Subject(s)
Alopecia , Adult , Female , Humans , Male , Middle Aged , Hair , Pressure/adverse effects , Traction/adverse effectsABSTRACT
BACKGROUND AND OBJECTIVE: Systemic adverse effects (AE) are a major concern of low-dose oral minoxidil (LDOM) treatment, especially in patients with arterial hypertension or arrhythmia. The objective of this study was to evaluate the safety of LDOM in patients with hypertension or arrhythmia. PATIENTS AND METHODS: Retrospective multicenter study of patients with hypertension or arrhythmia treated with LDOM for any type of alopecia. RESULTS: A total of 254 patients with hypertension [176 women (69.3%) and 78 men (30.7%)] with a mean age of 56.9 years (range 19-82) were included. From them, the dose of LDOM was titrated in 128 patients, allowing the analysis of 382 doses. Patients were receiving a mean of 1.45 (range 0-5) antihypertensive drugs. Systemic AE were detected in 26 cases (6.8%) and included lightheadedness (3.1%), fluid retention (2.6%), general malaise (0.8%), tachycardia (0.8%) and headache (0.5%), leading to LDOM discontinuation in 6 cases (1.5%). Prior treatment with doxazosin (P<0.001), or with three or more antihypertensive drugs (P=0.012) was associated with a higher risk of discontinuation of LDOM. CONCLUSIONS: LDOM treatment showed a favorable safety profile in patients with hypertension or arrhythmia, similar to general population.
Subject(s)
Hypertension , Minoxidil , Male , Humans , Female , Young Adult , Adult , Middle Aged , Aged , Aged, 80 and over , Minoxidil/adverse effects , Antihypertensive Agents/adverse effects , Alopecia/drug therapy , Alopecia/chemically induced , Hypertension/drug therapy , Arrhythmias, Cardiac/chemically induced , Arrhythmias, Cardiac/drug therapy , Treatment OutcomeABSTRACT
BACKGROUND AND OBJECTIVE: Systemic adverse effects (AE) are a major concern of low-dose oral minoxidil (LDOM) treatment, especially in patients with arterial hypertension or arrhythmia. The objective of this study was to evaluate the safety of LDOM in patients with hypertension or arrhythmia. PATIENTS AND METHODS: Retrospective multicenter study of patients with hypertension or arrhythmia treated with LDOM for any type of alopecia. RESULTS: A total of 254 patients with hypertension [176 women (69.3%) and 78 men (30.7%)] with a mean age of 56.9 years (range 19-82) were included. From them, the dose of LDOM was titrated in 128 patients, allowing the analysis of 382 doses. Patients were receiving a mean of 1.45 (range 0-5) antihypertensive drugs. Systemic AE were detected in 26 cases (6.8%) and included lightheadedness (3.1%), fluid retention (2.6%), general malaise (0.8%), tachycardia (0.8%) and headache (0.5%), leading to LDOM discontinuation in 6 cases (1.5%). Prior treatment with doxazosin (P<0.001), or with three or more antihypertensive drugs (P=0.012) was associated with a higher risk of discontinuation of LDOM. CONCLUSIONS: LDOM treatment showed a favorable safety profile in patients with hypertension or arrhythmia, similar to general population.
Subject(s)
Hypertension , Minoxidil , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Alopecia/drug therapy , Alopecia/chemically induced , Antihypertensive Agents/adverse effects , Arrhythmias, Cardiac/chemically induced , Arrhythmias, Cardiac/drug therapy , Hypertension/drug therapy , Minoxidil/adverse effects , Treatment Outcome , Retrospective StudiesABSTRACT
BACKGROUND: Low-dose rituximab is a protocol used in several autoimmune diseases, that has also shown to be effective and safe in pemphigus vulgaris. OBJECTIVES: To study whether low-dose rituximab is also effective for bullous pemphigoid. METHODS: Patients with BP were treated with a single cycle of two infusions of rituximab 500 mg at an interval of 2 weeks. Early and late end points were monitored. RESULTS: Six patients, five males and a female, with a mean age of 78.6 years (range 65-89) and a mean history of BP of 6.7 months (range 2-16) were included. A rapid and marked response was observed after a single cycle of treatment, with a mean time to disease control and to end of consolidation phase of 1.9 (range 1-3), and 4 weeks (range 3-5), respectively. Four patients achieved a late end point at a mean of 15.75 weeks (range 13-20). Three of them achieved partial remission with no therapy (two patients) or with minimal therapy (one patient), and one of them achieved complete remission with no therapy. One patient has 6 weeks of clinical follow-up after rituximab administration. The remaining patient relapsed 4 weeks after the rituximab treatment, and remains in complete remission with more than minimal therapy. One patient had a herpetic gingivostomatitis related to rituximab. CONCLUSIONS: Low-dose rituximab for BP achieved acceptable remission rates and steroid-sparing activity, with a better safety profile and a lower cost, compared to standard doses. This pilot study suggests that low-dose rituximab could be a therapeutic option for BP.
