Assuntos
Amiloidose/tratamento farmacológico , Clobetasol/análogos & derivados , Ácidos Nicotínicos/administração & dosagem , Creme para a Pele/administração & dosagem , Amiloidose/diagnóstico , Amiloidose/patologia , Biópsia , Clobetasol/administração & dosagem , Combinação de Medicamentos , Humanos , Masculino , Pessoa de Meia-Idade , Pele/efeitos dos fármacos , Pele/patologia , Resultado do TratamentoRESUMO
Pertuzumab and trastuzumab are monoclonal antibody inhibitors targeting human epidermal growth factor receptor 2 (HER-2) and are increasingly being utilised in the management of HER2-positive breast cancer, having been demonstrated to improve progression-free survival in conjunction with docetaxel. We present a rare presentation of a lichenoid drug eruption, in an annular atrophic variant, in a 35-year-old woman after initiation of HER2-inhibitor (pertuzumab and trastuzumab) therapy for metastatic breast cancer.
Assuntos
Antineoplásicos Imunológicos/efeitos adversos , Líquen Plano/imunologia , Receptor ErbB-2/imunologia , Adulto , Anticorpos Monoclonais Humanizados/administração & dosagem , Anticorpos Monoclonais Humanizados/efeitos adversos , Antineoplásicos Imunológicos/administração & dosagem , Neoplasias da Mama/tratamento farmacológico , Clobetasol/análogos & derivados , Clobetasol/uso terapêutico , Feminino , Glucocorticoides/uso terapêutico , Humanos , Líquen Plano/tratamento farmacológico , Trastuzumab/administração & dosagem , Trastuzumab/efeitos adversosAssuntos
Betametasona/uso terapêutico , Epitopos/imunologia , Penfigoide Bolhoso/tratamento farmacológico , Penfigoide Bolhoso/patologia , Administração Tópica , Biópsia por Agulha , Clobetasol/análogos & derivados , Clobetasol/uso terapêutico , Progressão da Doença , Quimioterapia Combinada , Ensaio de Imunoadsorção Enzimática , Técnica Direta de Fluorescência para Anticorpo , Seguimentos , Humanos , Immunoblotting , Imuno-Histoquímica , Lactente , Japão , Masculino , Penfigoide Bolhoso/imunologia , Medição de Risco , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
The fact that this patient's rash was limited to his chest provided an important diagnostic clue.
Assuntos
Acantólise , Erupções Acneiformes/diagnóstico , Clobetasol/análogos & derivados , Dermatite Seborreica/diagnóstico , Toxidermias/diagnóstico , Foliculite/diagnóstico , Ictiose , Terfenadina/análogos & derivados , Acantólise/diagnóstico , Acantólise/fisiopatologia , Acantólise/terapia , Administração Oral , Administração Tópica , Biópsia , Clobetasol/administração & dosagem , Fármacos Dermatológicos/administração & dosagem , Diagnóstico Diferencial , Antagonistas dos Receptores Histamínicos/administração & dosagem , Humanos , Ictiose/diagnóstico , Ictiose/fisiopatologia , Ictiose/terapia , Masculino , Pessoa de Meia-Idade , Pele/patologia , Terfenadina/administração & dosagem , Resultado do TratamentoRESUMO
Extramammary Paget's disease (EMPD) is a rare intraepidermal adenocarcinoma that can affect the vulval skin. Surgical excision is the gold-standard treatment, however, recurrence rates are high and extensive excisions can produce long-lasting cosmetic and functional defects. We describe one of the largest case series to-date (n = 6) on the use of topical 5% imiquimod cream as a novel treatment option and discuss our experiences. With the addition of our six cases to the literature, there are now 29 documented cases of vulval EMPD treated with 5% imiquimod cream. Of these, 50% of primary disease cases and 73% of recurrent primary disease cases have achieved clinical resolution with 5% imiquimod therapy alone. These findings suggest that imiquimod provides a viable alternative to surgical excision for vulval EMPD. However, we acknowledge that this is a simple retrospective analysis and that treatment scheduling and follow-up needs investigation in a trial setting.
