RESUMO
Patients with cutaneous T-cell lymphoma with progressive disease typically undergo a series of skin-directed and systemic therapy regimens during cycles of response and relapse. Extracorporeal photopheresis (ECP) is an effective and safe systemic treatment option, often reserved for later stages of disease and typically employed after failure of several other therapies. ECP has benefits in response rate, time to next treatment, and tolerability that may support its use earlier in the treatment cycle for advancing/progressing disease.
Assuntos
Linfoma Cutâneo de Células T , Micose Fungoide , Fotoferese , Neoplasias Cutâneas , Humanos , Micose Fungoide/patologia , Neoplasias Cutâneas/terapia , Neoplasias Cutâneas/patologia , Recidiva Local de Neoplasia , Linfoma Cutâneo de Células T/terapia , Linfoma Cutâneo de Células T/patologiaRESUMO
Options to prevent facial insect bites while sleeping are limited. Patients may prefer to avoid facial application of potentially neurotoxic insect repellants. Non-toxic “natural” repellants have limited efficacy, and netting may not be well-tolerated. Nightly facial application of 1% topical ivermectin (IVM) cream completely prevented overnight bites in 2 patients, both of whom reported recurrent bites after discontinuation, and a return to complete bite prevention after IVM resumption. Topical IVM may be an alternative facial mosquito bite prevention modality. J Drugs Dermatol. 2022;21(8):906-907. doi:10.36849/JDD.6432.
Assuntos
Mordeduras e Picadas de Insetos , Ivermectina , Humanos , Mordeduras e Picadas de Insetos/tratamento farmacológico , Mordeduras e Picadas de Insetos/prevenção & controle , Ivermectina/uso terapêuticoRESUMO
Dermatologists often recommend vitamin D for sun-protected patients. Most patients are not aware of the key role vitamin K2 plays in vitamin D metabolism and do not receive sufficient dietary vitamin K2. A survey of 50 sun-protecting patients shows 4/50 understood the role of vitamin K2 and 1/50 was supplementing vitamin K2. Therefore, counseling on vitamin K2 supplementation may be of benefit to sun-protected dermatology patients. J Drugs Dermatol. 2021;20(2):228-229. doi:10.36849/JDD.5829.
Assuntos
Suplementos Nutricionais , Conhecimentos, Atitudes e Prática em Saúde , Luz Solar/efeitos adversos , Vitamina D/administração & dosagem , Vitamina K 2/administração & dosagem , Adulto , Feminino , Humanos , Masculino , Pele/efeitos dos fármacos , Pele/efeitos da radiação , Inquéritos e Questionários/estatística & dados numéricos , Vitamina D/metabolismo , Vitamina D/farmacocinética , Vitamina K 2/metabolismo , Vitamina K 2/farmacocinéticaRESUMO
A carrier-based, immunogenic cell death (ICD)-eliciting platinum(IV) chemotherapeutic agent was synthesized via complexation between an axially derivatized Pt(IV)-tocopherol and hyaluronan (HA)-tocopherol nanocarrier. The resultant HA-Pt(IV) complex demonstrated antiproliferative activity and induced calreticulin translocation, an indicator of ICD, in murine and human head and neck cancer (HNC) cells. The intratumorally administered HA-Pt(IV) treatments were tolerable and efficacious in both immunocompetent and immunodeficient mice with HNC, partially because of the direct cytotoxicity. Superior efficacy and survival were observed in the immunocompetent group, suggesting a possible Pt(IV)-induced immunological response, which would only manifest in animals with an intact immune system. Subsequent imaging of tumor tissues demonstrated increased macrophage infiltration in the HA-Pt(IV)-treated tumors compared to the nontreated controls and the cisplatin-treated tumors, suggesting favorable inflammatory activation. RNA sequencing of HA-Pt(IV)-treated tumors indicated that carbohydrate and vitamin metabolisms were the most important Kyoto Encyclopedia of Genes and Genomes pathways, and molecular function, biological process, and cellular component were highly enriched gene ontology categories.
