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1.
Actas Dermosifiliogr ; 115(2): T150-T158, 2024 Feb.
Artículo en Inglés, Español | MEDLINE | ID: mdl-38048951

RESUMEN

BACKGROUND: Dupilumab is a new targeted therapy for severe atopic dermatitis (AD) with limited real-world evidence. OBJECTIVE: Explore our experience with dupilumab for AD in clinical practice at a tertiary care center. MATERIAL AND METHOD: Unicentric observational retrospective study including adult and pediatric patients with severe AD receiving dupilumab between December 2017 and December 2021. The Eczema Area and Severity Index (EASI) score, Pruritus Numerical Rating Scale (P-NRS) and Sleep disturbance Numerical Rating Scale (S-NRS) were recovered to assess severity and response. RESULTS: Fifty-nine patients received dupilumab: 52, 48, 26 and 13 patients reached 6, 12, 24 and 36 months of treatment, respectively. The EASI-75 response rates were 94.2%, 95.8%, 92.3% and 100% at months 6, 12, 24 and 36. The EASI-90 response rates were 63.5%, 72.9%, 84.6% and 92.3% at months 6, 12, 24 and 36. The EASI <7 response rates were 92.3%, 91.7%, 88.5% and 100% at months 6, 12, 24 and 36. The P-NRS ≥4 reduction rates were 86%, 87.5%, 92.3% and 100% at months 6, 12, 24 and 36. The S-NRS ≥4 reduction rates were 82.7%, 85.4%, 100% and 100% at months 6, 12, 24 and 36. Adverse events were mild and occurred in 20.3% of patients, all of them adults. CONCLUSION: Our findings support dupilumab's favorable efficacy and tolerability profile in clinical practice. Dupilumab offers a rapid and sustained response, regardless of combined therapy. Longer follow-ups are still required to adequately assess its performance.


Asunto(s)
Dermatitis Atópica , Adulto , Humanos , Niño , Dermatitis Atópica/tratamiento farmacológico , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Anticuerpos Monoclonales Humanizados/efectos adversos , Prurito/inducido químicamente , Resultado del Tratamiento , Método Doble Ciego
2.
Actas Dermosifiliogr ; 115(2): 150-158, 2024 Feb.
Artículo en Inglés, Español | MEDLINE | ID: mdl-37858860

RESUMEN

BACKGROUND: Dupilumab is a new targeted therapy for severe atopic dermatitis (AD) with limited real-world evidence. OBJECTIVE: Explore our experience with dupilumab for AD in clinical practice at a tertiary care center. MATERIAL AND METHOD: Unicentric observational retrospective study including adult and pediatric patients with severe AD receiving dupilumab between December 2017 and December 2021. The Eczema Area and Severity Index (EASI) score, Pruritus Numerical Rating Scale (P-NRS) and Sleep disturbance Numerical Rating Scale (S-NRS) were recovered to assess severity and response. RESULTS: Fifty-nine patients received dupilumab: 52, 48, 26 and 13 patients reached 6, 12, 24 and 36 months of treatment, respectively. The EASI-75 response rates were 94.2%, 95.8%, 92.3% and 100% at months 6, 12, 24 and 36. The EASI-90 response rates were 63.5%, 72.9%, 84.6% and 92.3% at months 6, 12, 24 and 36. The EASI <7 response rates were 92.3%, 91.7%, 88.5% and 100% at months 6, 12, 24 and 36. The P-NRS ≥4 reduction rates were 86%, 87.5%, 92.3% and 100% at months 6, 12, 24 and 36. The S-NRS ≥4 reduction rates were 82.7%, 85.4%, 100% and 100% at months 6, 12, 24 and 36. Adverse events were mild and occurred in 20.3% of patients, all of them adults. CONCLUSION: Our findings support dupilumab's favorable efficacy and tolerability profile in clinical practice. Dupilumab offers a rapid and sustained response, regardless of combined therapy. Longer follow-ups are still required to adequately assess its performance.


