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Desde los inicios de la gramática como disciplina sistemática en la antigua Grecia se ha planteado la cuestión del tratamiento de los fenómenos singulares en el marco de los paradigmas regulares. Aunque triunfó la idea de que la gramática (y, por tanto, la filología) es una tekhne, se sostuvo asimismo que se trataba de una empeiria, uno de cuyos elementos metodológicos era la observación de lo particular. Este concepto vuelve a surgir en el siglo XIX en el tratamiento del problema de la circularidad tanto en la crítica textual como en la hermenéutica, aunándose con el del carácter del intérprete. Se estudian los acercamientos a la idea de observación filológica en Ptolomeo Peripatético, Schleiermacher, Nietzsche y Giorgio Colli.

(1) Introduction: The association between melanoma (MM) and the occurrence of second primary neoplasms (SPNs) has been extensively studied, with reported incidence rates ranging from 1.5% to 20%. This study aims to evaluate the occurrence of SPNs in patients with a history of primary MM and to describe the factors that make the risk higher in our population. (2) Material and Methods: We conducted a prospective cohort study and calculated the incidence rates and relative risks (RR) for the development of different SPNs in 529 MM survivors from 1 January 2005 to 1 August 2021. Survival and mortality rates were obtained, and the Cox proportional hazards model was used to determine the demographic and MM-related factors that influence the overall risk. (3) Results: Among the 529 patients included, 89 were diagnosed with SPNs (29 prior to MM diagnosis, 11 synchronous, and 49 after MM), resulting in 62 skin tumors and 37 solid organ tumors. The estimated probability of developing SPNs after MM diagnosis was 4.1% at 1 year, 11% at 5 years, and 19% at 10 years. Older age, primary MM location on the face or neck, and histologic subtype of lentigo maligna mm were significantly associated with a higher risk of SPNs. (4) Conclusions: In our population, the risk of developing SPNs was higher in patients with primary MM located on the face and neck and with the histological subtype of lentigo maligna-MM. Age also independently influences the risk. Understanding these hazard factors can aid in the development of MM guidelines with specific follow-up recommendations for individuals with the highest risk.

The aim of this study was to evaluate the outcomes, complications and psychosocial impact of surgical treatment of giant congenital melanocytic nevus (GCMN).Patients with surgically treated GCMN who attended our clinic between May 2014 and May 2018 were included. Patient demographics and data on the characteristics of the nevus, surgical treatment, and the psychosocial impact (including C-DLQI/DLQI questionnaires) were collected.One hundred thirty-six patients were included (median age 9 years). Mean age at first surgery was 34 (+/- 61.45) months; 5.53 (+/- 3.69) surgical interventions were necessary to completely excise the nevus. The expanded skin flap was the preferred surgical technique in most locations. Complications were common but not severe. Of the patients studied, 70.4% reported that the surgery had a minor impact on their quality of life (QoL). Patients and caregivers stated that surgical treatment should begin as soon as possible, even in cases where early treatment did not have an impact on their QoL nor on their satisfaction with the surgery (p0.05). The lower the patient age at first surgery, the higher the surgeon's satisfaction (p0.01).Surgical treatment is a safe option for management of GCMN, and has a low impact on QoL. Patients, caregivers, and surgeons agree that the treatment should begin as soon as possible. This is the largest single-center study evaluating surgical treatment in GCMN patients and its psychosocial impact, and the first to take into account the patient, caregivers and dermatologists opinion of surgical results.

