Doxycycline, an Antibiotic or an Anti-Inflammatory Agent? The Most Common Uses in Dermatology. / Doxiciclina, ¿antibiótico o antiinflamatorio? Usos más frecuentes en dermatología.

Doxycycline is a synthetic tetracycline that was approved in 1967. This wide-spectrum antibiotic has been shown to also have useful anti-inflammatory properties that make it suitable for the treatment of a number of noninfectious conditions. Tetracyclines are probably the most commonly prescribed antibiotics in dermatology, where they are usually used at doses lower than those effective against infections. They also have an excellent efficacy and safety profile. Because of doxycycline's ability to inhibit the molecular pathways associated with certain processes, this antibiotic can be used to treat hair follicle diseases, granulomatous diseases, and vascular proliferation, among other conditions. The main properties of doxycycline and its many applications in dermatology make this drug one that specialists should become familiar with.

Studying the effect of systemic and biological drugs on intima-media thickness in patients suffering from moderate and severe psoriasis.

BACKGROUND: Psoriasis has been related to a large number of cardiovascular risk factors such as hypertension, diabetes mellitus and arteriosclerosis. The increased carotid intima-media thickness (IMT) could be considered to be a marker of generalized arteriosclerosis. OBJECTIVE: To assess the effect of systemic and biological drugs on psoriatic patients' carotid IMT. METHODS: A prospective study was performed. We studied 53 patients with moderate and severe psoriasis from our psoriasis dermatological unit, analysing lipid and glucose metabolism and performing a carotid IMT sonography before introduction of systemic and biological drugs. After that, we performed an 8-month closely analytic and sonographic follow-up. RESULTS: The IMT of the patients with psoriasis treated with biological drugs tended to decrease, although this occurrence was not statistically significant (P = 0.086). The subgroup analysis revealed that patients treated with methotrexate (P = 0.045) and anti-IL-12/23 (P = 0.010) presented a decrease in their IMT levels. This analysis also showed a decrease in glycaemia and insulin levels in patients treated with TNF-alpha inhibitors and ustekinumab. CONCLUSIONS: Our study suggests that the carotid IMT may benefit from treatment with biological drugs, particularly anti-IL-12/23 and methotrexate in patients suffering from moderate and severe psoriasis. However, larger longitudinal studies should be performed to fully confirm these results.

CLOVES syndrome: review of a PIK3CA-related overgrowth spectrum (PROS).

Overgrowth syndromes are characterized by global or localized disproportionate growth associated with other anomalies, including vascular malformations and neurological and/or visceral disorders. CLOVES (Congenital Lipomatous asymmetric Overgrowth of the trunk with lymphatic, capillary, venous, and combined-type Vascular malformations, Epidermal naevi, Scoliosis/Skeletal and spinal anomalies) is an overgrowth syndrome caused by mosaic activating mutation in gene PIK3CA, which gives rise to abnormal PI3K-AKT-mTOR pathway activation. These mutations are responsible for the clinical manifestations of the syndrome, which include low- and high-flow vascular malformations, thoracic lipomatous hyperplasia, asymmetric growth, and visceral and neurological disorders. These common anomalies are illustrated with figures from two personal cases. Identification of the clinical and genetic characteristics of CLOVES syndrome is crucial for the differential diagnosis with other overgrowth syndromes, such as Proteus or Klippel-Trenaunay (K-T) syndromes, and for the therapeutic management of the different anomalies. In this context, a new entity comprising different syndromes with phenotypic mutations in PIK3CA has been proposed, designated PIK3CA-related overgrowth spectrum (PROS), with the aim of facilitating clinical management and establishing appropriate genetic study criteria.

[Increase in cigarette smoking and decrease in the level of physical activity among Spanish adolescentes. AVENA study]. / Incremento del consumo de tabaco y disminución del nivel de práctica de actividad física en adolescentes españoles. Estudio AVENA.

OBJECTIVE: Cigarette smoking among adolescents as well as the level of physical activity constitutes a public health care issue. The aim is knowing the relationship between cigarette smoking and practice of physical activity. SETTING: Schooled Spanish adolescents SUBJECTS: 2859 Spanish adolescents (1357 boys, 1502 girls; age range: 13-18.5 years). INTERVENTIONS: A questionnaire is applied to know the level of cigarette smoking and four other questionnaires to know the level of physical activity during different periods. RESULTS: 40.8% of the adolescents stated not doing any physical activity at all, boys being more active than girls (p < 0.001). 29.9% of the adolescents stated usually smoking cigarettes, without differences by gender. Both active boys and girls stated smoking less (P < or = 0.01). The greater the age, the higher cigarette smoking and the lower the level of physical activity, both in boys and girls (p < 0.001). CONCLUSIONS: The level of physical activity is low, being even lower for girls. Cigarette smoking shows a negative relationship with the level of physical activity, the individuals more physically active being those smoking the less.