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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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 13 | 18 | 31 |
| 2024 Octubre | 107 | 76 | 183 |
| 2024 Septiembre | 122 | 67 | 189 |
| 2024 Agosto | 115 | 91 | 206 |
| 2024 Julio | 81 | 41 | 122 |
| 2024 Junio | 131 | 40 | 171 |
| 2024 Mayo | 77 | 49 | 126 |
| 2024 Abril | 71 | 37 | 108 |
| 2024 Marzo | 165 | 42 | 207 |
| 2024 Febrero | 211 | 42 | 253 |
| 2024 Enero | 77 | 37 | 114 |
| 2023 Diciembre | 65 | 25 | 90 |
| 2023 Noviembre | 105 | 45 | 150 |
| 2023 Octubre | 77 | 43 | 120 |
| 2023 Septiembre | 64 | 37 | 101 |
| 2023 Agosto | 61 | 19 | 80 |
| 2023 Julio | 97 | 30 | 127 |
| 2023 Junio | 92 | 30 | 122 |
| 2023 Mayo | 89 | 21 | 110 |
| 2023 Abril | 75 | 19 | 94 |
| 2023 Marzo | 110 | 27 | 137 |
| 2023 Febrero | 52 | 27 | 79 |
| 2023 Enero | 48 | 15 | 63 |
| 2022 Diciembre | 69 | 32 | 101 |
| 2022 Noviembre | 37 | 33 | 70 |
| 2022 Octubre | 34 | 22 | 56 |
| 2022 Septiembre | 42 | 30 | 72 |
| 2022 Agosto | 42 | 50 | 92 |
| 2022 Julio | 30 | 39 | 69 |
| 2022 Junio | 29 | 34 | 63 |
| 2022 Mayo | 80 | 47 | 127 |
| 2022 Abril | 56 | 30 | 86 |
| 2022 Marzo | 66 | 58 | 124 |
| 2022 Febrero | 39 | 32 | 71 |
| 2022 Enero | 65 | 39 | 104 |
| 2021 Diciembre | 56 | 32 | 88 |
| 2021 Noviembre | 51 | 43 | 94 |
| 2021 Octubre | 52 | 57 | 109 |
| 2021 Septiembre | 45 | 51 | 96 |
| 2021 Agosto | 24 | 37 | 61 |
| 2021 Julio | 34 | 28 | 62 |
| 2021 Junio | 29 | 26 | 55 |
| 2021 Mayo | 33 | 37 | 70 |
| 2021 Abril | 96 | 90 | 186 |
| 2021 Marzo | 49 | 27 | 76 |
| 2021 Febrero | 55 | 32 | 87 |
| 2021 Enero | 24 | 20 | 44 |
| 2020 Diciembre | 26 | 27 | 53 |
| 2020 Noviembre | 28 | 17 | 45 |
| 2020 Octubre | 38 | 15 | 53 |
| 2020 Septiembre | 34 | 16 | 50 |
| 2020 Agosto | 51 | 17 | 68 |
| 2020 Julio | 70 | 41 | 111 |
| 2020 Junio | 73 | 34 | 107 |
| 2020 Mayo | 27 | 17 | 44 |
| 2020 Abril | 4 | 2 | 6 |
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