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1.
Actas Dermosifiliogr ; 114(9): T755-T762, 2023 Oct.
Artículo en Inglés, Español | MEDLINE | ID: mdl-37479135

RESUMEN

BACKGROUND: Hidradenitis suppurativa (HS) is a chronic skin condition causing lesions in which high levels of interleukin (IL)-23 and T-helper17 cells are found. Adalimumab remains the only approved treatment. Guselkumab, an antibody targeting the p19 protein subunit of extracellular IL-23, is approved for the treatment of moderate-severe psoriasis, but evidence on its efficacy in treating HS is limited. OBJECTIVES: To assess the effectiveness and safety of guselkumab in treating moderate-severe HS under clinical practice conditions. METHODS: A multicentre retrospective observational study was carried out in 13 Spanish hospitals including adult HS patients treated with guselkumab within a compassionate use programme (March 2020-March 2022). Data referred to patient demographic and clinical characteristics at treatment initiation (baseline), patient-reported outcomes (Numerical Pain Rating Scale [NPRS] and Dermatology Life Quality Index [DLQI]), physician scores (International Hidradenitis Suppurativa Severity Score System [IHS4], HS Physical Global Score [HS-PGA] and Hidradenitis Suppurativa Clinical Response [HiSCR]) were recorded at baseline and at 16, 24, and 48weeks of treatment. RESULTS: A total of 69 patients were included. Most (84.10%) had severe HS (HurleyIII) and had been diagnosed for over ten years (58.80%). The patients had been subjected to multiple non-biological (mean: 3.56) or biological (mean: 1.78) therapies, and almost 90% of those treated with biologics had received adalimumab. A significant decrease in IHS4, HS-PGA, NPRS, and DLQI scores was observed from baseline to 48weeks of guselkumab treatment (all P<.01). HiSCR was achieved in 58.33% and 56.52% of the patients at 16 and 24weeks, respectively. Overall, 16 patients discontinued treatment, mostly due to inefficacy (n=7) or loss of efficacy (n=3). No serious adverse events were observed. CONCLUSIONS: Our results indicate that guselkumab may be a safe and effective therapeutic alternative for patients with severe HS that fail to respond to other biologics.


Asunto(s)
Productos Biológicos , Hidradenitis Supurativa , Adulto , Humanos , Adalimumab/uso terapéutico , Productos Biológicos/uso terapéutico , Hidradenitis Supurativa/tratamiento farmacológico , Hidradenitis Supurativa/diagnóstico , Hidradenitis Supurativa/patología , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Resultado del Tratamiento
2.
Actas Dermosifiliogr ; 114(9): 755-762, 2023 Oct.
Artículo en Inglés, Español | MEDLINE | ID: mdl-37331620

RESUMEN

BACKGROUND: Hidradenitis suppurativa (HS) is a chronic skin condition causing lesions in which high levels of interleukin (IL)-23 and T-helper 17 cells are found. Adalimumab remains the only approved treatment. Guselkumab, an antibody targeting the p19 protein subunit of extracellular IL-23, is approved for the treatment of moderate-severe psoriasis, but evidence on its efficacy in treating HS is limited. OBJECTIVES: To assess the effectiveness and safety of guselkumab in treating moderate-severe HS under clinical practice conditions. METHODS: A multicentre retrospective observational study was carried out in 13 Spanish Hospitals including adult HS patients treated with guselkumab within a compassionate use programme (March 2020-March 2022). Data referred to patient demographic and clinical characteristics at treatment initiation (baseline), patient-reported outcomes (Numerical Pain Rating Scale [NPRS] and Dermatology Life Quality Index [DLQI]), physician scores (International Hidradenitis Suppurativa Severity Score System [IHS4], HS Physical Global Score [HS-PGA] and Hidradenitis Suppurativa Clinical Response [HiSCR]) were recorded at baseline and at 16, 24, and 48 weeks of treatment. RESULTS: A total of 69 patients were included. Most (84.10%) had severe HS (Hurley III) and had been diagnosed for over ten years (58.80%). The patients had been subjected to multiple non-biological (mean 3.56) or biological (mean 1.78) therapies, and almost 90% of those treated with biologics had received adalimumab. A significant decrease in IHS4, HS-PGA, NPRS, and DLQI scores was observed from baseline to 48 weeks of guselkumab treatment (all p<0.01). HiSCR was achieved in 58.33% and 56.52% of the patients at 16 and 24 weeks, respectively. Overall, 16 patients discontinued treatment, mostly due to inefficacy (n=7) or loss of efficacy (n=3). No serious adverse events were observed. CONCLUSIONS: Our results indicate that guselkumab may be a safe and effective therapeutic alternative for patients with severe HS that fail to respond to other biologics.