Assuntos
Antineoplásicos/administração & dosagem , Cisplatino/administração & dosagem , Portadores de Fármacos/química , Neoplasias de Cabeça e Pescoço/tratamento farmacológico , Neoplasias de Cabeça e Pescoço/metabolismo , Ácido Hialurônico/química , Morte Celular Imunogênica/efeitos dos fármacos , Compostos Organoplatínicos/administração & dosagem , Tocoferóis/administração & dosagem , Animais , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Modelos Animais de Doenças , Feminino , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Hospedeiro Imunocomprometido , Masculino , Camundongos , Camundongos Endogâmicos C3H , Camundongos Nus , Resultado do TratamentoRESUMO
Vertical surgical sites or those on reclining patients often present a challenge when establishing and securing a sterile field. The drape or towel most proximal to the physician is often vertically oriented. The forces of gravity and movements of surgery can shift or detach this vertical drape. Sterile clamps are not always available or are needed for securing other instruments. We present a method to secure this vulnerable drape using a central fenestrated adherent drape.
Assuntos
Procedimentos Cirúrgicos Dermatológicos/instrumentação , Equipamentos Cirúrgicos , Humanos , EsterilizaçãoRESUMO
Distinct populations of effector memory T cells use different homing receptors to traffic to the skin and gut. Whether tissue-selective T cells are needed for early rejection of a neoplasm growing in these tissues remains an open question. We chose to study an allogeneic tumor model because growth of such a fully mismatched tumor would signify a profound immune deficit. We implanted allogeneic tumor cells in the skin or gut of mice deficient in either α(1,3) fucosyltransferases IV and VII, enzymes critical for generating E-selectin ligands on skin-homing T cells, or ß7 integrin, a component of the α4ß7 integrin ligand for the mucosal adressin MAdCAM. During the first 9 days after tumor implantation, FucTVII-/- mice showed a profoundly impaired capacity to reject tumors growing in the skin, but readily rejected tumors implanted in the gut. Rejection of tumors in the skin was even more impaired in mice deficient in both FucTIV and FucTVII. This impairment was corrected by infusion of T cells from normal mice. By contrast, ß7 integrin-/- mice showed profoundly impaired rejection of tumors in the gut, but no defect in the skin tumor rejection. These differences were unrelated to antigen recognition or effector function of T cells, since all strains of mice were capable of generating tumor-specific CTLs in vitro against the tumor cell line used in vivo. These results demonstrate that T-cell homing defects in vivo impair immune surveillance of peripheral epithelial tissues in a specific and selective fashion.
Assuntos
Neoplasias/imunologia , Linfócitos T/fisiologia , Aloenxertos , Animais , Linhagem Celular Tumoral , Fucosiltransferases/metabolismo , Cadeias beta de Integrinas/metabolismo , Camundongos Endogâmicos BALB C , Camundongos Knockout , Transplante de NeoplasiasRESUMO
Cellulitis, a bacterial infection of the skin and subcutaneous tissue, is often misdiagnosed. Cellulitis accounts for a large number of all infectious disease-related hospitalizations in the U.S. Cellulitis can be challenging to diagnose since it lacks pathognomonic findings. We reviewed all articles on cellulitis within the last 20 years that included a statistical analysis, with odds ratios (OR), of specific clinical features of cellulitis. We then constructed a mnemonic encompassing the features with the highest odds ratios. Our mnemonic is CELLULITIS for cellulitis history, edema, local warmth, lymphangitis, unilateral, leukocytosis, injury, tender, instant onset, and systemic signs. The first characteristic has the highest OR and may be the easiest to recall: past episode(s) of cellulitis.