Assuntos
Aminoquinolinas/administração & dosagem , Antineoplásicos/administração & dosagem , Doença de Paget Extramamária/tratamento farmacológico , Neoplasias Vulvares/tratamento farmacológico , Administração Cutânea , Idoso , Idoso de 80 Anos ou mais , Anti-Inflamatórios/administração & dosagem , Clobetasol/administração & dosagem , Clobetasol/análogos & derivados , Feminino , Humanos , Imiquimode , Pessoa de Meia-IdadeRESUMO
PURPOSE: To study the effects of a low administration rate and low concentration (0.1%) of clobetasone butyrate eyedrops in patients with Sjögren syndrome (SS).â© METHODS: This prospective, double-masked, randomized, placebo-controlled study included 40 subjects divided into 2 treatment groups: group 1 (2% polyvinylpyrrolidone eyedrops and placebo) and group 2 (2% polyvinylpyrrolidone and 0.1% clobetasone butyrate, 1 drop BID). The treatment lasted for 30 days, with visits at enrollment, baseline, day 15, day 30, and after 15 days of treatment discontinuation. At each visit, symptoms questionnaire, tear film break-up time, corneal fluorescein stain, lissamine green stain, conjunctival impression cytology for human leukocyte antigen-DR (HLA-DR) expression, intraocular pressure (IOP) measurement, and fundus examination were performed. â© RESULTS: No changes in IOP or fundus examination were observed in either group at each time point. Group 1 patients showed at day 30 a statistically significant amelioration of symptoms and reduction of HLA-DR expression. No changes in other parameters were detected. Group 2 patients showed at day 15 a statistically significant improvement of corneal and conjunctival stain versus baseline values and group 1 at the same time; after 30 days the symptoms score was statistically significantly better than baseline values and group 1 at the same time. The HLA-DR expression and the epithelial cells area were statistically significantly reduced versus baseline and group 1 at the same time. â© CONCLUSIONS: Anti-inflammatory therapy is critical for the treatment of SS dry eye. Clobetasone butyrate, at low dosage, proved to be safe and effective in treating this condition.
Assuntos
Clobetasol/análogos & derivados , Glucocorticoides/administração & dosagem , Síndrome de Sjogren/tratamento farmacológico , Administração Tópica , Clobetasol/administração & dosagem , Clobetasol/efeitos adversos , Túnica Conjuntiva/efeitos dos fármacos , Túnica Conjuntiva/metabolismo , Túnica Conjuntiva/patologia , Método Duplo-Cego , Síndromes do Olho Seco/tratamento farmacológico , Síndromes do Olho Seco/metabolismo , Síndromes do Olho Seco/patologia , Feminino , Glucocorticoides/efeitos adversos , Antígenos HLA-DR/metabolismo , Humanos , Pressão Intraocular/efeitos dos fármacos , Masculino , Pessoa de Meia-Idade , Soluções Oftálmicas , Excipientes Farmacêuticos/administração & dosagem , Povidona/administração & dosagem , Estudos Prospectivos , Síndrome de Sjogren/metabolismo , Síndrome de Sjogren/patologia , Lágrimas/química , Resultado do TratamentoRESUMO
Herbs and minerals have been used in clinical dermatology for hundreds of years and herbal ingredients are becoming increasingly popular with the public in treatment of various dermatological conditions characterised by inflammation and pruritus. The aim of this study was to compare the efficacy of traditional topical therapeutic agents with a moderate potency topical glucocorticoid on experimental contact dermatitis and contact urticaria. The effects of ichthammol 10% pet, zinc oxide 20% pet, camphor 20% pet, levomenthol 10% pet, tea tree oil 20 or 50% and clobetason butyrate 0.05% ointment were studied in the following experimental models: elicitation of allergic contact dermatitis to nickel, irritant contact dermatitis to benzalkonium chloride, and in immediate reactions to histamine and benzoic acid (non-immunological contact utricaria) respectively. Delayed reactions were evaluated using a clinical scoring system and immediate reactions were estimated by planimetry. Histamine-induced pruritus was evaluated using VAS. Tea tree oil reduced allergic contact dermatitis by 40.5% (p = 0.003), zinc oxide by 17.4% (p = 0.04) and clobetason butyrate by 23.5% (p = 0.01). Zinc oxide reduced histamine induced flare by 18.5% (p = 0.01), ichthammol by 19.2% (p = 0.02) and clobetason butyrate by 44.1% (p = 0.02). Irritant contact dermatitis and non-immunological contact urticaria were not influenced by the pre-treatments. Pruritus induced by histamine also remained unchanged. In conclusion, tea tree oil seems to be a more effective anti-eczematic agent than zinc oxide and clobetasone butyrate, while clobetasone butyrate is superior to both ichthammol and zinc oxide in topical treatment of urticarial reactions.
