Actas dermo-sifiliograficas最新文献

{"title":"Reconstruction of surgical defects using ultrathin skin graft strips harvested with DermaBlade® and secured exclusively with tissue adhesive.","authors":"F Alarcón Soldevilla, J M Sánchez Sánchez, A J Castillo Botero, M Torrent García","doi":"10.1016/j.ad.2026.104760","DOIUrl":"https://doi.org/10.1016/j.ad.2026.104760","url":null,"abstract":"","PeriodicalId":7173,"journal":{"name":"Actas dermo-sifiliograficas","volume":" ","pages":"104760"},"PeriodicalIF":2.9,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synergistic effect of sequential 532-nm and 595-nm lasers in port-wine stains: a randomized split-lesion trial.","authors":"J Naharro-Rodríguez, J Company-Quiroga, A Sánchez-Velázquez, E Berná-Rico, Ca Azcárraga-Llobet, F J Pérez-Bootello, C Moreno García Del Real, P Boixeda","doi":"10.1016/j.ad.2026.104770","DOIUrl":"https://doi.org/10.1016/j.ad.2026.104770","url":null,"abstract":"<p><strong>Background: </strong>Pulsed dye laser (PDL) is the current gold standard for the treatment of port-wine stains (PWS), yet clearance is often incomplete even after multiple sessions. Sequential application of vascular lasers with complementary optical targets may enhance therapeutic efficacy.</p><p><strong>Objectives: </strong>To evaluate whether sequential 532-nm potassium titanyl phosphate (KTP) followed by 595-nm PDL achieves better improvement than either modality alone.</p><p><strong>Methods: </strong>In this prospective, randomized, split-lesion trial, adults with PWS received a single laser session. Each lesion was divided into three matched regions treated with KTP alone, PDL alone, or immediate sequential KTP→PDL. The primary endpoint was blinded photographic IGA at 8 weeks. Secondary outcomes included pain, local reactions, and patient preference.</p><p><strong>Results: </strong>Sequential KTP→PDL achieved superior short-term improvement compared with either monotherapy, without new safety concerns. Local tolerability differed across protocols but no pigmentary alterations, scarring, or severe adverse events were observed. The sequential protocol was the preferred option in most patients.</p><p><strong>Conclusions: </strong>One-session sequential 532- and 595-nm treatment demonstrated greater short-term efficacy than either laser alone with an acceptable tolerability profile. This dual-wavelength approach may optimize PWS clearance and merits evaluation in longer, multi-session studies.</p><p><strong>Trial registration: </strong>NCT07015073.</p>","PeriodicalId":7173,"journal":{"name":"Actas dermo-sifiliograficas","volume":" ","pages":"104770"},"PeriodicalIF":2.9,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149214890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dermoscopy of intraepidermal keratinocytic neoplasms in solid organ transplant recipients: a single-center prospective real-world study supported by machine learning.","authors":"L Bernal Masferrer, M Álvarez-Salafranca, T Gracia Cazaña, M C Gómez, V Velasco-Tamariz, R Gamo-Villegas, M Claudia Matei, I Bernad Alonso, A Marín Aranzana, J Fernandez Rodriguez, Y Gilaberte","doi":"10.1016/j.ad.2026.104769","DOIUrl":"https://doi.org/10.1016/j.ad.2026.104769","url":null,"abstract":"<p><strong>Background: </strong>Actinic keratoses (AKs) and Bowen disease (BD) are precursors of cutaneous squamous cell carcinoma (cSCC) and are particularly relevant in solid organ transplant recipients (SOTRs) because of chronic immunosuppression. Early, accurate diagnosis is essential. Dermatoscopy is the most widely used and validated noninvasive diagnostic tool, although most studies have involved immunocompetent patients.</p><p><strong>Objectives: </strong>To evaluate the diagnostic accuracy of dermatoscopy in differentiating AK from BD in SOTRs, assess established dermoscopic criteria in this population, and compare the performance of expert observers, logistic regression, and machine learning models.</p><p><strong>Methods: </strong>We conducted a prospective observational study of 38 lesions clinically classified as AK or BD in SOTRs. Each lesion was assessed dermatoscopically by 3 blinded experts using 13 predefined criteria and subsequently biopsied for histopathological confirmation. Analyses included logistic regression, interobserver agreement, diagnostic performance, and evaluation of random forest models using SHapley Additive exPlanations (SHAP) values.</p><p><strong>Results: </strong>We evaluated 38 lesions in 36 patients; 22 were histopathologically diagnosed as BD (58%) and 16 as AK (42%). Dermoscopic sensitivity and specificity for BD were 61% and 79%, respectively (positive predictive value, 81%; negative predictive value, 58%). For AK, sensitivity was 79% and specificity was 61%. Logistic regression identified the strawberry pattern, thick white-yellow scales, and glomerular vessels as significantly associated with BD. SHAP analysis supported these associations but also identified differences between human and model-based feature interpretation.