Practical Dermoscopy
Progressive Orange Lesions on the Scalp
Lesiones anaranjadas de aparición progresiva en cuero cabelludo
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Gonzalez-Delgado, P. Cordero-Romero, J.M. Martín" "autores" => array:3 [ 0 => array:4 [ "nombre" => "V.A." "apellidos" => "Gonzalez-Delgado" "email" => array:1 [ 0 => "victorgd1989@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "P." "apellidos" => "Cordero-Romero" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "J.M." "apellidos" => "Martín" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital Clínico Universitario de Valencia, Valencia, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Departamento de Medicina, Universidad de Valencia, Valencia, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Lesiones anaranjadas de aparición progresiva en cuero cabelludo" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1016 "Ancho" => 800 "Tamanyo" => 130858 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Orange nodule with an erythematous base on the scalp.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Case Presentation</span><p id="par0005" class="elsevierStylePara elsevierViewall">A 66-year-old man presented with orange, noninfiltrated, fibrous papulonodular lesions that had grown progressively on the head, neck, and upper trunk (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">What Is Your Diagnosis?</p><p id="par0015" class="elsevierStylePara elsevierViewall">Cutaneous metastasis of pancreatic adenocarcinoma.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Comment</span><p id="par0020" class="elsevierStylePara elsevierViewall">Dermoscopy showed an orange background and centripetally arranged, tortuous, branched vascularization (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). Analysis of one of the lesions revealed dermal proliferation of epithelial cells, which were either isolated or formed small nests and trabeculae. Immunohistochemistry revealed positive staining for CK7 and negative staining for CK20 and CDX2. Taken together, the findings were compatible with cutaneous metastasis of pancreatic adenocarcinoma.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">An orange background on dermoscopy should raise suspicion of histiocytic aggregates, a finding associated with a broad spectrum of lesions, including xanthoma, xanthogranuloma, sarcoidosis, lupus vulgaris, and leishmaniasis. Less frequently, this finding is found in other lesions, such as cylindroma.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Cutaneous metastasis is a relatively infrequent finding (0.6–9% of tumors), the presence of which primarily depends on the stage and histological subtype of the primary tumor. The clinical presentation is highly variable. In some cases cutaneous metastasis can mimic angiomas or cysts, among other entities.<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">2,3</span></a> The most common dermoscopic finding (in up to 88% of cases) is the presence of vascular structures,<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a> which are predominantly serpentine, irregular, punctate, corkscrew-like, or branched, are usually small in caliber, and may disappear when pressed.<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">2–4</span></a> In a series published by Chernoff and coworkers,<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a> the most frequent finding was serpentine vascularization, followed by arboriform vascularization, although irregular polymorphic vascularization, as described in our patient, was also very frequent (59% of cases).</p><p id="par0035" class="elsevierStylePara elsevierViewall">Dermoscopy of cutaneous metastasis generally reveals a pink background and an absence of structures,<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">2–4</span></a> although pigmented areas are observed in some cases. These pigmented structures may have a melanocytic pattern (e.g. brownish lines or blue-gray blood cells),<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a> as described in metastatic breast carcinoma.<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">2,5</span></a> Cutaneous metastasis can also mimic other pigmented lesions, including dermatofibroma.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">In conclusion, we describe an atypical case of cutaneous metastasis of pancreatic cancer characterized by an orange background, a finding not previously associated with this type of lesion.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflicts of Interest</span><p id="par0045" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Case Presentation" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Comment" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Conflicts of Interest" ] 3 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Gonazlez-Delgado VA, Cordero-Romero P, Martín JM. Lesiones anaranjadas de aparición progresiva en cuero cabelludo. Actas Dermosifiliogr. 2020;111:317–318.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1016 "Ancho" => 800 "Tamanyo" => 130858 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Orange nodule with an erythematous base on the scalp.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 605 "Ancho" => 1500 "Tamanyo" => 104844 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Dermoscopy reveals an orange background without structures and with irregular, centripetally arranged vascularization in 2 lesions (A, B) and an eroded area in 1 lesion (A).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0035" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Yellow and orange in cutaneous lesions: clinical and dermoscopic data" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 13 | 18 | 31 |
| 2024 October | 107 | 76 | 183 |
| 2024 September | 122 | 67 | 189 |
| 2024 August | 115 | 91 | 206 |
| 2024 July | 81 | 41 | 122 |
| 2024 June | 131 | 40 | 171 |
| 2024 May | 77 | 49 | 126 |
| 2024 April | 71 | 37 | 108 |
| 2024 March | 165 | 42 | 207 |
| 2024 February | 211 | 42 | 253 |
| 2024 January | 77 | 37 | 114 |
| 2023 December | 65 | 25 | 90 |
| 2023 November | 105 | 45 | 150 |
| 2023 October | 77 | 43 | 120 |
| 2023 September | 64 | 37 | 101 |
| 2023 August | 61 | 19 | 80 |
| 2023 July | 97 | 30 | 127 |
| 2023 June | 92 | 30 | 122 |
| 2023 May | 89 | 21 | 110 |
| 2023 April | 75 | 19 | 94 |
| 2023 March | 110 | 27 | 137 |
| 2023 February | 52 | 27 | 79 |
| 2023 January | 48 | 15 | 63 |
| 2022 December | 69 | 32 | 101 |
| 2022 November | 37 | 33 | 70 |
| 2022 October | 34 | 22 | 56 |
| 2022 September | 42 | 30 | 72 |
| 2022 August | 42 | 50 | 92 |
| 2022 July | 30 | 39 | 69 |
| 2022 June | 29 | 34 | 63 |
| 2022 May | 80 | 47 | 127 |
| 2022 April | 56 | 30 | 86 |
| 2022 March | 66 | 58 | 124 |
| 2022 February | 39 | 32 | 71 |
| 2022 January | 65 | 39 | 104 |
| 2021 December | 56 | 32 | 88 |
| 2021 November | 51 | 43 | 94 |
| 2021 October | 52 | 57 | 109 |
| 2021 September | 45 | 51 | 96 |
| 2021 August | 24 | 37 | 61 |
| 2021 July | 34 | 28 | 62 |
| 2021 June | 29 | 26 | 55 |
| 2021 May | 33 | 37 | 70 |
| 2021 April | 96 | 90 | 186 |
| 2021 March | 49 | 27 | 76 |
| 2021 February | 55 | 32 | 87 |
| 2021 January | 24 | 20 | 44 |
| 2020 December | 26 | 27 | 53 |
| 2020 November | 28 | 17 | 45 |
| 2020 October | 38 | 15 | 53 |
| 2020 September | 34 | 16 | 50 |
| 2020 August | 51 | 17 | 68 |
| 2020 July | 70 | 41 | 111 |
| 2020 June | 73 | 34 | 107 |
| 2020 May | 27 | 17 | 44 |
| 2020 April | 4 | 2 | 6 |
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