Practical Dermoscopy
Millimetric Papule on the Antihelix Dermoscopically Constituted by Hairpin Vessels in a Radial Pattern
Pápula milimétrica en antehélix constituida dermatoscópicamente por corona de vasos en horquilla
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Destaca la presencia de al menos un infundíbulo hiperplásico con epitelio que remeda al de la vaina radicular externa del folículo piloso, con hipergranulosis y paraqueratosis, constituido por células claras monomorfas, con citoplasma eosinófilo pálido (por la presencia de glucógeno), de núcleo pequeño. A) Visión general. B) Tinción PAS en la que se pone de manifiesto el glucógeno de las células constituyentes de la neoplasia benigna. C) Imagen en detalle con correlación histológica-dermatoscópica de la paraqueratosis (*) y los vasos rodeando la lesión (∧).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. Martin-Gorgojo, F.J. Bru-Gorraiz, E. Pascual-Rodríguez" "autores" => array:3 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "Martin-Gorgojo" ] 1 => array:2 [ "nombre" => "F.J." "apellidos" => "Bru-Gorraiz" ] 2 => array:2 [ "nombre" => "E." 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"apellidos" => "Muñoz-Santos" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731021002039" "doi" => "10.1016/j.ad.2021.05.011" "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/S0001731021002039?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219021002407?idApp=UINPBA000044" "url" => "/15782190/0000011200000009/v1_202110091021/S1578219021002407/v1_202110091021/en/main.assets" ] "en" => array:16 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Practical Dermoscopy</span>" "titulo" => "Millimetric Papule on the Antihelix Dermoscopically Constituted by Hairpin Vessels in a Radial Pattern" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "837" "paginaFinal" => "838" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "A. Martin-Gorgojo, F.J. Bru-Gorraiz, E. Pascual-Rodríguez" "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" => "F.J." "apellidos" => "Bru-Gorraiz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "E." "apellidos" => "Pascual-Rodríguez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Sección de Especialidades Médicas, Servicio de ITS/Dermatología, Ayuntamiento de Madrid, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Sección de Especialidades Médicas, Servicio de Anatomía Patológica, Ayuntamiento de Madrid, 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" => "Pápula milimétrica en antehélix constituida dermatoscópicamente por corona de vasos en horquilla" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1110 "Ancho" => 2083 "Tamanyo" => 378613 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A, Clinical presentation of the lesion on the right antihelix. B, Dermoscopic image of the lesion using contact dermoscopy and 60× magnification (image acquisition was very difficult given the very small size of the lesion). Slightly whiteish central area without structure (*) and radially distributed hairpin vessels (^).</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 72-year-old woman with a history of nonmelanoma skin cancer visited our department for a skin check-up. On inspection, the only finding of note was a lesion on the right antihelix, which had appeared an unknown length of time earlier. The lesion was a slightly erythematous millimetric papule (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). No other similar lesions were found on the rest of the skin surface.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Diagnosis</span><p id="par0010" class="elsevierStylePara elsevierViewall">Trichilemmoma or tricholemmoma (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect1015">Comment</span><p id="par0015" class="elsevierStylePara elsevierViewall">Dermoscopy revealed hairpin vessels in a radial distribution around the periphery of the lesion, with an unstructured whiteish central area with an appearance reminiscent of an ostium. An excision biopsy of the lesion made it possible to reach a diagnosis of trichilemmoma, with some findings that supported the dermoscopic and histologic correlation (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).</p><p id="par0020" class="elsevierStylePara elsevierViewall">Trichilemmoma is a benign follicular tumor that is most commonly found on the central facial area, although it may be located on any part of the skin, except glabrous skin. Solitary trichilemmomas are common in adulthood, show no predominance by sex, and are asymptomatic. Different dermoscopic findings have been reported or this entity, including whiteish perivascular halos,<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> red iris-like structures, and occasionally, a hyperpigmented halo.