Background: Large prospective studies on the safety of Mohs micrographic (MMS) surgery are scarce, and most focus on a single type of surgical adverse event. Mid-term scar alterations and functional loss have not been described. Objectives: To describe the risk of MMS complications and the risk factors for them. Methods: A nationwide prospective cohort collected all adverse events on consecutive patients in 22 specialised centres. We used multilevel mixed-effects logistic regression to find out factors associated with adverse events. Results: 5,017 patients were included, with 14,421 patient-years of follow-up. 7.0% had some perioperative morbidity and 6.5% had mid-term and scar-related complications. The overall risk of complications was mainly associated with use of antiaggregant/anticoagulant and larger tumours, affecting deeper structures, not reaching a tumour-free border, and requiring complex repair. Age and outpatient setting were not linked to the incidence of adverse events. Risk factors for haemorrhage (0.9%) were therapy with antiaggregant/anticoagulants, tumour size, duration of surgery, and unfinished surgery. Wound necrosis (1.9%) and dehiscence (1.0%) were associated with larger defects and complex closures. Immunosuppression was only associated with an increased risk of necrosis. Surgeries reaching deeper structures, larger tumours and previous surgical treatments were associated with wound infection (0.9%). Aesthetic scar alterations (5.4%) were more common in younger patients, with larger tumours, in H-area, and in flap and complex closures. Risk factors for functional scar alterations (1.7%) were the need for general anaesthesia, larger tumours that had received previous surgery, and flaps or complex closures. Conclusions: MMS shows a low risk of complications. Most of the risk factors for complications were related to tumour size and depth, and the resulting need for complex surgery. Antiaggregant/anticoagulant intake was associated with a small increase in the risk of haemorrhage, that probably does not justify withdrawal. Age and outpatient setting were not linked to the risk of adverse events.

From his soul-dividing model (through a comparison with music 443d) Plato presents in the Republic the predominance of certain virtues in each part and its political meaning. This idea is later developed by other Greek philosophical schools in imperial time. Plutarch’s commentary on the Platonic passage let us know how Neoplatonists, Neo-Pythagoreans and Stoics have enriched the identification between Soul and Virtue with elements taken from the musical system and from the latestdoctrine on virtues, even establishing links with theory of knowledge.

Upper-lip reconstruction after Mohs micrographic surgery is challenging for dermatologic surgeons. We describe a series of 15 patients (7 men and 8 women; mean age, 65.6 years) with skin cancer on the upper lip treated with Mohs surgery: 10 were basal cell carcinomas, 2 were melanomas, and 3 were squamous cell carcinomas. The resulting defects measured between 3 and 7.6cm. We used island flaps to reconstruct the defects in all cases, hiding the incisions in the nasolabial fold, at the line where the skin meets the vermillion border of the lip, and in the relaxed skin tension lines. We explain key aspects of the surgeries and design of the reconstructions, with emphasis on the importance of occasionally sacrificing small areas of healthy skin. Cosmetic and functional outcomes were satisfactory in all patients, and there were no postsurgical complications.

Resumen: La reconstrucción del labio superior tras la cirugía de Mohs supone, en ocasiones, un reto para el cirujano dermatológico. Presentamos una serie de 15 pacientes (7 hombres y 8 mujeres; edad media de 65,6 años) con cáncer cutáneo (10 carcinomas basocelulares, 2 melanomas y 3 carcinomas escamosos) localizados en el labio superior intervenidos mediante cirugía de Mohs con defectos resultantes de 3-7,6 cm. Para la reconstrucción se empleó un colgajo en isla del labio superior diseñado escondiendo las incisiones en el pliegue nasolabial, en la línea de unión del bermellón con la piel y en las líneas de tensión de la piel relajada. Se explican las claves del diseño y la cirugía, enfatizando en la importancia de sacrificar en ocasiones pequeñas zonas de tejido sano. Se alcanzaron resultados satisfactorios cosméticos y funcionales, sin complicaciones posquirúrgicas en todos los pacientes. Abstract: Upper-lip reconstruction after Mohs micrographic surgery is challenging for dermatologic surgeons. We describe a series of 15 patients (7 men and 8 women; mean age, 65.6 years) with skin cancer on the upper lip treated with Mohs surgery: 10 were basal cell carcinomas, 2 were melanomas, and 3 were squamous cell carcinomas. The resulting defects measured between 3 and 7.6 cm. We used island flaps to reconstruct the defects in all cases, hiding the incisions in the nasolabial fold, at the line where the skin meets the vermillion border of the lip, and in the relaxed skin tension lines. We explain key aspects of the surgeries and design of the reconstructions, with emphasis on the importance of occasionally sacrificing small areas of healthy skin. Cosmetic and functional outcomes were satisfactory in all patients, and there were no postsurgical complications.

