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In this original research, we present the results in terms of effectiveness and safety of bimekizumab for hidradenitis suppurativa in real clinical practice. Results indicated significant improvement in all activity scores and patient-reported outcomes at week 16, including a notable decrease in mean IHS4 from 27.1 to 15.6 (p < 0.001), HS-PGA from 5.1 to 3.2 (p < 0.001), VAS pain from 8.3 to 4.7 (p < 0.001) and DLQI from 21.6 to 12.6 (p < 0.001). Bimekizumab, administered every 2 or 4 weeks, was well-tolerated with no discontinuations and no new safety concerns identified. These findings corroborate the drug's effectiveness and favourable safety profile observed in phase 3 clinical trials, supporting its use in real-world clinical practice for treating HS.
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INTRODUCTION: The use of biological therapy is becoming increasingly common in patients with hidradenitis suppurativa (HS). Levels of serum TNF-alfa and IL17 support the role of an immune system dysregulation in the pathogenesis of HS. Brodalumab targets the receptor A of IL-17, thus having a promising role in the treatment of HS. MATERIAL AND METHODS: A multicenter retrospective observational open-label study was conducted in two tertiary hospitals. Adults with moderate to severe HS under treatment with brodalumab 210 mg at week 0, 1, 2 and then every 2 weeks were included and assessed at weeks 0 and 16 which was the median follow-up time. Demographic and disease-related variables as well as response parameters (HiSCR and IHS4) and safety data were recorded and analysed. RESULTS: A total of 16 patients (75% males) were included in our study. 50% of patients presented an inflammatory phenotype and mean BMI was 28.37. HiSCR was achieved in 50% of patients and mean IHS4 decreased from 24.13 to 16.81 (p = 0.002). No differences were found between those who achieved HiSCR and those who did not. Grade 2 adverse events were reported in three patients with no fatal outcomes and treatment discontinuation was advised in four patients. CONCLUSIONS: Brodalumab seems to be effective and safe in patients with moderate to severe HS, even in those that did not respond to adalimumab, which, at the moment, is the only widely approved biologic for this indication. Thus, it stands as an interesting option for the treatment of HS.
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Anticuerpos Monoclonales Humanizados , Hidradenitis Supurativa , Índice de Severidad de la Enfermedad , Humanos , Hidradenitis Supurativa/tratamiento farmacológico , Hidradenitis Supurativa/sangre , Masculino , Femenino , Adulto , Anticuerpos Monoclonales Humanizados/uso terapéutico , Estudios Retrospectivos , Persona de Mediana Edad , Adulto Joven , Resultado del Tratamiento , Estudios de CohortesRESUMEN
BACKGROUND: Folliculitis decalvans (FD) is a rare neutrophilic cicatricial alopecia that poses a therapeutic challenge. OBJECTIVES: To describe the therapeutic response in a large number of cases of FD with long-term follow-up and analyze potential prognostic factors associated with severity of form and with a better therapeutic response. METHODS: This multicenter prospective study included patients with FD who had a minimum of 5 years of follow-up. Severity was assessed by the maximum diameter of the cicatricial area. Therapeutic response was evaluated according to stabilization of the size of the cicatricial areas and the improvement in clinical symptoms. RESULTS: A total of 60 patients (37 men [61.7%] and 23 women [38.3%]) with a mean age of 40 years were included. Earlier age of onset (P = .01) was statistically associated with severity of form. Treatment with rifampicin and clindamycin, tetracyclines, and intralesional steroids was the most effective. No statistically significant prognostic factors predicting a better therapeutic response were found. LIMITATIONS: Because FD is a rare disease, the main limitation was the sample size. CONCLUSIONS: An earlier age of onset was associated with the severe form of the disease. The proposed specific therapeutic protocol can be a very useful tool in clinical dermatologic practice.
