RESUMO
BACKGROUND: The aim of this registry supplement study was to evaluate the effects of the oral supplement Pycnogenol® on possible skin discolorations or other minor skin changes after varicose vein sclerotherapy in comparison with a standard management (SM). METHODS: One hundred sixty-one subjects completed the study. 84 took Pycnogenol® from the day before sclerotherapy for 12 weeks and followed SM. 77 followed SM only and served as controls. 420 injection sites were followed-up in the Pycnogenol® group and 431 in the control group. The number of injected veins (using only Aetoxysklerol) was on average 4-8 veins/patient. No side effects were observed for the SM or for supplementation. Pycnogenol® supplementation showed a good tolerability. The two management groups were comparable for age, sex and veins distribution at inclusion. RESULTS: After 12 weeks, skin discoloration assessed by a skin staining score was generally significantly lower and less frequent (P<0.05) with Pycnogenol® with a score of 0.4±0.2 compared to controls (with a score of 2.1±0.4). In addition, the number of stains per treated vein was significantly lower in the Pycnogenol® group than the control group. CONCLUSIONS: Varicose vein sclerotherapy is a minimally invasive procedure almost without complications. Pycnogenol® intake appears to improve healing and prevent skin discolorations after injection of the sclerosing agent. To verify this effect of Pycnogenol®, more studies for a longer period are needed.
Assuntos
Hiperpigmentação , Extratos Vegetais , Varizes , Humanos , Escleroterapia/efeitos adversos , Hiperpigmentação/induzido quimicamente , Hiperpigmentação/prevenção & controle , Flavonoides , Varizes/tratamento farmacológicoAssuntos
Dermatite Alérgica de Contato/etiologia , Dermatoses Faciais/induzido quimicamente , Hiperpigmentação/induzido quimicamente , Magnolia/efeitos adversos , Casca de Planta/efeitos adversos , Extratos Vegetais/efeitos adversos , Creme para a Pele/efeitos adversos , Idoso , Feminino , Humanos , Prurido/induzido quimicamenteRESUMO
BACKGROUND: With extending life expectancy, more people are diagnosed with cutaneous malignancies at advanced ages and are offered nonsurgical treatment. We assessed outcomes of the oldest-old adults after electrochemotherapy (ECT). METHODS: The International Network for Sharing Practices of ECT (InspECT) registry was queried for adults aged ≥90 years (ys) with skin cancers/cutaneous metastases of any histotype who underwent bleomycin-ECT (2006-2019). These were subanalysed with patients aged <90 ys after matching 1:2 for tumor location, number, size, histotype, and previous treatments. We assessed ECT modalities, toxicity (CTCAE), response (RECIST), and patient perception (EQ-5D). RESULTS: Sixty-one patients represented the study cohort (median 92 ys, range 92-104), 122 the control group (median 77 ys, range 23-89). Among the oldest-old, 44 patients (72%) had primary/recurrent skin cancers, 17 (28%) cutaneous metastases. Median tumour size was 15 mm (range, 5-450). The oldest-old adults underwent ECT mainly under local/regional anaesthesia (59% vs 39% p = .012). We observed no differences regarding dose and route of chemotherapy (intravenous vs intratumoral, p = .308), electrode geometry (linear vs hexagonal, p = .172) and procedural duration (18 vs 21 min, p = .378). Complete response (57.4 [95%-CI 44.1%-70.0%] vs 64.7% [95%-CI 55.6%-73.2%], p = .222) and 1-year local control (76.7% vs 81.7, p = .092) rates were comparable. Pain and skin hyperpigmentation were mild in both groups. Skin ulceration persisted longer in the oldest-old patients (4.4 vs 2.4 months, p = .008). CONCLUSIONS: The oldest-old adults with cutaneous malignancies undergo ECT most commonly under local/regional anaesthesia with safety profiles and clinical effectiveness similar to their younger counterparts, except in case of ulcerated tumors.
