Assuntos
Proteínas de Ligação a DNA/genética , Efeito Fundador , Neoplasias Cutâneas/genética , Proteína Grupo D do Xeroderma Pigmentoso/genética , Xeroderma Pigmentoso/genética , Adolescente , Criança , Pré-Escolar , Análise Mutacional de DNA , Feminino , Humanos , Masculino , Mutação , Neoplasias Cutâneas/patologia , África do Sul , Xeroderma Pigmentoso/patologia , Adulto JovemAssuntos
Estrogênios/metabolismo , Melanose/etiologia , Melanossomas/efeitos da radiação , Raios Ultravioleta/efeitos adversos , Técnicas de Cultura de Células , Células Cultivadas , Humanos , Melanossomas/metabolismo , Melanossomas/ultraestrutura , Microscopia Eletrônica , Projetos Piloto , Progesterona/metabolismo , Pele/citologia , Pele/efeitos da radiação , Pele/ultraestruturaAssuntos
Acantose Nigricans/diagnóstico , Nevo/diagnóstico , Receptor Tipo 2 de Fator de Crescimento de Fibroblastos/genética , Receptor Tipo 3 de Fator de Crescimento de Fibroblastos/genética , Acantose Nigricans/genética , Acantose Nigricans/patologia , Adulto , Biópsia , Feminino , Humanos , Mosaicismo , Mutação , Nevo/genética , Nevo/patologia , Pele/patologiaAssuntos
Duodeno/cirurgia , Anastomose Cirúrgica/métodos , Neoplasias do Colo/patologia , Neoplasias do Colo/cirurgia , Drenagem , Neoplasias Duodenais/patologia , Neoplasias Duodenais/cirurgia , Duodeno/anatomia & histologia , Duodeno/lesões , Humanos , Jejunostomia , Jejuno/cirurgia , Ilustração Médica , Mesentério , Invasividade Neoplásica , Pancreaticoduodenectomia , Posicionamento do Paciente , Ferimentos por Arma de Fogo/cirurgiaAssuntos
Antineoplásicos/uso terapêutico , Carcinoma Basocelular/tratamento farmacológico , Neoplasias Palpebrais/tratamento farmacológico , Imiquimode/uso terapêutico , Neoplasias Nasais/tratamento farmacológico , Neoplasias Cutâneas/tratamento farmacológico , Xeroderma Pigmentoso/tratamento farmacológico , Administração Cutânea , Antineoplásicos/administração & dosagem , Pré-Escolar , Humanos , Imiquimode/administração & dosagem , MasculinoAssuntos
GTP Fosfo-Hidrolases/genética , Melanose/genética , Proteínas de Membrana/genética , Mosaicismo , Neoplasias Primárias Múltiplas/genética , Síndromes Neurocutâneas/genética , Nevo Pigmentado/genética , Nevo/genética , Neoplasias Cutâneas/genética , Tumor de Wilms/genética , Pré-Escolar , Feminino , Humanos , Lactente , Recém-NascidoAssuntos
Adalimumab/efeitos adversos , Antirreumáticos/efeitos adversos , Toxidermias/etiologia , Paniculite de Lúpus Eritematoso/induzido quimicamente , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Adalimumab/uso terapêutico , Idoso , Antirreumáticos/uso terapêutico , Artrite Reumatoide/tratamento farmacológico , Feminino , HumanosRESUMO
Skin induration remains the major clinical symptom of systemic sclerosis (SSc), an autoimmune disease with potentially life-threatening visceral involvement. However, skin induration can be absent in some patients, making the diagnosis difficult to confirm and leading to delay in management. Skin pigmentation abnormalities have been reported in patients with SSc, and can be important to recognize for diagnosis. We report two patients who developed hyperpigmented skin patches without any sign of scleroderma, as a major clinical skin symptom of incipient SSc.