Asunto(s)
Productos Biológicos , Hidradenitis Supurativa , Adulto , Humanos , Hidradenitis Supurativa/tratamiento farmacológico , Hidradenitis Supurativa/diagnóstico , Hidradenitis Supurativa/patología , Adalimumab/efectos adversos , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Productos Biológicos/uso terapéutico , Resultado del Tratamiento
3.
Dermatol Ther ; 28(4): 258-63, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25864463

RESUMEN

Skin ageing is characterized by small and fine wrinkles, roughness, laxity, and pigmentation as a result of epidermal thinning, collagen degradation, dermal atrophy, and fewer fibroblasts. Plasma rich in growth factors (PRGF) is an autologous plasma preparation enriched in proteins obtained from patient's own blood aimed at accelerating tissue repair and regeneration. To evaluate the benefits of PRGF in skin photodamage, 10 healthy volunteers were treated with three consecutive intradermal injections of PRGF in the facial area. Clinical outcomes and histological analysis were performed. A statistically significant increase in the epidermis and papillary dermis thickness was seen after PRGF treatment (p < 0.001). Skin thickening was observed in all patients studied, being more intense in the group of patients with photodamage (p < 0.001). After PRGF treatment, a reduction of the average area fraction of solar elastosis was observed in patients with clinical and histological signs of skin photodamage (p < 0.05).No changeswere observed in the number of CD31, XIIIa factor, cKit, CD10, nor p53-positive cells. The improvement score after PRGF use was 0.75 (9/12) for the group of patients with signs of skin photodamage. Intradermal PRGF infiltration appears to be an effective treatment for the photodamaged skin.


Asunto(s)
Técnicas Cosméticas , Péptidos y Proteínas de Señalización Intercelular/uso terapéutico , Plasma Rico en Plaquetas , Envejecimiento de la Piel/efectos de los fármacos , Envejecimiento de la Piel/patología , Adulto , Dermis/patología , Epidermis/patología , Cara , Femenino , Humanos , Inyecciones Intradérmicas , Péptidos y Proteínas de Señalización Intercelular/administración & dosificación , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Rejuvenecimiento
4.
Actas Dermosifiliogr ; 106(1): 17-28, 2015.
Artículo en Inglés, Español | MEDLINE | ID: mdl-24878038

RESUMEN

Homeostasis, whose regulation at the molecular level is still poorly understood, is intimately related to the functions of epidermal stem cells. Five research groups have been brought together to work on new in vitro and in vivo skin models through the SkinModel-CM program, under the auspices of the Spanish Autonomous Community of Madrid. This project aims to analyze the functions of DNA methyltransferase 1, endoglin, and podoplanin in epidermal stem cell activity, homeostasis, and skin cancer. These new models include 3-dimensional organotypic cultures, immunodeficient skin-humanized mice, and genetically modified mice. Another aim of the program is to use skin-humanized mice to model dermatoses such as Gorlin syndrome and xeroderma pigmentosum in order to optimize new protocols for photodynamic therapy.


Asunto(s)
Homeostasis , Enfermedades de la Piel/fisiopatología , Fenómenos Fisiológicos de la Piel , Animales , Investigación Biomédica , Modelos Animales de Enfermedad , Folículo Piloso , Humanos , Ratones , Modelos Animales , Modelos Genéticos , Fotoquimioterapia , Enfermedades de la Piel/genética , Enfermedades de la Piel/terapia , Células Madre
5.
J Eur Acad Dermatol Venereol ; 27(9): 1143-50, 2013 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-22882643