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">If it presents in multiple form, a diagnosis of Cowden syndrome should be considered. If it presents in solitary form, as in our case, clinical diagnosis is practically impossible. For this reason, we believe that dermoscopy allows for a more approximate differential diagnosis, even in such incipient lesions as that of our patient. Nevertheless, the differential diagnosis, given the clinical and dermoscopic findings, should be established with other lesions such as an incipient keratoacanthoma or a cystic lesion such as an epidermal inclusion cyst.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Conflicts of interest</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:6 [ 0 => array:2 [ "identificador" => "xpalclavsec1427056" "titulo" => "Keywords" ] 1 => array:2 [ "identificador" => "sec0005" "titulo" => "Case description" ] 2 => array:2 [ "identificador" => "sec0010" "titulo" => "Diagnosis" ] 3 => array:2 [ "identificador" => "sec0015" "titulo" => "Comment" ] 4 => array:2 [ "identificador" => "sec0020" "titulo" => "Conflicts of interest" ] 5 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:1 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1427056" "palabras" => array:5 [ 0 => "Head and Neck Neoplasms" 1 => "Neoplasms, Adnexal and Skin Appendage" 2 => "Dermoscopy" 3 => "Dermatopathology" 4 => "Pathology" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Martin-Gorgojo A, Bru-Gorraiz FJ, Pascual-Rodríguez E. Pápula milimétrica en antehélix constituida dermatoscópicamente por corona de vasos en horquilla. Actas Dermosifiliogr. 2021;112:837–838.</p>" ] ] "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1110 "Ancho" => 2083 "Tamanyo" => 378613 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A, Clinical presentation of the lesion on the right antihelix. B, Dermoscopic image of the lesion using contact dermoscopy and 60× magnification (image acquisition was very difficult given the very small size of the lesion). Slightly whiteish central area without structure (*) and radially distributed hairpin vessels (^).</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" => 2056 "Ancho" => 2167 "Tamanyo" => 894868 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Histopathology findings of the fully excised lesion. Of note is the presence of at least one hyperplasic infundibulum with an epithelium reminiscent of that of the external root sheath of the hair follicle, with hypergranulosis and parakeratosis, consisting of clear monomorphic cells with a pale eosinophilic cytoplasm (due to the presence of glycogen) and a small nucleus. A, General view. B, PAS staining showing the glycogen of the cells that constitute the benign tumor. C, Detailed image with histology-dermoscopy correlation of the parakeratosis (*) and vessels surrounding the lesion (^).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dermoscopy of uncommon skin tumours" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A. Lallas" 1 => "E. Moscarella" 2 => "G. Argenziano" 3 => "C. Longo" 4 => "Z. Apalla" 5 => "G. Ferrara" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/ajd.12074" "Revista" => array:6 [ "tituloSerie" => "Australas J Dermatol" "fecha" => "2014" "volumen" => "55" "paginaInicial" => "53" "paginaFinal" => "62" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23866027" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dermoscopic pattern in facial trichilemmomas: red iris-like structure" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C. Horcajada-Reales" 1 => "J.A. Aviles-Izquierdo" 2 => "C. Ciudad-Blanco" 3 => "E. Conde-Montero" 4 => "V. Parra-Blanco" 5 => "P. Lázaro-Ochaita" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaad.2014.04.064" "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2015" "volumen" => "72" "paginaInicial" => "S30" "paginaFinal" => "S32" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25500033" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000011200000009/v1_202110091021/S1578219021002377/v1_202110091021/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/15782190/0000011200000009/v1_202110091021/S1578219021002377/v1_202110091021/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219021002377?idApp=UINPBA000044" ]
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| 2021 Noviembre | 66 | 50 | 116 |
| 2021 Octubre | 116 | 79 | 195 |
| 2021 Septiembre | 66 | 48 | 114 |
| 2021 Agosto | 49 | 40 | 89 |
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