RESUMEN Tradicionalmente, el estudio sobre la historia de la musica en Occidente comenzaba en la Edad Media, un periodo en el que la documentacion escrita, iconografica y organologica permitia un conocimiento profundo de las caracteristicas de su musica, tanto profana como sacra. En los ultimos anos, sin embargo, se ha producido en el ambito de los estudios clasicos una relectura atenta de las fuentes, especialmente griegas, favorecida por la aparicion de material papiraceo, lo que ha permitido avanzar en el conocimiento de la musica en la Helade, sobre todo a partir del siglo V a. C.: contextos literarios (acompanaba a distintos generos literarios como la tragedia o la epica), cultuales, su apreciacion filosofica y erudita, sus caracteristicas tecnicas y organologicas e incluso como sonaba esta musica gracias a la interpretacion de las pocas “partituras” conservadas. Aunque con la caida del Imperio Romano y el triunfo del cristianismo se produjo un colapso de las estructuras y fenomenos culturales paganos, hoy disponemos de un conocimiento bastante aceptable de lo que fue un elemento estetico muy apreciado por los antiguos. Podemos, asi, entender mejor los inicios de la musica medieval, sobre todo en Occidente. Palabras clave: musica griega antigua, teoria musical, historia de la musica Toponimos: Egipto, Mesopotamia, Grecia, Roma Periodo: Grecia clasica, antigua Roma ABSTRACT The study of the history of Western music usually begins with the Middle Ages, a period in which textual, iconographic and instrumental evidence had afforded in-depth knowledge of the characteristics of its music, both sacred and profane. In recent years, however, in the field of classical studies there has been closer re-reading of sources, Greek in particular, favoured by the discovery of papyri. This has advanced our knowledge of ancient Greek music: literary contexts, rituals, philosophical and scholarly appreciation, its instrumental characteristics and melodies from the few preserved scores. After the fall of the Roman Empire and the triumph of Christianity, classical models collapsed, but today we have reasonable knowledge of an aesthetic element that was particularly appreciated by the ancients. Consequently, we can better understand the beginnings of medieval music, especially in the West. Key words: ancient Greek music, musical theory, music history Place names: Egypt, Mesopotamia, Greece, Rome Period: classical Greece, ancient Rome REFERENCIAS Abert, H. (1899), Die Lehre vom Ethos in der griechischen Musik , Leipzig, Breitkopf und Hartel (reimpr. Tutzing 1968). Barker, A. (1984), Greek Musical Writings. Vol. I: The Musician and his Art, Cambridge University Press. — (1989), Greek Musical Writings. Vol. II: Harmonic and Acoustic Theory, Cambridge University Press. Belis, A. (1999), Les Musiciens dans l’Antiquite , Paris, Hachette. Beschi, L. (1991): “La prospettiva mitica della musica greca”, Melanges de l’ecole francaise de Rome , 103, pp. 35-50. Bundrick, Sh. D. (2005), Music and Image in Classical Athens , Cambridge University Press. Calero Rodriguez, L. (2017a), “De la musica oriental a las practicas musicales de la Grecia Arcaica”, en Construyendo la Antiguedad. Actas del III Congreso Internacional de Jovenes Investigadores del Mundo antiguo (CIJIMA III) , CEPOAT – Universidad de Murcia, pp. 217-232. — (2017b), “Actores y cantantes en la antigua Grecia: algunas consideraciones tecnicas”, Estudios Clasicos , 151, pp. 53-78. — (2017c), “The Dissapearance of the Enharmonic Genos in Ancient Greece”, Musicology Papers , 32.2, pp. 20-35. Comotti, G. (1991), La musica nella cultura greca e romana , Turin, Edizione di Torino. Csapo, E. (2004), “The Politics of the New Music”, en P. Murray y P. Wilson (eds . ), Music and the Muses. The Culture of Mousike in the Classical Athenian