Assuntos
Preenchedores Dérmicos/efeitos adversos , Dermatoses Faciais/terapia , Síndrome de Lipodistrofia Associada ao HIV/terapia , Dermatopatias Vasculares/terapia , Administração Cutânea , Terapia Combinada/métodos , Preenchedores Dérmicos/administração & dosagem , Durapatita/administração & dosagem , Durapatita/efeitos adversos , Face/irrigação sanguínea , Dermatoses Faciais/etiologia , Síndrome de Lipodistrofia Associada ao HIV/complicações , Hemofilia A/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Nitroglicerina/administração & dosagem , Fototerapia/métodos , Dermatopatias Vasculares/etiologia , Resultado do TratamentoRESUMO
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.
Assuntos
Aminoquinolinas/uso terapêutico , Antineoplásicos/uso terapêutico , Carcinoma Basocelular/tratamento farmacológico , Neoplasias Palpebrais/tratamento farmacológico , Síndrome da Imunodeficiência Adquirida/complicações , Aminoquinolinas/efeitos adversos , Antineoplásicos/efeitos adversos , Contraindicações de Procedimentos , Síndrome de Lipodistrofia Associada ao HIV/complicações , Humanos , Imiquimode , Masculino , Pessoa de Meia-Idade , Procedimentos de Cirurgia Plástica , Indução de Remissão , Úlcera Cutânea/induzido quimicamente , Retalhos CirúrgicosRESUMO
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.