RESUMO
BACKGROUND AND OBJECTIVE: Pivotal trials with omalizumab for treatment of chronic spontaneous urticaria (CSU) are generally run over 12 to 24weeks. However, in clinical practice, many patients need longer treatment. In this article, we present an algorithm for treatment with omalizumab. MATERIAL AND METHODS: The consensus document we present is the result of a series of meetings by the CSU working group of "Xarxa d'Urticària Catalana i Balear" (XUrCB) at which data from the recent literature were presented, discussed, compared, and agreed upon. RESULTS: Treatment with omalizumab should be initiated at the authorized dose, and is adjusted at 3-monthly intervals according to the Urticaria Activity Score Over 7days, the Urticaria Control Test, or both. CONCLUSIONS: The algorithm proposed is designed to provide guidance on how to adjust omalizumab doses, how and when to discontinue the drug, and how to reintroduce it in cases of relapse.
Assuntos
Algoritmos , Antialérgicos/uso terapêutico , Omalizumab/uso terapêutico , Urticária/tratamento farmacológico , Antialérgicos/administração & dosagem , Doença Crônica , Humanos , Omalizumab/administração & dosagemRESUMO
Epidermal nevi are hamartomatous lesions derived from the epidermis and/or adnexal structures of the skin; they have traditionally been classified according to their morphology. New variants have been described in recent years and advances in genetics have contributed to better characterization of these lesions and an improved understanding of their relationship with certain extracutaneous manifestations. In the second part of this review article, we will look at nevi derived from the adnexal structures of the skin and associated syndromes.
Assuntos
Neoplasias de Anexos e de Apêndices Cutâneos/classificação , Nevo/classificação , Cisto Epidérmico/classificação , Cisto Epidérmico/patologia , Doenças do Cabelo/classificação , Doenças do Cabelo/patologia , Folículo Piloso/patologia , Humanos , Neoplasias de Anexos e de Apêndices Cutâneos/genética , Neoplasias de Anexos e de Apêndices Cutâneos/patologia , Nevo/genética , Nevo/patologia , Nevo Pigmentado/classificação , Nevo Pigmentado/genética , Nevo Pigmentado/patologia , Nevo Sebáceo de Jadassohn/classificação , Nevo Sebáceo de Jadassohn/genética , Couro Cabeludo , Neoplasias Cutâneas/classificação , Neoplasias Cutâneas/genética , Neoplasias Cutâneas/patologiaRESUMO
Epidermal nevi are hamartomatous lesions derived from the epidermis and/or adnexal structures of the skin; they have traditionally been classified according to their morphology. New variants have been described in recent years and advances in genetics have contributed to better characterization of these lesions and an improved understanding of their relationship with certain extracutaneous manifestations. In the first part of this review article, we will look at nevi derived specifically from the epidermis and associated syndromes.
Assuntos
Epiderme/patologia , Queratinócitos/patologia , Nevo/classificação , Neoplasias Cutâneas/classificação , Anormalidades Múltiplas/classificação , Anormalidades Múltiplas/genética , Anormalidades Múltiplas/patologia , Doença de Darier/classificação , Doença de Darier/patologia , Estudos de Associação Genética , Doenças Genéticas Ligadas ao Cromossomo X/classificação , Doenças Genéticas Ligadas ao Cromossomo X/genética , Doenças Genéticas Ligadas ao Cromossomo X/patologia , Humanos , Eritrodermia Ictiosiforme Congênita/classificação , Eritrodermia Ictiosiforme Congênita/genética , Eritrodermia Ictiosiforme Congênita/patologia , Deformidades Congênitas dos Membros/classificação , Deformidades Congênitas dos Membros/genética , Deformidades Congênitas dos Membros/patologia , Mosaicismo , Mutação , Nevo/genética , Nevo/patologia , Pênfigo Familiar Benigno/classificação , Pênfigo Familiar Benigno/patologia , Síndrome de Proteu/classificação , Síndrome de Proteu/genética , Síndrome de Proteu/patologia , Neoplasias Cutâneas/genética , Neoplasias Cutâneas/patologia , SíndromeAssuntos
Antialérgicos/administração & dosagem , Doença Crônica/tratamento farmacológico , Omalizumab/administração & dosagem , Urticária/tratamento farmacológico , Adulto , Fatores Etários , Relação Dose-Resposta a Droga , Resistência a Medicamentos , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento , Urticária/patologiaRESUMO
Lentigo maligna is the most common form of in situ melanoma. It is most often found on the head and neck, and its clinical and dermoscopic features in this location have been extensively described in the literature. We present a series of 14 patients diagnosed with extrafacial lentigo maligna and lentigo maligna melanoma at Hospital General de Valencia and Hospital de Manacor in Spain, and describe the clinical, dermoscopic, and histologic features observed. Most of the melanomas were located on the upper limbs; the next most common locations were the trunk and the lower limbs. The dermoscopic patterns were consistent with facial lentigo maligna and superficial spreading melanoma. Extrafacial lentigo maligna is uncommon. It has similar clinical and histologic features to facial lentigo, but dermoscopy may show a mix of patterns typically seen in lentigo maligna and superficial spreading melanoma. This difference in dermoscopic features is essentially due to anatomical differences between skin on the face and on other parts of the body.
Assuntos
Sarda Melanótica de Hutchinson/patologia , Neoplasias Cutâneas/patologia , Idoso , Idoso de 80 Anos ou mais , Dermoscopia , Extremidades , Feminino , Células Gigantes/ultraestrutura , Humanos , Sarda Melanótica de Hutchinson/diagnóstico por imagem , Masculino , Melanócitos/ultraestrutura , Pessoa de Meia-Idade , Neoplasias Cutâneas/diagnóstico por imagem , TroncoRESUMO
We present a series of 12 patients with telaprevir-induced skin toxicity. Some patients presented eczematous lesion, while others presented nonscaling macular lesions that became more purpuric in the lower limbs. Seven of the 12 patients had skin lesions affecting more than 50% of the body surface area, but none had systemic manifestations. Oral corticosteroids, prescribed in 7 patients, produced symptomatic improvement, and the response to the antiviral treatment in these patients was good. The 3 biopsies performed showed a superficial perivascular dermatitis with foci of red cell extravasation. Monitoring is central to the management of skin reactions secondary to the protease inhibitors, as severe drug eruptions have been reported. Treatment is usually symptomatic. We describe 7 cases in which oral corticosteroids-whose use continues to be controversial -were administered as a last resort for the control of pruritus.