City , Oxford University Press, pp. 207-248. D’Angour, A. (2018), “The Musical Setting of Ancient Greek Texts”, en T. Phillips y A. D’Angour (eds.), Music, Text, & Culture in Ancient Greece , Oxford University Press, pp. 47-77. Danek, G. y Hagel, S. (1995), “Homer-Singen”, Wiener humanitische Blatter , 37, pp. 5-20. Delouve, F. (2009), “Aspects de l’ ethos musical dans l’antiquite grecque”, Intersections: Canadian Journal of Music , 29.2, pp. 52-65. Descamps, S. y Pariselle, Ch. (2017), “Etude et Restauration de la salpinx de Myrina”, en Musiques! Echos de l’Antiquite , Musee du Louvre-Lens, 2017, pp. 370-373. Emerit, S. (2017), “La musique pharaonique, un patrimoine plurimillenaire”, en Musiques! Echos de l’Antiquite , Musee du Louvre-Lens, pp. 48-61. Farmer, H. G. (1966a), “The Music of Ancient Egypt”, en E. Wellesz, Ancient and Oriental Music , Oxford University Press, pp. 255-282. Farmer, H. G., (1966b), “The Music of Ancient Mesopotamia”, en E. Wellesz, Ancient and Oriental Music , Oxford University Press, pp. 228-254. Garcia Lopez, J. (2000), “La musica en el desarrollo del genero teatral griego: la tragedia”, en Historia y Humanismo. Homenaje al Profesor Pedro Rojas Ferrer , Universidad de Murcia, pp. 247-267. Garcia Lopez, J., Perez Cartagena, F. J. y Redondo Reyes, P. (2012), La Musica en la Antigua Grecia , Ediciones de la Universidad de Murcia. Hagel, S. (2010), Ancient Greek Music. A New Technical History , Cambridge University Press. — (2017), “Comprendre la musique antique grâce aux nouvelles technologies”, en Musiques! Echos de l’Antiquite , Musee du Louvre-Lens, pp.366-369. Hagel, S., y Harrauer, Ch. (eds.) (2005), Ancient Greek Music in Performance. Symposion Wien 29.Sept.-1.Okt.2003 , Wien, Verlag der Osterreischen Akademie der Wissenschaften. Hickmann, H. (1987), Musicologie pharaonique. Etudes sur l’evolution de l’art musical dans l’Egypte ancienne , Collection d’etudes musicologiques, vol. 34, Baden-Baden. Kahn-Lyotard, L. (1995), “La lyra di Hermes”, en D. Restani (ed.), Musica e mito nella Grecia antica , Bolonia, Il Mulino, pp. 185-187. Lasserre, F. (1988), “Musica babilonese e musica greca”, en B. Gentili y R. Pretagostini (eds.), La musica in Grecia , Roma-Bari, Editori Laterza, pp. 72-95. Luque Moreno, J. (2006), “Los gramaticos griegos y la musica. Los musicos griegos y el lenguaje”, en E. Calderon, A. Morales y M. Valverde (eds.), Koinos Logos. Homenaje al profesor Jose Garcia Lopez , Universidad de Murcia, pp. 551-563. McKinnon, J. (1987), Music in Early Christian Literature , Cambridge University Press. Moutsopoulos, E. (1989), La Musique dans l’Oeuvre de Platon, Presses Universitaires de France. Peche, V. y Vendries, Ch. (2001), Musique et spectacles dans la Rome Antique et dans l’Occident romain , Paris, Editions Errance. Pohlmann, E. y West, M. L. (2001), Documents of Ancient Greek Music , Oxford University Press. Sanchez Munoz, D. (2019), Analysis of two terms related to music in Ancient Mesopotamia: nam-nar and nārūtu(m) , Tesis doctoral, Universidad de Granada, https://digibug.ugr.es/bitstream/handle/10481/58701/67856.pdf?sequence=4&isAllowed=y (Consulta: 21-12-2020). Taplin , O. (1999), “Spreading the word through performance”, en S. Goldhill y R. Osborne (eds.), Performance Culture and Athenian Democracy , Cambridge University Press, pp. 33-57. Wellesz, E. (1961), A History of Byzantine Music and Hymnography , Oxford University Press. West, M. L. (1992), Ancient Greek Music , Oxford, Clarendon. — (2003), The East Face of Helicon: West Asiatic Elements in Greek Poetry and Myth , Oxford, Clarendon. Wille, G. (1967), Musica romana , Amsterdam, Schippers. Ziegler, N. (2011), “Music, the Work of Professionals”, en K. Radner y E. Robson (eds.), The Oxford Handbook of Cuneiform Culture , Oxford University Press, pp. 288-312.

