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"apellidos" => "Belmar-Flores" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731012002992" "doi" => "10.1016/j.ad.2012.02.016" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731012002992?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219013000127?idApp=UINPBA000044" "url" => "/15782190/0000010400000002/v1_201304241618/S1578219013000127/v1_201304241618/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and research letter</span>" "titulo" => "Papular Acantholytic Dermatosis in the Genito-Crural Region: A Localized Form of Darier Disease or Hailey-Hailey Disease?" 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"apellidos" => "Catón-Santarén" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "R." "apellidos" => "Soloeta-Arechavala" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital Santiago, Vitoria, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, Hospital Santiago, Vitoria, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Dermatosis acantolítica papular del área genitocrural: ¿forma localizada de Darier o Hailey-Hailey?" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1250 "Ancho" => 1667 "Tamanyo" => 329066 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Mild epidermal hyperplasia with hyperkeratosis, parakeratosis, acanthosis, and focal acantholysis with suprabasal clefts. Hematoxylin-eosin, original magnification ×40.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">To the Editor</span>:</p><p id="par0905" class="elsevierStylePara elsevierViewall">Papular acantholytic dyskeratosis (PAD) is a skin condition that typically presents as multiple, small whitish papular lesions that may coalesce into plaques; more rarely it is seen as solitary papules. Involvement of the vulva was first described by Chorzelski et al.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> in 1984; this form is most frequently observed on the labia majora of middle-aged women with no familial history of the disease. Cases of PAD of the penis, anal canal, and inguinal skin folds have also been reported.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2–4</span></a> The condition is usually asymptomatic, although intense pruritus may develop. Histopathological changes include acantholysis with variable degrees of dyskeratosis, and direct and indirect immunofluorescence have been negative in almost all cases studied.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">We present a 58-year-old woman with no past medical history or family history of interest. She was referred to the dermatology department for pruritic lesions that had developed 2 months earlier in the genital region. She did not report any contact allergies or at-risk sexual activities. Physical examination revealed multiple, shiny whitish papules of 2 to 3<span class="elsevierStyleHsp" style=""></span>mm in diameter in a cobblestone pattern on the medial aspect of the thigh, on the labia majora, on the perineum, and in the perianal region (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). There were no similar lesions on other areas of the skin or mucosas and no nail changes. Laboratory tests (routine blood tests; serology for hepatitis B and C viruses, human immunodeficiency virus, and antinuclear, antibasement membrane, and antidesmoglein 1 and 3 antibodies; and cultures for bacteria and fungi) were normal or negative. Biopsy findings included mild epidermal hyperplasia with hyperkeratosis, parakeratosis, acanthosis, focal acantholysis with suprabasal clefts (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>), and dyskeratosis with corps ronds and grains (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>); a mild perivascular mononuclear inflammatory infiltrate was present in the papillary dermis. Direct immunofluorescence with immunoglobulin (Ig) M, IgG, IgA, complement components C3 and C1q, and fibrinogen antisera was negative. With a diagnosis of PAD of the genitocrural region, treatment was started with topical clobetasol, which produced an improvement in the pruritus, though the lesions persisted.