Subject(s)
Face/pathology , Melanoma/diagnosis , Skin Neoplasms/diagnosis , Aged, 80 and over , Fatal Outcome , Female , HumansABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Actinomycosis/diagnosis , Actinomycosis/drug therapy , Risk Factors , Actinomyces/drug effects , Actinomyces/isolation & purification , Amoxicillin-Potassium Clavulanate Combination/therapeutic use , Ceftriaxone/administration & dosage , Clindamycin/administration & dosage , Magnetic Resonance SpectroscopyABSTRACT
We report a 52-year old woman with a 28-year historyof disfiguring facial discoid lupus erythematosus(DLE), persistent despite both classical therapiesand rituximab. Ustekinumab 45 mg was started incombination with methotrexate and intralesionalcorticosteroids. Methotrexate and intralesionalcorticosteroids were withdrawn 30 months later andustekinumab maintained as monotherapy. Fortyeight months later stable improvement was achievedwithout side effects. Only nine patients with cutaneouslupus erythematosus (CLE) treated with ustekinumabhave been reported to date. Ustekinumab could be apromising alternative in severe and recalcitrant casesof CLE. Possibly, the Th17-inflammation pathway isplaying a role in these patients.
Subject(s)
Dermatologic Agents/therapeutic use , Facial Dermatoses/drug therapy , Lupus Erythematosus, Discoid/drug therapy , Ustekinumab/therapeutic use , Adrenal Cortex Hormones/therapeutic use , Facial Dermatoses/pathology , Female , Humans , Immunologic Factors/therapeutic use , Immunosuppressive Agents/therapeutic use , Injections, Intralesional , Lupus Erythematosus, Discoid/pathology , Methotrexate/therapeutic use , Middle Aged , Rituximab/therapeutic use , Treatment FailureABSTRACT
No disponible
Subject(s)
Humans , Male , Young Adult , Ulcer/complications , Ulcer/diagnosis , Cachexia/complications , Cachexia/diagnosis , Cachexia/etiology , Tuberculosis, Pulmonary/complications , Tuberculosis, Pulmonary/drug therapy , Tuberculosis, Pulmonary , Tuberculosis, Pulmonary/physiopathology , Isoniazid/therapeutic use , Rifampin/therapeutic use , Pyrazinamide/therapeutic use , Ethambutol/therapeutic useSubject(s)
Cachexia/etiology , Skin Ulcer/etiology , Tuberculosis, Cutaneous/diagnosis , Adolescent , Antitubercular Agents/therapeutic use , Drug Therapy, Combination , Humans , Male , Skin Ulcer/drug therapy , Tuberculosis, Cutaneous/complications , Tuberculosis, Cutaneous/drug therapy , Tuberculosis, Pulmonary/complications , Tuberculosis, Pulmonary/diagnosis , Tuberculosis, Pulmonary/drug therapySubject(s)
Contrast Media/adverse effects , Dermatitis/etiology , Iopamidol/adverse effects , Laser Therapy/adverse effects , Adult , Contrast Media/administration & dosage , Dermatitis/pathology , Hair Removal/methods , Humans , Iopamidol/administration & dosage , Laser Therapy/methods , Male , Tomography, X-Ray Computed/methodsABSTRACT
Depilation techniques have gain popularity in the last few decades. Nowadays there are available a wide variety of lasers as well as intense pulsed light for depilation. However, little is known about the long-term effects of these procedures when melanocytic nevi are affected by them. We report the cases of three patients where we observed clinical, dermoscopic and histopathological changes secondary to laser therapy and intense pulsed light depilation, respectively. We believe that it is necessary to perform further studies to prove the absence of malignant transformation so that we will be able to set up recommendations in those patients with a personal or family history of malignant melanoma and/or dysplastic nevi.
Subject(s)
Hair Removal/instrumentation , Low-Level Light Therapy/instrumentation , Nevus, Pigmented/pathology , Hair Removal/adverse effects , Humans , Low-Level Light Therapy/adverse effects , Male , Middle AgedABSTRACT
OBJECTIVE: To validate dermoscopy as a real-time noninvasive diagnostic imaging technique for actinic keratosis (AK). DESIGN: Prospective study to validate a diagnostic test. SETTING: Dermatology department of a tertiary university hospital in Fuenlabrada, Madrid, Spain. PATIENTS: A total of 178 patients with a clinical diagnosis of AK participated in the study. MAIN OUTCOME MEASURES: An independent blinded comparison was performed between dermoscopy results and histopathological findings, the gold standard for the diagnosis of AK. All the patients underwent both diagnostic tests. RESULTS: One hundred seventy-eight lesions were evaluated. The concordance between dermoscopy results and histopathological findings was 0.917. The sensitivity of dermoscopy for the diagnosis of AK was 98.7%, with a specificity of 95.0%, a positive likelihood ratio of 19.74, and a negative likelihood ratio of 0.01. A diagnostic algorithm that combined follicular openings and erythematous pseudonetwork demonstrated a sensitivity of 95.6% and a specificity of 95.0% for the diagnosis of AK. CONCLUSIONS: The sensitivity and specificity of dermoscopy for the diagnosis of AK were high, as was the concordance between dermoscopy results and histopathological findings. As a real-time noninvasive diagnostic imaging technique for AK, dermoscopy may be incorporated in the management of patients with these lesions.
Subject(s)
Dermoscopy , Keratosis, Actinic/pathology , Adult , Aged , Aged, 80 and over , Algorithms , Chi-Square Distribution , Double-Blind Method , Female , Humans , Keratosis, Actinic/diagnosis , Likelihood Functions , Male , Middle Aged , Prospective Studies , Sensitivity and SpecificitySubject(s)
Antineoplastic Agents/adverse effects , Benzenesulfonates/adverse effects , Drug Eruptions/etiology , Foot Dermatoses/chemically induced , Granuloma/chemically induced , Hand Dermatoses/chemically induced , Protein Kinase Inhibitors/adverse effects , Pyridines/adverse effects , Aged , Drug Eruptions/pathology , Foot Dermatoses/pathology , Granuloma/pathology , Hand Dermatoses/pathology , Humans , Male , Niacinamide/analogs & derivatives , Phenylurea Compounds , SorafenibSubject(s)
Dermatitis, Allergic Contact/diagnosis , Dermatitis, Allergic Contact/etiology , Histamine H2 Antagonists/adverse effects , Pyridoxine/adverse effects , Ranitidine/adverse effects , Vitamin B Complex/adverse effects , Adult , Dermatitis, Allergic Contact/pathology , Female , Humans , Patch TestsABSTRACT
Discoid lupus erythematosus (DLE) can be a therapeutic challenge. Antimalarials and topic steroids are the first-line standard therapies, while systemic steroids, immunomodulators (as azathioprine, methotrexate, cyclosporine), retinoids (acitretin), thalidomide, auranofin and dapsone are used as second-line therapies. We report two patients with recalcitrant DLE who were treated with three and two sessions of 5-aminolevulinic photodynamic therapy without an improvement and with a bad tolerance to the therapy.
