Subject(s)
Dermal Fillers/adverse effects , Facial Dermatoses/therapy , HIV-Associated Lipodystrophy Syndrome/therapy , Skin Diseases, Vascular/therapy , Administration, Cutaneous , Combined Modality Therapy/methods , Dermal Fillers/administration & dosage , Durapatite/administration & dosage , Durapatite/adverse effects , Face/blood supply , Facial Dermatoses/etiology , HIV-Associated Lipodystrophy Syndrome/complications , Hemophilia A/complications , Humans , Male , Middle Aged , Nitroglycerin/administration & dosage , Phototherapy/methods , Skin Diseases, Vascular/etiology , Treatment OutcomeABSTRACT
CLINICAL CASES: The cases are presented of two patients with periocular basal cell carcinoma of the eyelid who received topical imiquimod 5%, with a good response. Both had a functional state that contraindicated surgical treatment. CONCLUSION: Imiquimod cream 5% was shown to be an effective alternative to surgical treatment of periocular basal cell carcinoma, especially in those cases where surgery is not possible.
Subject(s)
Aminoquinolines/therapeutic use , Antineoplastic Agents/therapeutic use , Carcinoma, Basal Cell/drug therapy , Eyelid Neoplasms/drug therapy , Acquired Immunodeficiency Syndrome/complications , Aminoquinolines/adverse effects , Antineoplastic Agents/adverse effects , Contraindications, Procedure , HIV-Associated Lipodystrophy Syndrome/complications , Humans , Imiquimod , Male , Middle Aged , Plastic Surgery Procedures , Remission Induction , Skin Ulcer/chemically induced , Surgical FlapsABSTRACT
OBJECTIVE: We evaluated hyperhomocysteinaemia (HHcy) in a cohort of HIV-infected patients in order to assess its relation to cardiovascular risk (CVR) and identify determinants of HHcy variability. METHODS: Cross-sectional observational study. HIV-infected patients on stable highly active antiretroviral therapy (ART) were evaluated for the presence of the metabolic syndrome, lipodystrophy and traditional CVR factors. Plasma homocysteine levels were measured using high-performance liquid chromatography. RESULTS: Five hundred and sixty-seven patients (38% female) with a median age of 44 years were included in the study. Homocysteine (Hcy) was significantly higher in patients with the metabolic syndrome and lipodystrophy. No significant association was found between Hcy levels and the use of ART. However, Hcy was associated with higher blood pressure, waist circumference and waist-to-hip ratio, total lean body mass, visceral adipose tissue (VAT), VAT/total adipose tissue, homeostasis model assessment of insulin resistance (HOMA-IR), triglycerides, high-density lipoprotein cholesterol, apolipoprotein A1, B, and creatinine. All 10-year CVR assessment scores were significantly associated with Hcy. In a multivariate regression model, systolic blood pressure, vitamin supplementation and HOMA-IR were significantly and independently related to Hcy. CONCLUSIONS: Hcy is elevated in HIV-infected patients and is significantly associated with increased CVR. Measurement of Hcy might be useful in identifying particularly high-risk populations at whom therapeutic interventions could be targeted.