RESUMO
Malignant melanoma is one of the most aggressive solid tumors but has low morbidity if treated at an early stage. Over the past decade, the advent of targeted therapy and immunotherapy have productively enriched the treatment options for advanced melanomas and further improved the prognosis. The treatment of melanoma is a rapidly evolving field. In patients with sentinel lymph node (SLN)-positive (SLN+) melanoma, the role of complete lymph node dissection (CLND) is still a matter of debate. Sentinel lymph node biopsy (SLNB) is a staging procedure for melanoma that is routinely offered to patients with tumor thickness ≥1 mm or ≥0.8 mm with additional risk factors and is widely accepted as an important diagnostic and prognostic tool, since SLN+ patients can receive adjuvant targeted treatment or immunotherapy. Currently, the role of CLND has largely been replaced by often recommended adjuvant therapies since their approval. This article provides an overview of sentinel lymph-node surgery in cutaneous melanoma. J Drugs Dermatol. 2022;21(5):510-516. doi:10.36849/JDD.6198.
Assuntos
Melanoma , Linfonodo Sentinela , Neoplasias Cutâneas , Humanos , Fatores Imunológicos , Metástase Linfática/patologia , Melanoma/diagnóstico , Melanoma/patologia , Melanoma/cirurgia , Prognóstico , Estudos Retrospectivos , Linfonodo Sentinela/patologia , Linfonodo Sentinela/cirurgia , Biópsia de Linfonodo Sentinela/métodos , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/cirurgia , Melanoma Maligno CutâneoRESUMO
Acne scars are the ultimate outcome of acne vulgaris, a prevalent skin disorder affecting the pilo-sebaceous unit. Laser resurfacing has been demonstrated to be an efficient therapy option for acne scars. Hence, we adopted this concept and conducted a study to evaluate the safety and efficacy of low-energy double-pass 1450-nm diode laser on acne scars. This study was conducted on 48 patients with acne scars, treated at 4-week interval with low-energy double-pass 1450-nm diode laser. Patients were evaluated clinically and with photographs, at day 0, first month and third month post the final treatment and during follow-up visit. Five treatment sessions were completed by all patients. Approximately, 79.2% of patients showed around 30% improvement. At the end of third month follow-up, 92.9% of the patients demonstrated >30% improvement. Vesicle formation was observed in two cases, with no post-inflammatory hyperpigmentation and transient hyperpigmentation was observed in one case, which vanished within 2 months. Our study showed that 1450-nm diode laser treatment was efficient and well endured in facial acne scars when used with double-pass at low-energy.
Assuntos
Acne Vulgar , Terapia a Laser , Acne Vulgar/complicações , Acne Vulgar/diagnóstico , Cicatriz/etiologia , Cicatriz/patologia , Cicatriz/terapia , Estudos Transversais , Humanos , Lasers Semicondutores/uso terapêutico , Resultado do TratamentoRESUMO
Frontal fibrosing alopecia (FFA) mainly affects the anterior hairline and eyebrows and its etiology and associated factors remain obscure. The aim of this study was to evaluate the allergic contact dermatitis with patch test in patients with FFA. In this prospective study, 20 patients with FFA and 24 age and sex-matched healthy individuals were evaluated with patch testing. Diagnosis was made histologically, clinically and based on dermoscopic findings. Demographic data, age of onset, disease duration and FFA severity index are evaluated in all patients. Positive patch test reaction to one or more allergen was observed in 65% of patients while it was 37.5% in control group (P = .003). There was a significant difference between age (P = .006) and positive patch test results. No statistical significant difference was observed in the results of patch testing and disease duration (P = .519), menopausal status (P = .085), and FFA severity index (P = .573). Our findings suggest an association between FFA and allergic contact dermatitis. The utility of patch testing in FFA patients can explore the role of allergic etiology and may have an enormous impact on the diagnostic potential and quality of life of these patients.
Assuntos
Dermatite Alérgica de Contato , Líquen Plano , Alopecia/diagnóstico , Alopecia/epidemiologia , Alopecia/etiologia , Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/epidemiologia , Dermatite Alérgica de Contato/etiologia , Humanos , Estudos Prospectivos , Qualidade de VidaRESUMO
Numerous studies have demonstrated that the pigmentation of iris and around the eyelid is a common side effect of latanoprost, a prostaglandin F2alpha analogue used in the treatment of glaucoma. Hence, the authors decided to study the effectiveness of topical latanoprost on vitiligo patches around the eyelid. In this randomized, double-blind, clinical trial study, 31 patients with vitiligo vulgaris and focal vitiligo involving the eyelids were evaluated. Patients were randomly divided into two groups. First group received topical latanoprost gel twice daily for 12 weeks, whereas the second group received placebo with the same protocol. To evaluate severity of the disease the VIDA rating system was used. Serial photos of the patches were taken to compare and evaluate the repigmentation percentage of the patches. The patients in both groups had almost similar VIDA score (p > .05). First group showed improved pigmentation, whereas participants in the second group did not show any improvement in the pigmentation. The group treated with latanoprost showed significant reduction in the symptoms of the disease, whereas those treated with placebo did not show any alteration (p > .05). No significant complications were observed in either groups. Latanoprost proved effective in treating vitiligo disease involving eyelids.
