RESUMEN
Bevacizumab is a monoclonal antibody that exerts its antitumor activity by inhibiting vascular endothelial growth factor. Consequently, it suppresses endothelial cell proliferation, vascular permeability, and angiogenesis. This inhibitory effect contributes to tumour size reduction but causes wound-healing delay, specifically during the proliferative phase, in patients receiving bevacizumab. Although surgical wound-healing complications (WHC) associated with bevacizumab have been extensively reported, there is limited literature on peripheral WHC. More importantly, the histopathology of bevacizumab-associated WHC has not been described. We present the histopathology findings of a non-healing ulcer in a patient receiving bevacizumab, providing insight into the possible aetiology of this drug's adverse reaction. Furthermore, our patient's positive response to hyperbaric oxygen suggests its possible use for treatment of bevacizumab-associated non-healing wounds.
Asunto(s)
Inhibidores de la Angiogénesis/efectos adversos , Inhibidores de la Angiogénesis/uso terapéutico , Bevacizumab/efectos adversos , Bevacizumab/uso terapéutico , Úlcera por Presión/tratamiento farmacológico , Cicatrización de Heridas/efectos de los fármacos , Anciano , Humanos , Masculino , Resultado del TratamientoAsunto(s)
Antineoplásicos Inmunológicos/uso terapéutico , Color del Cabello/efectos de los fármacos , Neoplasias/tratamiento farmacológico , Receptor de Muerte Celular Programada 1/antagonistas & inhibidores , Antineoplásicos Inmunológicos/efectos adversos , Humanos , Neoplasias/inmunología , Receptor de Muerte Celular Programada 1/inmunologíaRESUMEN
Melanocytes, the cells responsible for skin pigmentation, are present in other parts of the body, such as the ocular, auditory, nervous, and cardiac systems. Within these systems, their roles serve a different purpose than their classical counterparts in skin as pigment cells. Such roles include cell turnover in retinal pigment epithelium, maintenance of balance and prevention of environmental damage in the auditory neuroepithelium, role-playing as dendritic cells within the leptomeninges, and prevention of oxidative damage in adipose tissue. Vitiligo, commonly known as a skin pigmentation disorder, has also been associated with several systemic disorders, such as Vogt-Koyanagi-Harada disease and Alezzandrini, Kabuki, and MELAS syndromes. Therefore, since these conditions involve compromise of systems in which melanocytes reside, it is not surprising that vitiligo has other systemic associations. The authors present a detailed review of systemic associations of vitiligo and melanocytes' roles in other organ systems with a focus on systemic disease.
Asunto(s)
Melanocitos/patología , Síndrome Uveomeningoencefálico/patología , Vitíligo/patología , Movimiento Celular/fisiología , Proliferación Celular , Transformación Celular Neoplásica/patología , Células Cultivadas , Diagnóstico Diferencial , Progresión de la Enfermedad , Femenino , Humanos , Hipopigmentación/patología , Hipopigmentación/fisiopatología , Masculino , Melanocitos/citología , Pronóstico , Medición de Riesgo , Síndrome Uveomeningoencefálico/diagnóstico , Vitíligo/fisiopatologíaRESUMEN
Over a decade ago, the FDA approved biologics for psoriasis, which changed how the disease is treated and, in most cases, has a significant positive impact on the lives of patients. Side effects primarily identified during the investigational and research phase led to the development of specific guidelines for treatment. The treatment guidelines have been amended to incorporate better understandings of side-effects over the years that the disease has been treated. In this study, we focused on a chart review that included assessing the current guidelines and their alignment with modern patient management and the recent side effects presented. This life-cycle evaluation included over 100 patients, management of their treatment, laboratory abnormalities, criteria for choosing or changing to a different biologic, and the effects of the treatments management throughout the years. The review identified some recommended changes in the application and treatment of psoriasis with biologics. To further evidence our findings, we hope to expand this study to a larger scale with more patients.
J Drugs Dermatol. 2017;16(3):215-217.
.Asunto(s)
Productos Biológicos/uso terapéutico , Práctica Privada/tendencias , Psoriasis/tratamiento farmacológico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Productos Biológicos/administración & dosificación , Productos Biológicos/efectos adversos , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Guías de Práctica Clínica como Asunto , Psoriasis/sangre , Calidad de Vida , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Adulto JovenRESUMEN
A 70-year-old man was referred by his rheumatologist to our dermatology clinic for evaluation of dermatitis on his right arm that appeared 3 months earlier. The skin lesion was asymptomatic and the patient denied current systemic symptoms, including fever, chills, and joint pain; however, 10 months prior to this presentation he experienced arthritis in the left knee. At that time, Borrelia serology revealed positive IgG (6.07; <0.8 negative, 0.8 to 0.99 borderline, ≥1 positive) and negative IgM titers. The patient had not received treatment for Lyme disease in the past. He was referred to rheumatology for evaluation of possible Lyme disease but did not follow up until 10 months later. The arthritis has since resolved. He travels frequently to France and recalls multiple tick bites during these trips.
Asunto(s)
Acrodermatitis/diagnóstico , Infecciones Asintomáticas , Borrelia burgdorferi/inmunología , Enfermedad de Lyme/diagnóstico , Enfermedades Cutáneas Bacterianas/diagnóstico , Enfermedad Relacionada con los Viajes , Acrodermatitis/inmunología , Anciano , Brazo , Dermatitis/diagnóstico , Francia , Humanos , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Enfermedad de Lyme/inmunología , Masculino , Enfermedades Cutáneas Bacterianas/inmunología , Estados UnidosAsunto(s)
Carcinoma de Células Escamosas/tratamiento farmacológico , Cetuximab/efectos adversos , Dermatitis/etiología , Trasplante de Corazón , Neoplasias Cutáneas/tratamiento farmacológico , Piel/patología , Voriconazol/farmacología , Antineoplásicos Inmunológicos/administración & dosificación , Antineoplásicos Inmunológicos/efectos adversos , Biopsia , Carcinoma de Células Escamosas/diagnóstico , Cetuximab/administración & dosificación , Inhibidores del Citocromo P-450 CYP3A/farmacología , Dermatitis/diagnóstico , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Piel/efectos de los fármacos , Neoplasias Cutáneas/diagnósticoRESUMEN
BACKGROUND: Dysplastic nevi (DN) have been a matter of controversy since their initial description in 1978 because of differences in the clinical and histological terminology, and large studies on histological outcomes of excising moderate to severely DN have not previously been described. OBJECTIVE: To determine the clinical characteristics of DN and histologic outcomes of excised moderate and severe DN. METHODS: Retrospective chart review of patients with DN or Clark's nevi at the Dermatology Department at Rutgers-Robert Wood Johnson Medical School in Somerset, New Jersey, from January 2009 to June 2012. Three hundred ninety-three lesions from 380 patients were included in this study. MAIN OUTCOME MEASURE: Histologic results of excised moderate and severe DN. RESULTS: Thirty-four percent of DN were excised because of the presence of moderate or severe atypia, personal history of melanoma, or both. None of the excised lesions showed evidence of melanoma; 81.6% of excisions showed scar or granulation tissue. Only 14% of excised lesions were found to have residual lesions, and 4.4% showed recurrent nevi. CONCLUSION: In 134 excisions of moderate to severe DN, no melanoma was identified. Most of the excisions showed scar or granulation tissue. The rate of residual lesions after shave biopsy of moderate or severe DN was lower than after punch biopsy.