Asunto(s)
Dermatitis Atópica , Adulto , Niño , Humanos , Anticuerpos Monoclonales Humanizados/efectos adversos , Dermatitis Atópica/tratamiento farmacológico , Método Doble Ciego , Prurito/inducido químicamente , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Resultado del Tratamiento
3.
Clin Exp Dermatol ; 39(4): 484-7, 2014 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-24758493

RESUMEN

Epstein-Barr virus-positive (EBV) diffuse large B-cell lymphoma (DLCBL) of the elderly is a newly described lymphoproliferative disorder that arises in elderly patients without a predisposing immunodeficiency. Clinical features at presentation may include lymphadenopathy, B-symptoms and extranodal involvement. The main sites of extranodal involvement are the skin, lung, tonsil and stomach. Histopathological findings include atypical large lymphoid cells with variable amounts of reactive cells, such as small lymphocytes, plasma cells and histiocytes. The neoplastic cells are positive for CD20, and in situ hybridization for EBV-encoded RNA is positive in the majority of neoplastic cells. We present a new case of EBV-positive DLBCL in an 85-year-old man, who presented to our clinic with a 2-month history of asymptomatic cutaneous lesions involving his face and scalp.


Asunto(s)
Infecciones por Virus de Epstein-Barr/patología , Neoplasias Faciales/virología , Neoplasias de Cabeza y Cuello/virología , Linfoma de Células B Grandes Difuso/virología , Cuero Cabelludo , Neoplasias Cutáneas/virología , Anciano de 80 o más Años , Diagnóstico Diferencial , Neoplasias Faciales/patología , Neoplasias de Cabeza y Cuello/patología , Humanos , Linfoma de Células B Grandes Difuso/patología , Masculino , Neoplasias Cutáneas/patología
4.
Actas Dermosifiliogr ; 105(6): 590-6, 2014.
Artículo en Inglés, Español | MEDLINE | ID: mdl-24530124

RESUMEN

OBJECTIVE: The aim of this study based on the records of the dermatology department of a tertiary referral hospital was to describe patients treated for allergic contact dermatitis induced by nickel between 2000 and 2010. MATERIALS AND METHODS: From records of the skin allergy section of the dermatology department we extracted and analyzed information for patients who underwent patch testing with the standard series of the Spanish Contact Dermatitis Research Group (GEIDAC), which includes a patch with 5% nickel sulfate in petroleum jelly. The possibility that nickel release from various objects might have triggered the patient's dermatitis was assessed with the dimethylglyoxime spot test, which reveals a reddish precipitate if the metal is present. RESULTS: A total of 3,404 patients underwent GEIDAC patch testing during the study period; 24.2% had positive reactions to the patch containing 5% nickel sulfate in petroleum jelly. However, the contact dermatitis could be attributed to nickel in only 57 of the 824 patients (6.9%) who showed sensitization to nickel. CONCLUSIONS: Patch-test evidence of sensitization was found to be clinically relevant in only a small percentage of patients. We emphasize the usefulness of the dimethylglyoxime test to help establish the relevance of a positive nickel patch test. This test is even useful for identifying the specific object responsible for a patient's dermatitis.


Asunto(s)
Dermatitis Alérgica por Contacto/diagnóstico , Dermatitis Alérgica por Contacto/etiología , Níquel/efectos adversos , Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Oximas , Pruebas del Parche , Estudios Retrospectivos , Centros de Atención Terciaria , Factores de Tiempo , Adulto Joven
6.
Actas Dermosifiliogr ; 101 Suppl 1: 88-96, 2010 May.
Artículo en Español | MEDLINE | ID: mdl-20492887

RESUMEN

The introduction of tumor necrosis factor (TNF) beta blockers has make it possible to obtain a significant advance in the control and knowledge of some inflammatory diseases, among them psoriasis. TNF is a cytokine that plays a key role in the control of infections and neoplasms. The increase of the risk of developing a neoplasm during the use of this group of drugs is one of the more debated adverse effects in the literature. We present the clinical case of one patient with long-course psoriasis who developed a breast adenocarcinoma after initiating treatment with etanercept. In this article, we provide a brief review on the possible associations existing between the use of anti-TNF therapy and the risk of the appearance of come neoplasms, among which leukemias, lymphomas and some solid tumors stand out.