RESUMEN

BACKGROUND: A better knowledge of the dynamic biological changes that the skin undergoes in response to ionizing radiation is advisable to improve the management of radiation dermatitis, allowing selection of patients needing treatment or close monitoring. OBJECTIVE: To describe the evolution of the skin in response to ionizing radiation through the reflectance confocal microscopy (RCM) features of acute radiation dermatitis. METHODS: In this prospective descriptive study, six women (median age, 55 years; range, 45-80 years) diagnosed with breast cancer in stages IA-IB undergoing adjuvant radiotherapy were included in the study through consecutive sampling. Clinical, dermoscopic and RCM evaluation of the skin were performed prior to treatment and on days 1, 15, 30 and 45 after radiotherapy. RESULTS: While clinical features of radiation dermatitis emerged after 30 days on average, histopathological changes were detectable by RCM after a mean time of 15 days. The main RCM features included initial appearance of spongiosis, exocytosis and inflammatory cells followed by the presence of dendritic-shaped cells, 'streaming-like figures', 'broken geographic papillae', epidermal architectural disarray, effacement of rete ridges, melanophages and, finally, hyperpigmentation of the basal layer. CONCLUSIONS: RCM may safely detect the dynamic biological changes that the skin undergoes in response to ionizing radiation, even before than clinical onset of acute radiation dermatitis. Therefore, RCM may be useful to make an early and non-invasive diagnosis of radiation dermatitis during radiotherapy, allowing an early selection of patients needing treatment or close monitoring and avoiding skin biopsies.


Asunto(s)
Radiodermatitis/patología , Piel/patología , Enfermedad Aguda , Anciano , Anciano de 80 o más Años , Neoplasias de la Mama/radioterapia , Femenino , Humanos , Microscopía Confocal , Persona de Mediana Edad , Estudios Prospectivos
6.
Clin Exp Dermatol ; 34(5): e1-3, 2009 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-19040518

RESUMEN

Wegener's granulomatosis (WG) is a multisystemic vasculitis, with skin involvement in 14% of cases and with palpable purpura, subcutaneous nodules and necrotic papules as the common features.(1) We present a patient diagnosed with WG who had multiple whitish papules similar to those of malignant atrophic papulosis (Degos' disease), which appeared during a flare of his disease. Lesions of malignant atrophic papulosis are said to be pathognomonic; nevertheless, various diseases with similar clinical lesions have been described. To our knowledge, this is the first reported case of such lesions in a patient with WG, and we suggest WG should be included in the differential diagnosis of Degos' disease.


Asunto(s)
Granulomatosis con Poliangitis/diagnóstico , Papulosis Atrófica Maligna/diagnóstico , Anciano , Biopsia , Diagnóstico Diferencial , Granulomatosis con Poliangitis/patología , Humanos , Masculino , Papulosis Atrófica Maligna/patología
7.
Actas dermo-sifiliogr. (Ed. impr.) ; 114(9): 755-762, oct. 2023. tab, graf
Artículo en Inglés | IBECS (España) | ID: ibc-226026

RESUMEN

Background Hidradenitis suppurativa (HS) is a chronic skin condition causing lesions in which high levels of interleukin (IL)-23 and T-helper 17 cells are found. Adalimumab remains the only approved treatment. Guselkumab, an antibody targeting the p19 protein subunit of extracellular IL-23, is approved for the treatment of moderate–severe psoriasis, but evidence on its efficacy in treating HS is limited.Objectives To assess the effectiveness and safety of guselkumab in treating moderate–severe HS under clinical practice conditions. Methods A multicentre retrospective observational study was carried out in 13 Spanish Hospitals including adult HS patients treated with guselkumab within a compassionate use programme (March 2020–March 2022). Data referred to patient demographic and clinical characteristics at treatment initiation (baseline), patient-reported outcomes (Numerical Pain Rating Scale [NPRS] and Dermatology Life Quality Index [DLQI]), physician scores (International Hidradenitis Suppurativa Severity Score System [IHS4], HS Physical Global Score [HS-PGA] and Hidradenitis Suppurativa Clinical Response [HiSCR]) were recorded at baseline and at 16, 24, and 48 weeks of treatment. Results A total of 69 patients were included. Most (84.10%) had severe HS (Hurley III) and had been diagnosed for over ten years (58.80%). The patients had been subjected to multiple non-biological (mean 3.56) or biological (mean 1.78) therapies, and almost 90% of those treated with biologics had received adalimumab (AU)


