Out-of-pocket costs for patients with psoriasis in an outpatient dermatology referral service.

Background: Psoriasis is a chronic disease that derives great costs to the health care system. In Colombia, due to deficiencies in this system, patients are more likely to incur in out-of-pocket expenses; money that has never been quantified in this country.

Objectives: To quantify out-of-pocket expenses and to analyze their relation to patients' clinical and labor characteristics in a cohort of psoriatic patients.

Cutaneous smooth muscle tumors associated with Epstein-Barr virus in an adult patient with HIV.

Epstein Barr virus-associated smooth muscle tumors are an uncommon neoplasm that occurs in immunosuppressed patients of any age. Usually, it presents as multifocal tumors mainly in the spinal cord, epidural region, gastrointestinal tract and liver, upper respiratory tract and skin, the latest with few cases reported in the literature and related with human immunodeficiency virus infection and acquired immune deficiency syndrome. The authors present the first case of a Colombian adult patient with human immunodeficiency virus infection and multifocal Epstein Barr virus-associated smooth muscle tumors in the skin and epidural region, confirmed by histopathology, immunohistochemistry and in situ hybridization studies.

Locally aggressive trichilemmal carcinoma.

Trichilemmal carcinoma is a rare adnexal neoplasia with histologic features reminiscent of the outer root sheath of hair follicles. The clinical presentation of trichilemmal carcinoma is variable, as it may mimic basal cell carcinomas and squamous cell carcinomas, thus requiring histologic diagnosis. We report the case of a patient with aggressive trichilemmal carcinoma in the auricle.