Multiple primary melanomas (MPM) refer to the occurrence of more than one synchronous or metachronous melanoma in the same individual. The aim of this study was to identify the frequency of MPM and describe the clinical and histopathologic characteristics of patients with MPM. An observational single-center retrospective study was designed based on a cohort of melanoma patients followed in a tertiary care hospital. Fifty-eight (8.9%) patients developed MPM. Most patients were men (65.5%) and the median age at the time of diagnosis of the first melanoma was 71 years old. The median time of diagnosis of the second melanoma from the first melanoma was 10.9 months, and 77.6% of second melanomas were diagnosed within the first 5 years. In total, 29 (50%) and 28 (48.3%) first and second melanomas were located in the trunk, respectively. Concordance of anatomic site between primary and subsequent melanoma was found in 46.6% of the patients. Proportion of in situ melanomas was increasingly higher in subsequent melanomas (from 36.21% of first melanomas to 100% of fifth melanomas). An increasing rate of melanomas with histological regression was observed within subsequent melanomas (from 60.3% of first melanomas to 80% of third melanomas). Our results support the importance of careful long-term follow-up with total body examination in melanoma patients.

Objetivo: Describir las características de la Injuria Renal Aguda (IRA) en pacientes hospitalizados en un hospital de tercer nivel de enero a abril del 2016. Material y métodos: Estudio descriptivo, transversal y retrospectivo que incluyó a los pacientes que ingresaron a los servicios de hospitalización de Medicina y Unidad de Cuidados Intensivos. El diagnóstico de IRA y su clasificación según severidad fueron establecidos según los criterios propuestos por Kidney Disease: Improving Global Outcomes. La función renal al alta fue evaluada mediante la estimación de la tasa de filtración glomerular (TFG). Resultados: La frecuencia general de IRA fue 64,83%. En el servicio de Medicina, la frecuencia fue 57,06% y en UCI, 88,14%. La mortalidad general fue 27,45%. Los pacientes con IRA presentaron anemia, diabetes y enfermedad renal crónica en 84,97%, 20,92% y 19,61%, respectivamente. Según severidad, la frecuencia general fue estadio 3: 46,41%, estadio 1: 30,07% y estadio 2: 23,53%. Las categorías de etiología probable más frecuentes fueron intrínseca (41,83%), pre-renal (27,45%) y multifactorial (15,03%). La mediana de TFG al alta en los pacientes que estuvieron en UCI fue 114,40 ml/min/1,73 m2 y en Medicina, 84,89 ml/min/1,73 m2. Según severidad, la menor mediana de TFG al alta se presentó en los pacientes con estadio 3 y, según etiología probable, aquellos que desarrollaron IRA intrínseca y multifactorial presentaron menor función renal al alta. Conclusiones: IRA es un trastorno frecuente en pacientes hospitalizados. La TFG al alta fue significativamente mayor en los pacientes en UCI que en aquellos en Medicina.

Leprosy is an infectious disease caused by Mycobacterium leprae and M. lepromatosis. It mainly affects skin and peripheral nerves, being its clinical presentation strongly dependent on the host's immune response. 1 The morbidities and deformities caused by the infection, along with the reemergence of this illness experienced both in Eastern and Western countries, make leprosy a particularly relevant disease still nowadays. 2 Lepromatous reactions (LR) are immune-mediated inflammatory complications of leprosy. Erythema nodosum leprosum (ENL), also known as type 2 reaction, is an acute LR that may occur before, during or after multidrug therapy. It is mostly related to borderline leprosy (BL) and lepromatous leprosy (LL). 1 It is a relapsing affection often needing of long-term treatments. 3 We present a case

Summary Background and objectives The increasing use of biologics in the treatment of inflammatory diseases has led to more cases of leishmaniasis in patients subjected to iatrogenic immunosuppression. The main objective was to describe the characteristics of the patients with cutaneous (CL) or mucocutaneous (MCL) leishmaniasis who were receiving a biological therapy at the time of diagnosis. Patients and methods A multicenter retrospective study was design based on a cohort of patients diagnosed with CL or MCL. All patients who were being treated with biologicals were included. For each case, two matched non‐exposed patients were included for comparison. Results 38 patients were diagnosed with CL or MCL while being treated with tumor necrosis factor alpha (TNF‐α) inhibitors. Leishmaniasis presented more frequently as a plaque (58.3%) with a larger median lesion size (2.5 cm), ulceration (92.1%), and required a greater median number of intralesional meglumine antimoniate infiltrations (3 doses) (P < 0.05) than in non‐exposed patients. We found no systemic involvement in patients being treated with anti‐TNF‐α. We did not find differences regarding the treatment characteristics whether biologic therapy was modified or not. Conclusions Although management should be individualized, maintenance of biologic therapy does not seem to interfere with treatment of CL or MCL.