Antecedentes La hidradenitis supurativa (HS) es una situación cutánea crónica que causa lesiones en las que se encuentran altos niveles de interleucina (IL)-23 y células TH-17 colaboradoras, siendo adalimumab el único tratamiento aprobado. Guselkumab, un anticuerpo que focaliza la subunidad de la proteína p19 de IL-23 extracelular, ha sido aprobado para tratar la psoriasis de moderada a severa, siendo limitada la evidencia sobre su eficacia en el tratamiento de la HS. Objetivos Evaluar la efectividad y seguridad de guselkumab para el tratamiento de la HS de moderada a severa, en condiciones de práctica clínica. Métodos Se llevó a cabo un estudio observacional retrospectivo y multicéntrico en 13 hospitales españoles, que incluyó pacientes adultos de HS tratados con guselkumab, dentro de un programa de uso compasivo (de marzo de 2020 a marzo de 2022). Se registraron al inicio y a las 16, 24 y 48 semanas de tratamiento los datos referentes a las características demográficas y clínicas de los pacientes, los resultados reportados por el paciente (Numerical Pain Rating Scale [NPRS] y Dermatology Life Quality Index [DLQI]), puntuaciones del facultativo (International Hidradenitis Suppurativa Severity Score System [IHS4], HS Physical Global Score [HS-PGA] e Hidradenitis Suppurativa Clinical Response [HiSCR]). Resultados Se incluyó un total de 69 pacientes, de los cuales la mayoría (84,10%) tenían HS severa (Hurley III) y habían sido diagnosticados hacía más de 10 años (58,80%). Dichos pacientes habían sido sometidos a múltiples terapias no biológicas (media 3,56) o biológicas (media 1,78), y casi el 90% de los tratados con biológicos habían recibido adalimumab. Se observó una reducción significativa de las puntuaciones IHS4, HS-PGA, NPRS y DLQI desde el inicio hasta las 48 semanas del tratamiento con guselkumab (total p<0,01). Se logró HiSCR en el 58,33% y el 56,52% de los pacientes, a las 16 y 24 semanas, respectivamente (AU)


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Hidradenitis Supurativa/tratamiento farmacológico , Fármacos Dermatológicos/uso terapéutico , Índice de Severidad de la Enfermedad , Resultado del Tratamiento , Estudios Retrospectivos
8.
Actas dermo-sifiliogr. (Ed. impr.) ; 114(9): t755-t762, oct. 2023. tab, graf
Artículo en Español | IBECS (España) | ID: ibc-226027

RESUMEN

Antecedentes La hidradenitis supurativa (HS) es una situación cutánea crónica que causa lesiones en las que se encuentran altos niveles de interleucina (IL)-23 y células TH-17 colaboradoras, siendo adalimumab el único tratamiento aprobado. Guselkumab, un anticuerpo que focaliza la subunidad de la proteína p19 de IL-23 extracelular, ha sido aprobado para tratar la psoriasis de moderada a severa, siendo limitada la evidencia sobre su eficacia en el tratamiento de la HS. Objetivos Evaluar la efectividad y seguridad de guselkumab para el tratamiento de la HS de moderada a severa, en condiciones de práctica clínica. Métodos Se llevó a cabo un estudio observacional retrospectivo y multicéntrico en 13 hospitales españoles, que incluyó pacientes adultos de HS tratados con guselkumab, dentro de un programa de uso compasivo (de marzo de 2020 a marzo de 2022). Se registraron al inicio y a las 16, 24 y 48 semanas de tratamiento los datos referentes a las características demográficas y clínicas de los pacientes, los resultados reportados por el paciente (Numerical Pain Rating Scale [NPRS] y Dermatology Life Quality Index [DLQI]), puntuaciones del facultativo (International Hidradenitis Suppurativa Severity Score System [IHS4], HS Physical Global Score [HS-PGA] e Hidradenitis Suppurativa Clinical Response [HiSCR]). Resultados Se incluyó un total de 69 pacientes, de los cuales la mayoría (84,10%) tenían HS severa (Hurley III) y habían sido diagnosticados hacía más de 10 años (58,80%). Dichos pacientes habían sido sometidos a múltiples terapias no biológicas (media 3,56) o biológicas (media 1,78), y casi el 90% de los tratados con biológicos habían recibido adalimumab. Se observó una reducción significativa de las puntuaciones IHS4, HS-PGA, NPRS y DLQI desde el inicio hasta las 48 semanas del tratamiento con guselkumab (total p<0,01). Se logró HiSCR en el 58,33% y el 56,52% de los pacientes, a las 16 y 24 semanas, respectivamente (AU)