Various techniques have been described for the reconstruction of surgical defects of the upper lip after skin cancer. Here, we propose a technique for reconstructing medium or large defects located at the junction of the nasogenian and nasolabial folds with a hatchet flap. We report on three patients treated with this technique, describing the surgical procedure and some interesting caveats. Two patients reconstructed with direct closure in this location are described in order to emphasize the better aesthetic result achieved with the hatchet flap, especially in terms of symmetry. While direct closure tends to decrease the ipsilateral nasolabial fold, the hatchet flap extends the scar to the fold below the commissure in a natural wrinkle, becoming symmetrical and much less noticeable after a few months. We conclude that the hatchet flap is technically easy and rapidly implemented for defects in the apical triangle of the upper lip, and achieves better results in terms of facial symmetry than direct closure.

Clinical utility of intralesional methotrexate to distinguish crateriform keratinocytic tumors before surgeryDear Editors,Keratoacanthoma (KA) and cutaneous squamous cell carci-noma (CSCC) may adopt an identical crateriform morpho-logy. Nowadays, the debate about whether KA is a distinct entity, or a low-grade variant of cutaneous squamous cell carcinoma (CSCC) still persists. Since CSCC is a more ag-gressive neoplasm, misdiagnosing crateriform lesions may have a negative impact on the patient's prognosis. Evaluating a partial biopsy is extremely challenging to confidently dis-tinguish KA from CSCC [1]. No distinctive gene expression profiles have been identified and no pathognomonic criteria to unequivocally differentiate between KA and CSCC exist [2]. Consequently, the surgical approach remains the gold standard in the management of crateriform tumors, especi-ally those arising on the face.

Background Reconstruction of large auricular defects with full-thickness skin grafts (FTSG) is a commonly reported option, but less attention has focused on the advantages and indications of using split-thickness skin grafts (STSG) in the ear. Objective We sought to report our experience using STSG for repair of defects located on the auricular concave surfaces, highlighting the utility of choosing the adjacent hairy skin as donor site. Methods We performed a retrospective review of all Mohs micrographic defects on the auricular concave surfaces repaired with STSG obtained from the adjacent hairy skin, between January 2017 and July 2018 at our institution. Results A total of 16 patients with defects on the auricular concavities resulting from removal of non-melanoma skin cancer were reconstructed with STSG taken from the adjacent hairy skin. Only one patient experienced partial graft failure and no other complications were observed after 6-month follow-up. Conclusion Split-thickness skin grafts are suitable for reconstructing concave areas in the ear, providing good cosmetic results with a simple, cost-effective and easily reproducible technique. Choosing the adjacent hairy skin as a donor area shortens the operative and postoperative time, and allows the procedure to be performed in a single surgical field.

Background: The clinical and pathological features of primary melanoma are not sufficiently sensitive to accurately predict which patients are at a greater risk of relapse. Recently, a 31-gene expression profile (DecisionDx-Melanoma) test has shown promising results. Objectives: To evaluate the early prognostic performance of a genetic signature in a multicentre prospectively evaluated cohort. Methods: Inclusion of patients with AJCC stages IB and II conducted between April 2015 and December 2016. All patients were followed up prospectively to assess their risk of relapse. Prognostic performance of this test was evaluated individually and later combined with the AJCC staging system. Prognostic accuracy of disease-free survival was determined using Kaplan-Meier curves and Cox regression analysis. Results of the gene expression profile test were designated as Class 1 (low risk) and Class 2 (high risk). Results: Median follow-up time was 26 months (IQR 22-30). The gene expression profile test was performed with 86 patients; seven had developed metastasis (8.1%) and all of them were in the Class 2 group, representing 21.2% of this group. Gene expression profile was an independent prognostic factor for relapse as indicated by multivariate Cox regression analysis, adjusted for AJCC stages and age. Conclusions: This prospective multicentre cohort study, performed in a Spanish Caucasian cohort, shows that this 31-gene expression profile test could correctly identify patients at early AJCC stages who are at greater risk of relapse. We believe that gene expression profile in combination with the AJCC staging system could well improve the detection of patients who need intensive surveillance and optimize follow-up strategies.

