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Background and objective Frontal fibrosing alopecia is an increasingly common form of scarring alopecia. The aim of this study was to describe the demographic and clinical characteristics of patients with FFA seen at the trichology unit of a medium-sized regional hospital and to report on treatments used. Material and methods We reviewed the medical records of all patients with FFA seen at the trichology unit of Hospital Universitario Infanta Sofia in Madrid, Spain between May 2016 and May 2018. We analyzed associations between disease severity, clinical patterns, need for oral medications, and other characteristics. Results Seventy-five patients (73 women and 2 men) were studied. Diagnosis was clinical in most cases and 13 cases (17.3%) were confirmed histologically. Median (interquartile range) age at reported onset of symptoms was 61 (12) years. Involvement of the eyebrows was recorded in 70 patients (93.3%) and signs of oral and genital lichen planus in 7 (9.6%). Eleven patients (14.7%) had hypothyroidism and 15 (20.0%) had signs of rosacea. Only 5 of the patients who presented a linear pattern (21.7%) had severe hairline recession. Patients with unstable and/or symptomatic disease (n = 24) were treated with oral medications (5-alpha reductase inhibitors, hydroxychloroquine, corticosteroids, and isotretinoin) or intralesional corticosteroids. Eighteen patients (75.0%) achieved disease stability. Ten of the 15 patients with signs of rosacea and 10 of those with facial papules required systemic treatment. Conclusions Most of the patients in this series of FFA were postmenopausal women. The prevalence of oral and genital lichen planus was higher than that observed in the general population. Patients with a linear pattern had less severe disease. Facial papules were more common in younger patients and both facial papules and rosacea were associated with a greater need for oral treatment.

Antecedentes y objetivo: La alopecia frontal fibrosante (AFF) es un tipo de alopecia cicatricial cuya incidencia está en aumento. Detallamos las características demográficas y clínicas, y los tratamientos utilizados en los pacientes con AFF atendidos en la consulta de tricología de un hospital de complejidad intermedia. Material y método: Se recopilaron de forma retrospectiva los datos de todos los pacientes diagnosticados de AFF atendidos en la consulta de Tricología del Hospital Universitario Infanta Sofía desde mayo de 2016 hasta mayo de 2018. Se evaluó la asociación entre la gravedad, el patrón clínico y la necesidad del tratamiento oral con el resto de las características de los pacientes. Resultados: Se incluyeron un total de 75 pacientes (73 mujeres y 2 varones). El diagnóstico en la mayoría de los casos fue clínico, y se realizó estudio histológico en 13 pacientes (17,3%). La mediana de la edad de inicio del cuadro fue de 61 [12] anos. ˜ En 70 casos (93,3%) se observó afectación de las cejas y en 7 pacientes (9,6%) se objetivaron signos de liquen orogenital. Asociaban hipotiroidismo 11 casos (14,7%) y en 15 (20,0%) se observaron signos de rosácea. Solo 5 (21,7%) de los pacientes con patrón lineal presentaban retroceso grave. En los pacientes inestables y/o sintomáticos (24 casos) se instauró tratamiento oral (con inhibidores de la 5 alfa reductasa, hidroxicloroquina, corticoides o isotretinoína) o intralesional con corticoides, logrando la estabilización en 18 pacientes (75,0%). Un total de 10 pacientes de los 15 que presentaban signos de rosácea, y 10 de los 20 pacientes que presentaban pápulas faciales precisaron tratamiento sistémico. Conclusión: La mayoría de nuestros pacientes son mujeres posmenopáusicas. Hemos encontrado un aumento de la proporción de casos con un liquen orogenital en relación con la población general, y una menor gravedad en los pacientes con un patrón lineal. Se ha objetivado la presencia de pápulas faciales con más frecuencia en pacientes más jóvenes, y una mayor probabilidad de necesitar tratamiento oral en los pacientes con rosácea y con pápulas faciales. Background and objective: Frontal fibrosing alopecia is an increasingly common form of scarring alopecia. The aim of this study was to describe the demographic and clinical characteristics of patients with FFA seen at the trichology unit of a medium-sized regional hospital and to report on treatments used. Material and method: We reviewed the medical records of all patients with FFA seen at the trichology unit of Hospital Universitario Infanta Sofía in Madrid, Spain between May 2016 and May 2018. We analyzed associations between disease severity, clinical patterns, need for oral medications, and other characteristics. Results: Seventy-five patients (73 women and 2 men) were studied. Diagnosis was clinical in most cases and 13 cases (17.3%) were confirmed histologically. Median (interquartile range) age at reported onset of symptoms was 61 (12) years. Involvement of the eyebrows was recorded in 70 patients (93.3%) and signs of oral and genital lichen planus in 7 (9.6%). Eleven patients (14.7%) had hypothyroidism and 15 (20.0%) had signs of rosacea. Only 5 of the patients who presented a linear pattern (21.7%) had severe hairline recession. Patients with unstable and/or symptomatic disease (n = 24) were treated with oral medications (5-alpha reductase inhibitors, hydroxychloroquine, corticosteroids, and isotretinoin) or intralesional corticosteroids. Eighteen patients (75.0%) achieved disease stability. Ten of the 15 patients with signs of rosacea and 10 of those with facial papules required systemic treatment. Conclusion: Most of the patients in this series of FFA were postmenopausal women. The prevalence of oral and genital lichen planus was higher than that observed in the general population. Patients with a linear pattern had less severe disease. Facial papules were more common in younger patients and both facial papules and rosacea were associated with a greater need for oral treatment. Sin financiación No data JCR 2020 0.272 SJR (2020) Q3, 95/138 Dermatology No data IDR 2020 UEM

