RESUMEN
Photodynamic therapy (PDT) has been used to treat certain types of non-melanoma skin cancer with promising results. However, some skin lesions have not fully responded to this treatment, suggesting a potential PDT-resistant phenotype. Therefore, novel therapeutic alternatives must be identified that improve PDT in resistant skin cancer. In this study, we analyzed the cell viability, intracellular protoporphyrin IX (PpIX) content and subcellular localization, proliferation profile, cell death, reactive oxygen species (ROS) detection and relative gene expression in PDT-resistant HSC-1 cells. PDT-resistant HSC-1 cells show a low quantity of protoporphyrin IX and low levels of ROS, and thus a low rate of death cell. Furthermore, the resistant phenotype showed a downregulation of HSPB1, SLC15A2, FECH, SOD2 and an upregulation of HMBS and BIRC5 genes. On the other hand, epigallocatechin gallate catechin enhanced the MAL-PDT effect, increasing levels of protoporphyrin IX and ROS, and killing 100% of resistant cells. The resistant MAL-PDT model of skin cancer squamous cells (HSC-1) is a reliable and useful tool to understand PDT cytotoxicity and cellular response. These resistant cells were successfully sensitized with epigallocatechin gallate catechin. The in vitro epigallocatechin gallate catechin effect as an enhancer of MAL-PDT in resistant cells is promising in the treatment of difficult skin cancer lesions.
Asunto(s)
Anticarcinógenos/farmacología , Carcinoma de Células Escamosas/tratamiento farmacológico , Catequina/análogos & derivados , Muerte Celular/efectos de los fármacos , Proliferación Celular/efectos de los fármacos , Terapia Combinada/métodos , Fotoquimioterapia/métodos , Neoplasias Cutáneas/tratamiento farmacológico , Ácido Aminolevulínico/análogos & derivados , Ácido Aminolevulínico/farmacología , Carcinoma de Células Escamosas/radioterapia , Catequina/farmacología , Muerte Celular/efectos de la radiación , Hipoxia de la Célula/efectos de los fármacos , Hipoxia de la Célula/genética , Hipoxia de la Célula/efectos de la radiación , Línea Celular Tumoral , Proliferación Celular/efectos de la radiación , Supervivencia Celular/efectos de los fármacos , Supervivencia Celular/efectos de la radiación , Ferroquelatasa/genética , Ferroquelatasa/metabolismo , Proteínas de Choque Térmico/genética , Proteínas de Choque Térmico/metabolismo , Humanos , Proteínas de Transporte de Membrana/genética , Proteínas de Transporte de Membrana/metabolismo , Chaperonas Moleculares/genética , Chaperonas Moleculares/metabolismo , Fármacos Fotosensibilizantes/metabolismo , Protoporfirinas/metabolismo , Especies Reactivas de Oxígeno/metabolismo , Neoplasias Cutáneas/radioterapia , Estrés Fisiológico/efectos de los fármacos , Estrés Fisiológico/genética , Estrés Fisiológico/efectos de la radiación , Superóxido Dismutasa/genética , Superóxido Dismutasa/metabolismo , Survivin/genética , Survivin/metabolismo , Simportadores/genética , Simportadores/metabolismoRESUMEN
Actinomycosis is a chronic granulomatous disease caused by Gram-positive anaerobic bacteria of the genus Actinomyces. Pulmonary actinomycosis is a rare infection in children, and its extension into the chest wall is infrequently reported. We report a case of pulmonary actinomycosis in a 14-year-old girl of Mapuche descent who presented with chronic respiratory symptoms and multiple discharging skin sinuses on her right lower chest wall. The diagnosis was made by skin biopsy, which showed sulfur granules with actinomyces colonies. She was successfully treated with intravenous ceftriaxone and penicillin G for 6 weeks, followed by oral amoxicillin for 6 months.
Asunto(s)
Actinomyces/aislamiento & purificación , Actinomicosis/complicaciones , Fístula Cutánea/microbiología , Enfermedades Pulmonares/microbiología , Adolescente , Femenino , Humanos , Indígenas SudamericanosRESUMEN
Mycetoma is a chronic, granulomatous, subcutaneous, inflammatory lesion caused by true fungi (eumycetoma) or filamentous bacteria (actinomycetoma). Mycetoma commonly affects young people between 20 and 40 years old. The most common affected site is the foot. The characteristic clinical triad is tumefaction, draining sinuses and discharging grains. We report a healthy 31-year-old male, with a 6-year history of a progressive inflammatory tumor associated with sinus tracts and granules on his left sole. Actinomycetoma was suspected. The clinical diagnosis was confirmed by microbiological and histopathological study. Polymerase chain reaction and DNA sequencing identified Actinomadura madurae. To our knowledge, this is the second case of mycetoma reported in Chile. Our report emphasizes the need to consider this diagnosis in patients with chronic granulomatous disease associated with sinus tracts, fistulas and grains.