Asunto(s)
Adenocarcinoma/inducido químicamente , Neoplasias de la Mama/inducido químicamente , Inmunoglobulina G/efectos adversos , Psoriasis/tratamiento farmacológico , Factor de Necrosis Tumoral alfa/antagonistas & inhibidores , Adulto , Árboles de Decisión , Etanercept , Femenino , Humanos , Receptores del Factor de Necrosis Tumoral
7.
Actas Dermosifiliogr ; 101(8): 717-21, 2010 Oct.
Artículo en Español | MEDLINE | ID: mdl-20965015

RESUMEN

Pyoderma gangrenosum is an inflammatory disease that has been found to be associated with many systemic illnesses. The case presented here is of a man with a 20-year history of hidradenitis suppurativa who developed pyoderma gangrenosum. The pyoderma lesions appeared as a single outbreak which resolved totally after immunosuppressive treatment. This association has been reported only rarely in the literature. Furthermore, in the cases reported, no relationship was apparent between the activity of both diseases. In all cases the clinical course appeared independent, with no apparent overlap in inflammatory activity or response to the drugs administered.


Asunto(s)
Hidradenitis Supurativa/complicaciones , Piodermia Gangrenosa/complicaciones , Absceso/tratamiento farmacológico , Corticoesteroides/uso terapéutico , Antibacterianos/uso terapéutico , Anticuerpos Monoclonales/uso terapéutico , Ciclosporina/uso terapéutico , Quimioterapia Combinada , Hidradenitis Supurativa/tratamiento farmacológico , Humanos , Inmunosupresores/uso terapéutico , Infliximab , Masculino , Persona de Mediana Edad , Piodermia Gangrenosa/diagnóstico , Piodermia Gangrenosa/tratamiento farmacológico , Retinoides/uso terapéutico , Úlcera Cutánea/tratamiento farmacológico , Úlcera Cutánea/etiología , Tacrolimus/uso terapéutico
8.
Actas Dermosifiliogr (Engl Ed) ; 111(3): 249-253, 2020 Apr.
Artículo en Inglés, Español | MEDLINE | ID: mdl-31864538

RESUMEN

BACKGROUND: The association between dipeptidyl peptidase 4 inhibitors (DPP-4i) and bullous pemphigoid (BP) has been demonstrated in several studies. The main aim of this study was to estimate the use of DPP-4i treatment in patients diagnosed with BP in our setting. METHODS: We selected patients histologically diagnosed with BP in our department between October 2015 and October 2018 and performed a retrospective chart review to assess clinical and epidemiological data and direct immunofluorescence (DIF) patterns. RESULTS: Of the 70 patients diagnosed with BP during the study period, 50% were diabetic and 88.57% of these were being treated with a DPP-4i when diagnosed with BP. The most common DPP-4i was linagliptin (used in 18.6% of patients), followed by vildagliptin (17.1%). The median latency period between initiation of DPP-4i treatment and diagnosis of BP was 27.5 months for all treatments, 16 months for linagliptin, and 39 months for vildagliptin (log rank < 0.01). A negative DIF result was significantly more common in patients not being treated with a DPP-4i. The DIF pattern most strongly (and significantly) associated with DPP-4i treatment was linear immunoglobulin G deposits along the dermal-epidermal junction. DPP-4i treatment was withdrawn in 87% of patients and 96% of these achieved a complete response. CONCLUSIONS: DPP-4i treatment is very common in patients with BP in our setting. The latency period between start of treatment and onset of BP seems to be shorter with linagliptin than with other types of gliptins. Patients receiving DPP-4i treatment may show different DIF patterns to those not receiving treatment.


Asunto(s)
Inhibidores de la Dipeptidil-Peptidasa IV , Penfigoide Ampolloso , Inhibidores de la Dipeptidil-Peptidasa IV/efectos adversos , Humanos , Linagliptina/efectos adversos , Penfigoide Ampolloso/inducido químicamente , Estudios Retrospectivos , Vildagliptina
9.
Actas Dermosifiliogr (Engl Ed) ; 110(9): 728-733, 2019 Nov.
Artículo en Inglés, Español | MEDLINE | ID: mdl-30449349

RESUMEN

Cutaneous hemangiomas are the most frequent benign tumors in children. When they affect the lumbar and perineal area some cases can be associated with an occult spinal dysraphism. The management of these hemangiomas lack consensus. We report 3 cases of children with lumbosacral and perineal hemangiomas with magnetic resonance image abnormalities and we review the literature to find out the type and timing of tests that should be performed to complete the study in these patients. Ultrasound is typically requested as young as possible, as this imaging technique is not possible 11the posterior spinal elements have ossified. MRI is the gold standard for diagnosing occult spinal dysraphism. According to the literature, the mean age for MRI screening should be around 6 months, when the fat formation in the filum terminale is expanded. In our opinion, an MRI scan should be performed at 6 months of age in every children with lumbar or perineal hemangioma regardless the lesion size, neurological symptoms or the ultrasound results.