Assuntos
Pálpebras , Latanoprosta/administração & dosagem , Vitiligo/tratamento farmacológico , Administração Tópica , Adolescente , Criança , Método Duplo-Cego , Feminino , Géis , Humanos , Masculino , Índice de Gravidade de Doença , Pigmentação da Pele/efeitos dos fármacos , Resultado do Tratamento , Vitiligo/patologia , Adulto JovemRESUMO
Acute herpes zoster lesions in most cases are self-limited except in older and immunocompromised patients, wherein the pain can cause significant suffering. Postherpetic neuralgia is a painful situation for patients that can compromise the quality of life. Here, we report a 30-year-old healthy young man who developed treatment-resistant postherpetic neuralgia after herpes zoster (fourth/fifth thoracic segment) without any underlying immunocompromised state. He also developed some cystic lesions, which were removed by aspiration and surgery. The skin lesions improved 2 weeks after the surgery and postherpetic neuralgia was completely cured after 5 months, however cystic lesions recurred multiple times and were excised completely during each visit. Postherpetic neuralgia has a significant impact on the health-care cost borne by the society and affected individual, hence, it is essential to select appropriate treatment to manage the pain of postherpetic neuralgia.
Assuntos
Herpes Zoster , Neuralgia Pós-Herpética , Adulto , Idoso , Herpes Zoster/complicações , Herpes Zoster/diagnóstico , Herpes Zoster/tratamento farmacológico , Humanos , Masculino , Neuralgia Pós-Herpética/diagnóstico , Neuralgia Pós-Herpética/tratamento farmacológico , Neuralgia Pós-Herpética/etiologia , Qualidade de Vida , RecidivaRESUMO
Pityriasis lichenoides is a scarce cutaneous disorder with unknown etiology. It contains a range of clinical manifestations including acute papular lesions that quickly grow into pseudo vesicles and central necrosis to small, scaling, benign-appearing papules.1,2.
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Anti-Inflamatórios não Esteroides/uso terapêutico , Etanercepte/uso terapêutico , Pitiríase Liquenoide/diagnóstico , Espondilite Anquilosante/tratamento farmacológico , Adulto , Anti-Inflamatórios não Esteroides/administração & dosagem , Anti-Inflamatórios não Esteroides/efeitos adversos , Diagnóstico Diferencial , Etanercepte/administração & dosagem , Etanercepte/efeitos adversos , Feminino , Humanos , Pitiríase Liquenoide/induzido quimicamente , Pitiríase Liquenoide/complicações , Espondilite Anquilosante/complicaçõesRESUMO
BACKGROUND: Pityriasis lichenoides chronica, a papulosquamous disorder often considered a subtype of pityriasis lichenoides. It is considered a clonal T-cell disorder, which may be associated with cutaneous T-cell lymphoma that may develops in response to foreign antigens. CASE PRESENTATION: We present a 38-year-old male patient with ankylosing spondylitis who was on treatment with etanercept. After 8 weeks of treatment, the patient presented with scaly erythematous papules, on the back and arms. He was diagnosed clinically with pityriasis lichenoides chronica. CONCLUSION: Pityriasis lichenoides chronica should be included among the broad clinical spectrum of chronic inflammatory skin diseases which may occur during treatment with TNF-alpha antagonists. J Drugs Dermatol. 2020;19(5): doi:10.36849/JDD.2020.2191.
Assuntos
Etanercepte/efeitos adversos , Pitiríase Liquenoide/induzido quimicamente , Espondilite Anquilosante/tratamento farmacológico , Inibidores do Fator de Necrose Tumoral/efeitos adversos , Administração Cutânea , Adulto , Glucocorticoides/administração & dosagem , Humanos , Masculino , Pitiríase Liquenoide/diagnóstico , Pitiríase Liquenoide/imunologia , Espondilite Anquilosante/imunologia , Resultado do Tratamento , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Fator de Necrose Tumoral alfa/imunologiaRESUMO
Copy: A number of biologics have been approved for use in plaque-type psoriasis. They act by either blocking the action of a specific type of cell or protein in the immune system. Case presentation: Herein, we report a case of a 46-year-old woman with a 12-year history of severe plaque psoriasis and psoriatic arthritis who was treated successfully with guselkumab and adalimumab after failure of prior topical corticosteroids, cyclosporine and narrow-band ultraviolet B (NBUVB) phototherapy. Conclusion: There is limited data supporting the combination of biological agents in the management of psoriasis and psoriatic arthritis. This is the first case report of plaque psoriasis with arthritis, successfully treated with guselkumab and adalimumab combination therapy, without concurrent use of other systemic agents during the treatment. However, further studies need to be carried out to evaluate the efficacy and safety of this biologic combination therapy. J Drugs Dermatol. 2019;18(4):394-396.