Assuntos
Técnicas e Procedimentos Diagnósticos , Hiperpigmentação/etiologia , Escleroderma Sistêmico/diagnóstico , Escleroderma Sistêmico/patologia , Pele/patologia , Idoso , Artrite/etiologia , Biópsia , Calcinose/etiologia , Feminino , Humanos , Doenças Pulmonares Intersticiais/etiologia , Angioscopia Microscópica , Pessoa de Meia-Idade , Escleroderma Sistêmico/fisiopatologia , Úlcera Cutânea/etiologiaAssuntos
Fármacos Dermatológicos/administração & dosagem , Ivermectina/administração & dosagem , Rosácea/tratamento farmacológico , Adolescente , Adulto , Idoso , Humanos , Metronidazol/administração & dosagem , Pessoa de Meia-Idade , Pomadas , Qualidade de Vida , Resultado do Tratamento , Adulto JovemRESUMO
Atopic dermatitis (AD) is a clinically defined, highly pruritic, chronic inflammatory skin disease of children and adults. The diagnosis is made using evaluated clinical criteria. Disease activity is best measured with a composite score assessing both objective signs and subjective symptoms, such as SCORAD. The management of AD must consider the clinical and pathogenic variabilities of the disease and also target flare prevention. Basic therapy includes hydrating topical treatment, as well as avoidance of specific and unspecific provocation factors. Anti-inflammatory treatment of visible skin lesions is based on topical glucocorticosteroids and the topical calcineurin inhibitors tacrolimus and pimecrolimus. Topical calcineurin inhibitors are preferred in sensitive locations. Tacrolimus and mid-potent steroids are proven for proactive therapy, which is long-term intermittent anti-inflammatory therapy of the frequently relapsing skin areas. Systemic anti-inflammatory or immunosuppressive treatment is indicated for severe refractory cases. Biologicals targeting key mechanisms of the atopic immune response are promising emerging treatment options. Microbial colonization and superinfection may induce disease exacerbation and can justify additional antimicrobial treatment. Systemic antihistamines (H1R-blockers) may diminish pruritus, but do not have sufficient effect on lesions. Adjuvant therapy includes UV irradiation, preferably UVA1 or narrow-band UVB 311 nm. Dietary recommendations should be patient specific and elimination diets should only be advised in case of proven food allergy. Allergen-specific immunotherapy to aeroallergens may be useful in selected cases. Psychosomatic counselling is recommended to address stress-induced exacerbations. 'Eczema school' educational programmes have been proven to be helpful for children and adults.
Assuntos
Dermatite Atópica/terapia , Adulto , Criança , Dermatite Atópica/tratamento farmacológico , Dermatite Atópica/radioterapia , HumanosRESUMO
BACKGROUND: There are a limited number of approved treatments for papulopustular rosacea (PPR) and remission is difficult to maintain after successful treatment. OBJECTIVES: To investigate remission over a 36-week extension period in patients with moderate to severe PPR successfully treated with 16 weeks' treatment with ivermectin 1% cream once daily (QD) or metronidazole 0.75% cream twice daily (BID) in a randomized, parallel-group Phase III study. METHODS: Treatment was discontinued in patients initially successfully treated [Investigator's Global Assessment (IGA) score of 0 or 1] with ivermectin 1% cream QD (n = 399) or metronidazole 0.75% cream BID (n = 365; Part A) and patients were followed every 4 weeks for up to 36 weeks (Part B). Treatment with the same study treatment as used in Part A was only re-initiated if patients relapsed (IGA ≥ 2). Efficacy assessments were: time to first relapse; relapse rate; and number of days free of treatment. Safety assessments included incidence of adverse events and local cutaneous signs and symptoms. RESULTS: The median time to first relapse was significantly longer (115 days vs. 85 days) and relapse rates at the end of the study period significantly lower (62.7% vs. 68.4%) for patients initially successfully treated with ivermectin 1% compared with metronidazole 0.75%; Kaplan-Meier plot demonstrated a statistically significant difference between the two arms (P = 0.0365). The median number of days free of treatment was higher for ivermectin compared with metronidazole (196 days vs. 169.5 days; P = 0.026). The percentage of patients who experienced a related adverse event was equally low in both groups. CONCLUSION: The results of this relapse study showed that an initial successful treatment with ivermectin 1% cream QD significantly extended remission of rosacea compared with initial treatment with metronidazole 0.75% cream BID following treatment cessation.