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">The main differential diagnosis of PAD is with Hailey-Hailey disease and Darier disease, which are hereditary genodermatoses in which loss of function mutations of the <span class="elsevierStyleItalic">ATP2C1</span> and <span class="elsevierStyleItalic">ATP2A2</span> calcium pump genes, respectively, have been reported in peripheral blood DNA samples. Darier disease, with very similar histopathological findings to those observed in our patient, usually develops in adolescence and is characterized by verrucous papules and plaques in seborrheic regions, with punctate palmoplantar keratoderma, verrucous papules on the dorsum of the hands and the feet, and characteristic nail changes. Hailey-Hailey disease can also show histological similarities with reported cases of PAD but, in contrast to Darier disease, there is a predominance of acantholysis and the dyskeratosis is very mild or absent; the disease typically presents in young adults, with painful erosions in the skin folds. Transient acantholytic dermatosis (Grover disease) should also be included in the differential diagnosis because of its histopathological similarities with PAD, although it typically presents in adults as transient confluent pruritic papules on the trunk.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The individual responses of patients with PAD to treatment with corticosteroids, topical retinoids, cryotherapy, electrocoagulation, or surgery have been reported as variable.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> In a recent study, laser therapy achieved lasting symptomatic improvement.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The issues we have discussed regarding the classification of PAD as a separate entity from Darier or Hailey-Hailey disease arise because there have been reports of cases of Darier and Hailey-Hailey disease localized to the genitocrural region that have been histologically similar to PAD.<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8,9</span></a> The fact that Hailey-Hailey disease can show a variable degree of penetration and can present at different ages leads to even greater confusion. Two recent publications have reported a mutation in <span class="elsevierStyleItalic">ATP2C1</span> in 3 cases of PAD of the genitocrural area, suggesting that at least some cases of PAD could be localized variants of Hailey-Hailey disease.<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4,10</span></a> It was not possible to perform a genetic study in our patient.</p><p id="par0030" class="elsevierStylePara elsevierViewall">In conclusion, we believe that PAD has not yet been fully defined, and that its final characterization will require genetic study to exclude localized Darier or Hailey-Hailey disease, as there may be clinical and histopathological overlap.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Please cite this article as: Montis-Palos MC, et al. Dermatosis acantolítica papular del área genitocrural: ¿forma localizada de Darier o Hailey-Hailey? Actas Dermosifiliogr. 2013;104:170–2.</p>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1112 "Ancho" => 1667 "Tamanyo" => 145550 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Multiple, shiny whitish papules of 2 to 3<span class="elsevierStyleHsp" style=""></span>mm in diameter in a cobblestone pattern on the medial aspect of the thigh, on the labia majora, on the perineum, and in the perianal region.</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" => 1250 "Ancho" => 1667 "Tamanyo" => 329066 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Mild epidermal hyperplasia with hyperkeratosis, parakeratosis, acanthosis, and focal acantholysis with suprabasal clefts. Hematoxylin-eosin, original magnification ×40.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1250 "Ancho" => 1667 "Tamanyo" => 207804 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Dyskeratosis with corps ronds and grains. Hematoxylin-eosin, original magnification ×63.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Is papular acantholytic dyskeratosis of the vulva a new entity?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "T.P. 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año/Mes | Html | Total | |