Asunto(s)
Hemangioma/diagnóstico por imagen , Neoplasias Cutáneas/diagnóstico por imagen , Antagonistas Adrenérgicos beta/uso terapéutico , Femenino , Hemangioma/tratamiento farmacológico , Humanos , Lactante , Lipoma/diagnóstico por imagen , Región Lumbosacra/diagnóstico por imagen , Masculino , Perineo/diagnóstico por imagen , Propranolol/uso terapéutico , Neoplasias Cutáneas/tratamiento farmacológico , Espina Bífida Oculta/diagnóstico por imagen
10.
Actas dermo-sifiliogr. (Ed. impr.) ; 115(2): 150-158, feb. 2024. tab, graf
Artículo en Inglés | IBECS (España) | ID: ibc-230312

RESUMEN

Background Dupilumab is a new targeted therapy for severe atopic dermatitis (AD) with limited real-world evidence. Objective Explore our experience with dupilumab for AD in clinical practice at a tertiary care center. Material and method Unicentric observational retrospective study including adult and pediatric patients with severe AD receiving dupilumab between December 2017 and December 2021. The Eczema Area and Severity Index (EASI) score, Pruritus Numerical Rating Scale (P-NRS) and Sleep disturbance Numerical Rating Scale (S-NRS) were recovered to assess severity and response. Results Fifty-nine patients received dupilumab: 52, 48, 26 and 13 patients reached 6, 12, 24 and 36 months of treatment, respectively. The EASI-75 response rates were 94.2%, 95.8%, 92.3% and 100% at months 6, 12, 24 and 36. The EASI-90 response rates were 63.5%, 72.9%, 84.6% and 92.3% at months 6, 12, 24 and 36. The EASI <7 response rates were 92.3%, 91.7%, 88.5% and 100% at months 6, 12, 24 and 36. The P-NRS ≥4 reduction rates were 86%, 87.5%, 92.3% and 100% at months 6, 12, 24 and 36. The S-NRS ≥4 reduction rates were 82.7%, 85.4%, 100% and 100% at months 6, 12, 24 and 36. Adverse events were mild and occurred in 20.3% of patients, all of them adults. Conclusion Our findings support dupilumab's favorable efficacy and tolerability profile in clinical practice. Dupilumab offers a rapid and sustained response, regardless of combined therapy. Longer follow-ups are still required to adequately assess its performance (AU)


Antecedentes Dupilumab es una nueva terapia dirigida para la dermatitis atópica (DA) grave con una evidencia en la vida real aún limitada. Objetivo Explorar nuestra experiencia con dupilumab para la DA en práctica clínica en un centro terciario. Material y método Estudio observacional retrospectivo y unicéntrico que incluye pacientes adultos y pediátricos con DA grave en tratamiento con dupilumab entre diciembre de 2017 y diciembre de 2021. La gravedad y la respuesta se evaluaron con las escalas Eczema Area and Severity Index (EASI), Pruritus Numerical Rating Scale y Sleep Disturbance Numerical Rating Scale. Resultado Cincuenta y nueve pacientes recibieron dupilumab: 52, 48, 26 y 13 pacientes alcanzaron los 6, 12, 24 y 36 meses de tratamiento, respectivamente. La tasa de EASI-75 fue del 94,2; 95,8; 92,3 y 100% a los 6, 12, 24 y 36 meses, respectivamente. La tasa de EASI-90 fue del 63,5; 72,9; 84,6 y 92,3% a los 6, 12, 24 y 36 meses, respectivamente. La tasa de EASI <7 fue del 92,3; 91,7; 88,5 y 100% a los 6, 12, 24 y 36 meses, respectivamente. La Pruritus Numerical Rating Scale ≥4 fue del 86; 87,5; 92,3 y 100% a los 6, 12, 24 y 36 meses, respectivamente. La tasa de reducción Sleep Disturbance Numerical Rating Scale ≥4 fue del 82,7; 85,4; 100 y 100% a los 6, 12, 24 y 36 meses, respectivamente. Los eventos adversos fueron leves y ocurrieron en el 20,3% de los pacientes, todos adultos. Conclusión Nuestros hallazgos apoyan el perfil favorable de eficacia y tolerabilidad de dupilumab en práctica clínica real. Dupilumab ofrece una respuesta rápida y mantenida, independientemente del uso de terapia combinada. Se requieren seguimientos más prolongados para evaluar su funcionamiento a largo plazo (AU)


Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Anticuerpos Monoclonales Humanizados/uso terapéutico , Dermatitis Atópica/tratamiento farmacológico , Índice de Severidad de la Enfermedad , Estudios Retrospectivos , Resultado del Tratamiento
11.
Actas dermo-sifiliogr. (Ed. impr.) ; 115(2): t150-t158, feb. 2024. tab, graf
Artículo en Español | IBECS (España) | ID: ibc-230313

RESUMEN

Antecedentes Dupilumab es una nueva terapia dirigida para la dermatitis atópica (DA) grave con una evidencia en la vida real aún limitada. Objetivo Explorar nuestra experiencia con dupilumab para la DA en práctica clínica en un centro terciario. Material y método Estudio observacional retrospectivo y unicéntrico que incluye pacientes adultos y pediátricos con DA grave en tratamiento con dupilumab entre diciembre de 2017 y diciembre de 2021. La gravedad y la respuesta se evaluaron con las escalas Eczema Area and Severity Index (EASI), Pruritus Numerical Rating Scale y Sleep Disturbance Numerical Rating Scale. Resultados Cincuenta y nueve pacientes recibieron dupilumab: 52, 48, 26 y 13 pacientes alcanzaron los 6, 12, 24 y 36 meses de tratamiento, respectivamente. La tasa de EASI-75 fue del 94,2; 95,8; 92,3 y 100% a los 6, 12, 24 y 36 meses, respectivamente. La tasa de EASI-90 fue del 63,5; 72,9; 84,6 y 92,3% a los 6, 12, 24 y 36 meses, respectivamente. La tasa de EASI <7 fue del 92,3; 91,7; 88,5 y 100% a los 6, 12, 24 y 36 meses, respectivamente. La Pruritus Numerical Rating Scale ≥4 fue del 86; 87,5; 92,3 y 100% a los 6, 12, 24 y 36 meses, respectivamente. La tasa de reducción Sleep Disturbance Numerical Rating Scale ≥4 fue del 82,7; 85,4; 100 y 100% a los 6, 12, 24 y 36 meses, respectivamente. Los eventos adversos fueron leves y ocurrieron en el 20,3% de los pacientes, todos adultos. Conclusión Nuestros hallazgos apoyan el perfil favorable de eficacia y tolerabilidad de dupilumab en práctica clínica real. Dupilumab ofrece una respuesta rápida y mantenida, independientemente del uso de terapia combinada. Se requieren seguimientos más prolongados para evaluar su funcionamiento a largo plazo (AU)


Background Dupilumab is a new targeted therapy for severe atopic dermatitis (AD) with limited real-world evidence. Objective Explore our experience with dupilumab for AD in clinical practice at a tertiary care center. Material and method Unicentric observational retrospective study including adult and pediatric patients with severe AD receiving dupilumab between December 2017 and December 2021. The Eczema Area and Severity Index (EASI) score, Pruritus Numerical Rating Scale (P-NRS) and Sleep disturbance Numerical Rating Scale (S-NRS) were recovered to assess severity and response. Results Fifty-nine patients received dupilumab: 52, 48, 26 and 13 patients reached 6, 12, 24 and 36 months of treatment, respectively. The EASI-75 response rates were 94.2%, 95.8%, 92.3% and 100% at months 6, 12, 24 and 36. The EASI-90 response rates were 63.5%, 72.9%, 84.6% and 92.3% at months 6, 12, 24 and 36. The EASI <7 response rates were 92.3%, 91.7%, 88.5% and 100% at months 6, 12, 24 and 36. The P-NRS ≥4 reduction rates were 86%, 87.5%, 92.3% and 100% at months 6, 12, 24 and 36. The S-NRS ≥4 reduction rates were 82.7%, 85.4%, 100% and 100% at months 6, 12, 24 and 36. Adverse events were mild and occurred in 20.3% of patients, all of them adults. Conclusion Our findings support dupilumab's favorable efficacy and tolerability profile in clinical practice. Dupilumab offers a rapid and sustained response, regardless of combined therapy. Longer follow-ups are still required to adequately assess its performance (AU)


Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Anticuerpos Monoclonales Humanizados/uso terapéutico , Dermatitis Atópica/tratamiento farmacológico , Índice de Severidad de la Enfermedad , Resultado del Tratamiento , Estudios Retrospectivos
15.
Actas dermo-sifiliogr. (Ed. impr.) ; 111(3): 249-253, abr. 2020. tab, graf
Artículo en Español | IBECS (España) | ID: ibc-191528

RESUMEN

ANTECEDENTES: La asociación entre los inhibidores de la dipeptidil peptidasa 4 (iDPP-4) y el penfigoide ampolloso (PA) se ha demostrado en varios estudios. El objetivo principal de este estudio era estimar el uso del tratamiento con iDPP-4i en pacientes diagnosticados de PA en nuestro entorno. MATERIAL Y MÉTODOS: Seleccionamos pacientes diagnosticados histológicamente de PA en nuestro departamento entre octubre de 2015 y octubre de 2018. Realizamos una revisión retrospectiva para evaluar los datos clínicos-epidemiológicos y los patrones de inmunofluorescencia directa (IFD). RESULTADOS: De los 70 pacientes diagnosticados con PA durante el período de estudio, el 50% eran diabéticos y el 88,57% de ellos estaban siendo tratados con un iDPP-4 en el momento del diagnóstico de PA. El iDPP-4 más frecuente era la linagliptina (utilizada en el 18,6% de los pacientes), seguida de la vildagliptina (el 17,1%). La mediana de tiempo de latencia entre el inicio del tratamiento con iDPP-4 y el diagnóstico de PA fue de 27,5 meses, siendo de 16 meses para la linagliptina y 39 meses para la vildagliptina (log Rank < 0,01). La IFD fue negativaUn resultado negativo de DIF fue significativamente más común en pacientes que no fueron tratados con un DPP-4i. El patrón DIF más fuertemente (y significativamente) asociado con el tratamiento con DPP-4i fueron los depósitos lineales de inmunoglobulina G a lo largo de la unión dermoepidérmica. El tratamiento con DPP-4i se retiró en el 87% de los pacientes y el 96% de ellos logró una respuesta completa. CONCLUSIÓN: El tratamiento con DPP-4i es muy común en pacientes con BP en nuestro entorno. El período de latencia entre el inicio del tratamiento y el inicio de la PA parece ser más corto con linagliptina que con otros tipos de gliptinas. Los pacientes que reciben tratamiento con DPP-4i pueden mostrar patrones DIF diferentes a los que no reciben tratamiento


BACKGROUND: The association between dipeptidyl peptidase 4 inhibitors (DPP-4i) and bullous pemphigoid (BP) has been demonstrated in several studies. The main aim of this study was to estimate the use of DPP-4i treatment in patients diagnosed with BP in our setting. METHODS: We selected patients histologically diagnosed with BP in our department between October 2015 and October 2018 and performed a retrospective chart review to assess clinical and epidemiological data and direct immunofluorescence (DIF) patterns. RESULTS: Of the 70 patients diagnosed with BP during the study period, 50% were diabetic and 88.57% of these were being treated with a DPP-4i when diagnosed with BP. The most common DPP-4i was linagliptin (used in 18.6% of patients), followed by vildagliptin (17.1%). The median latency period between initiation of DPP-4i treatment and diagnosis of BP was 27.5 months for all treatments, 16 months for linagliptin, and 39 months for vildagliptin (log rank < 0.01). A negative DIF result was significantly more common in patients not being treated with a DPP-4i. The DIF pattern most strongly (and significantly) associated with DPP-4i treatment was linear immunoglobulin G deposits along the dermal-epidermal junction. DPP-4i treatment was withdrawn in 87% of patients and 96% of these achieved a complete response. CONCLUSIONS: DPP-4i treatment is very common in patients with BP in our setting. The latency period between start of treatment and onset of BP seems to be shorter with linagliptin than with other types of gliptins. Patients receiving DPP-4i treatment may show different DIF patterns to those not receiving treatment


