Examinando por Autor "Pinedo Moraleda, Fernando"

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Combined in vivo reflectance confocal microscopy and digital dermoscopy for follow up of patients at high risk of malignant melanoma: A prospective case series study
(Wiley, 2017) Floristan Muruzabal, Uxua; Gamo Villegas, Reyes; Pampin Franco, Ana; Pinedo Moraleda, Fernando; Perez Fernandez, Elia; Lopez Estebaranz, Jose
Digital dermoscopy (DD) follow up is a useful strategy for monitoring patients at high risk of melanoma. Reflec tance confocal microscopy (RCM) is a valuable second-level examination after dermoscopy for the evaluation of difficult to diagnose lesions. The aim of this study was to assess the value of RCM in routine DD monitoring of patients at high risk of melanoma. In this prospective study, performed over 22 months, changing melanocytic lesions were detected by DD and excised. RCM imaging was performed before surgical excision of all the lesions, and histopathology used as the gold standard diagnostic test. Eighty-seven lesions, including 11 thin melanomas, were studied. Dermoscopic evaluation at follow up revealed a significant association between melanoma and asymmetry in two axes (P = 0.035). Enlargement and other changes in structure or color did not significantly differ between nevi and melanomas. Widespread pagetoid cells, non-edged papillae, irregular and dishomogeneous junctional clusters, and sheet-like structures were significantly associated with malignancy (P < 0.001). RCM allowed accurate diagnosis of melanoma in 10 of 11 cases (90.9%). The remaining case was classified as a dys plastic nevus. Forty-six lesions (52.8%) in which RCM revealed no atypia were deemed unnecessarily removed. This study was limited by sample size. In conclusion, combined DD and RCM facilitates the recognition of thin malignant melanomas and reduces unnecessary excisions.
Pityriasis rubra pilaris successfully treated with infliximab
(ACTA DERMATO-VENEREOLOGICA, 2007) Ruiz Genao, Diana; López Estebaranz, Jose Luis; Naz Villalba, Elena; Gamo Villegas, Reyes; Calzado Villarreal, Leticia; Pinedo Moraleda, Fernando
En el trabajo publicado en Acta Derm Venerolologica se describe la pitiriasis rubra pilaris (PRP) y su manejo aportándose por primera vez utilización de terapia biológica en esta patología. La PRP es una enfermedad cutánea poco común y crónica caracterizada por erupciones rojas, escamosas y a menudo con pápulas en la piel. Se clasifica en varias formas clínicas, siendo la forma clásica la más común, aunque también existen variantes más raras. La etiología exacta de la PRP no está completamente comprendida, pero se cree que implica una combinación de factores genéticos y ambientales, así como disfunciones del sistema inmunológico.
Validity of clinical diagnosis in dermatology
(JOHN LIBBEY EUROTEXT LTD, 2011) Rodriguez Caravaca, Gil; Mosquera Gonzalez, Margarita; Villar del Campo, M Concepción; López Estebaranz, Jose Luis; Pinedo Moraleda, Fernando; De la Torre Escuredo, Basilio
Objective: We evaluated the accuracy of the clinical diagnostic process performed by dermatologists. Material and Methods: We conducted a cross-sectional study, based on a retrospective search of data at a dermatology outpatient department. Fifteen skin diseases were selected. A group of patients with those diseases at their first outpatient visit and a further histopathological study were included. The accuracy of any given clinical diagnosis was studied taking the histopathological diagnosis as the gold standard. Validity indices were calculated. Results: We studied 2188 patients. Skin diseases were more prevalent among women (P < 0.05). While the clinical diagnostic process displayed a high level of validity in melanocytic naevi and basal cell carcinoma, a poor level was nevertheless observed for Bowen’s disease (sensitivity 22.8%, specificity 96.5%). The most frequent sites of appearance of dermatological problems were face and trunk. Conclusions: Evaluation of diagnosis in pathologies having an available “gold standard” enables the accuracy of clinical diagnoses to be verified. The validity of clinical diagnosis was high.