Practical Dermoscopy
Pigmented Scalp Macule
Mácula pigmentada en cuero cabelludo
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Martin-Gorgojo, A. Comunión-Artieda, A. Guzmán-Sierra" "autores" => array:3 [ 0 => array:4 [ "nombre" => "A." "apellidos" => "Martin-Gorgojo" "email" => array:1 [ 0 => "alejandromartingorgojo@aedv.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "A." "apellidos" => "Comunión-Artieda" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "A." "apellidos" => "Guzmán-Sierra" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología - ITS, Ayuntamiento de Madrid, Sección de Especialidades Médicas, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, Ayuntamiento de Madrid, Sección de Especialidades Médicas, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Mácula pigmentada en cuero cabelludo" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1007 "Ancho" => 1000 "Tamanyo" => 221206 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Histology images of the lesion.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Case Description</span><p id="par0005" class="elsevierStylePara elsevierViewall">A 54-year-old man visited our department for assessment of a skin lesion in the parietal area, which had been growing gradually since it was detected the previous year. The lesion was a dark-brown and black macule with irregular borders, measuring 15 mm at its largest diameter (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">What is your diagnosis?</span><p id="par0010" class="elsevierStylePara elsevierViewall">Pigmented Bowen disease (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Comment</span><p id="par0015" class="elsevierStylePara elsevierViewall">Dermatoscopy revealed dark-brown and black pigmented areas with a granular appearance, sparing the follicular orifices, together with a pigmented pseudonetwork. No hyperkeratotic areas, scabs, or vascular structures were observed. The surrounding skin presented clear signs of photoaging. An excision biopsy of the lesion confirmed the diagnosis of pigmented Bowen disease (with clearly atypical cytology, with abnormal anisokaryosis and mitosis, as well as lack of involvement of the acrosyringia) with a central area showing a lichenoid infiltrate, with intense surrounding solar elastosis (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>).</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Bowen disease is defined as an intraepidermal carcinoma. It occurs more frequently in women over 60 years of age and is located in regions subject to chronic exposure to sunlight. In overall terms, it may give rise to squamous cell carcinoma in between 3% and 5% of cases.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> The pigmented variety is considered to be rare (less than 2%, according to a series of more than 400 cases<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>). Different dermoscopic findings have been reported for this entity, including whitish desquamation, black or brown scabs, areas that appear to show regression, pigment (brown or greyish-blue in granular distribution, imitating remains of an atypical network, like globules or irregularly distributed areas of pigment), hypopigmented areas, variable vascular pattern (predominantly glomerular, or atypical—punctate, linear, arboriform, or forked).<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3–5</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The clinical and dermatologic presentation of Bowen disease is highly variable. They can often be difficult to differentiate from those of seborrheic keratosis, actinic keratosis, or even the pigmented variety of melanocytic lesions.</p><p id="par0030" class="elsevierStylePara elsevierViewall">We report a case of Bowen disease with an unusual clinical and dermoscopic presentation. Although epiluminescence provided orientation regarding the nature of the lesion and made it possible to consider a differential diagnosis that included pigmented actinic keratosis as the most probable option, the biopsy for diagnosis by means of histology is essential.