RESUMEN

ABSTRACT: We report a rare case of cellular schwannoma (CS) manifesting as an ulcerated nodular lesion, mimicking spindle cell melanoma on the sole of the foot. CS, a benign variant of schwannoma, typically occurs in deep soft tissues but can rarely present cutaneously. The diagnosis of CS heavily relies on histopathological examination and immunohistochemical staining for specific markers such as SOX10 and S100. In this case, initial clinical suspicion of nodular melanoma was confirmed on biopsy, which revealed a spindle cell neoplasm positive for SOX10 and negative for melanocytic markers. Misdiagnosis of nodular melanoma was averted through complete excision. CS diagnosis demands careful consideration due to its resemblance to other spindle cell neoplasms, especially melanoma. Meticulous histopathological evaluation and immunostaining are important to differentiate CS from similar lesions, ensuring accurate diagnosis and appropriate management. This report contributes valuable insights into the diagnostic challenges and management of CS, particularly in unusual cutaneous presentations.

Asunto(s)

Melanoma , Neurilemoma , Neoplasias Cutáneas , Humanos , Melanoma/diagnóstico , Melanoma/patología , Neurilemoma/patología , Neurilemoma/diagnóstico , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/diagnóstico , Diagnóstico Diferencial , Errores Diagnósticos , Masculino , Biomarcadores de Tumor/análisis , Inmunohistoquímica , Femenino , Persona de Mediana Edad , Pie/patología

RESUMEN

The Expert Patients Program (EPP), an educational intervention for chronic diseases aimed at nonprofessionals, has high nonparticipation and dropout rates. We used quantitative and qualitative methods to identify the prevalence of and reasons for nonparticipation in 100 patients with acute myocardial infarction and 69 with stroke. We confirmed a high prevalence of refusal, identifying three groups based on degree of participation: patients who refused to attend (51%), patients who attended and then dropped out (10%), and patients who attended (39%). Patients who refused to participate or dropped out were mainly women and former/current smokers with a better-than-average physical condition. In addition, they were invited to participate in the EPP long after their cardiovascular event. We found that the degree of participation depended upon the patient's individual and social context and the professional profile of the recruiter. Therefore, tailored strategic interventions should be designed for each type of participation.