Querol-Cisneros, E. (Elena)

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2018 - 20203

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    Cocaine-induced pyoderma gangrenosum-like lesions
    (Wiley, 2018) Tomás-Velázquez, A. (Alejandra); Moreno, E. (Esther); España, A. (Agustín); Gil-Sanchez, M.P. (María Pilar); Rodríguez-Garijo, N. (Nuria); Idoate, M.A. (Miguel Ángel); Querol-Cisneros, E. (Elena)
    Cocaine consumption is increasing at an alarming rate. This drug produces euphoria, anorexia, increased alertness and diminished sleep requirements. It is estimated that up to 80 % of cocaine is contaminated with levamisole, a substance which may potentiate the drug’s chemical effects [ 1 ] . Multiple mucocutaneous manifestations have been associated with cocaine use [ 2 ] , including cocaine-induced pyoderma gangre-nosum (CIPG), cocaine-induced midline destructive lesions (CIMDL) and retiform purpura (RP). We present three cases of cocaine abuse with skin lesions compatible with PG, and review the epidemiological, clinical, histopathological and immunological characteristics of CIPG and RP. We suggest that these two conditions are more closely related than previously thought. Additionally, in our opinion, no specific immunological or histological profile would be indicative of levamisole toxicity.
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    Split-thickness skin grafts obtained from adjacent hairy skin for reconstructing auricular concave surfaces after Mohs surgery
    (Elsevier, 2020) García-Martínez, F.J. (Francisco Javier); Redondo-Bellón, P. (Pedro); Querol-Cisneros, E. (Elena)
    Background: Reconstruction of large auricular defects with full-thickness skin grafts (FTSG) is a commonly reported option, but less attention has focused on the advantages and indications of using split-thickness skin grafts (STSG) in the ear. Objective: We sought to report our experience using STSG for repair of defects located on the auricular concave surfaces, highlighting the utility of choosing the adjacent hairy skin as donor site. Methods: We performed a retrospective review of all Mohs micrographic defects on the auricular concave surfaces repaired with STSG obtained from the adjacent hairy skin, between January 2017 and July 2018 at our institution. Results: A total of 16 patients with defects on the auricular concavities resulting from removal of non-melanoma skin cancer were reconstructed with STSG taken from the adjacent hairy skin. Only one patient experienced partial graft failure and no other complications were observed after 6-month follow-up. Conclusion: Split-thickness skin grafts are suitable for reconstructing concave areas in the ear, providing good cosmetic results with a simple, cost-effective and easily reproducible technique. Choosing the adjacent hairy skin as a donor area shortens the operative and postoperative time, and allows the procedure to be performed in a single surgical field.
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    Methotrexate-induced epidermal necrosis in a child with osteosarcoma
    (John Wiley & Sons Ltd., 2020) Tomás-Velázquez, A. (Alejandra); Gutierrez-Jimeno, M. (Miriam); Moreno, E. (Esther); Rodríguez-Garijo, N. (Nuria); Aguado, L. (Leyre); Querol-Cisneros, E. (Elena)
    Methotrexate is a folic acid antagonist used to treat psoria-sis, rheumatoid arthritis and neoplasms. It is renally excreted unchanged, at levels of about 90% within 24 hours. Several risk factors for intoxication have been described, including folate deficiency, liver cirrhosis, renal failure or the use of me-dications such as sulfonamides, salicylate and nonsteroidal anti-inflammatory drugs. Adverse cutaneous reactions such as photosensitivity, alopecia, urticaria, mucositis, erythe-ma, desquamation, Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN) are well known. Methotrexate epidermal necrosis (MEN) should also be considered because of its severity, its similarity to TEN and the importance of rapidly administering appropriate treatment. Some cases of MEN have been reported in psoriasis patients, in whom the occurrence with an underlying skin disease has been found to be more common.