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Adalimumab/administração & dosagem , Anticorpos Monoclonais/administração & dosagem , Produtos Biológicos/administração & dosagem , Psoríase/tratamento farmacológico , Anticorpos Monoclonais Humanizados , Esquema de Medicação , Resistência a Medicamentos , Quimioterapia Combinada/métodos , Feminino , Humanos , Injeções Subcutâneas , Pessoa de Meia-Idade , Psoríase/diagnóstico , Psoríase/patologia , Índice de Gravidade de Doença , Resultado do TratamentoAssuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Dermatologia/métodos , Transmissão de Doença Infecciosa/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , COVID-19 , Infecções por Coronavirus/transmissão , Humanos , Pneumonia Viral/transmissão , SARS-CoV-2Assuntos
COVID-19/epidemiologia , Dermatologistas , Internet , SARS-CoV-2 , Interface Usuário-Computador , HumanosRESUMO
Introduction: Pyoderma gangrenosum (PG) is a noninfectious, reactive inflammatory neutrophilic dermatosis that is commonly associated with autoimmune and neoplastic disorders. There are emerging diagnostic tools and treatment options for PG.Area covered: The diagnosis of PG should be seriously considered when managing ulcers to avoid unnecessary medical and surgical complications with prompt and suitable treatment. There are no standardized treatment guidelines for PG, and current therapy largely depends on the severity and progression of the disease. Systemic corticosteroids, immunosuppressant therapy, and biologic agents remain mainstay therapies. In this article, we present a literature review of recent diagnostic and novel treatment options for the management of PG. The literature research considered clinical studies or scientific reviews. Studies were identified by searching electronic databases and reference lists of respective articles till August 2019.Expert opinion: The true diagnosis of PG is challenging, as there is no diagnostic gold standard. PARACELSUS is a novel diagnostic tool. Biologics and small molecules are emerging systemic therapy options that are relatively new in treatment of PG.
Assuntos
Fármacos Dermatológicos/administração & dosagem , Pioderma Gangrenoso/tratamento farmacológico , Corticosteroides/administração & dosagem , Fatores Biológicos/administração & dosagem , Progressão da Doença , Humanos , Imunossupressores/administração & dosagem , Pioderma Gangrenoso/diagnóstico , Pioderma Gangrenoso/patologia , Índice de Gravidade de DoençaRESUMO
Eosinophilic ulcer (EU) is a rare self-limiting chronic benign lesion of the oral mucosa. It is an uncommon and benign disease, which may leading to diagnostic difficulties. Biopsy is recommended to rule out any malignant etiology.
RESUMO
BACKGROUND: Pitted keratolysis (PK) is a common bacterial infection of skin characterized by noninflammatory superficial pits. Very few studies have focused on variations in clinical manifestations of PK. We conducted this study so that diagnosis of this treatable condition is not missed when it presents in an uncommonly perceived way. AIMS AND OBJECTIVES: Assessment of PK patients for various sites and morphologies. MATERIALS AND METHODS: A total of 30 patients with PK were assessed for various sites and morphologies. Bacterial and fungal cultures along with histopathology were performed. RESULTS: Of 30 patients, 24 were females. Hyperhidrosis and malodour were the most common symptoms. Interdigital interface skin of the toes was the first site affected in most patients. Plantar skin was affected in all patients with involvement of interface skin of the toes in 29 patients. Other sites affected were palms, finger web spaces, nonglabrous skin, paronychium, and nail. Other than classical pits, scaly crusted inflammatory lesions with post-inflammatory hyperpigmentation (PIH) were noted. Associated keratoderma was also reported in some patients. DISCUSSION: The presence of hyperhidrosis, malodour, and plantar lesions is consistent with previous studies. Interface skin between toes as the first site affected, involvement of toe web spaces, and associated keratoderma have been reported rarely. However, female preponderance, involvement of finger web spaces, nonglabrous skin, paronychium, nail changes, the presence of inflammation with crusting, and PIH have never been reported previously. CONCLUSION: PK can involve web spaces, nonglabrous skin, and paronychium, and can cause nail changes. The lesions can be inflammatory with crusting and PIH.