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1.
Actas Dermosifiliogr ; 115(6): T547-T554, 2024 Jun.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-38653368

RESUMO

BACKGROUND AND OBJECTIVES: Bexarotene has been approved to treat advanced stage cutaneous T-cell lymphomas (CTCL) since 1999. However, very few data have been published on its long-term safety and efficacy profile. The aim of this study is to determine the tolerability to bexarotene and outcomes by collecting the 2nd largest case series to date on its long-term use vs CTCL. MATERIAL AND METHOD: This was a multicenter retrospective review of 216 patients with mycosis fungoides (174), or Sézary syndrome (42) on a 10-year course of bexarotene alone or in combination with other therapies at 19 tertiary referral teaching hospitals. RESULTS: A total of 133 men (62%) and 83 women (38%) were included, with a mean age of 63.5 year (27-95). A total of 45% were on bexarotene monotherapy for the entire study period, 22% started on bexarotene but eventually received an additional therapy, 13% were on another treatment but eventually received bexarotene while the remaining 20% received a combination therapy since the beginning. The median course of treatment was 20.78 months (1-114); and the overall response rate, 70.3%. Complete and partial response rates were achieved in 26% and 45% of the patients, respectively. Treatment was well tolerated, being the most common toxicities hypertriglyceridemia (79%), hypercholesterolemia (71%), and hypothyroidism (52%). No treatment-related grade 5 adverse events were reported. CONCLUSIONS: Our study confirms bexarotene is a safe and effective therapy for the long-term treatment of CTCL.


Assuntos
Bexaroteno , Micose Fungoide , Síndrome de Sézary , Neoplasias Cutâneas , Tetra-Hidronaftalenos , Humanos , Bexaroteno/uso terapêutico , Masculino , Feminino , Idoso , Estudos Retrospectivos , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Neoplasias Cutâneas/tratamento farmacológico , Adulto , Tetra-Hidronaftalenos/uso terapêutico , Tetra-Hidronaftalenos/efeitos adversos , Micose Fungoide/tratamento farmacológico , Síndrome de Sézary/tratamento farmacológico , Espanha , Linfoma Cutâneo de Células T/tratamento farmacológico , Resultado do Tratamento , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos
2.
Actas Dermosifiliogr ; 115(6): 547-554, 2024 Jun.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-38395224

RESUMO

BACKGROUND AND OBJECTIVES: Bexarotene has been approved to treat advanced stage cutaneous T-cell lymphomas (CTCL) since 1999. However, very few data have been published on its long-term safety and efficacy profile. The aim of this study is to determine the tolerability to bexarotene and outcomes by collecting the 2nd largest case series to date on its long-term use vs CTCL. MATERIAL AND METHOD: This was a multicenter retrospective review of 216 patients with mycosis fungoides (174), or Sézary syndrome (42) on a 10-year course of bexarotene alone or in combination with other therapies at 19 tertiary referral teaching hospitals. RESULTS: A total of 133 men (62%) and 83 women (38%) were included, with a mean age of 63.5 year (27-95). A total of 45% were on bexarotene monotherapy for the entire study period, 22% started on bexarotene but eventually received an additional therapy, 13% were on another treatment but eventually received bexarotene while the remaining 20% received a combination therapy since the beginning. The median course of treatment was 20.78 months (1-114); and the overall response rate, 70.3%. Complete and partial response rates were achieved in 26% and 45% of the patients, respectively. Treatment was well tolerated, being the most common toxicities hypertriglyceridemia (79%), hypercholesterolemia (71%), and hypothyroidism (52%). No treatment-related grade 5 adverse events were reported. CONCLUSIONS: Our study confirms bexarotene is a safe and effective therapy for the long-term treatment of CTCL.