Background Hidradenitis suppurativa (HS) is a chronic skin condition causing lesions in which high levels of interleukin (IL)-23 and T-helper 17 cells are found. Adalimumab remains the only approved treatment. Guselkumab, an antibody targeting the p19 protein subunit of extracellular IL-23, is approved for the treatment of moderate–severe psoriasis, but evidence on its efficacy in treating HS is limited.Objectives To assess the effectiveness and safety of guselkumab in treating moderate–severe HS under clinical practice conditions. Methods A multicentre retrospective observational study was carried out in 13 Spanish Hospitals including adult HS patients treated with guselkumab within a compassionate use programme (March 2020–March 2022). Data referred to patient demographic and clinical characteristics at treatment initiation (baseline), patient-reported outcomes (Numerical Pain Rating Scale [NPRS] and Dermatology Life Quality Index [DLQI]), physician scores (International Hidradenitis Suppurativa Severity Score System [IHS4], HS Physical Global Score [HS-PGA] and Hidradenitis Suppurativa Clinical Response [HiSCR]) were recorded at baseline and at 16, 24, and 48 weeks of treatment. Results A total of 69 patients were included. Most (84.10%) had severe HS (Hurley III) and had been diagnosed for over ten years (58.80%). The patients had been subjected to multiple non-biological (mean 3.56) or biological (mean 1.78) therapies, and almost 90% of those treated with biologics had received adalimumab (AU)


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Hidradenitis Supurativa/tratamiento farmacológico , Fármacos Dermatológicos/uso terapéutico , Índice de Severidad de la Enfermedad , Resultado del Tratamiento , Estudios Retrospectivos
12.
Actas Dermosifiliogr ; 99(1): 5-33, 2008.
Artículo en Español | MEDLINE | ID: mdl-18206084

RESUMEN

In recent years, a series of new drugs have been developed through the application of molecular biology. These drugs act by blocking specific molecules of the immune system and have been developed to act on specific targets that play an important role in the pathophysiology of the diseases in which their therapeutic use has now been approved. Over time, experience has been accumulated in the use of these drugs in the treatment of skin diseases for which they have not been approved but in which the pathophysiology suggests that they could also be effective. The use of these drugs is increasing in difficult-to-treat cases of skin diseases for which the drugs are not approved. The second part of this review of off-label use of biologic agents in dermatology considers the use of etanercept, efalizumab, alefacept, rituximab, basiliximab, omalizumab, and cetuximab.


Asunto(s)
Productos Biológicos/uso terapéutico , Enfermedades de la Piel/tratamiento farmacológico , Alefacept , Anticuerpos Antiidiotipos , Anticuerpos Monoclonales/uso terapéutico , Anticuerpos Monoclonales Humanizados , Anticuerpos Monoclonales de Origen Murino , Basiliximab , Cetuximab , Daclizumab , Aprobación de Drogas , Etanercept , Humanos , Inmunoglobulina G/uso terapéutico , Omalizumab , Receptores del Factor de Necrosis Tumoral/uso terapéutico , Proteínas Recombinantes de Fusión/uso terapéutico , Rituximab
13.
Actas Dermosifiliogr ; 98(10): 657-78, 2007 Dec.
Artículo en Español | MEDLINE | ID: mdl-18035024

RESUMEN

In recent years, the therapeutic armamentarium available to dermatologists has been extended thanks to the development of numerous biologic agents. In our field, immunomodulators--although currently only approved for psoriasis--have given rise to new therapeutic possibilities in a number of inflammatory skin diseases. Since these new agents have more specific immunologic mechanisms of action, their efficacy and safety is an improvement on traditional immunosuppressants. Consequently, it is very likely that they will play an important role in dermatology in the next few years. This article, the first part of a review of off-label use of biologic agents in dermatology, describes the anti-tumor necrosis factor-alpha antibodies, infliximab and adalimumab.


Asunto(s)
Anticuerpos Monoclonales/uso terapéutico , Enfermedades de la Piel/tratamiento farmacológico , Adalimumab , Anticuerpos Monoclonales Humanizados , Prescripciones de Medicamentos/normas , Enfermedad Injerto contra Huésped/tratamiento farmacológico , Humanos , Infliximab
14.
Actas Dermosifiliogr ; 97(10): 653-7, 2006 Dec.
Artículo en Español | MEDLINE | ID: mdl-17173829

RESUMEN

Atypical mycobacterial infections are increasingly important in immunosuppressed patients as well as in healthy hosts. The atypical mycobacterium that most commonly affects the skin is Mycobacterium marinum. The infection should be suspected upon the presence of ulcers, nodules or chronic plaques and a history of contact with fresh or salt water. Optimal therapy is yet to be established. We report a case of Mycobacterium marinum infection in a patient receiving immunosuppressive therapy that responded favourably to treatment with doxicycline. We review the different antibiotic regimens prescribed in the past years for the treatment of Mycobacterium marinum infection.


