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We report the case of a 90-year-old male who presented with an erythematous desquamative plaque on his left cheek. Histopathology demonstrated an epidermal lesion with multifocal epithelial growth. The cells were small, with scant cytoplasm and hyperchromatic nuclei with molding and a high mitotic and apopototic rate. Immunohistochemistry showed positivity for CK20, CK7, synaptophysin and INMS1. These findings are consistent with a Merkel cell carcinoma in situ. This tumor corresponds to a primary neuroendocrine neoplasm of the skin, which usually affects elderly people with sun-exposed skin. Usually, it presents as a dermal tumor but intraepidermal involvement alone is extremely rare. In this scenario, a broad differential diagnosis should be considered, excluding all neoplasms that may present intraepidermal forms. The evolution of this entity is unknown.

Porokeratotic eccrine and hair follicle nevus is a very rare non-hereditary disorder of keratinization with eccrine and hair follicle involvement with only 9 cases described in the literature. In 2009 the term porokeratotic anexial ostial nevus was proposed to comprehend porokeratotic eccrine and hair follicle nevus and a related and more common process without follicular involvement: porokeratotic eccrine ostial and dermal duct nevus Recent findings suggest that both entities may be produced by a mutation in GJB2 gene, which is associated to KID syndrome. Herein we report 2 cases of porokeratotic eccrine and hair follicle nevus and review the existing cases in the Spanish and English literature.

OBJECTIVES To investigate the patterns of melanoma recurrence in the local population, including factors that may influence in this event and timing of relapse, and to determine the mode of detection of them. METHODS This is a retrospective cohort study of patients with melanoma who underwent sentinel lymph node biopsy at the Complejo Hospitalario de Navarra (Spain) from 2002 to 2012. The following data were collected of each patient: age, gender, date of diagnosis, location of melanoma, histological subtype, Breslow thickness, ulceration, mitosis, sentinel node status, AJCC 8th edition stage, site of first diagnosed metastasis, mode of relapse, date of first relapse and time of death. RESULTS Of 308 patients, 30% people suffered metastasis. The mean follow-up time was 68.63 months. 51.1% of relapses were locoregional and 48.9% haemato-visceral. Sentinel node status was the only variable associated with higher risk of haemato-visceral metastasis (p

Resumen Fundamento y objetivo La calcifilaxia es una vasculopatia cutanea isquemica de vasos de pequeno tamano con una alta morbimortalidad. Hasta el momento actual han sido publicadas muy pocas series de pacientes con esta enfermedad, ninguna procedente de un hospital espanol. Los principales objetivos de este trabajo son analizar el perfil demografico, clinico e histologico de los pacientes diagnosticados de calcifilaxia en nuestro servicio, para identificar posibles factores de riesgo y potenciales estrategias terapeuticas. Material y metodo Estudio retrospectivo de los casos vistos en el Servicio de Dermatologia con diagnostico de calcifilaxia con una biopsia confirmatoria, en el periodo de enero de 2010 a agosto de 2015. Resultados Se estudiaron 9 pacientes, con edades de 76-86 anos. Todos tenian comorbilidades cardiovasculares y el 67% tenia insuficiencia renal. Se observo un 33% de mortalidad. Conclusiones Ante el posible diagnostico de calcifilaxia debe realizarse una analitica sanguinea completa para descartar otras causas de ulceras cutaneas. El tratamiento de estos pacientes debe llevarse a cabo por un equipo multidisciplinar. Resaltamos el papel del tiosulfato sodico en el tratamiento de esta entidad.

Background and objective Calciphylaxis is a cutaneous ischaemic vascular disease of small vessels with high morbidity and mortality. To date very few series of patients with this disease have been published, none from a Spanish hospital. The main objectives of this work are to analyse the demographic, clinical and histological profile of patients diagnosed in our department to identify risk factors and potential therapeutic strategies. Material and method We made a retrospective study of the cases seen in the dermatology department with a diagnosis of calciphylaxis and who had a confirmatory biopsy in the period between January 2010 to August 2015. Results Nine patients were studied, with an age range of 76–86 years. All had cardiovascular comorbidities and 67% had renal failure. A 33% mortality was observed. Conclusions Faced with a possible diagnosis of calciphylaxis, a complete blood analysis is mandatory to rule out other causes of skin ulcers. The management of these patients should be undertaken by a multidisciplinary team. We emphasize the role of sodium thiosulfate in the treatment of this condition.