Risk of adverse events in psoriasis patients receiving classic systemic drugs and biologics in a 5-year observational study of clinical practice: 2008-2013 results of the Biobadaderm registry.

BACKGROUND: Biobadaderm is the Spanish registry of psoriasis patients receiving systemic treatment in clinical practice. OBJECTIVE: To compare the safety of biologics and classic systemic treatment. METHODS: Prospective cohort of patients receiving biologics and classic systemic therapies between 2008 and 2013 in 12 hospitals are included. We registered demographic data, diagnoses, comorbidities, treatments and adverse events (AE). We obtained raw relative risks (RR) for specific AE. Multivariate analysis consisted of Cox models adjusting for age, gender, chronic hepatic disease and previous cancer. RESULTS: A total of 1030 patients received biologics (2061 AE in 3681 person-years), 926 patients classic systemic drugs (1015 AE in 1517 person-years). Ninety-three per cent of AE in both groups were non-serious, 6% serious and 0.003% fatal. The age- and gender-adjusted hazard ratio of AE was lower in the biologics group [hazard ratio 0.6 (95% CI: 0.5-0.7)].We found no differences in rates of serious and mortal AE. Some system organ class AE rates differed between both groups. As limitations: Prescription bias might affect the incidence of AE in both groups. Association of drug and AE was based on timing: associations might not be causal. CONCLUSION: Patients receiving biologics had lower risk of AE. We did not find differences in the risk of serious or fatal AE.

The Usefulness of 0.2% Topical Nitroglycerin for Chondrodermatitis Nodularis Helicis.

BACKGROUND AND OBJECTIVE: Chondrodermatitis nodularis helicis (CNH) is a painful idiopathic degenerative condition involving the skin and cartilage of the helix or antihelix of the ear. Topical nitroglycerin 2% is a relatively recent treatment option for CNH that has produced good results, although with adverse effects (17% of cases). The use of a lower concentration would probably achieve similar results with fewer adverse effects. The aim of this study was to evaluate the effectiveness and safety of topical nitroglycerin 0.2% in the treatment of CNH. MATERIAL AND METHODS: We performed a retrospective observational study of patients treated in 2 Spanish hospitals between 2012 and 2014. The effectiveness of treatment was determined by clinical photography and assessment of symptoms using a verbal numerical rating scale. RESULTS: Of the 29 patients treated, 93% showed clinical improvement. In the group of responders, mean treatment duration was 1.8 months and mean follow-up was 5.9 months. Overall tolerance was good in all cases. CONCLUSION: Topical nitroglycerin 0.2% is an effective and well-tolerated conservative treatment option that improves the appearance of lesions and provides symptomatic relief in the majority of patients with CNH.

Contact urticaria to raw potato.

Although potatoes represent a large part of diets worldwide, adverse reactions to them are considered uncommon and usually result from ingestion, mainly in children. In contrast, immediate reactions to contact with raw potato has been reported more frequently in adults, usually in the form of an oral contact dermatitis or contact urticaria, but also may manifest as asthma, rhinoconjunctivitis, wheezing or even anaphylaxis. We report a case of non-occupational allergic contact urticaria caused by raw potato, which we then documented by prick testing.

[Topical, intratumor and intravenous nitrogen mustard in the treatment of mycosis fungoides (author's transl)]. / Tratamiento de la micosis fungoide con mostaza nitrogenada tópica, intratumoral e intravenosa.

Topical nitrogen mustard (NH2) is recommended in mycosis fungoides stages 1 or 2 (eczematous premycotic phase and plaque stage), intratumor infiltration in stage 3 (tumor stage) and intravenous administration in stages 4 and 5 (widespread disease). Following these criteria ten patients with mycosis fungoides have been treated with NH2. Six cases were included in stages 1 or 2 and complete remission was achieved in four of them. Therapy had to discontinued in one case due to allergic hypersensitivity. The remaining patient experienced clinical improvement after 27 months of continued treatment. There were three patients in stages 4 and 5 and all their plaques disappeared after topical NH2, but tumor regression was completely achieved in one case adn partially in the remaining two. A case with Sezary's syndrome was treated in addition with chlorambucil. Association of newer palliative measures (topical NH2, high energy electron beam therapy, nitrosourea derivatives) offer a hope of cure for patients in stages 1 or 2. Tumor stage requires systemic chemotherapeutic agents (chlorambucil tablets and intravenous nitrogen mustard).

[Granular parakeratosis]. / Paraqueratosis granular.

Granular parakeratosis is a rare entity that results from an acquired disorder of keratinization. Clinically presents as dark erythematous plaques, occasionally pruritic, that usually involve the axilla and other intertriginous areas. The pathology is characteristic and consists of thickening of the stratum corneum with compact parakeratosis and retention of keratohyaline granules, whereas the stratum granulosum is preserved. The etiology is unknown although some factors such as irritating physical or chemical agents have been implicated. Treatment response is variable. We report a new case in a 50-year-old woman with brownish and hyperkeratotic plaques on both axillae, of two years duration, with a compatible pathology that showed a favorable response to tacalcitol.