Introducción y objetivos: La hidradenitis supurativa (HS) es una enfermedad inflamatoria crónica de la piel que influencia negativamente la calidad de vida. En la actualidad no existen escalas en español que la evalúen. El objetivo del presente estudio fue desarrollar y validar un cuestionario específico para evaluar la calidad de vida en pacientes con HS. Material y métodos: Se desarrolló un estudio multicéntrico en España entre 2016 y 2017 para elaborar un cuestionario. Para ello se consideró tanto el marco conceptual como el conocimiento de la situación del paciente mediante la revisión de la bibliografía, reuniones de profesionales de diferentes áreas y entrevistas con pacientes. El cuestionario resultante se pasó a un grupo de 30 pacientes con 30 ± 10 días de intervalo entre uno y otro. Resultados: El análisis de fiabilidad muestra una buena consistencia interna y reproductibilidad con puntuación alfa de Cronbach de 0, 920 (test) y 0, 917 (retest) y coeficiente de correlación intraclase con DLQI y Skindex-29 de 0, 698 IC 95% (0, 456-0, 844) y 0, 900 IC 95% (0, 801-0, 951) respectivamente. Se establecieron puntos de corte para su uso y se comprobó que el instrumento es sensible al cambio. Conclusiones: El cuestionario HSQoL-24 es la primera prueba autoadministrada específica para evaluar la calidad de vida en HS en español. Sencillo de usar y puntuar por los profesionales. Este estudio demuestra que el instrumento es fiable, válido y sensible al cambio, pendiente de realizar estudio confirmatorio con una muestra mayor con 100 pacientes con HS. Introduction and objectives: Hidradenitis suppurativa (HS) is a chronic inflammatory disease of the skin with a negative impact on quality of life. Up to now, there are no disease specific instruments in Spanish to assess quality of life in HS. The objective of this study was to develop and validate a questionnaire to evaluate the quality of life in patients with HS. Material and methods: A multicentre study was carried out in Spain between 2016 and 2017 to develop the questionnaire. Both the conceptual framework and understanding of the patient''s situation were considered through a review of the literature, consensus of professionals from different related health areas, and in-depth interviews with patients. The resulting questionnaire was passed to a group of 30 patients with 30±10 days of interval between both assessments. Results: The reliability analysis shows a good internal consistency and reproducibility with Cronbach''s alpha score of 0.920 (test) and 0.917 (retest) and intraclass correlation coefficient with DLQI and Skindex-29 of 0.698 IC 95% (0.456-0.844) and 0.900 IC 95% (0.801-0.951) respectively. Cut-off points were established for its use and the instrument was found to be sensitive to change. Conclusions: The HSQoL-24 is the first disease-specific self-administered instrument to assess quality of life in patients with HS in Spanish. It is user friendly, and easy to score. This study shows that the instrument is reliable, valid and sensitive to change, pending confirmatory study with a larger sample of 100 patients with HS.