Asunto(s)
Infecciones por Mycobacterium no Tuberculosas/microbiología , Mycobacterium marinum/aislamiento & purificación , Infección de Heridas/microbiología , Anciano , Antibacterianos/uso terapéutico , Azatioprina/efectos adversos , Azatioprina/uso terapéutico , Doxiciclina/uso terapéutico , Traumatismos de los Pies/complicaciones , Traumatismos de los Pies/microbiología , Úlcera del Pie/tratamiento farmacológico , Úlcera del Pie/microbiología , Humanos , Huésped Inmunocomprometido , Inmunosupresores/efectos adversos , Inmunosupresores/uso terapéutico , Úlcera de la Pierna/tratamiento farmacológico , Úlcera de la Pierna/microbiología , Masculino , Metotrexato/efectos adversos , Metotrexato/uso terapéutico , Infecciones por Mycobacterium no Tuberculosas/diagnóstico , Infecciones por Mycobacterium no Tuberculosas/tratamiento farmacológico , Infecciones por Mycobacterium no Tuberculosas/etiología , Agua de Mar/microbiología , Espondilitis Anquilosante/complicaciones , Espondilitis Anquilosante/tratamiento farmacológico , Infección de Heridas/tratamiento farmacológico
15.
Actas dermo-sifiliogr. (Ed. impr.) ; 106(1): 17-28, ene.-feb. 2015. ilus, tab
Artículo en Español | IBECS (España) | ID: ibc-133274

RESUMEN

La homeostasis de la piel, cuya regulación molecular es aún bastante desconocida, está íntimamente relacionada con la función de las células madre epidérmicas. El programa SkinModel-CM, auspiciado por la Comunidad de Madrid, reúne 5 grupos de investigación con el propósito de desarrollar nuevos modelos experimentales in vitro e in vivo para analizar la función de ADN metiltransferasa 1, la endoglina y la podoplanina en la actividad de las células madre epidérmicas y en la homeostasis y el cáncer cutáneos. Estos nuevos modelos comprenden tanto cultivos organotípicos 3 D, como ratones inmunodeficientes con la piel humanizada y ratones modificados genéticamente. Otro objetivo del programa es el uso de ratones con la piel humanizada como modelo para reconstruir enfermedades cutáneas, tales como el síndrome de Gorlin y el xeroderma pigmentoso, con el objeto de optimizar nuevos protocolos de intervención mediante la terapia fotodinámica (AU)


Homeostasis, whose regulation at the molecular level is still poorly understood, is intimately related to the functions of epidermal stem cells. Five research groups have been brought together to work on new in vitro and in vivo skin models through the SkinModel-CM program, under the auspices of the Spanish Autonomous Community of Madrid. This project aims to analyze the functions of DNA methyltransferase 1, endoglin, and podoplanin in epidermal stem cell activity, homeostasis, and skin cancer. These new models include 3-dimensional organotypic cultures, immunodeficient skin-humanized mice, and genetically modified mice. Another aim of the program is to use skin-humanized mice to model dermatoses such as Gorlin syndrome and xeroderma pigmentosum in order to optimize new protocols for photodynamic therapy (AU)


Asunto(s)
Humanos , Homeostasis/fisiología , Enfermedades de la Piel/fisiopatología , Metilasas de Modificación del ADN/fisiología , Células Madre/fisiología , Modelos Animales de Enfermedad , Fototerapia , Folículo Piloso/fisiología , Modelos Genéticos , Bioingeniería/métodos
17.
Actas dermo-sifiliogr. (Ed. impr.) ; 99(1): 5-33, ene. 2008.
Artículo en Es | IBECS (España) | ID: ibc-058654