FAT1, which encodes a protocadherin, is one of the most frequently mutated genes in human cancers1-5. However, the role and the molecular mechanisms by which FAT1 mutations control tumour initiation and progression are poorly understood. Here, using mouse models of skin squamous cell carcinoma and lung tumours, we found that deletion of Fat1 accelerates tumour initiation and malignant progression and promotes a hybrid epithelial-to-mesenchymal transition (EMT) phenotype. We also found this hybrid EMT state in FAT1-mutated human squamous cell carcinomas. Skin squamous cell carcinomas in which Fat1 was deleted presented increased tumour stemness and spontaneous metastasis. We performed transcriptional and chromatin profiling combined with proteomic analyses and mechanistic studies, which revealed that loss of function of FAT1 activates a CAMK2-CD44-SRC axis that promotes YAP1 nuclear translocation and ZEB1 expression that stimulates the mesenchymal state. This loss of function also inactivates EZH2, promoting SOX2 expression, which sustains the epithelial state. Our comprehensive analysis identified drug resistance and vulnerabilities in FAT1-deficient tumours, which have important implications for cancer therapy. Our studies reveal that, in mouse and human squamous cell carcinoma, loss of function of FAT1 promotes tumour initiation, progression, invasiveness, stemness and metastasis through the induction of a hybrid EMT state., info:eu-repo/semantics/published

Characterization of patients, surgery procedures and the risk factors for dermatofibrosarcoma protuberans (DFSP) recurrences is poorly defined. In this study, we aimed to describe the demographics, tumor characteristics and interventions of DFSP treated with Mohs micrographic surgery (MSS) to determine the rate and risk factors for recurrence. Data were collected from REGESMOHS, a nationwide prospective cohort study of patients treated with MMS in Spain. From July 2013 to February 2020, 163 patients with DFSP who underwent MMS were included. DFSP was mostly located on trunk and extremities. Recurrent tumors had deeper tumor invasion and required higher number of MMS stages. Paraffin MMS was the most frequently used technique. Overall recurrence rate was 0.97 cases/100 person-years (95% IC = 0.36-2.57). No differences were found in epidemiological, tumor, surgery characteristics or surgical technique (frozen or paraffin MMS [p = 0.6641]) in terms of recurrence. Median follow-up time was 28.6 months with 414 patient-years of follow-up. In conclusion, we found an overall low recurrence rate of DFSP treated with MMS. None of the studied risk factors, including MMS techniques, was associated with higher risk for recurrence.

©. This manuscript version is made available under the CC-BY-SA 4.0 license http://creativecommons.org/licenses/by-sa/4.0/ This document is the Published/ Accepted Manuscript version of a Published Work that appeared in final form in [Humanitas]. To access the final edited and published work see[https://orcid.org/0000-0002-5426-3848] The geographer Strabo, commenting on the Homeric term “barbarophōnoi”, upholds the onomatopoeic origin of the term barbaros and outlines an history of its usage, which goes from the meaning of “speak roughly” to the one of “mispronunciation” of Greek (Geog. 14.2.28). In order to interpret the passage, pertinent texts from the medical and acoustic-musical are discussed. It is concluded that Strabo is familiar with the ideas about voice and language from the Greek tradition, which lead him to a definition of barbaros based, mainly, on a linguistic criterion.

En Almagesto 1.1, Claudio Ptolomeo presenta la división clásica de la filosofía en teoría y práctica, apoyándose en la tradición peripatética pero con elementos diversos en su expresión. En esta división, Ptolomeo privilegia el ámbito teórico y defiende el estudio de las matemáticas como la disciplina que conlleva una mejor predisposición del alma hacia la belleza y las virtudes éticas. En el análisis del pasaje del proemio, se compara el tratamiento ptolemaico de la cuestión con los de Arquitas, Alcínoo y otros autores., In the Almagest 1.1, Claudius Ptolemy presents the classical division of philosophy into theory and practice, based on the Peripatetic tradition with different elements in its expression. In this division, Ptolemy privileges the theoretical realm and defends the study of mathematics as a discipline that entails a better predisposition of the soul towards beauty and ethical virtues. In the analysis of the preface, Ptolemy’s treatment of the issue is compared to those of Archytas, Alcinous and other authors., Instituto de Investigaciones en Humanidades y Ciencias Sociales