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Case Description" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "What is your diagnosis?" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Comment" ] 3 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-03-20" "fechaAceptado" => "2019-04-18" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Martin-Gorgojo A, Comunión-Artieda A, Guzmán-Sierra A. Mácula pigmentada en cuero cabelludo. Actas Dermosifiliogr. 2021;112:61–62.</p>" ] ] "multimedia" => array:3 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 543 "Ancho" => 905 "Tamanyo" => 129694 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Clinical presentation of the parietal lesion.</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1090 "Ancho" => 905 "Tamanyo" => 294540 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A, Dermoscopic image of the upper pole of the lesion. B, Lower pole.</p>" ] ] 2 => array:8 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1007 "Ancho" => 1000 "Tamanyo" => 221206 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Histology images of the lesion.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Precancerous skin lesions" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "C. Ferrandiz" 1 => "J. Malvehy" 2 => "C. Guillen" 3 => "C. Ferrandiz-Pulido" 4 => "M. Fernandez-Figueras" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ad.2016.07.016" "Revista" => array:6 [ "tituloSerie" => "Actas Dermosifiliogr." "fecha" => "2017" "volumen" => "108" "paginaInicial" => "31" "paginaFinal" => "41" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27658688" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pigmented Bowen’s disease and review of 420 Bowen’s disease lesions" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "G. Ragi" 1 => "M.S. Turner" 2 => "L.E. Klein" 3 => "H.L. Stoll Jr" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Dermatol Surg." 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"fecha" => "2008" "volumen" => "99" "paginaInicial" => "419" "paginaFinal" => "420" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18501179" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000011200000001/v1_202101161046/S1578219020303802/v1_202101161046/en/main.assets" "Apartado" => array:4 [ "identificador" => "19289" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Practical Dermoscopy" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000011200000001/v1_202101161046/S1578219020303802/v1_202101161046/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219020303802?idApp=UINPBA000044" ]
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| 2024 Octubre | 83 | 45 | 128 |
| 2024 Septiembre | 89 | 27 | 116 |
| 2024 Agosto | 106 | 75 | 181 |
| 2024 Julio | 80 | 30 | 110 |
| 2024 Junio | 80 | 51 | 131 |
| 2024 Mayo | 80 | 37 | 117 |
| 2024 Abril | 74 | 28 | 102 |
| 2024 Marzo | 68 | 39 | 107 |
| 2024 Febrero | 77 | 35 | 112 |
| 2024 Enero | 79 | 34 | 113 |
| 2023 Diciembre | 72 | 25 | 97 |
| 2023 Noviembre | 95 | 24 | 119 |
| 2023 Octubre | 77 | 20 | 97 |
| 2023 Septiembre | 52 | 31 | 83 |
| 2023 Agosto | 47 | 14 | 61 |
| 2023 Julio | 83 | 34 | 117 |
| 2023 Junio | 77 | 19 | 96 |
| 2023 Mayo | 67 | 21 | 88 |
| 2023 Abril | 91 | 26 | 117 |
| 2023 Marzo | 75 | 33 | 108 |
| 2023 Febrero | 56 | 35 | 91 |
| 2023 Enero | 56 | 39 | 95 |
| 2022 Diciembre | 52 | 44 | 96 |
| 2022 Noviembre | 23 | 29 | 52 |
| 2022 Octubre | 28 | 21 | 49 |
| 2022 Septiembre | 29 | 40 | 69 |
| 2022 Agosto | 23 | 33 | 56 |
| 2022 Julio | 20 | 43 | 63 |
| 2022 Junio | 29 | 39 | 68 |
| 2022 Mayo | 118 | 66 | 184 |
| 2022 Abril | 90 | 40 | 130 |
| 2022 Marzo | 102 | 73 | 175 |
| 2022 Febrero | 78 | 41 | 119 |
| 2022 Enero | 109 | 55 | 164 |
| 2021 Diciembre | 130 | 59 | 189 |
| 2021 Noviembre | 97 | 62 | 159 |
| 2021 Octubre | 92 | 84 | 176 |
| 2021 Septiembre | 86 | 59 | 145 |
| 2021 Agosto | 76 | 63 | 139 |
| 2021 Julio | 72 | 52 | 124 |
| 2021 Junio | 64 | 52 | 116 |
| 2021 Mayo | 87 | 67 | 154 |
| 2021 Abril | 249 | 116 | 365 |
| 2021 Marzo | 139 | 58 | 197 |
| 2021 Febrero | 107 | 62 | 169 |
| 2021 Enero | 65 | 35 | 100 |
| 2020 Diciembre | 25 | 14 | 39 |
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