---|---|---|---|
2024 Noviembre | 28 | 16 | 44 |
2024 Octubre | 143 | 47 | 190 |
2024 Septiembre | 154 | 36 | 190 |
2024 Agosto | 155 | 93 | 248 |
2024 Julio | 138 | 37 | 175 |
2024 Junio | 141 | 35 | 176 |
2024 Mayo | 114 | 51 | 165 |
2024 Abril | 100 | 27 | 127 |
2024 Marzo | 113 | 30 | 143 |
2024 Febrero | 99 | 37 | 136 |
2024 Enero | 105 | 41 | 146 |
2023 Diciembre | 98 | 27 | 125 |
2023 Noviembre | 103 | 37 | 140 |
2023 Octubre | 79 | 37 | 116 |
2023 Septiembre | 106 | 29 | 135 |
2023 Agosto | 86 | 22 | 108 |
2023 Julio | 83 | 45 | 128 |
2023 Junio | 69 | 29 | 98 |
2023 Mayo | 83 | 26 | 109 |
2023 Abril | 77 | 49 | 126 |
2023 Marzo | 91 | 45 | 136 |
2023 Febrero | 72 | 26 | 98 |
2023 Enero | 64 | 35 | 99 |
2022 Diciembre | 78 | 61 | 139 |
2022 Noviembre | 51 | 24 | 75 |
2022 Octubre | 46 | 36 | 82 |
2022 Septiembre | 32 | 42 | 74 |
2022 Agosto | 41 | 57 | 98 |
2022 Julio | 37 | 40 | 77 |
2022 Junio | 47 | 37 | 84 |
2022 Mayo | 87 | 52 | 139 |
2022 Abril | 96 | 44 | 140 |
2022 Marzo | 91 | 68 | 159 |
2022 Febrero | 55 | 55 | 110 |
2022 Enero | 87 | 60 | 147 |
2021 Diciembre | 55 | 73 | 128 |
2021 Noviembre | 88 | 71 | 159 |
2021 Octubre | 91 | 70 | 161 |
2021 Septiembre | 81 | 64 | 145 |
2021 Agosto | 83 | 54 | 137 |
2021 Julio | 43 | 38 | 81 |
2021 Junio | 52 | 59 | 111 |
2021 Mayo | 62 | 45 | 107 |
2021 Abril | 77 | 99 | 176 |
2021 Marzo | 76 | 43 | 119 |
2021 Febrero | 93 | 43 | 136 |
2021 Enero | 90 | 43 | 133 |
2020 Diciembre | 69 | 35 | 104 |
2020 Noviembre | 58 | 28 | 86 |
2020 Octubre | 57 | 28 | 85 |
2020 Septiembre | 46 | 16 | 62 |
2020 Agosto | 46 | 28 | 74 |
2020 Julio | 59 | 14 | 73 |
2020 Junio | 39 | 30 | 69 |
2020 Mayo | 35 | 27 | 62 |
2020 Abril | 42 | 34 | 76 |
2020 Marzo | 25 | 30 | 55 |
2020 Febrero | 16 | 9 | 25 |
2020 Enero | 4 | 11 | 15 |
2019 Diciembre | 8 | 10 | 18 |
2019 Noviembre | 2 | 9 | 11 |
2019 Octubre | 0 | 13 | 13 |
2019 Septiembre | 11 | 14 | 25 |
2019 Agosto | 5 | 5 | 10 |
2019 Julio | 5 | 28 | 33 |
2019 Junio | 4 | 48 | 52 |
2019 Mayo | 8 | 143 | 151 |
2019 Abril | 11 | 53 | 64 |
2019 Marzo | 1 | 24 | 25 |
2019 Febrero | 7 | 18 | 25 |
2019 Enero | 4 | 14 | 18 |
2018 Diciembre | 5 | 7 | 12 |
2018 Noviembre | 6 | 8 | 14 |
2018 Octubre | 2 | 6 | 8 |
2018 Septiembre | 10 | 5 | 15 |
2018 Agosto | 0 | 14 | 14 |
2018 Julio | 0 | 11 | 11 |
2018 Junio | 0 | 11 | 11 |
2018 Mayo | 0 | 4 | 4 |
2018 Abril | 0 | 7 | 7 |
2018 Marzo | 18 | 16 | 34 |
2018 Febrero | 82 | 20 | 102 |
2018 Enero | 97 | 23 | 120 |
2017 Diciembre | 108 | 17 | 125 |
2017 Noviembre | 79 | 21 | 100 |
2017 Octubre | 107 | 19 | 126 |
2017 Septiembre | 78 | 40 | 118 |
2017 Agosto | 78 | 26 | 104 |
2017 Julio | 103 | 22 | 125 |
2017 Junio | 93 | 28 | 121 |
2017 Mayo | 74 | 31 | 105 |
2017 Abril | 80 | 23 | 103 |
2017 Marzo | 71 | 25 | 96 |
2017 Febrero | 66 | 16 | 82 |
2017 Enero | 81 | 15 | 96 |
2016 Diciembre | 175 | 37 | 212 |
2016 Noviembre | 175 | 22 | 197 |
2016 Octubre | 188 | 17 | 205 |
2016 Septiembre | 259 | 30 | 289 |
2016 Agosto | 207 | 21 | 228 |
2016 Julio | 70 | 17 | 87 |
2016 Junio | 7 | 24 | 31 |
2016 Mayo | 5 | 18 | 23 |
2016 Abril | 4 | 3 | 7 |
2016 Marzo | 7 | 6 | 13 |
2016 Febrero | 8 | 14 | 22 |
2016 Enero | 8 | 20 | 28 |
2015 Diciembre | 11 | 1 | 12 |
2015 Noviembre | 10 | 1 | 11 |
2015 Octubre | 11 | 1 | 12 |
2015 Septiembre | 2 | 14 | 16 |
2015 Agosto | 9 | 4 | 13 |
2015 Julio | 273 | 24 | 297 |
2015 Junio | 252 | 14 | 266 |
2015 Mayo | 236 | 31 | 267 |
2015 Abril | 216 | 18 | 234 |
2015 Marzo | 241 | 21 | 262 |
2015 Febrero | 163 | 8 | 171 |
2015 Enero | 140 | 14 | 154 |
2014 Diciembre | 141 | 7 | 148 |
2014 Noviembre | 132 | 6 | 138 |
2014 Octubre | 125 | 8 | 133 |
2014 Septiembre | 84 | 4 | 88 |
2014 Agosto | 101 | 5 | 106 |
2014 Julio | 98 | 8 | 106 |
2014 Junio | 109 | 9 | 118 |
2014 Mayo | 100 | 8 | 108 |
2014 Abril | 113 | 7 | 120 |
2014 Marzo | 111 | 21 | 132 |
2014 Febrero | 95 | 16 | 111 |
2014 Enero | 69 | 11 | 80 |
2013 Diciembre | 64 | 12 | 76 |
2013 Noviembre | 21 | 13 | 34 |
2013 Octubre | 8 | 9 | 17 |
2013 Septiembre | 6 | 19 | 25 |
2013 Agosto | 7 | 39 | 46 |
2013 Julio | 11 | 19 | 30 |
2013 Junio | 3 | 33 | 36 |
2013 Mayo | 11 | 29 | 40 |
2013 Abril | 7 | 43 | 50 |
2013 Marzo | 8 | 19 | 27 |