Background The use of Mohs micrographic surgery (MMS) for rare cutaneous tumors is poorly defined. We aim to describe the demographics, tumor presentation and topography, surgery characteristics and complications of MMS for rare cutaneous tumors in a national registry. Methods Prospective cohort study of patients treated with MMS in Spain between July 2013 and June 2018. The inclusion criteria were patients with cutaneous tumors with final diagnosis different from basal cell carcinoma, squamous cell carcinoma, dermatofibrosarcoma protuberans, or any kind of melanoma. Results Five thousand and ninety patients were recorded in the registry, from which only 73 tumors (1.4%) fulfilled the inclusion criteria: atypical fibroxanthoma (18), microcystic adnexal carcinoma (10), extramammary Paget's disease (7), Merkel cell carcinoma (5), dermatofibroma (4), trichilemmal carcinoma (4), desmoplastic trichoepithelioma (4), sebaceous carcinoma (3), leiomyosarcoma (2), porocarcinoma (2), angiosarcoma (2), trichoblastoma (1), superficial acral fibromyxoma (1), and others (10). No intra-surgery morbidity was registered. Postsurgery complications appeared in six patients (9%) and were considered mild. Median follow-up time was 0.9 years during which three Merkel cell carcinomas, one angiosarcoma, one microcystic adnexal carcinoma, and four others recurred (12.3%). Conclusion This national registry shows that rare cutaneous tumors represent a negligible part of the total MMS performed in our country with a low complication rate.

Simple Summary Many people with skin cancer will have their cancer come back. The 31-gene expression profile (31-GEP) test can help predict if a cancer has a low (Class 1) or high (Class 2) chance of returning. This study looked at 86 patients with early skin cancer to see how well the 31-GEP test predicted if their cancer would return. None of the patients with a Class 1 GEP result had their cancer return within 3 years, but one-fourth of patients with a Class 2 result did. This study showed that the 31-GEP test can help predict if a patient's skin cancer will return. Accurate risk prediction can help doctors make better treatment plans for patients with skin cancer. Background: Fifteen to forty percent of patients with localized cutaneous melanoma (CM) (stages I-II) will experience disease relapse. The 31-gene expression profile (31-GEP) uses gene expression data from the primary tumor in conjunction with clinicopathologic features to refine patient prognosis. The study's objective was to evaluate 31-GEP risk stratification for disease-free survival (DFS) in a previously published cohort with longer follow-up. Methods: Patients with stage IB-II CM (n = 86) were prospectively tested with the 31-GEP. Follow-up time increased from 2.2 to 3.9 years. Patient outcomes were compared using Kaplan-Meier and Cox regression analysis. Results: A Class 2B result was a significant predictor of 3-year DFS (hazard ratio (HR) 8.4, p = 0.008) in univariate analysis. The 31-GEP significantly stratified patients by risk of relapse (p = 0.005). A Class 2B result was associated with a lower 3-year DFS (75.0%) than a Class 1A result (100%). The 31-GEP had a high sensitivity (77.8%) and negative predictive value (95.0%). Conclusions: The 31-GEP is a significant predictor of disease relapse in patients with stage IB-II melanoma and accurately stratified patients by risk of relapse.

Recent publication of the results of clinical trials in which lymph node dissection was not associated with any survival benefit in patients with sentinel node metastasis makes it necessary to reconsider the treatment of patients with melanoma. This article provides an update on the available evidence on the diverse factors (routes of metastatic spread, predictors, adjuvant therapy, etc.) that must be considered when treating patients with sentinel node-positive melanoma. The authors propose a decision-making algorithm for use in this clinical setting. The current evidence no longer supports lymph node dissection in patients with low-risk sentinel node metastasis (sentinel node tumor load ≤ 1 mm).

Resumen La reciente publicacion de los resultados de ensayos clinicos en los que la diseccion ganglionar no ha demostrado beneficio de supervivencia en pacientes con metastasis en el ganglio centinela plantea la necesidad de modificar el tratamiento del paciente con melanoma. El presente trabajo aporta una actualizacion de la evidencia sobre diferentes aspectos necesarios (vias de progresion metastasica, factores predictores, tratamiento adyuvante, etc.) para la toma de decisiones en el paciente con melanoma y metastasis en el ganglio centinela y plantea un algoritmo de toma de decisiones para este escenario clinico. La evidencia actualmente disponible respalda el abandono de la diseccion ganglionar en aquellos pacientes con metastasis de bajo riesgo en el ganglio centinela (carga tumoral en el ganglio centinela inferior o igual a 1 mm).