Assuntos
Antibióticos Antineoplásicos/uso terapêutico , Bleomicina/uso terapêutico , Eletroquimioterapia , Recidiva Local de Neoplasia/tratamento farmacológico , Neoplasias Cutâneas/tratamento farmacológico , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Anestesia Local , Antibióticos Antineoplásicos/efeitos adversos , Bleomicina/efeitos adversos , Eletroquimioterapia/efeitos adversos , Feminino , Humanos , Hiperpigmentação/induzido quimicamente , Masculino , Análise por Pareamento , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Dor/etiologia , Medidas de Resultados Relatados pelo Paciente , Sistema de Registros , Critérios de Avaliação de Resposta em Tumores Sólidos , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/secundário , Úlcera Cutânea/induzido quimicamente , Taxa de Sobrevida , Carga Tumoral , Adulto JovemRESUMO
Minocycline-induced pigmentation (MIP) is an infrequent complication of minocycline therapy, with four subtypes each with distinct clinical features and histologic staining patterns. MIP may resolve following discontinuation of minocycline therapy or it may persist indefinitely. A 64-year-old Caucasian male presented with a 6 month history of progressive blue-gray facial pigmentation distributed symmetrically over his face. One session utilizing a 755 nm picosecond Alexandrite laser resulted in immediate and significant clearance of the pigment in all treated areas. Long-term follow-up at 2 years revealed no recurrence of the MIP.
Assuntos
Antibacterianos/efeitos adversos , Hiperpigmentação/induzido quimicamente , Lasers de Estado Sólido/uso terapêutico , Terapia com Luz de Baixa Intensidade/métodos , Minociclina/efeitos adversos , Humanos , Lasers de Estado Sólido/efeitos adversos , Terapia com Luz de Baixa Intensidade/efeitos adversos , Masculino , Pessoa de Meia-IdadeAssuntos
Toxidermias/etiologia , Líquen Plano/induzido quimicamente , Materia Medica/efeitos adversos , Metadona/efeitos adversos , Analgésicos Opioides/administração & dosagem , Analgésicos Opioides/efeitos adversos , Toxidermias/diagnóstico , Feminino , Humanos , Hiperpigmentação/induzido quimicamente , Hiperpigmentação/diagnóstico , Líquen Plano/diagnóstico , Materia Medica/administração & dosagem , Metadona/administração & dosagemRESUMO
INTRODUCTION: Latanoprost is a prostaglandin F2α analogue, which has been used as a first-line drug for open-angle glaucoma. Common side effects of latanoprost include hyperpigmentation. While it usually occurs on irides or periocular skin, diffuse facial hyperpigmentation is rarely reported. CASE PRESENTATION: A 71-year-old woman was presented with diffuse gray-brown colored maculopatches on her face. The symptom appeared 1 week after she started to use latanoprost eye drops for glaucoma. Biopsy specimen revealed vacuolar degeneration of dermo-epidermal junction and pigment incontinence in dermis. OBJECTIVE: The aim of this paper is to introduce a rare adverse effect of latanoprost and effective way of treatment. METHODS: We stopped her from using latanoprost. She was also treated with 532-nm potassium titanyl phosphate laser and low-fluence 1064-nm Q-switched Nd:YAG laser, while using topical agents. RESULT: After 10 weeks, we observed hyperpigmentation of her face was effectively and safely treated. The patient was satisfied with the result. CONCLUSION: Diffuse facial pigmentation could be one of the latanoprost-induced adverse effects and the laser treatments with topical agents we used can make it improve faster.
Assuntos
Anti-Hipertensivos/efeitos adversos , Glaucoma/tratamento farmacológico , Hiperpigmentação/induzido quimicamente , Latanoprosta/efeitos adversos , Pigmentação da Pele/efeitos dos fármacos , Administração Cutânea , Administração Oftálmica , Idoso , Anti-Hipertensivos/administração & dosagem , Biópsia , Tartarato de Brimonidina/administração & dosagem , Fármacos Dermatológicos/administração & dosagem , Substituição de Medicamentos , Face , Feminino , Humanos , Hiperpigmentação/diagnóstico , Hiperpigmentação/patologia , Hiperpigmentação/terapia , Lasers de Estado Sólido/uso terapêutico , Latanoprosta/administração & dosagem , Terapia com Luz de Baixa Intensidade/instrumentação , Terapia com Luz de Baixa Intensidade/métodos , Soluções Oftálmicas/administração & dosagem , Soluções Oftálmicas/efeitos adversos , Pele/efeitos dos fármacos , Pele/patologia , Resultado do TratamentoRESUMO
WHAT IS KNOWN AND OBJECTIVE: Polymyxins, especially polymyxin B, has become the last line of therapy against Gram-negative pathogens' carbapenemase producers. However, given increasing use of polymyxin B in clinical settings its therapeutic value has been evaluated worldwide due to its toxic effects. The aim of this study was to assess the efficacy and safety of antimicrobial therapy with polymyxin B in patients with multidrug-resistant bacteria in Brazil. METHODS: This was a prospective cohort study in a 403-bed academic tertiary care centre, located in the countryside of Brazil. Patients receiving polymyxin B intravenous treatment for at least 72 hours were eligible for the study. Antimicrobial susceptibility, adverse reactions and clinical outcomes were submitted for descriptive analysis. Main outcomes measure the following: Patients' conditions following treatment (Treatment Success, Mortality, Treatment Failure, Inadequate Empiric Treatment or Indeterminate Response) and toxicities induced by polymyxin B (nephrotoxicity and skin hyperpigmentation). RESULTS AND DISCUSSION: Among 247 patients, treatment success was achieved in 25.1%, while mortality was observed in 32.8%. Empirical therapy was prescribed for 26.3% of the patients. Nephrotoxicity was reported in 40.5%. The carbapenemase producer, Klebsiella pneumonia, was the bacterium most associated with mortality (22.2%). CONCLUSIONS: Even though polymyxin B is currently the main therapy against carbapenemase producers, its use demands robust criteria to lead to positive clinical outcomes.
