Effectiveness of omalizumab in a case of urticarial vasculitis.

Urticarial vasculitis (UV) is a mainly leucocytoclastic vasculitis with urticarial plaques. Treating these patients is challenging as the available treatments have poor efficacy. Oral corticosteroids are considered the first-line treatment, but H1 antihistamines, dapsone, colchicine, antimalarials, ciclosporin and antileucotrienes have all been tried also. However, because of their adverse effects and/or lack of efficacy, new agents are still needed. Omalizumab, an anti-IgE antibody, shows efficacy in chronic spontaneous urticaria, and might also be a good treatment for angio-oedema and urticarial vasculitis. To our knowledge, there have been only seven relevant case reports published in the English literature. We add a new case of severe chronic recurrent urticarial vasculitis refractory to all of the drugs mentioned above. We started the patient on subcutaneous omalizumab 300 mg every 4 weeks, which produced clinical improvement within the first month and total remission in the fifth month. The patient has remained stable for 23 months, and follow-up is ongoing.

Successful treatment of refractory idiopathic angio-oedema with omalizumab: review of the literature and function of IgE in angio-oedema.

The management of angio-oedema is quite complicated because of the frequent poor response to usual treatments, including H1 antihistamines, systemic corticosteroids, immunosuppressant drugs, antileucotriene drugs or tranexamic acid. Omalizumab, an anti-immunoglobulin (Ig)-E antibody, has shown good resuts in chronic spontaneous urticaria, and might also be a good option for angio-oedema. To our knowledge, there have been eight relevant case reports published in the English literature. We report two further cases (a 55-year-old man and a 36-year-old woman) with severe chronic recurrent angio-oedema affecting the face, pharynx, hands, feet and hips. Both patients were refractory to H1 antihistamines, systemic corticosteroids and tranexamic acid. We decided to start with subcutaneous omalizumab 375 mg every other week and tapering doses up to 375 mg every 4 weeks. Both patients showed a very good response to the therapy, with clinical improvement in the first week. This response remained stable more than 3 years later.

Refractory pyoderma gangrenosum treated with infliximab in an infant.

We report the case of an 11-month-old boy with severe recalcitrant pyoderma gangrenosum refractory to prednisone, dapsone and ciclosporin. Treatment with infliximab was well tolerated, and resulted in an excellent clinical response that has been sustained for 15 months. The characteristics of this condition in children and the use of infliximab in infants are both reviewed.

Social Networks and Atopic Dermatitis: Cross-Sectional Descriptive Study. / Redes sociales y dermatitis atópica: estudio descriptivo transversal.

BACKGROUND: Social networks have become key tools for finding and disseminating medical information. OBJECTIVE: To describe the characteristics of social network postings on atopic dermatitis, the content that is posted, and the number of followers of pages, groups, or accounts. MATERIAL AND METHODS: We selected pages, groups, or accounts related to atopic dermatitis on Facebook, Twitter, and Linkedin during January and February of 2020. For each site, group, or account we recorded country of origin, year created, purpose, presence of links, provision of a contact email, and number of followers. We also analyzed the topics treated in recent content posts on the pages with the largest numbers of followers in each network. RESULTS: A total of 257 pages, groups, or accounts were included: Facebook, 171; Twitter, 59; and LinkedIn, 27. Facebook had the largest total number of pages and mean (SD) number of followers: 1416.71 (3722.63). Patient support groups accounted for most of the pages (63%), but businesses or product offers had more followers (P <.035). Of the 909 posts of informative content we analyzed, the most frequent topic was "general information about atopic dermatitis" (27.94%). CONCLUSIONS: Our findings show the importance of clearly defining the roles and limitations of social media platforms for designing future information campaigns and new patient-centered approaches to reaching patients with atopic dermatitis.

[Leishmania braziliensis: report of a pediatric imported case with response to liposomal amphotericin B]. / Leishmania braziliensis: descripción de un caso pediátrico importado con respuesta a anfotericina B liposomal.

Leishmania braziliensis is the main etiologic agent of leishmaniasis in South America. A 9-year-old boy consulted for the presence of round, ulcerative lesions with raised borders that were painful and have appeared after a travel to Bolivia and Brazil. The culture for parasites showed leishmanias and the PCR was positive for L. braziliensis. The patient underwent treatment with itraconazol but due to the persistence of lesions he received liposomal amphotericin B with complete resolution of the lesions. In all lesions by L. braziliensis the treatment must be systemic due to the risk of mucosal dissemination. Liposomal amphotericin B is a convenient alternative to pentavalent antimonials given its efficacy and good tolerance.