Assuntos
Dermatite de Contato/tratamento farmacológico , Óleo de Melaleuca/uso terapêutico , Adulto , Idoso , Compostos de Benzalcônio , Ácido Benzoico/imunologia , Cânfora/administração & dosagem , Cânfora/farmacologia , Cânfora/uso terapêutico , Clobetasol/administração & dosagem , Clobetasol/análogos & derivados , Clobetasol/farmacologia , Clobetasol/uso terapêutico , Feminino , Histamina/imunologia , Humanos , Masculino , Mentol/administração & dosagem , Mentol/farmacologia , Mentol/uso terapêutico , Pessoa de Meia-Idade , Níquel/imunologia , Compostos de Amônio Quaternário/administração & dosagem , Compostos de Amônio Quaternário/farmacologia , Compostos de Amônio Quaternário/uso terapêutico , Óleo de Melaleuca/administração & dosagem , Óleo de Melaleuca/farmacologia , Óxido de Zinco/administração & dosagem , Óxido de Zinco/farmacologia , Óxido de Zinco/uso terapêuticoRESUMO
A 32-year-old woman presented with cystic eyelid lesions accompanied by foul-smelling discharge. Excision biopsy showed that she had Darier disease, and she was referred to dermatology for further management. Despite clinically indolent-looking lesions, biopsy and histology allowed the diagnosis of this rare condition to be made.
Assuntos
Cistos/diagnóstico , Doença de Darier/diagnóstico , Doenças Palpebrais/diagnóstico , Adapaleno , Adulto , Biópsia , Clobetasol/administração & dosagem , Clobetasol/análogos & derivados , Cistos/tratamento farmacológico , Doença de Darier/tratamento farmacológico , Fármacos Dermatológicos/administração & dosagem , Doenças Palpebrais/tratamento farmacológico , Feminino , Glucocorticoides/administração & dosagem , Humanos , Naftalenos/administração & dosagem , Odorantes , PomadasRESUMO
Porokeratosis is a disorder of clonal hyperproliferation of keratinocytes with several different clinical manifestations. Cutaneous lesions vary in their appearance and distribution. All variants share the distinguishing cornoid lamella on histopathological examination. We present an unusual case of disseminated porokeratosis of Mibelli in an immunocompetent patient.
Assuntos
Poroceratose/patologia , Abdome , Idoso , Braço , Biópsia , Nádegas , Clobetasol/análogos & derivados , Clobetasol/uso terapêutico , Fármacos Dermatológicos/uso terapêutico , Virilha , Humanos , Imunocompetência , Perna (Membro) , Masculino , Especificidade de Órgãos , Poroceratose/diagnóstico , Prurido/etiologiaRESUMO
Lichen sclerosus (LS) is a chronic inflammatory skin condition usually located in the anogenital area. Topical corticosteroid therapy is the first choice treatment which may arrest or delay the progression of the disorder. We report the case of a 74-year-old man presented with a 6-month history of nodular lesions localized on penis. The man had a previous history of genital lesions that had been diagnosed as LS and treated with long-term topical corticosteroid therapy. After 3 months of corticosteroid therapy, the patient observed the appearance of several nodular erythematous lesions on the penis with progressive disappearance of the clinical symptoms of LS. These purple to red asymptomatic angiomatoid nodules resembled the clinical features of Kaposi sarcoma.