Introducción y objetivos: La hidradenitis supurativa (HS) es una enfermedad inflamatoria crónica de la piel que influencia negativamente la calidad de vida. En la actualidad no existen escalas en español que la evalúen. El objetivo del presente estudio fue desarrollar y validar un cuestionario específico para evaluar la calidad de vida en pacientes con HS. Material y métodos: Se desarrolló un estudio multicéntrico en España entre 2016 y 2017 para elaborar un cuestionario. Para ello se consideró tanto el marco conceptual como el conocimiento de la situación del paciente mediante la revisión de la bibliografía, reuniones de profesionales de diferentes áreas y entrevistas con pacientes. El cuestionario resultante se pasó a un grupo de 30 pacientes con 30 ± 10 días de intervalo entre uno y otro. Resultados: El análisis de fiabilidad muestra una buena consistencia interna y reproductibilidad con puntuación alfa de Cronbach de 0,920 (test) y 0,917 (retest) y coeficiente de correlación intraclase con DLQI y Skindex-29 de 0,698 IC 95% (0,456-0,844) y 0,900 IC 95% (0,801-0,951) respectivamente. Se establecieron puntos de corte para su uso y se comprobó que el instrumento es sensible al cambio. Conclusiones: El cuestionario HSQoL-24 es la primera prueba autoadministrada específica paraevaluar la calidad de vida en HS en espa˜nol. Sencillo de usar y puntuar por los profesionales.Este estudio demuestra que el instrumento es fiable, válido y sensible al cambio, pendiente derealizar estudio confirmatorio con una muestra mayor con 100 pacientes con HS. Introduction and objectives: Hidradenitis suppurativa (HS) is a chronic inflammatory disease of the skin with a negative impact on quality of life. Up to now, there are no disease specific instruments in Spanish to assess quality of life in HS. The objective of this study was to develop and validate a questionnaire to evaluate the quality of life in patients with HS. Material and methods: A multicentre study was carried out in Spain between 2016 and 2017 to develop the questionnaire. Both the conceptual framework and understanding of the patient's situation were considered through a review of the literature, consensus of professionals from different related health areas, and in-depth interviews with patients. The resulting questionnaire was passed to a group of 30 patients with 30±10 days of interval between both assessments. Results: The reliability analysis shows a good internal consistency and reproducibility with Cronbach's alpha score of 0.920 (test) and 0.917 (retest) and intraclass correlation coefficient with DLQI and Skindex-29 of 0.698 95% CI (0.456-0.844) and 0.900 95% CI (0.801-0.951) respectively. Cut-off points were established for its use and the instrument was found to be sensitive to change. Conclusions: The HSQoL-24 is the first disease-specific self-administered instrument to assess quality of life in patients with HS in Spanish. It is user friendly, and easy to score. This study shows that the instrument is reliable, valid and sensitive to change, pending confirmatory study with a larger sample of 100 patients with HS

Gouty panniculitis is caused by the deposition of urate crystals in the subcutaneous tissue, accompanied by a lobular panniculitis. It presents as subcutaneous nodules, most commonly located on the lower extremities. Being an unusual clinical presentation of gout, the sonographic findings of gouty panniculitis have been scarcely described in the literature. Our report describes the ultrasound features we found in a case of gouty panniculitis and the usefulness of this technique for diagnosis and monitoring of this disease.

Spanish legislation recognizes patients' right to be informed about various aspects of their illness and to make autonomous decisions regarding diagnosis and treatment. As dermatologists, we need to become familiar with this legislation, heed its stipulations, and implement them in our practice.

Resumen La legislacion de nuestro pais reconoce que el paciente tiene derecho a ser informado sobre los distintos aspectos de su enfermedad y a su autonomia en la toma de decisiones relativas al diagnostico y tratamiento de la misma. Como dermatologos tenemos la obligacion de conocer, respetar y ejecutar dicha normativa en nuestra labor asistencial.

Resumen Aportamos algunos datos acerca de los anuncios publicados en la revista Actas Dermosifiliograficas durante el periodo 1909-1939. Destacan los anuncios relacionados con el tratamiento de las enfermedades de transmision sexual. Son un ejemplo de la estrecha relacion existente entre la industria farmaceutica y las revistas medicas.