Subject(s)
Pemphigoid, Bullous , Pemphigus , Male , Humans , Female , Child, Preschool , Child , Rituximab/therapeutic use , Pemphigoid, Bullous/drug therapy , Pilot Projects , Treatment Outcome , Pemphigus/drug therapy , Immunologic Factors/therapeutic use , Retrospective StudiesABSTRACT
BACKGROUND: Low-dose rituximab is a protocol used in several autoimmune diseases, that has also shown to be effective and safe in pemphigus vulgaris. OBJECTIVES: To study whether low-dose rituximab is also effective for bullous pemphigoid. METHODS: Patients with BP were treated with a single cycle of two infusions of rituximab 500mg at an interval of 2 weeks. Early and late end points were monitored. RESULTS: Six patients, five males and a female, with a mean age of 78.6 years (range 65-89) and a mean history of BP of 6.7 months (range 2-16) were included. A rapid and marked response was observed after a single cycle of treatment, with a mean time to disease control and to end of consolidation phase of 1.9 (range 1-3), and 4 weeks (range 3-5), respectively. Four patients achieved a late end point at a mean of 15.75 weeks (range 13-20). Three of them achieved partial remission with no therapy (two patients) or with minimal therapy (one patient), and one of them achieved complete remission with no therapy. One patient has 6 weeks of clinical follow-up after rituximab administration. The remaining patient relapsed 4 weeks after the rituximab treatment, and remains in complete remission with more than minimal therapy. One patient had a herpetic gingivostomatitis related to rituximab. CONCLUSIONS: Low-dose rituximab for BP achieved acceptable remission rates and steroid-sparing activity, with a better safety profile and a lower cost, compared to standard doses. This pilot study suggests that low-dose rituximab could be a therapeutic option for BP.
Subject(s)
Pemphigoid, Bullous , Pemphigus , Male , Humans , Female , Child, Preschool , Child , Rituximab/therapeutic use , Pemphigoid, Bullous/drug therapy , Pilot Projects , Treatment Outcome , Pemphigus/drug therapy , Immunologic Factors/therapeutic use , Retrospective StudiesSubject(s)
COVID-19 Vaccines , COVID-19 , Arm , BNT162 Vaccine , Health Personnel , Humans , RNA, Messenger , SARS-CoV-2Subject(s)
COVID-19 , Chilblains , Case-Control Studies , Chilblains/diagnosis , Humans , SARS-CoV-2 , SkinSubject(s)
Mite Infestations , Mites , Animals , Humans , Microscopy, Confocal , Mite Infestations/diagnostic imagingABSTRACT
COVID-19 is an infectious disease caused by severe acute respiratory coronavirus 2 (SARS-CoV-2). Vesicular skin rashes have been reported as associated with COVID-19, but there is little information about this cutaneous manifestation. We designed a prospective observational study of patients diagnosed with COVID-19 who had vesicular lesions. Clinical characterization of skin findings was conducted by dermatologists. When possible, histological analysis and detection of SARS-CoV-2 in the content of the vesicles was performed. In total, 24 patients were included. A disseminated pattern was found in 18 patients (75%), and a localized pattern was found in 6 (25%). Median duration of the skin rash was 10 days. Of the 24 patients, 19 (79.2%) developed the skin rash after the onset of COVID-19 symptoms. Histological examination in two patients was consistent with viral infection, SARS-CoV-2 was not detected in four patients. This single-centre study shows the clinical characteristics of vesicular skin rashes in patients with COVID-19.
Subject(s)
Blister/virology , COVID-19/complications , Exanthema/virology , Adult , Aged , Blister/pathology , Exanthema/pathology , Female , Humans , Male , Middle Aged , Prospective Studies , SARS-CoV-2/isolation & purification , Young AdultSubject(s)
COVID-19/pathology , Erythema Multiforme/pathology , Adrenal Cortex Hormones/therapeutic use , Aged , Anti-Bacterial Agents/therapeutic use , Antiviral Agents/therapeutic use , Azithromycin/therapeutic use , C-Reactive Protein/metabolism , COVID-19/blood , COVID-19/physiopathology , Ceftriaxone/therapeutic use , Drug Combinations , Erythema Multiforme/blood , Erythema Multiforme/drug therapy , Female , Fibrin Fibrinogen Degradation Products/metabolism , Hospitalization , Humans , Hydroxychloroquine/therapeutic use , Lopinavir/therapeutic use , Lymphocyte Count , Middle Aged , Ritonavir/therapeutic use , COVID-19 Drug TreatmentABSTRACT
Disseminated herpes simplex virus (HSV) is mainly seen in immunocompromised individuals. Atypical lesions can be present in both primary infection and reactivation disease. Compared with the general population, inmunocompromised hosts are at greater risk of increased persistency and severity of clinical manifestations, including severe systemic involvement such as esophagitis, meningitis, and hepatitis. Herein, we report the case of a liver transplant recipient with atypical disseminated herpes simplex virus-1 complicated by HSV-related hepatitis. Dermatological consultation and histological assessment were crucial for a correct diagnosis and treatment.