Assuntos
Glucocorticoides/efeitos adversos , Líquen Escleroso e Atrófico/tratamento farmacológico , Doenças do Pênis/induzido quimicamente , Idoso , Clobetasol/efeitos adversos , Clobetasol/análogos & derivados , Clobetasol/uso terapêutico , Glucocorticoides/uso terapêutico , Humanos , Líquen Escleroso e Atrófico/patologia , Masculino , Doenças do Pênis/tratamento farmacológico , Doenças do Pênis/patologia , Pênis/patologia , Sarcoma de Kaposi/diagnóstico , Sarcoma de Kaposi/patologiaAssuntos
Poroceratose/patologia , Couro Cabeludo/patologia , Idoso , Biópsia , Clobetasol/análogos & derivados , Clobetasol/uso terapêutico , Fármacos Dermatológicos/uso terapêutico , Glucocorticoides/uso terapêutico , Humanos , Masculino , Ácidos Nicotínicos/uso terapêutico , Poroceratose/tratamento farmacológico , Falha de TratamentoAssuntos
Psoríase/tratamento farmacológico , Adalimumab , Alefacept , Anti-Inflamatórios/uso terapêutico , Anticorpos Monoclonais/uso terapêutico , Anticorpos Monoclonais Humanizados , Atitude Frente a Saúde , Betametasona/uso terapêutico , Imagem Corporal , Calcitriol/análogos & derivados , Calcitriol/uso terapêutico , Clobetasol/análogos & derivados , Clobetasol/uso terapêutico , Fármacos Dermatológicos/uso terapêutico , Diagnóstico Diferencial , Monitoramento de Medicamentos , Etanercepte , Humanos , Imunoglobulina G/uso terapêutico , Imunossupressores/uso terapêutico , Infliximab , Psoríase/diagnóstico , Psoríase/etiologia , Psoríase/psicologia , Receptores do Fator de Necrose Tumoral/uso terapêutico , Proteínas Recombinantes de Fusão/uso terapêutico , Índice de Gravidade de DoençaRESUMO
The clinical benefit of currently available tar blend shampoos for the treatment of scalp psoriasis is restricted due to their limited efficacy, low cosmetic appeal and potential for carcinogenicity. This 4-week multicentre, randomized, parallel-group, investigator-masked study included 162 subjects and aimed to compare the efficacy, safety and cosmetic acceptability of clobetasol propionate 0.05% shampoo versus a currently marketed tar blend 1% shampoo in subjects with moderate to severe scalp psoriasis. Clobetasol propionate shampoo was superior to tar blend shampoo with respect to all efficacy variables tested (p<0.001): Total and Global Severity Score; erythema; plaque thickening; desquamation; pruritus; total scalp area involved; and the subject's global assessment of clinical improvement. Both treatments were safe and well-tolerated. Furthermore, more subjects indicated that clobetasol propionate shampoo was more cosmetically acceptable than tar blend shampoo. Clobetasol propionate 0.05% shampoo is a good alternative to tar blend shampoo in the treatment of moderate to severe scalp psoriasis.