</p><p><strong>Conclusions: </strong>Established dermoscopic criteria may underestimate lesion severity in SOTRs, particularly for BD. Some features traditionally associated with AK, including the strawberry pattern and rosettes, were more indicative of BD in this cohort. Diagnostic algorithms require further validation in immunosuppressed populations, and explainable machine learning may provide complementary diagnostic insights.</p>","PeriodicalId":7173,"journal":{"name":"Actas dermo-sifiliograficas","volume":" ","pages":"104769"},"PeriodicalIF":2.9,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149214932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunosenescence markers as predictors of cutaneous keratinocyte carcinoma risk in heart transplant recipients: a prospective pilot study of 30 patients.","authors":"I Oteiza-Rius, A Goñi-Lerena, I Manrique, P Redondo, R Salido-Vallejo, L Aguado-Gil","doi":"10.1016/j.ad.2026.104766","DOIUrl":"https://doi.org/10.1016/j.ad.2026.104766","url":null,"abstract":"<p><p>Cutaneous keratinocyte carcinomas (CKCs) are more frequent and aggressive in solid organ transplant recipients (SOTRs), particularly heart transplant recipients (HTRs), owing to prolonged immunosuppressive treatment. This prospective cohort study evaluated the association between immunosenescence markers and CKC development in 30 HTRs over 1 year of follow-up. Lymphocyte subpopulations were analyzed by flow cytometry, along with cellular immunosenescence markers including PD-1, CD57, and TIGIT. At the end of follow-up, 23.3% of patients developed new CKCs. These patients showed a higher proportion of CD8⁺PD-1⁺ lymphocytes compared to those without new CKCs. No significant differences were found in CD4⁺ lymphocyte populations, NK cells, or regulatory T cells. These results suggest that CD8⁺PD-1⁺ lymphocytes may represent a potential biomarker associated with increased CKC risk in HTRs.</p>","PeriodicalId":7173,"journal":{"name":"Actas dermo-sifiliograficas","volume":" ","pages":"104766"},"PeriodicalIF":2.9,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eosinophilic dermatosis of hematologic malignancy in a patient with diffuse large B-cell lymphoma: A diagnostic challenge.","authors":"A Vidal Ruiz, R Mora Díaz, N Eirís Salvado","doi":"10.1016/j.ad.2026.104751","DOIUrl":"https://doi.org/10.1016/j.ad.2026.104751","url":null,"abstract":"","PeriodicalId":7173,"journal":{"name":"Actas dermo-sifiliograficas","volume":" ","pages":"104751"},"PeriodicalIF":2.9,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Below-knee dermatologic surgery: Prevention of surgical complications, wound healing, and reconstructive techniques-A narrative review.","authors":"M Selva-Del Río, M Alegre, D Morgado-Carrasco","doi":"10.1016/j.ad.2026.104757","DOIUrl":"https://doi.org/10.1016/j.ad.2026.104757","url":null,"abstract":"<p><strong>Background: </strong> Below-knee dermatologic surgery is associated with an increased risk of surgical site infection, wound dehiscence, and postoperative pain. Optimizing perioperative care and reconstructive strategies is particularly important in older patients undergoing skin cancer surgery.</p><p><strong>Methods: </strong> A narrative literature review was conducted in April 2025 using PubMed and Google Scholar. Clinical trials, observational studies, systematic reviews, and meta-analyses addressing complications, perioperative interventions, wound healing, and reconstruction following lower-leg dermatologic surgery were evaluated.</p><p><strong>Results: </strong> Preoperative cleansing with 4% chlorhexidine, perioperative compression, monofilament sutures, and zinc oxide dressings may help reduce postoperative complications. Routine perioperative antibiotic prophylaxis is not recommended. Neoadjuvant intralesional methotrexate or 5-fluorouracil may reduce tumor size, simplify surgical reconstruction, or avoid surgery in selected patients with cutaneous squamous cell carcinoma. Direct closure is the preferred reconstructive approach when feasible. Alternatives include secondary intention healing, pinch grafts, split-thickness and full-thickness skin grafts, and local flaps, particularly the keystone flap. Based on the available evidence and clinical experience, a practical management algorithm is proposed.</p><p><strong>Conclusions: </strong> Below-knee dermatologic surgery requires individualized perioperative management and careful selection of reconstructive techniques. Antiseptic cleansing, compression therapy, appropriate suture selection, and selected reconstructive approaches may improve outcomes. However, much of the available evidence is derived from retrospective studies, highlighting the need for prospective investigations.