Abstract Malignant lentigo (LM) is a variant of in situ melanoma that develops mainly in areas of chronic sun exposure in middle-aged patients. Without treatment, 5% to 50% of the LM can progress to a lentigo maligna melanoma (LMM). Although the treatment of choice is surgical, imiquimod seems to be a viable and non-invasive option in patients with large tumors, elderly or people with underlying disease, or who simply reject the surgical removal of the lesion. We present a case of LM satisfactorily treated with topical imiquimod.

Resumen El lentigo maligno (LM) es una variante de melanoma in situ que se desarrolla principalmente en áreas de exposición solar crónica en pacientes de etnia blanca, de edad media-avanzada. Sin tratamiento, del 5% hasta el35% de los LM pueden progresar a un melanoma lentigo maligno (LMM). Aunque el tratamiento de elección es quirúrgico, el imiquimod aparece como una opción no invasiva viable. Suele indicarseen pacientes con tumores de gran tamaño, personas de edad avanzada o con patología de base, o que simplemente rechazan la extirpación quirúrgica de la lesión, especialmente por ser desfigurante. Se presenta una paciente con LM tratada satisfactoriamente con imiquimod tópico.

Currently, the potential for cardiovascular (CV) stress-induced risk is primarily based on the theoretical (obvious) side effects of stress on the CV system. Salivary cortisol and α-amylase, produced respectively by the hypothalamus-pituitary-adrenal (HPA) axis and the sympathetic-adrenomedullary (SAM) system during stress response, are still not included in the routine evaluation of CV risk and require additional and definitive validation. Therefore, this article overviews studies published between 2010 and 2015, in which salivary cortisol and α-amylase were measured as stress biomarkers to examine their associations with CV/CMR (cardiometabolic risk) clinical and subclinical indicators. A comprehensive search of PubMed, Web of Science and Scopus electronic databases was performed, and 54 key articles related to the use of salivary cortisol and α-amylase as subclinical indicators of stress and CV/CMR factors, including studies that emphasized methodological biases that could influence the accuracy of study outcomes, were ultimately identified. Overall, the biological impact of stress measured by salivary cortisol and α-amylase was associated with CV/CMR factors. Results supported the use of salivary cortisol and α-amylase as potential diagnostic tools for detecting stress-induced cardiac diseases and especially to describe the mechanisms by which stress potentially contributes to the pathogenesis and outcomes of CV diseases.

Five patients with cutaneous mastocytosis are presented with the clinical variant of "macularis eruptive telangiectasia perstans" (METP), with associated clinical findings. In most cases the disease occurs in adults with clinical manifestations limited to the skin with a good prognosis. We emphasize the importance of studying by a dermatologist and the necessity of interdisciplinary consideration and a proper follow-up.

Se comunican cinco pacientes con mastocitosis cutánea, en la forma clínica de "telangiectasia macularis eruptiva perstans" (TMEP), con hallazgos clínicos asociados. En la mayoría de los pacientes, la enfermedad se presenta en adultos con manifestaciones clínicas limitadas a la piel, con buen pronóstico. Destacamos la importancia de su conocimiento por el dermatólogo, la necesidad de su estudio y seguimiento multidisciplinario.

The complex of tuberous sclerosis is an hereditary disease that passes in the autosomal dominant way. It is characterized by convulsions, mental retardation and manifestations in different organs. The cutaneous signs are used to be determinant for the diagnosis of the illness. Among these, it is important the fibrous plaque, which is usually localized in the forehead, but it can also be observed in any area of the scalp.When it is presented, it is used to be the first cutaneous sign of the illness, and like it happened in our patient, underdiagnosed. So, the importance of the fibrous plaque lies in recognizing it as an early cutaneous marker and pathognomonic of the disease.

El complejo de la Esclerosis tuberosa es una afección hereditaria, que se transmite en forma autosómica dominante. Se caracteriza por convulsiones, retraso mental y manifestaciones en diversos órganos. Los signos cutáneos suelen ser determinantes para el diagnóstico de la enfermedad. Entre éstos se destaca la placa fibrosa, la que se localiza más frecuentemente en la frente, pero puede observarse en cualquier área del cuero cabelludo. Cuando está presente, suele ser el signo cutáneo inicial de la enfermedad, como ocurrió en nuestro paciente, subdiagnosticado. Su importancia radica entonces en reconocerlo como un marcador precoz y patognomónico de la enfermedad.

Primary object in modern concept of facial rejuvenation is to give a natural result, reducing the surgical cuts and limiting the scars. The fronto-temporal-orbital endoscopic facelift is, in our opinion, the best way to satisfy this purpose. Its peculiarities, such as mini-invasive technique, moderate natural tension on face soft tissue and redistribution and restoration of the facial volumes with the lack of cutaneous resection, allow to achieve a result as much natural as possible. By the same time, we get harmony between the anatomic face structures, shorter cuts and minimal scars. In our practice, when necessary, we associate the lipofilling of the zygomatic-malar area, of the perioral region and of the cheek and a superficial resurfacing of the face with Erbium laser. For the lower third of the face we practice cervical facelift to reduce scar. Since November 1998 until December 2006 we performed 221 fronto-temporal-orbital endoscopic facelifts: 21 men and 200 women aged included in the 28 and 55 years. Dissection is made over or under galeal plane according to the zones. Then we go on sectioning the procerus muscle, the corrugatoris muscle ant the orbital portion of orbicularis oculi muscle at the level of the lower eyelid. Finally, we make a sagittal traction by fixing points according to a paramedial vector and a time vector. Results at a distance (6, 12 and 24 months) have revealed a remarkable patients´ satisfaction with an aesthetic result that keeps natural in the time.

En el concepto moderno de rejuvenecimiento facial, lo principal es conseguir un resultado natural evitando las marcas quirúrgicas y limitando las cicatrices. El lifting endoscopio fronto-témporo-orbitario es, en nuestra opinión, el mejor método para conseguir este objetivo. Entre sus peculiaridades están el ser una técnica mínimamente invasiva, que proporciona una tensión moderada natural a los tejidos blandos de la cara y redistribuye y restaura los volúmenes faciales con el mínimo de resección cutánea, logrando un resultado lo más natural posible. Al mismo tiempo, conseguimos la armonía entre las estructuras anatómicas faciales, mínimas incisiones y mínimas cicatrices. En nuestra práctica, cuando es necesario, asociamos lipofilling del área zigomático-malar, de la región perioral y de las mejillas y un rejuvenecimiento facial superficial con láser de Erbio. Para el tercio inferior de la cara empleamos estiramiento cervicofacial con cicatriz reducida. Entre Noviembre de 1998 y Diciembre de 2006 hemos realizado 221 liftings endoscópicos fronto-témporo-orbitarios: 21 hombres y 200 mujeres de edades comprendidas entre los 28 y los 55 años. Practicamos la disección en el plano infra o supragaleal según las zonas; continuamos seccionando el músculo procerus, el corrugador y la porción orbitaria del músculo orbicular a nivel del párpado inferior. Finalmente, practicamos una tracción sagital fijando puntos de acuerdo a un vector paramediano y a otro horario. Los resultados a largo plazo (6, 12 y 24 meses) revelan una notable satisfacción por parte de los pacientes con un resultado estético que permanece natural en el tiempo.