ABSTRACT
BACKGROUND: The past 5 years have seen a proliferation of new treatments for atopic dermatitis (AD). We analyzed recent drug survival data for cyclosporine in this setting. Because the Spanish National Healthcare system requires patients with AD to be treated with cyclosporine before they can be prescribed other systemic treatments, drug survival for cyclosporine may be shorter than in other diseases. MATERIAL AND METHOD: Multicenter, observational, prospective cohort study using data from the Spanish Atopic Dermatitis Registry (BIOBADATOP). Data from the Spanish Registry of Systemic Treatments in Psoriasis (BIOBADADERM) were used to create a comparison cohort. RESULTS: We analyzed data for 130 patients with AD treated with cyclosporine (median drug survival, 1 year). Median cyclosporine survival in the psoriasis comparison group (150 patients) was 0.37 years. Drug survival was significantly longer in AD than in psoriasis (P<.001). CONCLUSION: Drug survival of cyclosporine in the BIOBADATOP registry is similar to that described in other series of patients with AD and longer than that observed in the BIOBADADERM psoriasis registry.
Subject(s)
Dermatitis, Atopic , Psoriasis , Humans , Cyclosporine/therapeutic use , Dermatitis, Atopic/drug therapy , Immunosuppressive Agents/therapeutic use , Prospective Studies , Psoriasis/drug therapy , Registries , Treatment OutcomeABSTRACT
The generation of cell blocks (CB) obtained from ultrasound-guided fine needle aspiration biopsies (USFNAB) is a well-established technique in breast and thyroid pathology, but is rarely used in dermatology. We reviewed CBs obtained from USFNAB of skin lesions, which were categorized as malignant skin tumors, benign skin tumors, inflammatory skin tumors or deposit skin diseases. The diagnostic yield of each category was compared to histopathology. The USFNAB of 51 skin lesions was processed into CBs. There was overall agreement between histopathology and CBs in 84.31% of cases. Diagnostic group concordance for benign, malignant as well as inflammatory and deposit skin lesions were 69.2%, 93.7% and 86.3% respectively. Cell block generation from USFNAB aspirates of skin lesions should be considered as part of the dermatologic diagnostic armamentarium. Further experience is needed to better understand for which types of dermatologic lesions it would be clearly indicated.
Subject(s)
Image-Guided Biopsy , Skin Neoplasms , Humans , Biopsy, Fine-Needle , Ultrasonography , Ultrasonography, Interventional , Skin Neoplasms/diagnostic imaging , Retrospective StudiesABSTRACT
The generation of cell blocks (CBs) obtained from ultrasound-guided fine needle aspiration biopsies (USFNAB) is a well-established technique in breast and thyroid pathology, but is rarely used in dermatology. We reviewed CBs obtained from USFNAB of skin lesions, which were categorized as malignant skin tumors, benign skin tumors, inflammatory skin tumors or deposit skin diseases. The diagnostic yield of each category was compared to histopathology. The USFNAB of 51 skin lesions was processed into CBs. There was overall agreement between histopathology and CBs in 84.31% of cases. Diagnostic group concordance for benign, malignant as well as inflammatory and deposit skin lesions were 69.2%, 93.7% and 86.3% respectively. Cell block generation from USFNAB aspirates of skin lesions should be considered as part of the dermatologic diagnostic armamentarium. Further experience is needed to better understand for which types of dermatologic lesions it would be clearly indicated.