</p>","PeriodicalId":7173,"journal":{"name":"Actas dermo-sifiliograficas","volume":" ","pages":"104757"},"PeriodicalIF":2.9,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pemphigus herpetiformis: association with malignancies and therapeutic challenges.","authors":"M Brufau-Cochs, P Giavedoni, X Bosch-Amate, J Riera-Monroig, A García-Herrera, N Ishii, T Hashimoto, P Iranzo, J M Mascaró-Galy","doi":"10.1016/j.ad.2026.104764","DOIUrl":"https://doi.org/10.1016/j.ad.2026.104764","url":null,"abstract":"<p><p>This case series examines the histopathological, immunological, and therapeutic characteristics of 7 patients diagnosed with pemphigus herpetiformis (PH) at a tertiary hospital between 1989 and 2025. The most common clinical manifestation was pruritic annular lesions. Direct immunofluorescence was positive in all cases, whereas serological testing (enzyme-linked immunosorbent assay, indirect immunofluorescence, and immunoblotting) performed at 2 independent referral centers detected anti-desmoglein 1 antibodies in only 2 patients, with negative antigen-specific results in the remaining patients. An association between PH and malignancy was observed in 43% of cases, particularly with lung cancer, including the first reported case of PH associated with pancreatic cancer. These findings underscore the importance of recognizing this potential association to optimize patient management. Regarding treatment, conventional therapies such as corticosteroids and dapsone showed variable efficacy, whereas rituximab appeared less effective than in other pemphigus variants.</p>","PeriodicalId":7173,"journal":{"name":"Actas dermo-sifiliograficas","volume":" ","pages":"104764"},"PeriodicalIF":2.9,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leprosy: a disease we must not forget. Two cases in a nonendemic region.","authors":"J J Lluch-Galcerá, C Alcoverro, J M Carrascosa, A Quer, I Bielsa","doi":"10.1016/j.ad.2026.104762","DOIUrl":"https://doi.org/10.1016/j.ad.2026.104762","url":null,"abstract":"","PeriodicalId":7173,"journal":{"name":"Actas dermo-sifiliograficas","volume":" ","pages":"104762"},"PeriodicalIF":2.9,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Penile pyoderma gangrenosum.","authors":"I López Riquelme, E Gómez Moyano, L Martínez Pilar","doi":"10.1016/j.ad.2026.104765","DOIUrl":"https://doi.org/10.1016/j.ad.2026.104765","url":null,"abstract":"","PeriodicalId":7173,"journal":{"name":"Actas dermo-sifiliograficas","volume":" ","pages":"104765"},"PeriodicalIF":2.9,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and dermoscopic predictors of invasiveness in small-diameter melanomas (≤ 6 mm): A multicenter study of 160 cases.","authors":"Alejandro Martín-Gorgojo, Tania-Maria Capusan, Francisco-Javier Bru-Gorraiz, Ana-Patricia Miguélez, Alicia Comunión, Marta Feito, Cristina Gómez, Ignacio Sánchez-Carpintero, Matías Mayor, María José Beato, Ana-Belén Enguita, Yolanda Delgado, Esteban Daudén, Ricardo Ruiz-Rodríguez, Ángel Pizarro","doi":"10.1016/j.ad.2026.104759","DOIUrl":"https://doi.org/10.1016/j.ad.2026.104759","url":null,"abstract":"<p><strong>Background: </strong>Small-diameter melanomas (≤ 6 mm) are increasingly diagnosed, but their recognition remains challenging because conventional clinical and dermoscopic criteria may be absent or subtle. We investigated their clinical and dermoscopic characteristics and associations with invasiveness.</p><p><strong>Methods: </strong>This retrospective, multicenter observational study included 160 histologically confirmed primary cutaneous melanomas measuring ≤ 6 mm, excised between 1998 and 2018. Clinical features were assessed using the ABCDE rule adapted for small melanomas, and global and local dermoscopic characteristics were evaluated for associations with invasiveness.</p><p><strong>Results: </strong>Of 160 melanomas, 92 (57.5%) were in situ and 68 (42.5%) were invasive. Only 48 lesions (30%) exhibited at least three ABCDE characteristics, and the overall ABCDE score was not associated with invasiveness. In contrast, invasiveness was significantly associated with multiple suspicious global or local dermoscopic features, more than two colors, peripheral globules, blue-white veil, regression, and polymorphous vessels. Digital dermoscopic surveillance was associated with a higher proportion of in situ melanomas.</p><p><strong>Conclusions: </strong>A substantial proportion of small-diameter melanomas are already invasive despite limited clinical atypia. Although conventional ABCDE criteria and dermoscopy have diagnostic limitations, specific dermoscopic features and their accumulation may help identify potentially invasive lesions. Digital dermoscopic surveillance may facilitate detection at the in situ stage.</p>","PeriodicalId":7173,"journal":{"name":"Actas dermo-sifiliograficas","volume":" ","pages":"104759"},"PeriodicalIF":2.9,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}