Assuntos
Clobetasol/análogos & derivados , Ceratolíticos/administração & dosagem , Psoríase/tratamento farmacológico , Dermatoses do Couro Cabeludo/tratamento farmacológico , Administração Cutânea , Clobetasol/administração & dosagem , Método Duplo-Cego , Feminino , Preparações para Cabelo , Humanos , Masculino , Pessoa de Meia-Idade , Psoríase/patologia , Dermatoses do Couro Cabeludo/patologia , Índice de Gravidade de Doença , Alcatrões , Resultado do TratamentoAssuntos
Doença de Darier/diagnóstico , Complicações na Gravidez/diagnóstico , Administração Cutânea , Adulto , Clobetasol/administração & dosagem , Clobetasol/análogos & derivados , Doença de Darier/tratamento farmacológico , Doença de Darier/patologia , Diagnóstico Diferencial , Feminino , Humanos , Gravidez , Complicações na Gravidez/tratamento farmacológico , Complicações na Gravidez/patologia , Segundo Trimestre da GravidezRESUMO
Skin atrophy is one of the most frequent side-effects of the topical glucocorticoid. Skin barrier impairment has also been reported as a steroid-induced side effect. Although there have been various studies on preventing or minimizing this atrophogenic effect, little has been reported about preventing barrier impairment. This study was performed to determine the effects of a multilamellar emulsion (MLE) that had a well-ordered lamellar structure on the steroid-induced barrier impairment and epidermal atrophy. To confirm these effects of MLE, 0.05% clobetasol-17-propionate (CP) and 0.05% clobetasol-17-propionate in MLE (MLE/CP) were topically applied to both flanks of hairless mice for 9 days. The topically applied CP induced a significant impairment of the epidermal permeability barrier, and MLE/CP also did not have a preventive effect on this change. However, skinfold thickness studies and histological studies showed that MLE/CP significantly reduced the steroid-induced atrophy. The topical application of MLE/CP was also shown to have a preventive effect on the steroid-induced increase of the stratum corneum (SC) surface pH. In addition, the electron microscopic findings showed relatively well-conserved lamellar bilayers in the skin treated with MLE, as compared to CP only. The results showed that the topical application of MLE immediately after CP treatment prevented the glucocorticoid-induced transepidermal water loss values increase. Light microscopy measurements showed that the skin treated with MLE immediately after CP treatment for 1 week had a slightly lower decline of skin thickness than did the CP-treated skin. These results suggest that MLE should be effective for preventing glucocorticoid-induced epidermal atrophy and for repairing the barrier impairment.
Assuntos
Clobetasol/análogos & derivados , Epiderme/efeitos dos fármacos , Epiderme/patologia , Absorção Cutânea/efeitos dos fármacos , Administração Tópica , Animais , Atrofia , Biópsia por Agulha , Clobetasol/farmacologia , Modelos Animais de Doenças , Emulsões , Feminino , Glucocorticoides , Imunoquímica , Masculino , Camundongos , Camundongos Pelados , Permeabilidade/efeitos dos fármacos , Probabilidade , Valores de Referência , Fatores de Risco , Sensibilidade e Especificidade , Absorção Cutânea/fisiologia , Dermatopatias/tratamento farmacológico , Dermatopatias/patologiaRESUMO
Bullous pemphigoid, the most frequent bullous autoimmune dermatosis of the adult, typically presents as disseminated tense blisters on normal or erythematous skin. The diagnosis can be confirmed by direct and indirect immunofluorescence, the detection of circulating autoantibodies against the basement membrane proteins collagen XVII/BP180 and BP230, and histopathology. Autoantibody reactivity against collagen XVII can be measured by ELISA and correlates with disease activity. The ELISA therefore provides a useful tool for monitoring disease activity. Treatment of bullous pemphigoid usually consists of topical and / or systemic steroids in combination with immunosuppressive agents. The intensity of skin involvement and the concurrent diseases and medications of the patient must be considered when selecting a certain treatment. Interdisciplinary cooperation between general practitioners, internists and other specialists facilitates the optimal adaptation of the medication and the early discovery of potential side effects.