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Alopecia/patología , Foliculitis/tratamiento farmacológico , Foliculitis/patología , Dermatosis del Cuero Cabelludo/tratamiento farmacológico , Dermatosis del Cuero Cabelludo/patología , Corticoesteroides/uso terapéutico , Alopecia/tratamiento farmacológico , Alopecia/etiología , Antibacterianos/uso terapéutico , Cicatriz/tratamiento farmacológico , Cicatriz/patología , Estudios de Cohortes , Terapia Combinada , Femenino , Foliculitis/complicaciones , Estudios de Seguimiento , Humanos , Isotretinoína/uso terapéutico , Masculino , Minoxidil/uso terapéutico , Análisis Multivariante , Fotoquimioterapia/métodos , Estudios Retrospectivos , Medición de Riesgo , Dermatosis del Cuero Cabelludo/complicaciones , España , Factores de Tiempo , Resultado del TratamientoRESUMEN
Essential generalized telangiectasia as the result of postcapillary venule dilatation, is characterized by the sudden development of generalized telangiectasias, sometimes involving the conjunctiva. A few pediatric cases have been reported. The main condition in the differential diagnosis includes syndromes with telangiectasia such as hereditary hemorrhagic telangiectasia of Rendu-Osler, unilateral nevoid telangiectasia, and neonatal lupus erythematous. We present an 11-month-old boy that presented because of telangiectasia located on the face and neck. The telangiectasias appeared at two months of age and followed a progressive course. Nd-YAG laser therapy could be an interesting therapeutic approach in cosmetically compromised cases.
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Dermatosis Facial/diagnóstico , Telangiectasia/diagnóstico , Diagnóstico Diferencial , Humanos , Lactante , Masculino , CuelloRESUMEN
BACKGROUND: To our knowledge, there are no large multicenter studies concerning frontal fibrosing alopecia (FFA) that could give clues about its pathogenesis and best treatment. OBJECTIVE: We sought to describe the epidemiology, comorbidities, clinical presentation, diagnostic findings, and therapeutic choices in a large series of patients with FFA. METHODS: This retrospective multicenter study included patients given the diagnosis of FFA. Clinical severity was classified based on the recession of the frontotemporal hairline. RESULTS: In all, 355 patients (343 women [49 premenopausal] and 12 men) with a mean age of 61 years (range 23-86) were included. Early menopause was detected in 49 patients (14%), whereas 46 (13%) had undergone hysterectomy. Severe FFA was observed in 131 patients (37%). Independent factors associated with severe FFA after multivariate analysis were: eyelash loss, facial papules, and body hair involvement. Eyebrow loss as the initial clinical presentation was associated with mild forms. Antiandrogens such as finasteride and dutasteride were used in 111 patients (31%), with improvement in 52 (47%) and stabilization in 59 (53%). LIMITATIONS: The retrospective design is a limitation. CONCLUSIONS: Eyelash loss, facial papules, and body hair involvement were associated with severe FFA. Antiandrogens were the most useful treatment.
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Alopecia/tratamiento farmacológico , Alopecia/patología , Azaesteroides/uso terapéutico , Finasterida/uso terapéutico , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Alopecia/epidemiología , Biopsia con Aguja , Estudios de Cohortes , Dutasterida , Femenino , Fibrosis/epidemiología , Fibrosis/patología , Frente , Humanos , Inmunohistoquímica , Masculino , Persona de Mediana Edad , Análisis Multivariante , Posmenopausia/fisiología , Estudios Retrospectivos , Medición de Riesgo , Índice de Severidad de la Enfermedad , Distribución por Sexo , España/epidemiología , Resultado del Tratamiento , Adulto JovenRESUMEN
A boy aged 6 years was referred to our clinic for evaluation of the presence of fair, thin hair on both of his elbows. This condition had first been observed when he was 2 years of age and the hair had subsequently increased in length and thickness (Figure 1). He had a history of asthma and was being treated by a paediatrician. His family medical record was otherwise unremarkable. This unusual hairiness was symmetrically distributed on the extensor surfaces of both proximal forearms and distal arms. The underlying skin showed no abnormalities. No hypertrichosis was found elsewhere and examination of teeth, skeleton and fingernails was also normal. No other morphological changes were noted. In addition, his height was appropriate for his age. No developmental, mental or physical impairment was observed. The blood cell count and general biochemistry, as well as thyroid and sexual hormonal profiles were all normal. Radiological examination, which was performed on the parents' request, was normal. The boy was diagnosed with hypertrichosis cubiti (HC), and shaving of the areas was recommended.
