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3.
J Am Acad Dermatol ; 72(2): 239-45, 2015 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-25592340

RESUMEN

BACKGROUND: Mycoplasma pneumoniae infection is associated with extrapulmonary complications, including mucocutaneous eruptions. These eruptions, which have been termed either "Stevens-Johnson syndrome" or "erythema multiforme" in the literature, may differ from drug-induced Stevens-Johnson syndrome or viral-associated erythema multiforme. OBJECTIVE: We sought to review the literature characterizing morphology and disease course of M pneumoniae-associated mucocutaneous disease. METHODS: A comprehensive literature search identified 95 articles with 202 cases. RESULTS: Patients were often young (mean age: 11.9 years) and male (66%). Cutaneous involvement ranged from absent (34%), to sparse (47%), to moderate (19%). Oral, ocular, and urogenital mucositis was reported in 94%, 82%, and 63% of cases, respectively. Treatments included antibiotics (80%), systemic corticosteroids (35%), supportive care alone (8%), and/or intravenous immunoglobulin (8%). Complications included mucosal damage (10%), cutaneous scarring (5.6%), recurrence (8%), and mortality (3%). LIMITATIONS: Mild cases may not have been published; thus this review may have a bias toward more severe disease. CONCLUSION: M pneumoniae-associated mucocutaneous disease has prominent mucositis and sparse cutaneous involvement, although cutaneous involvement varies. Because of the distinct morphology, mild disease course, and potentially important clinical implications regarding treatment, we propose a revision of the nomenclature system and suggest the term "Mycoplasma-induced rash and mucositis" for these cases.


Asunto(s)
Exantema/diagnóstico , Exantema/microbiología , Mucositis/microbiología , Infecciones por Mycoplasma/diagnóstico , Mycoplasma pneumoniae/aislamiento & purificación , Corticoesteroides/uso terapéutico , Distribución por Edad , Antibacterianos/uso terapéutico , Niño , Diagnóstico Diferencial , Eritema Multiforme/diagnóstico , Exantema/tratamiento farmacológico , Femenino , Humanos , Inmunoglobulinas Intravenosas/uso terapéutico , Masculino , Mucositis/tratamiento farmacológico , Infecciones por Mycoplasma/tratamiento farmacológico , Distribución por Sexo , Síndrome de Stevens-Johnson/diagnóstico , Síndrome , Resultado del Tratamiento
4.
J Drugs Dermatol ; 14(10 Suppl): s42-7, 2015 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-26461834

RESUMEN

Tinea pedis is a frequently encountered dermatophytosis affecting the superficial skin of the feet, primarily of adults. The prevalence of tinea pedis has increased over the last several decades due to an increase in multiple risk factors. Infection from dermatophytes is most common, but infection from other fungi can also result in tinea pedis. Four distinct clinical presentations occur: interdigital, moccasin, vesicular, and acute ulcerative types. A variety of physical exam findings can help the clinician identify patients with tinea pedis.


Asunto(s)
Antifúngicos/uso terapéutico , Tiña del Pie/diagnóstico , Tiña/diagnóstico , Antifúngicos/administración & dosificación , Pie/microbiología , Humanos , Prevalencia , Tiña/tratamiento farmacológico , Tiña/epidemiología , Tiña/microbiología , Tiña del Pie/tratamiento farmacológico , Tiña del Pie/epidemiología
6.
Skin Appendage Disord ; 5(2): 108-110, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-30815445

RESUMEN

Lichen planopilaris (LPP) is a scarring alopecia seen classically in older Caucasian women. Frontal fibrosing alopecia (FFA) is a distinct disease that shares the histologic and trichoscopic features of LPP but differs in its clinical presentation in that it involves the frontal scalp and occasionally the eyelashes and eyebrows of older Caucasian women. Several recent studies have described a link between FFA and the use of sunscreen. Here we report a case of LPP arising in the part line of the scalp of a woman with a history of long-term daily application of spray-on sunscreen to the hair part line.

