RESUMEN
Cutaneous T cell lymphomas most commonly have a CD4+ memory T cell phenotype and exhibit a relatively indolent course, but may in rare cases present with a CD8+ cytotoxic phenotype with a strikingly more aggressive clinical behavior. Primary cutaneous aggressive epidermotropic CD8+ T cell lymphoma is an extremely rare entity with distinct clinicopatological features. The clinical features and prognosis of the recently-described CD8+ peripheral lymphoma are very different from cytotoxic CD8+ epidermotropic lymphoma, but the histological and phenotypic characteristics are very similar. We report a new case of CD8+ epidermotropic lymphoma with a chronic course and suggest the possibility of an overlap between these two types of lymphoma.
Asunto(s)
Linfoma Cutáneo de Células T/diagnóstico , Neoplasias Cutáneas/diagnóstico , Anciano , Antígenos CD/análisis , Antígenos CD/inmunología , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Linfocitos T CD8-positivos/inmunología , Ciclofosfamida/uso terapéutico , Doxorrubicina/uso terapéutico , Femenino , Humanos , Antígeno Ki-67/análisis , Antígeno Ki-67/inmunología , Linfoma Cutáneo de Células T/tratamiento farmacológico , Linfoma Cutáneo de Células T/inmunología , Linfoma Cutáneo de Células T/radioterapia , Linfoma de Células T Periférico/diagnóstico , Linfoma de Células T Periférico/inmunología , Recurrencia Local de Neoplasia/diagnóstico , Recurrencia Local de Neoplasia/inmunología , Prednisona/uso terapéutico , Pronóstico , Neoplasias Cutáneas/tratamiento farmacológico , Neoplasias Cutáneas/inmunología , Neoplasias Cutáneas/radioterapia , Resultado del Tratamiento , Vincristina/uso terapéuticoRESUMEN
Psoriasis is a chronic inflammatory skin condition that affects approximately 3% of the population. Up to 50% of patients with psoriasis have concurrent nail psoriasis, up to 30% of patients with skin psoriasis also have psoriatic arthritis and of these, approximately 80% have nail disease. The treatment of nail psoriasis is often challenging, and there is a need for new therapeutic options. Effective biological agents used in the treatment of moderate to severe chronic plaque psoriasis may represent a new therapeutic modality for this disease. A case of rapid improvement is reported in nail psoriasis under etanercept monotherapy with maintained efficacy following the withdrawal of continued therapy.
Asunto(s)
Inmunoglobulina G/uso terapéutico , Factores Inmunológicos/uso terapéutico , Enfermedades de la Uña/tratamiento farmacológico , Psoriasis/tratamiento farmacológico , Receptores del Factor de Necrosis Tumoral/uso terapéutico , Adulto , Etanercept , Humanos , MasculinoRESUMEN
The diagnosis and management of four cases of dermatological disorders, most of which are related to the endocrine disorder of androgen excess, are presented. Combined oral contraceptives (COCs) may be useful when well-tolerated hormonal therapy and/or when contraception is required. A female patient with androgenetic alopecia or female pattern balding, without underlying hyperandrogenism, was treated with ethinylestradiol/chlormadinone acetate (EE/CMA) 0.03 mg/2 mg for 6 months and experienced stabilization of hair loss (case report 1). A patient who had previously received a COC for an irregular menstrual pattern but again experienced irregular menses and also acne after stopping treatment was diagnosed with acne associated with polycystic ovary syndrome (PCOS) [case report 2]. After 6 month's treatment with EE/CMA 0.03 mg/2 mg, this patient had fewer acne lesions and became eumenorrheic. A third patient who had excess hair since childhood was diagnosed with idiopathic hirsutism (no underlying gynecological or endocrinological disorder was found) and was treated with EE/CMA 0.03 mg/2 mg (case report 3). Less hair growth was reported after 6 months' treatment. Case report 4 describes a patient who presented with oligomenorrhea and acne. She was diagnosed with PCOS with acne, seborrhea and mild hirsutism. Treatment with EE/CMA 0.03 mg/2 mg for 6 months resulted in improvements in her facial acne, seborrhea and hirsutism; she also became eumenorrheic. These four cases illustrate that EE/CMA may be a useful and well tolerated treatment option in the management of patients with dermatological disorders with or without hyperandrogenization.