Assuntos
Celulite (Flegmão)/diagnóstico , Febre/diagnóstico , Leucocitose/diagnóstico , Linfangite/diagnóstico , Pele/lesões , Taquicardia/diagnóstico , Celulite (Flegmão)/complicações , Edema/etiologia , Febre/etiologia , Temperatura Alta , Humanos , Leucocitose/etiologia , Linfangite/etiologia , Anamnese , Memória , Exame Físico , Taquicardia/etiologia , Fatores de TempoAssuntos
Criocirurgia , Otoscópios , Humanos , Crioterapia , Esterilização , Instrumentos CirúrgicosAssuntos
Dermatite , Estomas Cirúrgicos , Humanos , Estomas Cirúrgicos/efeitos adversos , Lidocaína , Anestésicos LocaisAssuntos
Queilite , Dermatite Alérgica de Contato , Neoplasias Labiais , Humanos , Isotretinoína , Lábio , HidrocortisonaRESUMO
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Assuntos
Compostos de Boro/uso terapêutico , Compostos Bicíclicos Heterocíclicos com Pontes/uso terapêutico , Dermatite Seborreica/diagnóstico , Administração Cutânea , Compostos de Boro/administração & dosagem , Compostos Bicíclicos Heterocíclicos com Pontes/administração & dosagem , Dermatite Seborreica/tratamento farmacológico , Dermatite Seborreica/patologia , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade , Sulco NasogenianoRESUMO
Paring is useful for both diagnosis and treatment of plantar warts. Paring techniques generally involve scalpel blades, abrasive tools, or curettes. However, these tools do not permit the use of an "awl-like" carving technique of the wart afforded by using a punch biopsy tool. We have found this technique to be associated with greater precision and safety, as well as potentially increased efficacy compared to traditional methods.
Assuntos
Biópsia/instrumentação , Dermatoses do Pé/cirurgia , Verrugas/cirurgia , Humanos , Podiatria/métodosRESUMO
BACKGROUND: Hydroxyurea is an antimetabolite primarily used to treat myeloproliferative disorders, and chronic treatment is associated with many cutaneous adverse effects ranging in severity from ichthyosis to aggressive nonmelanoma skin cancer. CASE PRESENTATION: We report a 67-year-oldman with a history of polycythemia vera who was referred for management of progressively worsening dorsal hand lesions. The patient presented withhyperpigmentation, ichthyosis, plantar keratoderma, dermatomyositis-like eruptions, two squamous cell carcinomas, and actinic keratoses. The adversereactions observed were acknowledged to be related to chronic hydroxyurea use. The patient underwent Mohs excision of the squamous cell carcinomas and thehydroxyurea was promptly discontinued; subsequent cutaneous improvement of the dermatomyositislike lesions ensued. Another clinically suspicious aggressive squamous cell carcinoma was suspected and the patient was referred to the plastic surgery department for complete excision because of the size of the lesion. The patient remains on periodic dermatology follow up. CONCLUSIONS: We report a case that exemplifies the cutaneous adverse effects of chronic hydroxyurea therapy. Although many cases improve after drug discontinuation, strict photoprotection and ongoing surveillance are indicated given the recently proposed premalignant potential of dermatomyositis-like eruptions and the aggressive nature of hydroxyurea-induced nonmelanoma skin cancer.
Assuntos
Carcinoma de Células Escamosas/induzido quimicamente , Dermatomiosite/induzido quimicamente , Hidroxiureia/efeitos adversos , Ceratose/induzido quimicamente , Lesões Pré-Cancerosas/induzido quimicamente , Neoplasias Cutâneas/induzido quimicamente , Idoso , Biópsia , Humanos , Ceratose/patologia , Masculino , Policitemia Vera/complicações , Policitemia Vera/tratamento farmacológicoRESUMO
Weight loss clinics are common in the United States. Unfortunately, some offer dubious weight loss methods such as self-administered human chorionic gonadotropic (HCG) injections. HCG products are unregulated, yet, widely available. Infection is among the risks potentially associated with this treatment. We report a case of skin infection caused by Mycobacterium fortuitum after HCG injection.