RESUMEN
INTRODUCTION: Studies reporting incidences of non-melanoma skin cancer (NMSC) are heterogeneous, depend on the geographic area of the studied population and are often short-term. The aim of this study is to determine the incidence of NMSC in patients treated with oral PUVA therapy in the Mediterranean area. MATERIAL AND METHODS: A retrospective, observational study was carried out with a sample of 234 patients treated with systemic PUVA between 1982 and 1996, carrying out a historical follow-up until May 2017. The incidencedensity rate of CCNM (crude and adjusted) was calculated by direct standardisation. The incidence of CCNM was compared with that reported in the general population in a similar geographical area. RESULTS: 50 neoplasms were diagnosed in 22 patients. The prevalence of CCNM in patients treated with phototherapy was 10.3%. The mean follow-up time was 21 years. The crude-adjusted incidence density rate of CCNM was 554.4-183.9 cases/100,000 treated patients per year. The crude-adjusted incidence density rate of basal cell carcinoma was 352.3-111.2 cases/100.000 patients and of squamous cell carcinoma was 229-77.7 cases /100,000 patients. CONCLUSION: PUVA therapy is associated with an increased risk of CCNM inthe Mediterranean population.
Asunto(s)
Carcinoma Basocelular/epidemiología , Carcinoma de Células Escamosas/epidemiología , Terapia PUVA/efectos adversos , Neoplasias Cutáneas/epidemiología , Adulto , Factores de Edad , Carcinoma Basocelular/inducido químicamente , Carcinoma de Células Escamosas/inducido químicamente , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Terapia PUVA/métodos , Neoplasias Cutáneas/inducido químicamenteRESUMEN
La dermatitis atópica es una dermatosis inflamatoria de curso crónico caracterizada por un intenso prurito. Se trata de una enfermedad multifactorial que resultaría de la interacción de factores genéticos, ambientales, defectos en la función barrera y una serie de factores inmunológicos. La dermatitis atópica afecta sobretodo a la infancia, pero también puede persistir o comenzar en el adulto. Los casos de adultos afectados recogidos en la literatura, hacen referencia casi exclusivamente a aquéllos en los que la enfermedad se inició en la infancia pero que permanece llegada la vida adulta. Sin embargo, debemos tener en cuenta otro subgrupo de pacientes libres de enfermedad durante la infancia en los que el comienzo de la dermatitis ató pica se produce con los años incluso en la senectud. A pesar de que en este subgrupo las lesiones afectan típicamente a flexuras en forma de eczema exudativo o liquenificado, existe un número no despreciable de pacientes con lesiones de distribución o morfología atípica. Revisamos la etiopatogenia, criterios diagnósticos, clínica, diagnóstico diferencial y tratamiento, incidiendo en la terapéutica de la dermatitis atópica severa o refractaria a los tratamientos convencionales
Atopic dermatitis is a highly pruritic chronic inflammatory skin disorder. The disease results from an interaction between susceptibility genes, the host's environment, skin barrier defects and immunologycal factors. It's a common condition that is often thought to predominantly affect infants and children.Reports on adult disease are most exclusively related to the early-onset atopic dermatitis extending into adult life. However; atopic dermatitis may begin for the first time at an adult age, this subgroup is called adult-onset atopic dermatitis.Although a majority of patients has typical flexural distribution and lichenified/ exudative eczematous pattern, a considerable number of patients could have a different distribution and different morphology. Pathogenesis, clinical patterns and distribution, diagnostic criteria, differential diagnosis and management, specially systemic therapies used in severe or resistant cases of atopic dermatitis, are reviewed