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Trastornos del Crecimiento/diagnóstico , Hipertricosis/congénito , Piel/patología , Biopsia , Niño , Diagnóstico Diferencial , Trastornos del Crecimiento/etiología , Humanos , Hipertricosis/diagnóstico , Hipertricosis/etiología , MasculinoRESUMEN
INTRODUCTION: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease. Biologic drugs have a key role in the long-term anti-inflammatory treatment of moderate to severe patients due to their immunomodulatory properties. The aim of this study is to evaluate the effectiveness and safety of secukinumab in patients with moderate to severe HS after 16 weeks of treatment, and to explore potential predictors of clinical response to the drug. METHODS: Multicenter observational retrospective study. Patients treated with secukinumab 300 mg every 2 or 4 weeks who had completed at least 16 weeks of follow-up from nine hospitals based in southern Spain (Andalusia) were included in this study. Treatment effectiveness was assessed using the Hidradenitis Suppurativa Clinical Response (HiSCR). Information about adverse events was collected, the therapeutic burden of the patients was calculated as the summation of systemic medical treatments and surgical interventions (excluding incision and drainage) experienced until the start of secukinumab treatment. RESULTS: Forty-seven patients with severe HS were included for analysis. At week 16, 48.9% (23/47) of patients achieved HiSCR. Adverse events were present in 6.4% (3/47) of the patients. The multivariate analysis showed that female sex and, to a lesser extent, lower body mass index (BMI) and a lower therapeutic burden were potentially associated with a higher probability of HiSCR achievement. CONCLUSIONS: Favorable short-term effectiveness and safety of secukinumab in the treatment of severe HS patients were observed. Female sex, lower BMI and a lower therapeutic burden may be associated with a higher probability of achieving HiSCR.
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Aminoquinolinas/uso terapéutico , Carcinoma de Células Escamosas/tratamiento farmacológico , Neoplasias del Pene/tratamiento farmacológico , Porfiria Cutánea Tardía/diagnóstico , Antineoplásicos/uso terapéutico , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/patología , Humanos , Imiquimod , Masculino , Persona de Mediana Edad , Neoplasias del Pene/diagnóstico , Neoplasias del Pene/patología , Resultado del TratamientoAsunto(s)
Alopecia/congénito , Alopecia/epidemiología , Dermoscopía/métodos , Hueso Temporal , Administración Tópica , Adolescente , Factores de Edad , Alopecia/diagnóstico , Alopecia/tratamiento farmacológico , Niño , Preescolar , Estudios de Cohortes , Femenino , Humanos , Incidencia , Lactante , Masculino , Minoxidil/uso terapéutico , Fotograbar , Medición de Riesgo , Índice de Severidad de la Enfermedad , Factores Sexuales , España/epidemiología , Resultado del Tratamiento , Adulto JovenAsunto(s)
Dermatosis de la Mano/patología , Dermatosis de la Mano/terapia , Queratodermia Palmoplantar/patología , Queratodermia Palmoplantar/terapia , Administración Tópica , Adolescente , Biopsia con Aguja , Crioterapia/métodos , Diagnóstico Diferencial , Femenino , Dermatosis de la Mano/diagnóstico , Dermatosis de la Mano/genética , Humanos , Inmunohistoquímica , Queratodermia Palmoplantar/diagnóstico , Queratodermia Palmoplantar/genética , Examen Físico/métodos , Ácido Salicílico/uso terapéutico , Resultado del TratamientoAsunto(s)
Dermatitis Exfoliativa/complicaciones , Dermatosis del Pie/complicaciones , Odorantes , Antibacterianos/administración & dosificación , Clindamicina/administración & dosificación , Dermatitis Exfoliativa/microbiología , Dermatitis Exfoliativa/terapia , Dermatosis del Pie/diagnóstico , Dermatosis del Pie/microbiología , Dermatosis del Pie/terapia , Humanos , Masculino , Adulto JovenRESUMEN
Patau syndrome is a chromosomal disorder associated with multiple malformations caused by inheritance of an extra chromosome (trisomy 13). Some skin defects have been reported in patients with Patau syndrome, such as scalp defects, glabellar stains, deep palmar creases, rocker-bottom feet, convex soles, hyperconvextity of the nails, and multiple hemangiomas. To our knowledge, widespread comedonal and cystic acne have not been previously reported in Patau syndrome.