Assuntos
Antibacterianos/uso terapêutico , Infecções por Bactérias Gram-Negativas/tratamento farmacológico , Polimixina B/uso terapêutico , Administração Intravenosa , Antibacterianos/efeitos adversos , Brasil , Farmacorresistência Bacteriana Múltipla/efeitos dos fármacos , Feminino , Humanos , Hiperpigmentação/induzido quimicamente , Masculino , Testes de Sensibilidade Microbiana/métodos , Pessoa de Meia-Idade , Polimixina B/efeitos adversos , Estudos Prospectivos , Resultado do TratamentoRESUMO
BACKGROUND: Minocycline is a commonly prescribed tetracycline antibiotic used for the treatment of a number of dermatological conditions including acne and rosacea. Long-term adverse effects of minocycline include cutaneous hyperpigmentation. Various treatment options have been suggested for the treatment of minocycline pigmentation. We report a case of a patient on long-term low-dose minocycline for the treatment of rosacea with type III minocycline hyperpigmentation. A comparison was made between Q-Switch Nd:YAG and picosecond laser over a nine 9-period with treatments spaced 1 month apart, with a clearance in the patient pigmentation after four treatments with picosecond laser.
Assuntos
Antibacterianos/efeitos adversos , Hiperpigmentação/induzido quimicamente , Hiperpigmentação/radioterapia , Terapia com Luz de Baixa Intensidade/instrumentação , Minociclina/efeitos adversos , Idoso de 80 Anos ou mais , Feminino , Humanos , Lasers de Estado Sólido/efeitos adversos , Terapia com Luz de Baixa Intensidade/efeitos adversosRESUMO
Phytophotodermatitis is a clinical diagnosis from phototoxicity of the skin induced by contact with plants or their extracts. Phytophotodermatitis maypresent with burning, erythema, patches, plaques, vesicles, bullae, or hyperpigmented patches in welldemarcated and unusual shapes. Inquiring about occupation, hobbies, and plant or plant extract contact is essential to establishing the diagnosis. Herein we present a case of phytophotodermatitisafter use of carrot extract-containing sunscreen presenting as a hyperpigmented patch in a geometric distribution with accentuation of pigment within the dynamic rhytides.
Assuntos
Daucus carota/efeitos adversos , Dermatite Fototóxica/etiologia , Hiperpigmentação/induzido quimicamente , Extratos Vegetais/efeitos adversos , Protetores Solares/efeitos adversos , Adulto , Dermatite Fototóxica/diagnóstico , Feminino , Humanos , Protetores Solares/químicaRESUMO
Minocycline is a derivative of tetracycline. It has been widely used in dermatology for the treatment of acne and rosacea. One of its adverse effects is pigmentation of various body tissues. Clinically, 3 main distinct types of hyperpigmentation by minocycline have been distinguished: type I, with blue-gray to black pigment on the face in areas of scarring or inflammation; type II, with blue-gray pigment on normal skin of the legs, forearms and on the shins; and type III, with a diffuse muddy-brown discoloration in areas of sun exposure. In the current report, we present the case of a 50-year old man with a history of severe acne treated with minocycline in the past, who currently complained about discoloration of his face. He had also taken colloidal silver supplements for "good health" about 16 years ago. Physical examination revealed gray-blue discoloration on the face, sclera, hard palate and back. Histologic examination showed intracellular pigment deposits in macrophages of the superficial dermis in a perivascular and an interstitial distribution. The pigment stained with Fontana-Masson and von Kossa, whereas it was Perls' iron negative. This case does not fit well into any of the previously described patterns of minocycline-related hyperpigmentation.