RESUMEN

En los últimos años han aparecido una serie de nuevos fármacos desarrollados por biología molecular. Estos medicamentos actúan bloqueando moléculas específicas del sistema inmunológico y se desarrollan para actuar sobre dianas específicas que tienen un papel importante en la fisiopatología de determinadas enfermedades para cuyo tratamiento son aprobadas. Con el tiempo se ha ido adquiriendo experiencia con estos medicamentos en el tratamiento de dermatosis para las que no han sido diseñados, pero para las que, por compartir un mismo mecanismo fisiopatológico, pueden ser útiles. El empleo de estos medicamentos en el tratamiento de casos difíciles de numerosas enfermedades dermatológicas para las cuales no están aprobados es creciente. Esta segunda parte de la revisión analiza el uso, fuera de indicación, en el tratamiento de la dermatosis de los siguientes fármacos biológicos: etanercept, efalizumab, alefacept, rituximab, daclizumab, basiliximab, omalizumab y cetuximab


In recent years, a series of new drugs have been developed through the application of molecular biology. These drugs act by blocking specific molecules of the immune system and have been developed to act on specific targets that play an important role in the pathophysiology of the diseases in which their therapeutic use has now been approved. Over time, experience has been accumulated in the use of these drugs in the treatment of skin diseases for which they have not been approved but in which the pathophysiology suggests that they could also be effective. The use of these drugs is increasing in difficult-to-treat cases of skin diseases for which the drugs are not approved. The second part of this review of off-label use of biologic agents in dermatology considers the use of etanercept, efalizumab, alefacept, rituximab, basiliximab, omalizumab, and cetuximab


Asunto(s)
Humanos , Terapia Biológica/métodos , Enfermedades de la Piel/tratamiento farmacológico , Aprobación de Drogas , Antígeno-1 Asociado a Función de Linfocito , Antígenos CD58 , Antígenos CD20 , Inmunoglobulina E , Interleucina-2/antagonistas & inhibidores , Receptores ErbB/antagonistas & inhibidores , Factor de Necrosis Tumoral alfa/antagonistas & inhibidores
18.
Actas dermo-sifiliogr. (Ed. impr.) ; 98(10): 657-658, dic. 2007. ilus, tab
Artículo en Es | IBECS (España) | ID: ibc-057206

RESUMEN

En los últimos años el armamento terapéutico de los dermatólogos se ha incrementado como consecuencia de la introducción de múltiples fármacos biológicos. En Dermatología los inmunomoduladores están aprobados únicamente para la psoriasis. No obstante todos estos medicamentos han abierto nuevas posibilidades de tratamiento para numerosas dermatosis inflamatorias. La eficacia y el perfil de seguridad de estos fármacos puede considerarse mejor al de los inmunosupresores clásicos, dado que actúan sobre mecanismos inmunológicos más específicos, siendo muy probable que en los próximos años estos medicamentos biológicos adquieran un importante papel en el campo de la Dermatología. Este artículo, primera parte de la revisión de usos fuera de indicación de fármacos biológicos en Dermatología, describe los anticuerpos antifactor de necrosis tumoral (TNF): infliximab y adalimumab


In recent years, the therapeutic armamentarium available to dermatologists has been extended thanks to the development of numerous biologic agents. In our field, immunomodulators--although currently only approved for psoriasis--have given rise to new therapeutic possibilities in a number of inflammatory skin diseases. Since these new agents have more specific immunologic mechanisms of action, their efficacy and safety is an improvement on traditional immunosuppressants. Consequently, it is very likely that they will play an important role in dermatology in the next few years. This article, the first part of a review of off-label use of biologic agents in dermatology, describes the anti-tumor necrosis factor-a antibodies, infliximab and adalimumab


Asunto(s)
Masculino , Femenino , Humanos , Enfermedades de la Piel/tratamiento farmacológico , Medicamentos sin Prescripción/farmacología , Medicamentos sin Prescripción/uso terapéutico , Sarcoidosis/tratamiento farmacológico , Anticuerpos Monoclonales/uso terapéutico , Granuloma Anular/tratamiento farmacológico , Terapia PUVA , Psoriasis/tratamiento farmacológico , Esclerodermia Localizada/complicaciones , Esclerodermia Localizada/tratamiento farmacológico , Adyuvantes Inmunológicos/uso terapéutico , Prescripción Homeopática/tendencias , Prescripciones de Medicamentos/normas , Inmunosupresores/uso terapéutico , Necrobiosis Lipoidea/tratamiento farmacológico , Hidradenitis Supurativa/tratamiento farmacológico , Piodermia Gangrenosa/tratamiento farmacológico , Síndrome de Sweet/tratamiento farmacológico
19.
Actas dermo-sifiliogr. (Ed. impr.) ; 97(10): 653-657, dic. 2006. ilus
Artículo en Es | IBECS (España) | ID: ibc-049275