We review advertisements published in the journal Actas Dermosifiliograficas between 1909 and 1939. Treatments for sexually transmitted diseases were advertised with particular frequency, and they offer a case in point that exemplifies the close relationship between the pharmaceutical industry and medical journals.

Resumen En 1936 Covisa y Bejarano publicaron su tratado titulado Elementos de Dermatologia. El libro destacaba por su modernidad, al dejar atras los debates nosologicos que caracterizaban a la Dermatologia del siglo anterior, y al agrupar las enfermedades por su etiologia y patogenia, apoyandose en los avances cientificos y tecnicos de la epoca. Era tambien el primer texto adaptado a la realidad espanola, y no una simple adaptacion de un texto extranjero. Sin embargo, la Guerra Civil iniciada ese mismo ano determino el futuro de los autores y del propio libro. Covisa y Bejarano tuvieron una intensa participacion en la administracion sanitaria y universitaria de la Segunda Republica y se vieron obligados a exiliarse a America. El libro tuvo escasa distribucion por librerias en aquel dificil momento, y tampoco se realizarian nuevas ediciones. Nunca sabremos que habria sucedido de no haber estallado la guerra, pero creemos justo recordar esta importante obra.

In 1936, Covisa and Bejarano published a treatise entitled Elementos de Dermatologia (The Elements of Dermatology). In this surprisingly modern book they abandoned the nosological debates characteristic of the 19th century and instead classified diseases according to their etiology and pathogenesis based on the scientific and technical advances of the time. Moreover, unlike other books available at the time, which were essentially adaptations of foreign texts, this was the first medical work to reflect the reality of Spanish medicine. However, the future of both the book and its authors was to be determined by the start of the Spanish Civil War in the same year. Covisa and Bejarano, who were both extremely active in the public health system and medical education during the Second Republic, were obliged to seek exile in America. Due to the difficulties of the time, very few copies of the book reached the public and no new editions were ever printed. We will never know what would have happened if the war had not started, but we believe that this important work should be remembered.

On Social Prophylaxis of Venereal Diseases is a book written by 4 Spanish dermatologists: Bravo, Covisa, Sainz de Aja, and Villarejo. It is an illustration of the information provided on venereal disease at the beginning of twentieth century in Spain.

Brief comment is made on the first article published in the journal Actas Dermo-Sifiliograficas with photographic documentation of the case history and histological findings. It was written by the founder of the journal, Dr. Juan de Azua, in 1909.

Resumen Se realiza un breve comentario del primer articulo publicado en la revista Actas Dermo-Sifiliograficas con documentacion grafica del caso clinico y de los hallazgos histologicos. Fue redactado por nuestro fundador, el Dr. Juan de Azua, en el ano 1909.

On Social Prophylaxis of Venereal Diseases is a book written by 4 Spanish dermatologists: Bravo, Covisa, Sainz de Aja, and Villarejo. It is an illustration of the information provided on venereal disease at the beginning of the twentieth century in Spain.

Resumen El amiloide es un material proteinaceo que se deposita en los tejidos en una gran variedad de situaciones clinicas; en la piel puede ser hallado con o sin afectacion sistemica concomitante. La amiloidosis cutanea primaria localizada designa a aquellas amiloidosis con afectacion exclusivamente cutanea, sin afectacion a otros niveles. Las formas mas comunes dentro de este grupo son la amiloidosis macular y el liquen amiloideo. La amiloidosis nodular es extremadamente infrecuente y mantiene importantes diferencias clinicas, pronosticas, histologicas y patogenicas con respecto a las variantes macular y liquenoide. Presentamos un nuevo caso de amiloidosis cutanea primaria localizada nodular con placas y nodulos diseminados, que no desarrollo afectacion sistemica tras tres anos desde el debut de las lesiones.

Amyloid is a proteinaceous material that is deposited in the tissues in a large variety of clinical contexts; in the skin it can be found with or without concomitant systemic disease. Primary localized cutaneous amyloidosis encompasses those amyloidoses restricted to the skin without involvement of other systems. The most common forms within this group are macular and lichen amyloidosis. Nodular amyloidosis is extremely rare, and there are notable differences in clinical presentation, prognosis, histology, and pathogenesis between this entity and the macular and lichenoid variants. We report a new case of nodular primary localized cutaneous amyloidosis with disseminated plaques and nodules in which no systemic disease developed in the 3 years following the appearance of the lesions.

