Efficacy and safety of adalimumab 80 mg in the treatment of psoriasis: a bicentric retrospective study.

Adalimumab (ADA) is a recombinant human monoclonal antibody indicated for the treatment of psoriasis that specifically inhibits tumor necrosis factor. Until recently we only had the presentation of 40 mg of ADA, being the standard dose in adults an initial administration of 80 mg, followed by 40 mg every 2 weeks. Newly the presentation of 80 mg of ADA has been commercialized, allowing the administration of the standard dose or a higher dose, with fewer injections. In this study, we retrospectively studied 11 patients with psoriasis who have received treatment with the presentation of 80 mg of ADA in two dermatology departments of two hospitals in Spain since its commercialization until June 2019. At the end of the study, an improvement in the mean final Psoriasis Area Severity Index (PASI) of all patients was observed, without any patient presenting any adverse effects. This study shows the efficacy and safety of 80 mg of ADA in a sample of 11 patients with psoriasis.

Use of high frequency ultrasonography in dermatology departments in Spain.

BACKGROUND: High Frequency Ultrasonography (HFUS) is a rapid, reliable, and effective diagnostic technique that has become progressively employed within the past years among dermatologists. OBJECTIVE: To describe the use of HFUS among dermatology departments in Spain. METHODS: An observational, cross-sectional descriptive study was conducted in 23 dermatology departments at Spanish public hospitals. Study data was collected during 10 working days. RESULTS: Fifty dermatologists from 11 Spanish regions participated in the study; 659 HFUS procedures were undertaken in 633 patients. HFUS indications were benign tumors (41%), malignant tumors (28%), inflammatory diseases (18%), skin appendage conditions (10%), and cosmetic conditions (1%). HFUS was performed for assessing the clinical differential diagnosis (58% of cases), surgical planning (17%), follow-up (17%), and other reasons (7%). Among the diagnostic group, the scan confirmed clinical diagnosis in 82% of cases and helped to change the clinical diagnosis in 17% cases (10% of total scans). HFUS procedure duration was less than 5 minutes (45%), between 5 and 10 minutes (32%), and more than 10 minutes (21%). Mean patient satisfaction score (range 0 to 5) was 4.8. CONCLUSIONS: The use of HFUS in usual practice is increasing, especially among younger dermatologists. This procedure is effective both for confirming and changing diagnosis, as well as for therapy decision making and follow-up. It is also worth remarking that a very high degree of patient satisfaction was recorded. The descriptive results reported in this study support the use of ultrasonography techniques and further reinforce their use in Dermatology.

Omalizumab in chronic urticaria: a retrospective series of 15 cases.

Omalizumab is a monoclonal anti-IgE antibody approved for the treatment of severe allergic asthma. There is increasing evidence in the literature of its usefulness in chronic urticaria. Herein, we report a retrospective case series of 15 patients with chronic idiopathic urticaria treated with omalizumab. We reviewed their medical records to assess the improvement achieved after 3 and 6 months of treatment. Complete response was defined as symptom disappearance that could be followed by discontinuation of antihistamines, and partial response as symptom improvement, but with symptom worsening when attempting to discontinue antihistamines. After 3 months of treatment, 12 patients responded, with partial response in 9 and complete response in 3. At 6 months, 8 of 10 patients continuing on omalizumab had a complete response and 2 a partial response. The results of the present retrospective series show the effectiveness of omalizumab in most treated patients, which is consistent with other recently published series and studies. These data support its role in the management of patients with chronic urticaria refractory to conventional treatments.

Familial necrobiosis lipoidica not associated with diabetes.

A 42-year-old woman presented with a 12-year history of extensive yellow and erythematous plaques, round and oblong with irregular configuration and glossy atrophic central areas on the pretibial aspects of both legs. Her 45-year-old sister presented with a 7-year history of a single plaque with erythematous margins, abundant telangiectases, and an atrophic center in the lower portion of the left leg. There was no family history of type-1 or type-2 diabetes mellitus. Both patients had normal fasting glucose concentration, oral glucose tolerance test, and glucose overload test. Different treatment options including topical corticosteroids were unsuccessful. Treatment with oral fumaric acid esters was attempted but the medication was discontinued because of intolerable side effects (flushing and gastrointestinal discomfort). At present, after a follow-up of 2 years, the plaques remain unchanged. These two cases should be added to the few cases of familial nondiabetic necrobiosis lipoidica previously reported.