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Penfigoide Ampolloso/epidemiología , Técnica del Anticuerpo Fluorescente Directa/normas , Penfigoide Ampolloso/inducido químicamente , Estudios Retrospectivos , Inhibidores de la Dipeptidil-Peptidasa IV/administración & dosificación
16.
Actas dermo-sifiliogr. (Ed. impr.) ; 110(9): 728-733, nov. 2019. ilus
Artículo en Español | IBECS (España) | ID: ibc-185564

RESUMEN

Los hemangiomas infantiles son los tumores benignos más frecuentes en la población pediátrica. Cuando afectan al área lumbar y perineal, algunos casos pueden asociarse a alguna malformación subyacente como una disrafia espinal oculta. El manejo de estos hemangiomas carece de consenso. Describimos 3 casos de niños con hemangiomas lumbosacros y perineales con anomalías en la resonancia magnética y revisamos la literatura para valorar qué pruebas y en qué momento se deben realizar para completar el estudio en estos pacientes. Por lo general, se solicita una ecografía lo más precozmente posible, ya que esta técnica no es posible realizarla una vez que los elementos espinales posteriores se han osificado, lo que generalmente ocurre a los 6 meses de edad. La resonancia magnética es la prueba de referencia para diagnosticar una disrafia espinal oculta. De acuerdo con la literatura, la edad media para este examen debe ser alrededor de los 6 meses, cuando la formación de grasa en el filum terminale se ha visto incrementada. En nuestra opinión, se debería realizar una resonancia magnética a los 6 meses de edad en todos los niños con hemangioma lumbar o perineal, independientemente del tamaño de la lesión, la ausencia de síntomas neurológicos o los resultados de la ecografía


Cutaneous hemangiomas are the most frequent benign tumors in children. When they affect the lumbar and perineal area some cases can be associated with an occult spinal dysraphism. The management of these hemangiomas lack consensus. We report 3 cases of children with lumbosacral and perineal hemangiomas with magnetic resonance image abnormalities and we review the literature to find out the type and timing of tests that should be performed to complete the study in these patients. Ultrasound is typically requested as young as possible, as this imaging technique is not possible 11 the posterior spinal elements have ossified. MRI is the gold standard for diagnosing occult spinal dysraphism. According to the literature, the mean age for MRI screening should be around 6 months, when the fat formation in the filum terminale is expanded. In our opinion, an MRI scan should be performed at 6 months of age in every children with lumbar or perineal hemangioma regardless the lesion size, neurological symptoms or the ultrasound results


Asunto(s)
Humanos , Masculino , Femenino , Recién Nacido , Lactante , Hemangioma/diagnóstico por imagen , Hemangioma/tratamiento farmacológico , Espectroscopía de Resonancia Magnética/métodos , Plexo Lumbosacro/diagnóstico por imagen , Plexo Lumbosacro/patología , Disrafia Espinal/diagnóstico por imagen , Propranolol/administración & dosificación , Neurocirugia
18.
Actas dermo-sifiliogr. (Ed. impr.) ; 105(6): 590-596, jul.-ago. 2014. tab, ilus
Artículo en Español | IBECS (España) | ID: ibc-125171

RESUMEN

OBJETIVO: El objetivo de este trabajo es el estudio descriptivo de los pacientes con dermatitis alérgica de contacto por níquel que han sido atendidos en un hospital de referencia en dermatología en un periodo de 10 años. MATERIAL Y MÉTODOS: Se han analizado los datos de todos los pacientes parchados con la batería estándar del Grupo Español de Investigación en Dermatitis de Contacto y Alérgica Cutánea (GEIDAC) que incluye un parche con sulfato de níquel en vaselina al 5%, a partir de la base de datos informatizada de la sección de alergia cutánea de nuestro servicio. Para conocer la implicación de diferentes objetos metálicos en el origen de la dermatitis utilizamos un método colorimétrico llamado test de dimetilglioxima (DMGO). RESULTADOS: Durante el periodo de estudio se ha explorado mediante pruebas epicutáneas con la batería estándar del GEIDAC a 3.404 pacientes. Del total de pacientes parchados un 24,2% presentaron un parche positivo para sulfato de níquel al 5% en vaselina. Sin embargo, de los 824 pacientes sensibilizados al níquel solo en 57 de ellos (6,9%) se pudo demostrar una asociación de la sensibilización con la dermatitis por la que consultaban. CONCLUSIONES: Solo se identificó relevancia presente en un pequeño porcentaje de pacientes con positividad al níquel en las pruebas epicutáneas. Destacamos la utilidad del test de DMGO como método de ayuda para establecer la relevancia de la positividad del parche con níquel, e incluso para conocer el objeto causante de dicha dermatitis