Asunto(s)
Infecciones por Actinomycetales/patología , Dermatosis del Pie/microbiología , Micetoma/patología , Infecciones por Actinomycetales/tratamiento farmacológico , Adulto , Antibacterianos/uso terapéutico , Biopsia , Dermatosis del Pie/patología , Humanos , Masculino , Micetoma/tratamiento farmacológico , Resultado del Tratamiento , Combinación Trimetoprim y Sulfametoxazol/uso terapéuticoAsunto(s)
Dípteros , Forunculosis/patología , Miasis/parasitología , Piel/parasitología , Animales , Brasil , Femenino , Humanos , Larva , Viaje , Adulto JovenRESUMEN
BACKGROUND: Photodynamic therapy (PDT) has been shown to be an effective alternative for acne. However, there is little information comparing the efficacy of red light alone and methyl aminolaevulinate (MAL)-PDT. AIMS: To compare the efficacy and tolerability of red light alone and MAL-PDT in patients with mild to moderate facial acne. METHODS: Thirty six patients with mild to moderate acne were enrolled. Eighteen patients recieved MAL-PDT and 18 received red light alone in two sessions, 2 weeks apart. Acne grade and lesion counts were assessed by blinded evaluators at baseline, 2, 4 and 10 weeks. RESULTS: At week 2, clinical improvement from acne grade II-IV to 0-I was observed in 82.3% of MAL-PDT group and 14.2% of red light alone group. Red light alone group had a gradual clinical improvement over time with a 77% response at week 10. In contrast, MAL-PDT group had a rapid clinical improvement with total response at week 10. Both treatments were significantly effective for improving acne lesions. However, MAL-PDT group had a greater response (P < 0.001). Histologically, decreased amounts of sebocytes and lipids along with atrophic sebaceous glands were observed after MAL-PDT. CONCLUSION: MAL-PDT has a quicker onset of action with a higher response than red light alone. MAL-PDT may induce a reduction in the size of the sebaceous glands and then long-term acne remission.
Asunto(s)
Acné Vulgar/tratamiento farmacológico , Ácido Aminolevulínico/análogos & derivados , Fotoquimioterapia/métodos , Fármacos Fotosensibilizantes/uso terapéutico , Adolescente , Adulto , Ácido Aminolevulínico/uso terapéutico , Cara , Femenino , Humanos , Luz , Masculino , Índice de Severidad de la Enfermedad , Resultado del Tratamiento , Adulto JovenRESUMEN
BACKGROUND: Propionibacterium acnes is an important target in acne management. Antibiotic resistance has increased, reducing its clinical efficiency. OBJECTIVE: To study the prevalence, antimicrobial susceptibility patterns, and resistance mechanisms of P. acnes isolated from patients with acne. METHODS: Skin swabs were collected from 83 patients. Agar dilution determined the minimum inhibitory concentrations of five antibiotics. Polymerase chain reaction and DNA sequencing were used to identify mutations. Results P. acnes was isolated in 80 of 83 patients (96%), and 27 patients had resistance to antibiotics (33.7%). The mean age was older in the antibiotic-resistant group (20.8 ± 5.8 vs. 18.3 ± 3.7, P = 0.02). Resistance to trimethoprim-sulfamethoxazole was 26.3%, erythromycin 12.5%, and clindamycin 7.5%. All clindamycin-resistant strains had cross-resistance to erythromycin, and 40% erythromycin-resistant strains had cross-resistance to trimethoprim-sulfamethoxazole. All strains were sensitive to tetracycline and doxycycline. The use of topical erythromycin or clindamycin was a risk factor to carry resistant strains (P = 0.02, P = 0.04, respectively). Resistance to trimethoprim-sulfamethoxazole was associated with acne severity (P = 0.02). Six of the 10 erythromycin-resistant strains had a mutation in the peptidyl transferase region of the 23S rRNA gene: one A2058G and five A2059G. No strain carrying mutation G2057A was found. CONCLUSIONS: Resistance to trimethoprim-sulfamethoxazole was the most common pattern found, and further studies are required to clarify its resistance mechanism. A certain tetracycline resistance was expected, but interestingly all strains remained sensitive. Resistance to erythromycin and clindamycin were influenced using topical formulations. Mutation A2059G was related to high resistance to erythromycin. Antibiotic resistance is increasing, and new strategies are needed.