RESUMEN

Las infecciones por micobacterias atípicas están adquiriendo cada vez mayor importancia en los pacientes inmunodeprimidos, así como en huéspedes sanos. El Mycobacterium marinum es la micobacteria atípica que afecta la piel con mayor frecuencia. Debe sospecharse ante la existencia de úlceras, nódulos o placas crónicas y el antecedente de un contacto con medios acuáticos. El tratamiento óptimo no está aún bien establecido. Presentamos un nuevo caso de infección por Mycobacterium marinum en un paciente que seguía tratamiento con fármacos inmunosupresores, que respondió favorablemente al tratamiento con doxiciclina y revisamos los distintos regímenes antibióticos utilizados para el tratamiento de la infección por Mycobacterium marinum en los últimos años


Atypical mycobacterial infections are increasingly important in immunosuppressed patients as well as in healthy hosts. The atypical mycobacterium that most commonly affects the skin is Mycobacterium marinum. The infection should be suspected upon the presence of ulcers, nodules or chronic plaques and a history of contact with fresh or salt water. Optimal therapy is yet to be established. We report a case of Mycobacterium marinum infection in a patient receiving immunosuppressive therapy that responded favourably to treatment with doxicycline. We review the different antibiotic regimens prescribed in the past years for the treatment of Mycobacterium marinum infection


Asunto(s)
Masculino , Persona de Mediana Edad , Humanos , Mycobacterium marinum/citología , Mycobacterium marinum/aislamiento & purificación , Granuloma/complicaciones , Granuloma/diagnóstico , Doxiciclina/uso terapéutico , Antibacterianos/uso terapéutico , Combinación Amoxicilina-Clavulanato de Potasio/uso terapéutico , Inmunosupresores/uso terapéutico , Infecciones por Mycobacterium no Tuberculosas/complicaciones , Infecciones por Mycobacterium no Tuberculosas/diagnóstico , Infecciones/complicaciones , Factores de Riesgo , Rifampin/uso terapéutico , Etambutol/uso terapéutico , Tetraciclinas/uso terapéutico , Claritromicina/uso terapéutico , Rifabutina/uso terapéutico , Imipenem/uso terapéutico , Infecciones por Mycobacterium no Tuberculosas/etiología , Infecciones por Mycobacterium no Tuberculosas/terapia
20.
Med. segur. trab ; 52(202): 29-37, mar. 2006. ilus, tab
Artículo en Es | IBECS (España) | ID: ibc-056169

RESUMEN

Los agentes de revelado fotográfico son derivados de la parafenilendiamina, que pueden actuar como irritantes y/o sensibilizantes cutáneos en trabajadores de procesos fotográficos, manifestándose las lesiones no sólo en forma de eczema de contacto, sino también como lesiones liquenoides. La incidencia de dermatosis profesionales por reveladores de color ha disminuido en los últimos años debido a la automatización de los procesos de revelado y a la aparición de la fotografía digital. Presentamos un caso de dermatitis de contacto liquenoide secundaria al revelador CD2 en un trabajador de laboratorio fotográfico automatizado que ocasionalmente reparaba las averías que se presentaban en la maquinaria. Las lesiones eran clínica e histológicamente liquenoides y las pruebas epicutáneas resultaron positivas a CD2. Nuestro caso presenta además la particularidad de la diseminación de las lesiones hacia zonas donde no era evidente el contacto con el líquido revelador


Colour developing agents, derivatives of paraphenylendiamine, can be both irritants and sensitizers in photographic processing workers. They cause allergic contact dermatitis and also lichenoid reactions. The incidence of occupational dermatosis from colour developers has decreased in the last years because of the automation in the developer processing and the emergence of digital photography. We present a case of lichenoid contact dermatitis in a mechanized photographic laboratory worker, who occasionally repaired machinery's damages. Lesions were clinical and histhopatological lichenoid and patch test were positives to CD2. Our case presents the singularity of the dissemination of the lesions to areas of the skin where it was not evident the contact with the colour developers agents


Asunto(s)
Masculino , Adulto , Humanos , Erupciones Liquenoides/inducido químicamente , 25817 , Fenilendiaminas/efectos adversos , Alérgenos/efectos adversos , Exposición Profesional/efectos adversos , Dermatitis Profesional/etiología
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