7.
Int J Dermatol ; 57(5): 515-520, 2018 May.
Artículo en Inglés | MEDLINE | ID: mdl-29057463

RESUMEN

Anaplastic large cell lymphoma (ALCL) limited to the skin is a distinct disease that is designated primary cutaneous ALCL (pcALCL). It has an indolent course with a significantly better prognosis compared to systemic ALCL (sALCL). Anaplastic lymphoma kinase (ALK) expression in lesions of cutaneous ALCL is classically considered to be a marker for skin involvement by sALCL. However, recent reports of patients with ALK-positive pcALCL challenge this concept and raise prognostic and therapeutic dilemmas. Herein, we report a case of ALK-positive pcALCL in a 45-year-old woman who was treated with local radiotherapy. We review previously reported cases in the literature to better characterize this rare variant. Overall, the rates of cutaneous recurrence, systemic dissemination, and disease-related mortality in ALK-positive pcALCL do not differ from those previously reported in pcALCL. ALK-positive pcALCL is diagnosed at younger age and has a better disease course in children compared to adults with lower incidences of skin recurrence and progression to systemic disease. We conclude that ALK-positivity in cutaneous ALCL does not necessarily imply systemic disease. ALK-positive pcALCL has an excellent prognosis and should be treated by excision and/or radiotherapy. However, patients must remain under close long-term follow-up as recurrence and progression to systemic disease may occur.


Asunto(s)
Linfoma Anaplásico Cutáneo Primario de Células Grandes/patología , Linfoma Anaplásico Cutáneo Primario de Células Grandes/radioterapia , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/radioterapia , Biopsia con Aguja , Supervivencia sin Enfermedad , Femenino , Estudios de Seguimiento , Humanos , Inmunohistoquímica , Linfoma Anaplásico Cutáneo Primario de Células Grandes/diagnóstico , Linfoma Anaplásico Cutáneo Primario de Células Grandes/mortalidad , Masculino , Persona de Mediana Edad , Invasividad Neoplásica/patología , Estadificación de Neoplasias , Medición de Riesgo , Neoplasias Cutáneas/diagnóstico , Neoplasias Cutáneas/mortalidad , Análisis de Supervivencia , Resultado del Tratamiento
8.
Skin Appendage Disord ; 5(1): 9-12, 2018 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-30643774

RESUMEN

BACKGROUND: Topical efinaconazole 10% solution is a promising new treatment for distal lateral subungual onychomycosis (DLSO). However, it is unknown whether this treatment is both compatible and efficacious in individuals wearing toenail polish. MATERIALS AND METHODS: We evaluated the efficacy and compatibility of efinaconazole 10% solution with concurrent nail polish use in treating DLSO over 52 weeks. Efficacy was assessed using the onychomycosis severity index (OSI) and by measuring nail growth and thickness, while compatibility with nail polish was evaluated with questionnaires. RESULTS: Eleven patients completed the study; 6 wore nail polish regularly and 5 abstained from polish. The efficacy of efinaconazole was not diminished by concurrent nail polish use as measured by OSI, nail growth, and thickness. However, this treatment produced undesirable cosmetic changes to the quality of nail polish over time. CONCLUSIONS: While efinaconazole 10% solution is an effective treatment of DLSO in patients wearing nail polish, this treatment may diminish the quality of the polish. Further research and development is needed to enhance the compatibility of topical onychomycosis treatments with nail polish use.

9.
Photodiagnosis Photodyn Ther ; 18: 257-259, 2017 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-28373119

RESUMEN

Treating skin cancers and extensive actinic keratosis in patients with bullous pemphigoid (BP) can be challenging. Treatment options pose unique risks in these patients as surgical wounds can have delayed wound healing and photodynamic therapy (PDT) may exacerbate their blistering disease. We report the successful use of PDT to treat actinic keratosis and skin cancers in two patients with BP, both of whom had excellent response to PDT and tolerated treatment without any bullous disease flares. Carefully selected patients with skin cancers and stable, well controlled BP can be safely considered for treatment using PDT.


