ABSTRACT
Background: The treatment of psoriasis in patients with a personal history of cancer is a matter of debate and limited evidence is available to guide clinicians. Objectives: To report a multicenter real-life experience of a group of patients with psoriasis undergoing treatment with guselkumab and a history of cancer. Methods: We conducted a multicenter retrospective Spanish study enrolling patients with moderate-to-severe plaque psoriasis and neoplasia being treated with guselkumab for their psoriasis. Results: Twenty patients with moderate-to-severe psoriasis and at least 12 weeks of ongoing treatment were included. For the analysis, a 52 week follow-up period was evaluated in terms of efficacy and safety. Most of the malignancies in these patients were solid tumors. The percentage of patients achieving psoriasis area and severity index ≤3 at week 12 and week 52 was 80% and 87.5%, respectively, whereas 68.8% of patients achieved psoriasis area and severity index ≤1. A 52-week survival rate of 100% in the study population was observed (n = 20), including those patients with concomitant active cancers (n = 14). No adverse effects or dropouts related to guselkumab safety profile were detected. Limitations: Modest sample size and the retrospective nature of the study. Conclusion: Guselkumab not only demonstrates high effectiveness in treating psoriasis but also exhibits a favorable safety profile in patients with neoplasms.
ABSTRACT
BACKGROUND: The microbiological diagnosis of skin lesions related to COVID-19 is not well known. OBJECTIVE: Perform a microbiological diagnosis in COVID19-related cutaneous manifestations. METHODS: A cross-sectional study was performed with 64 patients with cutaneous manifestations associated with COVID-19 who underwent serological and nasopharyngeal reverse transcription polymerase chain reaction (RT-PCR) for SARS-CoV-2. RESULTS: Out of the 64 patients, 6 patients had positive RT-PCR, with all of them developing SARS-CoV-2 IgG and 4 of them had positive IgM + IgA. Of the 58 patients with negative RT-PCR, 8 cases had positive IgM + IgA and only one of them had IgG seroconversion. Therefore, the infection was demonstrated in 7 cases (10.9%) and was doubtful in 7 other cases (10.9%) who presented negative RT-PCR and presence of IgA + IgM without subsequent seroconversion of IgG. Fifty patients (78.1%) had negative serological tests. The most frequent cutaneous pattern was pseudo-chilblain (48.4%) followed by maculo-papular pattern (26.6%), urticarial lesions (10.9%), vesicular eruptions (6.3%) and livedoid pattern (4.7%). The maculo-papular pattern showed the highest positivity in RT-PCR (3 cases; 17.6%) and serologies (4 cases; 23.5%). Skin lesions developed after the systemic symptoms in most patients (19 cases; 61.3%). CONCLUSIONS: Microbiological confirmation tests may not be an effective diagnostic technique for COVID-related cutaneous manifestations or that attributed lesions are not related to COVID-19. Confounding factors such as adverse drug reaction, serological cross-reactions with other viruses, the low production of antibodies in asymptomatic or mild forms of COVID-19 or its rapid disappearance, increase diagnostic uncertainty.
Subject(s)
COVID-19 , Antibodies, Viral , Cross-Sectional Studies , Humans , SARS-CoV-2 , Sensitivity and SpecificitySubject(s)
Acanthoma , Skin Neoplasms , Acanthoma/diagnostic imaging , Dermoscopy , Humans , Skin Neoplasms/diagnostic imagingSubject(s)
Humans , Male , Middle Aged , Adalimumab/adverse effects , Anti-Inflammatory Agents/adverse effects , Antibodies, Monoclonal/therapeutic use , Colitis, Ulcerative/drug therapy , Leishmaniasis, Cutaneous/diagnosis , Leishmaniasis, Cutaneous/drug therapy , Infliximab/therapeutic use , Treatment OutcomeSubject(s)
Humans , Male , Aged , Immunocompromised Host , Physical Examination , Symptom Assessment , Arm Injuries , Arm Injuries/surgery , Alternariosis , Microbiology , Communicable DiseasesSubject(s)
COVID-19 , Granuloma Annulare , Consensus , Granuloma Annulare/diagnosis , Granuloma Annulare/etiology , Humans , Prospective Studies , SARS-CoV-2 , Spain , Staining and LabelingSubject(s)
Humans , Male , Aged , Cicatrix , Exanthema/diagnosis , Exanthema/therapy , C-Reactive Protein , Leukopenia , Lymphopenia , Rickettsia conorii , Communicable Diseases , MicrobiologyABSTRACT
No disponible
Subject(s)
Humans , Male , Child , Leishmaniasis, Cutaneous/diagnosis , Leishmaniasis, Cutaneous/pathology , Dermoscopy/methods , Leishmania/isolation & purification , Erythema/parasitology , Erythema/pathologyABSTRACT
Abstract Granuloma annulare may be caused by multiple triggers. Among these are vaccinations, which have been described as an infrequent cause of granuloma annulare. The authors report the first case of generalized granuloma annulare associated with pneumococcal vaccination in a 57-year-old woman, who presented cutaneous lesions 12 days after vaccination.
