RESUMEN
Pityriasis lichenoides chronica (PLC) is an infrequent dermatosis of unknown aetiology, wholse evolution and response to treatment differs between children and adults. When PLC is recalcitrant or unresponsive to topical treatment, phototherapy is one of the main treatments used. We carried out a prospective study of adult diffuse PLC treated with narrowband ultraviolet B (NB-UVB). We treated eight patients whose disease showed no response to topical therapy, and obtained a complete response rate of 88% in a mean of 23 sessions (cumulative dose 16.99 J/cm2 ). However, the relapse rate was 43% in the first 6 months. Our results are similar to those of other published studies but there is much variability between them in the doses applied and the number of sessions needed. Further studies are necessary to devise a protocol for NB-UVB treatment of PLC.
Asunto(s)
Pitiriasis Liquenoide/radioterapia , Terapia Ultravioleta/métodos , Adolescente , Adulto , Anciano , Enfermedad Crónica , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Dosis de Radiación , Recurrencia , Literatura de Revisión como Asunto , Adulto JovenRESUMEN
Chronic infantile neurologic cutaneous articular (CINCA) syndrome is a serious chronic systemic inflammatory disease that presents at a young age and that is characterized by skin, joint, and central nervous system disease. Skin symptoms are the first to appear, in the form of a longstanding nonpruritic urticarial rash, with exacerbations coinciding with episodes of fever, arthritis, and enlarged lymph nodes. The findings of biopsy of skin lesions are extremely variable but characterized by perivascular neutrophilic infiltrate. With the discovery of mutations in the CIAS1 gene, which encodes a protein known as cryopyrin, this entity has been classified as one of the cryopyrin-associated autoinflammatory diseases, along with familial cold urticaria and Muckle-Wells syndrome. This discovery has also made available new therapeutic options. We present the case of a boy diagnosed with CINCA syndrome who presented with an outbreak of painful skin lesions and fever. These lesions were thought to be an exacerbation of underlying lesions during an episode of fever.
Asunto(s)
Artritis/genética , Proteínas Portadoras/genética , Fiebre/etiología , Síndromes Neurocutáneos/diagnóstico , Corticoesteroides/uso terapéutico , Adulto , Antiinflamatorios no Esteroideos/uso terapéutico , Proteínas Portadoras/fisiología , Enfermedad Crónica , Diagnóstico Diferencial , Quimioterapia Combinada , Humanos , Proteína Antagonista del Receptor de Interleucina 1/uso terapéutico , Masculino , Meningitis Aséptica/etiología , Proteína con Dominio Pirina 3 de la Familia NLR , Síndromes Neurocutáneos/complicaciones , Síndromes Neurocutáneos/tratamiento farmacológico , Síndromes Neurocutáneos/genética , Síndromes Neurocutáneos/patología , Recurrencia , Síndrome de Sweet/diagnóstico , SíndromeRESUMEN
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.