Assuntos
Antibacterianos/efeitos adversos , Argiria/patologia , Hiperpigmentação/induzido quimicamente , Minociclina/efeitos adversos , Prata/efeitos adversos , Acne Vulgar/tratamento farmacológico , Idoso , Argiria/etiologia , Suplementos Nutricionais/efeitos adversos , Humanos , Masculino , Mucosa/efeitos dos fármacos , Pele/efeitos dos fármacosAssuntos
Hemossiderina/efeitos adversos , Hiperpigmentação/radioterapia , Lasers de Estado Sólido/uso terapêutico , Terapia com Luz de Baixa Intensidade , Idoso , Anemia Ferropriva/tratamento farmacológico , Extravasamento de Materiais Terapêuticos e Diagnósticos , Feminino , Hemossiderina/administração & dosagem , Humanos , Hiperpigmentação/induzido quimicamente , Infusões IntravenosasRESUMO
Prostaglandin F2α analogs, commonly prescribed for glaucoma treatment, have been shown to induce side effects such as cutaneous hypertrichosis and hyperpigmentation. Therefore, these medications have theoretic applications in the treatment of alopecia and disorders of hypopigmentation. We reviewed the literature to find original studies assessing the use of prostaglandin F2α analogs in these settings. Studies and reports were analyzed in regards to androgenic alopecia, alopecia areata, chemotherapy-induced alopecia, vitiligo, and hypopigmented scarring. Based on the results of these studies, and consideration of pathophysiologic mechanism, the most promising applications for prostaglandin F2α analogs include androgenic alopecia, chemotherapy-induced alopecia, and alopecia areata concurrently treated with corticosteroids.
Assuntos
Alopecia/tratamento farmacológico , Amidas/uso terapêutico , Cloprostenol/análogos & derivados , Hipopigmentação/tratamento farmacológico , Prostaglandinas F Sintéticas/uso terapêutico , Corticosteroides/administração & dosagem , Corticosteroides/uso terapêutico , Amidas/efeitos adversos , Animais , Bimatoprost , Cloprostenol/efeitos adversos , Cloprostenol/uso terapêutico , Dinoprosta/fisiologia , Modelos Animais de Doenças , Método Duplo-Cego , Avaliação Pré-Clínica de Medicamentos , Pestanas/efeitos dos fármacos , Glaucoma/tratamento farmacológico , Folículo Piloso/efeitos dos fármacos , Humanos , Hiperpigmentação/induzido quimicamente , Hipertricose/induzido quimicamente , Melaninas/biossíntese , Camundongos , Prostaglandinas F Sintéticas/administração & dosagem , Prostaglandinas F Sintéticas/efeitos adversos , Ensaios Clínicos Controlados Aleatórios como Assunto , Estudos Retrospectivos , Método Simples-CegoRESUMO
BACKGROUND: Exogenous ochronosis (EO), a disfiguring cutaneous complication of topical hydroquinone use, is difficult to treat. There are few reports of successful outcomes following treatment with different modalities. OBJECTIVE: We assessed the results of treatment of EO with the Q-switched Nd:YAG laser. MATERIAL AND METHODS: Patients with histologically-confirmed EO were treated with the Q-switched Nd:YAG laser. RESULTS AND CONCLUSION: Q-switched Nd:YAG laser treatment appears to be effective in reducing the dyschromia of EO.
Assuntos
Dermatoses Faciais/radioterapia , Hiperpigmentação/radioterapia , Lasers de Estado Sólido/uso terapêutico , Terapia com Luz de Baixa Intensidade , Ocronose/radioterapia , Adulto , Idoso , Povo Asiático , Dermatoses Faciais/induzido quimicamente , Feminino , Humanos , Hidroquinonas/efeitos adversos , Hiperpigmentação/induzido quimicamente , Pessoa de Meia-Idade , Ocronose/induzido quimicamenteRESUMO
The effective and safe treatment of acne vulgaris often is affected by individual patient characteristics, including skin color and cultural background. Skin of color is especially prone to hyperpigmentation, both from lesions and from irritating therapy. Clinicians also should be aware of cultural attitudes and folk remedies that may adversely affect dermatologic conditions such as acne.