Subject(s)
Image-Guided Biopsy , Skin Neoplasms , Humans , Biopsy, Fine-Needle , Ultrasonography , Ultrasonography, Interventional , Skin Neoplasms/diagnostic imaging , Retrospective StudiesABSTRACT
BACKGROUND: In recent years, remarkable improvements in our understanding of atopic dermatitis (AD) have revolutionized treatment perspectives, but access to reliable data from clinical practice is essential. MATERIALS AND METHOD: The Spanish Atopic Dermatitis Registry, BIOBADATOP, is a prospective, multicenter database that collects information on patients of all ages with AD requiring systemic therapy with conventional or novel drugs. We analyzed the registry to describe patient characteristics, diagnoses, treatments, and adverse events (AEs). RESULTS: We studied data entries for 258 patients who had received 347 systemic treatments for AD. Treatment was discontinued in 29.4% of cases, mostly due to a lack of effectiveness (in 10.7% of cases). A total of 132 AEs were described during follow-up. Eighty-six AEs (65%) were linked to a systemic treatment, most commonly dupilumab (39AEs) and cyclosporine (38AEs). The most common AEs were conjunctivitis (11patients), headache (6), hypertrichosis (5), and nausea (4). There was 1severe AE (acute mastoiditis) associated with cyclosporine. CONCLUSIONS: Initial findings on AEs from the Spanish BIOBADATOP registry are limited by short follow-up times precluding comparisons or calculation of crude and adjusted incidence rates. At the time of our analysis, no severe AEs had been reported for novel systemic therapies. BIOBADATOP will help answer questions on the effectiveness and safety of conventional and novel systemic therapies in AD.
Subject(s)
Dermatitis, Atopic , Humans , Dermatitis, Atopic/drug therapy , Dermatitis, Atopic/epidemiology , Prospective Studies , Cyclosporine/therapeutic use , Administration, Cutaneous , Registries , Treatment Outcome , Severity of Illness IndexSubject(s)
Hemangioma, Capillary , Hemangioma , Adult , Erythema/etiology , Hemangioma/diagnosis , Humans , InfantABSTRACT
Advances in our understanding of the biology and therapy of vascular anomalies have made this condition a common reason for consulting a dermatologist. In addition, multidisciplinary units have been created to manage patients with complex vascular anomalies. Although most vascular anomalies are diagnosed based on clinical findings, a thorough evaluation often requires additional imaging tests to determine the nature, extension, and prognosis of these lesions. Because it is fast and noninvasive, ultrasound is usually the first imaging test ordered. In the present review, we provide a state-of-the-art synthesis of key concepts in the ultrasound examination of vascular anomalies so that they are more accessible to clinicians and medical imaging specialists involved in the management of these lesions.
Subject(s)
Skin Diseases, Vascular/diagnostic imaging , Ultrasonography , Vascular Malformations/diagnostic imaging , Hemangioma/diagnostic imaging , Humans , Skin Neoplasms/diagnostic imagingSubject(s)
Alopecia/chemically induced , Antibodies, Monoclonal/adverse effects , Dermatologic Agents/adverse effects , Drug Eruptions/etiology , Erythema/chemically induced , Scalp Dermatoses/chemically induced , Adult , Alopecia/pathology , Antibodies, Monoclonal, Humanized , Drug Eruptions/pathology , Humans , Male , Scalp Dermatoses/pathologyABSTRACT
Recent years have witnessed an increase in the use of ultrasound imaging of the skin in the field of dermatology, as the technique reveals details of vessels and other structures that cannot be detected on physical examination. Extradigital glomus tumors are rarely seen in clinical practice and can pose a diagnostic challenge for dermatologists. We report on 4 patients with a clinical suspicion of extradigital glomus tumor and on 1 patient with a clinical suspicion of subungual glomus tumor. All 5 patients underwent ultrasound examination in B mode and color and pulsed-wave Doppler prior to surgical excision of the tumor and histologic examination, which confirmed the diagnosis in each case. Ultrasound imaging of the skin, combined with clinical findings, provided a simple, noninvasive way of making a prompt diagnosis and identifying the exact location of the lesion for surgical removal.
Subject(s)
Fingers , Glomus Tumor/diagnostic imaging , Skin Neoplasms/diagnostic imaging , Aged , Female , Humans , Male , Middle Aged , UltrasonographyABSTRACT
Scabies is a cutaneous infestation caused by Sarcoptes scabiei var. hominis, a small mite that performs its whole life cycle within the epidermis. In this case report, we provide images of the sonographic signs of scabies. We found that the adult mite can be seen as a hyperechoic well-defined ovoid area within the epidermal layer at the end of the hypoechoic burrow, while the eggs correspond to tiny heteroechoic dots along the burrow. In conclusion, ultrasound may prove useful to differentiate between inhabited vs non-inhabited scabiotic burrows.
