Inter- and intra-observer variability in the selection of therapy for infantile hemangiomas among pediatric dermatologists in Spain.

Background: Guidelines and expert recommendations on infantile hemangiomas (IH) are aimed at increasing homogeneity in clinical decisions based on the risk of sequelae.

Objective: The objective was to analyze the inter- and intra-observer agreement among pediatric dermatologists in the choice of treatment for IH.

Methods: We performed a cross-sectional inter-rater and intra-rater agreement study within the Spanish infantile hemangioma registry.

Use of Topical Nitric-Zinc Complex Solution to Treat Palmoplantar and Periungual Warts in a Pediatric Population.

Introduction: Nitric-zinc complex solution (NZCS) is a topically applied solution containing nitric acid, zinc, copper, and organic acids that induce a painless caustic effect on "difficult-to-treat" warts, including palmoplantar and periungual locations. The objective of the present prospective clinical study was to describe the efficacy and tolerability of NZCS in the treatment of palmoplantar and periungual warts in children.

Methods: Eligible patients were immunocompetent children and adolescents, with at least one palmoplantar or periungual wart.

Successful treatment of granulomatous reactions secondary to injection of esthetic implants.

Background: In recent years, various injectable materials have come into use to improve esthetic appearance.

Objective: We describe the clinical and histopathologic aspects of two patients who received intradermal injections of an unknown dermal filler and the different diagnostic tools used to identify the unknown injected material (reflexion electron microscopy, electron dispersing x-ray) and discuss the possibility of a metastatic granulomatous reaction in one patient. We also describe two treatments for this complication and evaluate the legal considerations of the use of materials that have been adulterated and/or whose composition is unknown to the patient.

Immunologic escape and angiogenesis in human malignant melanoma.

Background: Melanoma escape mechanisms include immunosuppressive and angiogenic cytokine production.

Objective: We sought to determine vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) expression by immunohistochemistry, and soluble circulating plasma levels of VEGF, bFGF, IL-10, and transforming growth factor-beta2 in patients with different stages of melanoma.

Methods: Biopsy specimens from 42 patients with primary melanoma and 9 with cutaneous metastases were studied by immunohistochemistry.

'Skin popping' ulceration in an HIV patient. Successful treatment with antiretroviral drugs and stanozolol.

Skin popping refers to the practice of injecting drugs beneath the skin without concern for vascular access. We describe a male HIV seropositive injecting-drug user with chronic cutaneous ulcerations on the legs at sites of skin popping. Treatment with antiretroviral drugs and stanozolol was associated with a striking clinical improvement of the ulcer in two weeks.