Anetoderma is a rare elastolytic disorder included within the group of cutaneous atrophies. Its pathogenesis is not yet clearly established, but immunological mechanisms could play an important role in dermal elastolysis. It has been associated with different autoantibodies and autoimmune disorders. We present a case of anetoderma in a systemic lupus erythematosus patient with anti-proliferating-cell-nuclear-antigen and antiphospholipid antibodies, highlighting the peculiarities of such an association.

Fifteen cases of chondroid syringoma have been studied histologically and by immunohistochemical methods in an attempt to establish their phenotypic profile and to elucidate their histogenesis. The epithelial elements were classified as tubuloglandular, solid nests and stromal cells. The inner cell layers of tubuloglandular components had distinct epithelial features, expressing cytokeratin, carcino-embryonic antigen and epithelial membrane antigen. The outer cell layers expressed vimentin, S-100 protein, neuron-specific enolase and muscle-specific actin and were negative for epithelial markers. The immunophenotypes of stromal cells and solid nests were similar to those of the outer cell layers. These data suggest that the stromal components may derive from the outer cell of tubuloglandular elements and that myo-epithelial cells have an important role in the histogenesis of these lesions and in their mesenchymal matrix production.

Objectives The aim of the present work was to establish a specialised pharmaceutical care programme for patients with multiple sclerosis in order to analyse its effects on patient satisfaction, the detection of drug-related problems, and the identification and resolution of negative outcomes associated with medication. Methods This was a prospective, longitudinal study with a pre/post-exposure design regarding the pharmaceutical care programme implemented: in bimonthly visits the pharmacist identified, detected and resolved drug-related problems and negative outcomes, and also provided information about the treatment. All patients with multiple sclerosis treated with immunomodulatory drugs from 1 June to 31 December 2011 were included in the study. A Likert scale questionnaire was used before and 6 months after the implementation to assess its impact on perceived patient satisfaction. Results In all, 32 patients (20 women and 12 men), with an age of 39.7±8.3 years were included. A total of 26 were receiving treatment with interferon β and 6 with glatiramer acetate. All items assessing the pharmacist's skills and interest in the patient along with those assessing the information received by the patient showed significant improvement (p<0.001). Overall satisfaction also improved significantly (p=0.016). Of the 13 negative outcomes associated with medication identified, 9 were resolved. Eight negative outcomes were classified as ‘non-quantitative safety problems’ and two as ‘untreated health problems’ were due to the drug-related problem ‘probability of adverse effects’. Three classified as ‘quantitative ineffectiveness’ were due to an ‘insufficiently treated health problem’. Conclusions The implementation of a specialised pharmaceutical care programme led to a significant improvement in perceived patient satisfaction. It has also allowed for better detection of drug-related problems and identification and resolution of negative outcomes associated with medication.

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