Asunto(s)
Ácido Aminolevulínico/administración & dosificación , Ácido Aminolevulínico/uso terapéutico , Carcinoma Basocelular/tratamiento farmacológico , Queratosis Actínica/tratamiento farmacológico , Penfigoide Ampolloso/tratamiento farmacológico , Fotoquimioterapia/métodos , Neoplasias Cutáneas/tratamiento farmacológico , Administración Cutánea , Anciano , Carcinoma Basocelular/complicaciones , Carcinoma Basocelular/patología , Relación Dosis-Respuesta a Droga , Humanos , Queratosis Actínica/complicaciones , Queratosis Actínica/patología , Masculino , Penfigoide Ampolloso/complicaciones , Penfigoide Ampolloso/patología , Fármacos Fotosensibilizantes/administración & dosificación , Neoplasias Cutáneas/complicaciones , Neoplasias Cutáneas/patología , Resultado del Tratamiento
10.
Dermatol Ther (Heidelb) ; 6(4): 555-578, 2016 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-27541148

RESUMEN

Acne is a very common non-infectious skin condition that is frequently treated in dermatological practices. Because acne is often chronic and may persist for years, safe and effective long-term maintenance therapy is often required. Given the increasing frequency of antibiotic-resistant bacteria and the gravity of the consequences of this trend, it behooves dermatologists to maximize use of non-antimicrobial therapy when treating acne. In this review of the literature we present data regarding the efficacy and appropriate use of non-antimicrobial treatments for acne. A variety of topical and oral treatment options exist that can be used in a step-wise manner according to the patients' severity and therapeutic response. Non-antimicrobial treatments can be highly efficacious at controlling acne, especially when used as maintenance therapy. While antibiotics have a role in acne treatment, they should not be used as monotherapy, and lengthy courses of antibiotic use are discouraged.

11.
Am J Clin Dermatol ; 17(1): 33-47, 2016 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-26649440

RESUMEN

Our ability to successfully treat patients with moderate to severe psoriasis has improved significantly over the last several years with the development of more targeted therapies. IL-17A, a member of the IL-17 family of interleukins, is involved in regulating the innate and adaptive immune systems and has been identified as a key cytokine involved in the pathogenesis of psoriasis and psoriatic arthritis. In this review, we summarize our understanding of IL-17 and its role in psoriasis and psoriatic arthritis, as well as key findings from clinical trials using anti-IL-17 medications for the treatment of the aforementioned diseases. Secukinumab, ixekizumab, and brodalumab are three anti-IL-17 medications used for treating psoriasis, of which only secukinumab is FDA approved; ixekizumab and brodalumab remain under clinical development. Results from clinical trials show that these three medications are highly effective in treating psoriasis and appear to be as safe as other biologic treatments that are FDA approved.


Asunto(s)
Anticuerpos Monoclonales Humanizados/uso terapéutico , Anticuerpos Monoclonales/uso terapéutico , Interleucina-17/antagonistas & inhibidores , Psoriasis/tratamiento farmacológico , Anticuerpos Monoclonales/administración & dosificación , Anticuerpos Monoclonales/efectos adversos , Anticuerpos Monoclonales Humanizados/administración & dosificación , Anticuerpos Monoclonales Humanizados/efectos adversos , Artritis Psoriásica/tratamiento farmacológico , Productos Biológicos/efectos adversos , Productos Biológicos/uso terapéutico , Ensayos Clínicos Fase II como Asunto , Ensayos Clínicos Fase III como Asunto , Humanos , Interleucina-17/metabolismo , Terapia Molecular Dirigida , Transducción de Señal
13.
Skin Appendage Disord ; 5(1): 50-51, 2018 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-30643782
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