Assuntos
Penfigoide Bolhoso , Corticosteroides/administração & dosagem , Corticosteroides/efeitos adversos , Corticosteroides/uso terapêutico , Adulto , Idoso , Anti-Inflamatórios/administração & dosagem , Anti-Inflamatórios/efeitos adversos , Anti-Inflamatórios/uso terapêutico , Autoanticorpos/análise , Azatioprina/administração & dosagem , Azatioprina/efeitos adversos , Azatioprina/uso terapêutico , Biópsia , Western Blotting , Criança , Clobetasol/administração & dosagem , Clobetasol/efeitos adversos , Clobetasol/análogos & derivados , Clobetasol/uso terapêutico , Ciclofosfamida/administração & dosagem , Ciclofosfamida/efeitos adversos , Ciclofosfamida/uso terapêutico , Dapsona/administração & dosagem , Dapsona/efeitos adversos , Dapsona/uso terapêutico , Fármacos Dermatológicos/administração & dosagem , Fármacos Dermatológicos/efeitos adversos , Fármacos Dermatológicos/uso terapêutico , Diagnóstico Diferencial , Quimioterapia Combinada , Ensaio de Imunoadsorção Enzimática , Feminino , Técnica Direta de Fluorescência para Anticorpo , Técnica Indireta de Fluorescência para Anticorpo , Humanos , Imunoglobulinas Intravenosas/administração & dosagem , Imunoglobulinas Intravenosas/efeitos adversos , Imunoglobulinas Intravenosas/uso terapêutico , Imunossupressores/administração & dosagem , Imunossupressores/efeitos adversos , Imunossupressores/uso terapêutico , Masculino , Ácido Micofenólico/administração & dosagem , Ácido Micofenólico/efeitos adversos , Ácido Micofenólico/análogos & derivados , Ácido Micofenólico/uso terapêutico , Niacinamida/administração & dosagem , Niacinamida/efeitos adversos , Niacinamida/uso terapêutico , Penfigoide Bolhoso/classificaçãoRESUMO
BACKGROUND: Studies show that pulsed dye laser (PDL) has some clinical benefits on psoriasis with a low clearance rate. In addition, it has been suggested that applying keratolytics before treatment might be helpful in PDL therapy. Topical corticosteroids remain the most commonly prescribed agents for psoriasis. OBJECTIVE: This study was designed to compare the efficacy of the PDL treatment with that of PDL treatment after salicylic acid on psoriatic plaques. The other goal of this study was to compare the efficacy of the PDL treatment with that of clobetasol propionate treatment. METHODS: Twenty-two patients with chronic, stable psoriatic plaques that involved less than 20% of their body were included in the study. Three similar-appearing psoriasis plaques in these patients were selected. Whereas the first plaque received only PDL, the second plaque received PDL after salicylic acid, and the third plaque received clobetasol propionate ointment and salicylic acid. Evaluation of the study plaques was carried out by the modified Psoriasis Area and Severity Index (mPASI) score and by measuring the area of the plaques. RESULTS: Of the 21 patients, 19 completed the study. Although the decrease in mPASI scores was determined to be maximum for clobetasol propionate + salicylic acid-treated plaques and minimum for only PDL-treated plaques, the decrease was statistically significant in all groups when compared with baseline (p < .003). At the 3- and 6-week evaluations, there was a statistically significant difference between clobetasol propionate + salicylic acid-treated plaques and the two PDL-treated plaques (p < .003); however, the difference observed at the 9-, 12-, and 15-week evaluations was statistically significant only between clobetasol propionate + salicylic acid-treated plaques and PDL-treated plaques (p < .003). When the baseline and 15-week evaluations were compared, there was no statistically significant increase in the mean lesion areas of clobetasol propionate + salicylic acid-treated psoriatic plaques (p > .003), but there was a statistically significant increase in the mean lesion areas of two PDL-treated psoriatic plaques (p < .003). CONCLUSION: The results of this study showed that the effect of PDL could be increased when salicylic acid was added to treatment, although there was no statistically significant difference between both treatment protocols. However, clobetasol propionate + salicylic acid treatment is more effective than both PDL and PDL + salicylic acid treatment.