Subject(s)
Scabies , Animals , Adult , Humans , Scabies/diagnostic imaging , Sarcoptes scabieiABSTRACT
The present global outbreak of monkeypox has reached more than 79,000 cases by November 2022. While clinical features have been extensively studied, ultrasound findings in monkeypox skin lesions have not been described to date. In our work, we performed a complete sonographic study with Doppler and elastography of 3 patients with polymerase chain reaction-proven monkeypox. The most characteristic findings in skin lesions were hyperechoic epidermal thickening, dermo-hypodermal thickening with focal hypoechogenicity and increased intralesional vascularization. Regarding lymphadenopathies, we found vascularization of hilar distribution and an increased cortical stiffness and shoft hiliar area.
Subject(s)
Elasticity Imaging Techniques , Mpox (monkeypox) , Skin Diseases , Humans , Ultrasonography , Ultrasonography, DopplerSubject(s)
Port-Wine Stain/diagnostic imaging , Port-Wine Stain/pathology , Skin/blood supply , Skin/pathology , Ultrasonography, Doppler , Adolescent , Adult , Child , Female , Humans , Male , Middle Aged , Pilot Projects , Young AdultSubject(s)
Herpesviridae Infections/transmission , Immunosuppressive Agents/adverse effects , Lung Transplantation/adverse effects , Postoperative Complications/etiology , Sarcoma, Kaposi/etiology , Thoracic Neoplasms/etiology , Antibodies, Viral/blood , Drug Substitution , Erythema/etiology , Everolimus/therapeutic use , Herpesvirus 8, Human/immunology , Herpesvirus 8, Human/isolation & purification , Humans , Male , Middle Aged , Mycophenolic Acid/adverse effects , Mycophenolic Acid/therapeutic use , Postoperative Complications/diagnosis , Postoperative Complications/virology , Sarcoma, Kaposi/diagnosis , Sarcoma, Kaposi/virology , Tacrolimus/adverse effects , Tacrolimus/therapeutic use , Thoracic Neoplasms/diagnosis , Thoracic Neoplasms/virology , Tissue Donors , Viremia/diagnosis , Viremia/etiologyABSTRACT
BACKGROUND: We reviewed all cases of multiple primary melanoma diagnosed at our department over a 32-year period (1987-2019) to better characterize this subgroup of patients and develop a tailored protocol to offer them closer follow-up. METHODS: Retrospective, observational, descriptive study of patients diagnosed with multiple primary melanoma at a tertiary care hospital between January 1987 and March 2019. We collected clinical, epidemiologic, and histologic characteristics of primary and subsequent melanomas and performed a descriptive analysis. RESULTS: Thirty-one patients (15 men and 16 women) with a median age of 67years (range, 36-85years) were included. Second primary melanomas were diagnosed after a median of 2years (range, 0-4years). The median number of melanomas per patient was 2 (range, 2-6). Twenty-three of the 31 patients, 25 had 2 primary melanomas (80%), 4 had 3 melanomas (13%), and 2 patients each had 5 and 6 primary melanomas. Subsequent melanomas were less invasive than the initial primary melanomas. Median Breslow thickness was 1mm (range, 0.67-4mm) for the first primary melanoma and 0.5mm (range, 0.32-2.42mm) for subsequent melanomas. CONCLUSIONS: Subsequent melanomas are thinner than primary melanomas. We observed an increase in the number of cases of multiple primary melanoma diagnosed in the last 2years of our study. Our findings highlight the importance of close, long-term follow-up of patients.
Subject(s)
Melanoma , Neoplasms, Multiple Primary , Skin Neoplasms , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Melanoma/epidemiology , Middle Aged , Neoplasms, Multiple Primary/epidemiology , Retrospective Studies , Skin Neoplasms/epidemiologyABSTRACT
A forty-two-year-old male recipient of a cadaver renal transplant showed multiple nodulocystic lesions on his back and lateral aspects of his neck four months after beginning immunosuppressive therapy with cyclosporine A and prednisone. Results of histopathologic studies revealed that they were epidermoid infundibular cysts. We note the relationship between this clinical appearance and cyclosporine A, as well as this agent's cutaneous side effects.