In recent years, the demand for cosmetic interventions to augment soft tissue by injecting different substances has increased, due to their apparent innocuity. However, these procedures are not free from adverse reactions, such as the formation of foreign body granulomas, a phenomenon described in literature with most of the materials used. We report the case of a female patient with inflammatory lesions of the face, whose diagnosis was made after the histopathological study, which revealed a granuloma caused by liquid silicone.

La realización de tatuajes temporales de henna negra esb una práctica decorativa que va progresivamente en aumento en los últimos años, debido a su aparente inocuidad y a su desaparición en pocas semanas. La henna negra contiene parafenilendiamina (PPD) en su composición, un colorante sintético cuyo principal uso es como componente de tintes capilares, con gran poder sensibilizante. De forma paralela al aumento de la difusión de los tatuajes de henna negra están apareciendo múltiples casos de eccemas de contacto alérgico tras su realización. Gran parte de estos casos se dan en niños y adolescentes durante el período estival, por la gran oferta de tatuadores en los lugares de vacaciones y el desconocimiento de los padres de los riesgos que representan estos tatuajes. En la labor de paliar esta desinformación tenemos un papel fundamental los médicos, en particular, los pediatras, medicos de atención primaria y dermatólogos, que podemos ser consultados antes de la realización de un tatuaje de este tipo y que trataremos a los pacientes cuando hayan desarrollado lesiones. Se presenta nuestra experiencia aportando 8 casos y revisando brevemente la literatura especializada al respecto. : Temporary henna tattoos have become increasingly popular in the last few years, because of their apparent harmlessness and disappearance in few weeks. Black henna contains paraphenylenediamine (PPD), a synthetic colorant which is used in hair dyes and can cause sensitization. Many cases of allergic contact dermatitis occurring after tattooing have been reported, especially in children and teenagers during the summer time, since there are many tattoo-painters at holiday places and the parents are unaware of the risks of these tattoos. Clinicians, particularly pediatricians, primary care physicians and dermatologists should seek to remedy this misinformation. We can be the first person to be consulted before the tattoo painting and we will treat patients with lesions. We present our experience of eight cases of allergic contact dermatitis after tattooing and briefly review the literature on the risks of black henna tattoos.

Annular elastolytic giant cell granuloma (AEGCG) is an uncommon entity clinically characterized by erythematous annular plaques with atrophic and hypopigmented center, that predominates in sun-exposed zones. The histology shows a granulomatous infiltrate without palisading image, made up of lymphocytes, histiocytes and giant cells, with phagocytosis of elastic fibers, without necrobiosis or mucin deposit. We present the case of a male patient with atypical clinical manifestation on the non-sun exposed skin and AEGCG characteristic histology.

Tinea corporis es producida por la infeccion por dermatofitos de la piel lampina. Habitualmente son lesiones poco extensas en pacientes inmunocompetentes. Un varon de 40 anos, de origen rumano, consulto por lesiones cutaneas pruriginosas anulares de hasta 30 cm, de borde papuloso eritemato escamoso, afectando hasta un 60% de la superficie corporal total. Se realizo una vision con hidroxido de potasio (KOH) y cultivo de las lesiones, que resultaron positivos para Trichophyton rubrum, estableciendose el diagnostico de tinea corporis. Las condiciones sociosanitarias desempenan un papel de gran importancia en las infecciones por dermatofitos, siendo un grupo de riesgo la poblacion inmigrante. En el caso presentado, pensamos que es la situacion sociosanitaria del paciente la que ha debido determinar la presentacion clinica peculiar de una tinea corporis de tan gran extension.

We present the case of a 63-year-old woman with herpetiform pemphigus and disseminated esophageal carcinoma which began to manifest themselves simultaneously. Some cases of herpetiform pemphigus associated with neoplasms have previously been reported, but these have primarily been bronchopulmonary. The association of any type of pemphigus with esophageal cancer is very infrequent. We should be alert to the infrequent varieties of pemphigus and atypical bullous diseases, because they sometimes do not meet the diagnostic criteria of paraneoplastic pemphigus, but are the first manifestation of an underlying neoplasm.