Asunto(s)
Acné Vulgar/microbiología , Antibacterianos/farmacología , Farmacorresistencia Bacteriana Múltiple/genética , Propionibacterium acnes/efectos de los fármacos , Propionibacterium acnes/genética , Adolescente , Adulto , Factores de Edad , Análisis de Varianza , Clindamicina/farmacología , Doxiciclina/farmacología , Eritromicina/farmacología , Femenino , Humanos , Masculino , Pruebas de Sensibilidad Microbiana , Mutación , ARN Ribosómico 23S/genética , Índice de Severidad de la Enfermedad , Tetraciclina/farmacología , Combinación Trimetoprim y Sulfametoxazol/farmacología , Adulto JovenAsunto(s)
Antibacterianos/efectos adversos , Inmunoglobulina A/inmunología , Neumonía Neumocócica/tratamiento farmacológico , Enfermedades Cutáneas Vesiculoampollosas/inducido químicamente , Enfermedades Cutáneas Vesiculoampollosas/inmunología , Anciano , Ampicilina/efectos adversos , Femenino , Humanos , Neumonía Neumocócica/inmunología , Sulbactam/efectos adversosRESUMEN
Mycetoma is a chronic, granulomatous, subcutaneous, inflammatory lesion caused by true fungi (eumycetoma) or filamentous bacteria (actinomycetoma). Mycetoma commonly affects young people between 20 and 40 years old. The most common affected site is the foot. The characteristic clinical triad is tumefaction, draining sinuses and discharging grains. We report a healthy 31-year-old male, with a 6-year history of a progressive inflammatory tumor associated with sinus tracts and granules on his left sole. Actinomycetoma was suspected. The clinical diagnosis was confirmed by microbiological and histopathological study. Polymerase chain reaction and DNA sequencing identified Actinomadura madurae. To our knowledge, this is the second case of mycetoma reported in Chile. Our report emphasizes the need to consider this diagnosis in patients with chronic granulomatous disease associated with sinus tracts, fistulas and grains.
El micetoma es una lesión subcutánea inflamatoria granulomatosa crónica causada por hongos (eumiceto-ma) o bacterias filamentosas (actinomicetoma). Afecta a adultos entre los 20-40 años y el sitio más comúnmente afectado es el pie. La tríada característica es un aumento de volumen del tejido afectado, con trayectos sinuosos y gránulos excretados. Comunicamos el caso de un hombre de 31 años, sano, con una historia de 6 años de un tumor asociado a trayectos sinuosos y gránulos en la región plantar izquierda. El diagnóstico clínico de micetoma fue confirmado mediante estudio microbiológico e histológico. La amplificación y secuenciación del AlDN bacteriano identificó Actinomadura madurae. Es el segundo caso de actinomicetoma reportado en Chile. Consideramos importante considerar este diagnóstico en pacientes con enfermedad granulomatosa crónica asociado a trayectos sinuosos, fístulas y gránulos.
Asunto(s)
Adulto , Humanos , Masculino , Infecciones por Actinomycetales/patología , Dermatosis del Pie/microbiología , Micetoma/patología , Infecciones por Actinomycetales/tratamiento farmacológico , Antibacterianos/uso terapéutico , Biopsia , Dermatosis del Pie/patología , Micetoma/tratamiento farmacológico , Resultado del Tratamiento , Combinación Trimetoprim y Sulfametoxazol/uso terapéuticoAsunto(s)
Animales , Femenino , Humanos , Adulto Joven , Dípteros , Forunculosis/patología , Miasis/parasitología , Piel/parasitología , Brasil , Larva , ViajeRESUMEN
Las manifestaciones clínicas y la presentación de la infección por Bartonella henselae posrasguño de gato son muy variadas, por lo que es un diagnóstico que debe tenerse presente para realizarlo. Se presentan los casos de 5 pacientes en los que los estudios por imágenes y la serología fueron de gran utilidad para su confirmación.