retrospective, observational study involving 192 patients from 25 Spanish hospitals. Evaluated variables included overall survival and incidence rate of Merkel cell polyomavirus, in patients diagnosed from 2012 to 2016. Results: The Spanish incidence rate was estimated 0.32/100,000 inhabitants/year, with variations according to geographical regions, being slightly higher in areas with greater sunlight exposure. In total, 61.5% of tumours showed expansive growth (progressive growth of the tumour), 78.6% showed localisation in UV-exposed skin. 97.4% of patients were diagnosed by excisional biopsy. Surgery was the first line treatment in 96.6% of patients, radiotherapy in 24.6%, and chemotherapy in 6.3%. These treatments were not mutually exclusive. Median overall survival was 38.3 months (78.4% at 12 months and 60% at 24 months). MCPyV was present in 33.8% of patients. Conclusion: The incidence of MCC in Spain is one of the highest in Europe, with a slight predominance in men. The sample has shown that a biopsy is available for diagnosis in most cases. Moreover, the treatment is surgical when the tumour is localized and is associated with lymphadenectomy, and/or it is radiotherapy if widespread, This study has been developed with GETHI group (Spanish group of orphan and infrequent tumours, from the Spanish Grupo Espanol ˜ de Tumores Hu´erfanos e Infrecuentes) as promotor. This research was financially supported by Merck KGaA, Darmstadt, Germany, as part of an alliance between Merck KGaA and Pfizer. Merck KGaA, Darmstadt, Germany and Pfizer reviewed the manuscript for medical accuracy only before journal submission. The authors are fully responsible for the content of this manuscript, and the views and opinions described in the publication reflect solely those of the authors

[Background]: Psoriasis is a frequent inflammatory skin disease that is mainly mediated by IL-23, IL-1β, and IL-17 cytokines. Although psoriasis is a hyperproliferative skin disorder, the possible role of amino acid transporters has remained unexplored., [Objective]: We sought to investigate the role of the essential amino acid transporter L-type amino acid transporter (LAT) 1 (SLC7A5) in psoriasis., [Methods]: LAT1 floxed mice were crossed to Cre-expressing mouse strains under the control of keratin 5, CD4, and retinoic acid receptor–related orphan receptor γ. We produced models of skin inflammation induced by imiquimod (IMQ) and IL-23 and tested the effect of inhibiting LAT1 (JPH203) and mammalian target of rapamycin (mTOR [rapamycin])., [Results]: LAT1 expression is increased in keratinocytes and skin-infiltrating lymphocytes of psoriatic lesions in human subjects and mice. LAT1 deletion in keratinocytes does not dampen the inflammatory response or their proliferation, which could be maintained by increased expression of the alternative amino acid transporters LAT2 and LAT3. Specific deletion of LAT1 in γδ and CD4 T cells controls the inflammatory response induced by IMQ. LAT1 deletion or inhibition blocks expansion of IL-17–secreting γ4+δ4+ and CD4 T cells and dampens the release of IL-1β, IL-17, and IL-22 in the IMQ-induced model. Moreover, inhibition of LAT1 blocks expansion of human γδ T cells and IL-17 secretion by human CD4 T cells. IL-23 and IL-1β stimulation upregulates LAT1 expression and induces mTOR activation in IL-17+ γδ and TH17 cells. Deletion or inhibition of LAT1 efficiently controls IL-23– and IL-1β–induced phosphatidylinositol 3-kinase/AKT/mTOR activation independent of T-cell receptor signaling., [Conclusion]: Targeting LAT1-mediated amino acid uptake is a potentially useful immunosuppressive strategy to control skin inflammation mediated by the IL-23/IL-1β/IL-17 axis., Supported by grants SAF2017-82886-R (to F.S.-M.), PI17/01972 (to E.D.), and SAF2013-42850-R (to M.F.) from the Spanish Ministry of Economy and Competitiveness; CAM (S2017/BMD-3671-INFLAMUNE-CM) from the Comunidad de Madrid (to F.S.-M.); and CIBERCV, BIOIMID PIE13/041 from Instituto de Salud Carlos III and Fundacion La Marato TV3 (20152330 31). The project leading to these results has also received funding from FUNDACION BBVA A EQUIPOS DE INVESTIGACION CIENTIFICA 2018 and from ‘‘la Caixa’’ Banking Foundation under the project code HR17-00016 (to F.S.-M.) and from Agencia Estatal de Investigacion, Fondo Europeo de Desarrollo Regional, European Union.

Objetivo estudiar las enfermedades asociadas y las manifestaciones clinicas e histopatologicas de pacientes con calcificacion a nivel de la pared de los vasos cutaneos (CVC). Proponer una nueva clasificacion de las calcinosis cutaneas. Pacientes y metodo se realiza un estudio retrospectivo de 17 pacientes con CVC. Se valoran diferentes parametros clinicos, pruebas complementarias y variables histologicas. Resultados doce pacientes se asociaban a insuficiencia renal. Quince presentaban hipertension arterial y/o diabetes mellitus y/o ateroesclerosis. En ocho, la calcificacion vascular se observo en enfermedades cutaneas de diagnostico conocido o sin filiar. La presencia de placas eritematoviolaceas con ulceracion y el hallazgo de una epidermis y dermis necrosadas junto a mas de dos vasos calcificados se correlacionaban con los pacientes asociados a insuficiencia renal. Conclusiones a) diferencias clinico-patologicas permiten distinguir dos grupos principales de pacientes: uno en el que la CVC representa un epifenomeno de diferentes enfermedades de diagnostico conocido y otro asociado a insuficiencia renal; b) el mecanismo por el cual se produce la CVC es probablemente multifactorial, y c) proponemos una nueva clasificacion de las calcinosis cutaneas que incluye una forma vascular y otra extravascular (con tres subtipos: distrofica, metastasica e idiopatica).

Squamous metaplasia in the skin has been reported in the eccrine ducts as eccrine squamous syringometaplasia (ESS). To our knowledge, squamous metaplasia of sebaceous gland (SMSG) has not been described in human skin. Twenty-two biopsy specimens from patients with pressure lesions after cardiac surgery with extracorporeal circulation were evaluated for the presence of SMSG. Squamous metaplasia of sebaceous gland was identified in five of the eight scalp biopsies and none of the buttock biopsies. The squamous metaplasia began in the germinative outer layer and advanced in a centripetal way. We believe that SMSG is an unspecific change of the sebaceous cells secondary to a chronic injury. Ischemia appears to play a mayor role, but other factors such as chronic trauma or toxicosis can not be ruled out.

The cytologic characteristics of hairy leukoplakia (HL) are described based on the findings observed in four lesions. All cases were confirmed by histologic study, and Epstein-Barr virus DNA was detected by means of in situ hybridization of tissue sections. All smears from the lesions exhibited a distinctive appearance and three types of epithelial changes were observed: (1) intranuclear inclusions of Cowdry type A, (2) intranuclear inclusions with a ground-glass appearance, and (3) clumping and margination of chromatin around the nuclear membrane. Other findings were the presence of bacterial colonies in all lesions and Candida organisms in three of them. The results of this study suggest that conventional exfoliative cytologic examination may prove to be a useful, simple, cost-effective, and reliable method to diagnose hairy leukoplakia.