Assuntos
Bexaroteno , Micose Fungoide , Síndrome de Sézary , Neoplasias Cutâneas , Tetra-Hidronaftalenos , Humanos , Bexaroteno/uso terapêutico , Masculino , Feminino , Idoso , Estudos Retrospectivos , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Neoplasias Cutâneas/tratamento farmacológico , Adulto , Tetra-Hidronaftalenos/uso terapêutico , Tetra-Hidronaftalenos/efeitos adversos , Micose Fungoide/tratamento farmacológico , Síndrome de Sézary/tratamento farmacológico , Espanha , Linfoma Cutâneo de Células T/tratamento farmacológico , Resultado do Tratamento , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos
5.
An Sist Sanit Navar ; 44(2): 163-176, 2021 Aug 19.
Artigo em Espanhol | MEDLINE | ID: mdl-34132245

RESUMO

BACKGROUND: Cutaneous, superficial and or suprafascial leiomyoma are divided into three variants: piloleiomyomas (PL), angioleiomyomas (AL) and genital leiomyomas (GL) that include the vulvar, scrotal and areolar forms. This study set out to establish the clinical and histological characteristics and incidence of each variant, and any likely associations with internal neoplasms. METHODS: A review was carried out of 255 cases of cutaneous leiomyomas diagnosed between 1982 and 2018 at the Pathology departments of three hospitals (Navarra and Alicante). Demographic, clinical, histological and immunohistochemical variables were described and compared. RESULTS: The incidence of PL in Navarra was 4.3 cases per million inhabitants a year, with another 20 cases of AL and 1.4 cases of GL. Cutaneous forms make up approximately 3.5% of the total leiomyomas. The population with PL suffered more frequently from breast cancer (OR?=?4.8; CI 95%: 1.3-17.4; p?=?0.006). Nipple leiomyomas are small, accompanied by localised pain, and are predominantly fascicular or solid, with very infrequent effect on the subcutaneous cellular tissue and scarce atypia. This makes for a contrast with the other GLs, which are medium sized and infrequently painful, predominantly nodular, and frequent effect on the subcutaneous tissue and atypia. CONCLUSIONS: The information provided here about the clinical and histological characteristics of the different varieties of leiomyomas indicate that there is a need to reconsider the classification of nipple leiomyomas outside the group of GLs. An association between PL and breast carcinoma was detected, which needs to be confirmed in future studies so as to determine if this leiomyoma is a risk marker for breast cancer.


Assuntos
Leiomioma , Neoplasias Cutâneas , Humanos , Leiomioma/epidemiologia , Neoplasias Cutâneas/epidemiologia
6.
An Sist Sanit Navar ; 42(3): 303-307, 2019 Dec 05.
Artigo em Espanhol | MEDLINE | ID: mdl-31859267

RESUMO

BACKGROUND: To describe the dermoscopic features in superficial basal cell carcinoma that are associated with a poor therapeutic response to imiquimod treatment. METHOD: Clinical and dermatoscopic photographs of 56 superficial basal cell carcinomas of different patients were compared retrospectively, assessed in our office for five years and treated with topic 5% imiquimod five days a week for six weeks. The different dermatoscopic signs of the lesions were identified and the association of each of them with the response to treatment was assessed. RESULTS: A total response to treatment was achieved by 69.5% of the lesions of patients treated with imiquimod. Dermatoscopy of responding lesions showed a higher frequency of lesions with in focus gray dots (43.6%) and multiple erosions of less than 2 mm (61.5%), without observing statistically significant differences. Within the group with poor response to treatment, a greater number of lesions were found with the presence of arborizing telangiectasias (58.8%), blue-gray ovoid nests (41.1%), ulceration (58.8%), shiny white-red structureless areas (82.2%) and chrysalis (41.2%). The areas in blue-white veil areas (23.5%) and rainbow pattern (23.5%) were only observed in non-responding lesions. Both groups were similar regarding age, sex, diameter of lesions and frequency of some dermatoscopic signs: fine short telangiectasias, gray blue globules, arc-leaf areas and cart-wheel structures. CONCLUSION: The study identified dermatoscopic criteria that are significantly associated with a worse response to treatment with imiquimod. In contrast, we found no dermatoscopic signs that correlate specifically to a complete response to treatment.


Assuntos
Antineoplásicos/administração & dosagem , Carcinoma Basocelular/tratamento farmacológico , Imiquimode/administração & dosagem , Neoplasias Cutâneas/tratamento farmacológico , Administração Cutânea , Idoso , Carcinoma Basocelular/diagnóstico , Carcinoma Basocelular/patologia , Dermoscopia/métodos , Feminino , Humanos , Masculino , Estudos Retrospectivos , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/patologia , Resultado do Tratamento
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