OBJECTIVE: The aim of this study based on the records of the dermatology department of a tertiary referral hospital was to describe patients treated for allergic contact dermatitis induced by nickel between 2000 and 2010. MATERIALS AND METHODS: From records of the skin allergy section of the dermatology department we extracted and analyzed information for patients who underwent patch testing with the standard series of the Spanish Contact Dermatitis Research Group (GEIDAC), which includes a patch with 5% nickel sulfate in petroleum jelly. The possibility that nickel release from various objects might have triggered the patient's dermatitis was assessed with the dimethylglyoxime spot test, which reveals a reddish precipitate if the metal is present. RESULTS: A total of 3,404 patients underwent GEIDAC patch testing during the study period; 24.2% had positive reactions to the patch containing 5% nickel sulfate in petroleum jelly. However, the contact dermatitis could be attributed to nickel in only 57 of the 824 patients (6.9%) who showed sensitization to nickel. CONCLUSIONS: Patch-test evidence of sensitization was found to be clinically relevant in only a small percentage of patients. We emphasize the usefulness of the dimethylglyoxime test to help establish the relevance of a positive nickel patch test. This test is even useful for identifying the specific object responsible for a patient's dermatitis


Asunto(s)
Humanos , Níquel/efectos adversos , Dermatitis Alérgica por Contacto/diagnóstico , Pruebas del Parche/métodos , Factores de Riesgo
20.
Actas dermo-sifiliogr. (Ed. impr.) ; 101(supl.1): 88-96, mayo 2010. ilus
Artículo en Español | IBECS (España) | ID: ibc-87728

RESUMEN

La introducción de los fármacos bloqueadores del factor de necrosis tumoral (TNF) ha permitido un gran avance en el control y conocimiento de ciertas enfermedades inflamatorias, entre las que se incluye la psoriasis. El TNF es una citocina que desempeña un papel clave en el control de infecciones y neoplasias. El incremento del riesgo de desarrollar una neoplasia durante el empleo de este grupo de fármacos es uno de los efectos adversos más discutidos en la literatura. Presentamos el caso clínico de una paciente con psoriasis de larga evolución que desarrolló un adenocarcinoma de mama tras iniciar el tratamiento con etanercept. En este artículo realizamos una breve revisión acerca de la posible asociación existente entre el empleo de terapia anti-TNF y el riesgo de aparición de ciertas neoplasias, entre las que destacan las leucemias, los linfomas y determinados tumores sólidos (AU)


The introduction of tumor necrosis factor (TNF) beta blockers has make it possible to obtain a significant advance in the control and knowledge of some inflammatory diseases, among them psoriasis.TNF is a cytokine that plays a key role in the control of infections and neoplasms. The increase of the risk of developing a neoplasm during the use of this group of drugs is one of the more debated adverse effects in the literature. We present the clinical case of one patient with long-course psoriasis who developed a breast adenocarcinoma after initiating treatment with etanercept. In this article, we provide a brief review on the possible associations existing between the use of anti-TNF therapy and the risk of the appearance of come neoplasms, among which leukemias, lymphomas and some solid tumors stand out (AU)


Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Factor de Necrosis Tumoral alfa/inmunología , Factor de Necrosis Tumoral alfa/uso terapéutico , Psoriasis/complicaciones , Psoriasis/diagnóstico , Psoriasis/terapia , Neoplasias/complicaciones , Neoplasias/diagnóstico , Neoplasias/patología , Adenocarcinoma/complicaciones , Adenocarcinoma/diagnóstico , Adenocarcinoma/patología , Linfoma/complicaciones , Linfoma/diagnóstico , Leucemia/complicaciones , Leucemia/diagnóstico
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