Assuntos
Clobetasol/análogos & derivados , Glucocorticoides/administração & dosagem , Ceratolíticos/administração & dosagem , Terapia com Luz de Baixa Intensidade , Psoríase/terapia , Ácido Salicílico/administração & dosagem , Adulto , Idoso , Clobetasol/administração & dosagem , Terapia Combinada , Quimioterapia Combinada , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Psoríase/patologia , Resultado do TratamentoRESUMO
X-linked inhibitor of apoptosis protein (XIAP) is a member of the inhibitor of apoptosis proteins family of caspase inhibitors that selectively binds and inhibits caspases-3, -7 and -9, but not caspase-8. As such, XIAP blocks a substantial portion of the apoptosis pathway and is an attractive target for novel therapeutic agents for the treatment of malignancy. Antisense oligonucleotides directed against XIAP are effective in vitro and are currently being evaluated in clinical trials. Small molecule XIAP inhibitors that target the baculovirus IAP repeat (BIR) 2 or BIR 3 domain are in preclinical development and are advancing toward the clinic. This review will discuss the progress being made in developing antisense and small-molecule XIAP inhibitors.
Assuntos
Apoptose/efeitos dos fármacos , Neoplasias/tratamento farmacológico , Oligonucleotídeos Antissenso/uso terapêutico , Proteínas Inibidoras de Apoptose Ligadas ao Cromossomo X/antagonistas & inibidores , Proteínas Inibidoras de Apoptose Ligadas ao Cromossomo X/genética , Benzoquinonas/farmacologia , Benzoquinonas/uso terapêutico , Inibidores de Caspase , Clobetasol/análogos & derivados , Clobetasol/farmacologia , Clobetasol/uso terapêutico , Humanos , Neoplasias/fisiopatologia , Oligonucleotídeos Antissenso/análise , Oligonucleotídeos Antissenso/farmacologia , Estrutura Terciária de Proteína , Ubiquitina-Proteína Ligases/antagonistas & inibidores , Proteínas Inibidoras de Apoptose Ligadas ao Cromossomo X/química , Proteínas Inibidoras de Apoptose Ligadas ao Cromossomo X/metabolismoRESUMO
Sebaceous hyperplasia is a cutaneous lesion consisting of soft, yellow, papular lesions usually occurring on the face in elderly patients. The occurrence of the lesion on the vulva is exceptionally rare. We were able to identify only three cases reported in the literature. We report a case of sebaceous hyperplasia of the vulva with an unusual presentation.
Assuntos
Glândulas Sebáceas/patologia , Vulva/patologia , Administração Tópica , Biópsia , Clobetasol/administração & dosagem , Clobetasol/análogos & derivados , Clobetasol/uso terapêutico , Diagnóstico Diferencial , Feminino , Humanos , Hiperplasia/tratamento farmacológico , Hiperplasia/patologia , Pessoa de Meia-Idade , Vasoconstritores/administração & dosagem , Vasoconstritores/uso terapêuticoRESUMO
BACKGROUND: Lichen planus with simultaneous oral and genital involvement in males is a quite rare condition and often difficult to diagnose. The prevalence, treatment options, and management for this condition are far from being established, and research in this area primarily relies on anecdotes. We present the clinical features of eight cases of peno-gingival lichen planus and propose a management algorithm for this condition based on the best available published evidence. METHODS: Personal medical history was collected for all cases. Following careful examination of the oral and genital mucosae, pathology was obtained, previous treatments and duration of mucosal lesions ascertained, treatment initiated, and response evaluated at 8 weeks on both oral and genital lesions. The first-line drug was topical clobetasol propionate 0.05% cream in all cases; in case of failure, topical cyclosporin was used. A review of the literature on treatment options for this rare condition was performed based upon standard literature review practices. RESULTS: Five cases presented gingival lesions that clinically resembled lichen planus. Glans penis was involved in all patients. All patients responded to treatment except for one. Oral candidiasis was the only observed side effect. CONCLUSIONS: Genital lichen planus may be suspected in males when atrophic-erosive gingival lichen planus is found. A thorough multidisciplinary medical management and active early treatment are necessary to improve symptoms and prevent genital sequelae and, given the risk of squamous cell carcinoma, as a preventative strategy, although this area still needs investigation. Therapeutic trials relating to the treatment of peno-gingival lichen planus may be undertaken considering that current management relies exclusively on observations of case reports.