ABSTRACT
BACKGROUND AND OBJECTIVE: Systemic adverse effects (AE) are a major concern of low-dose oral minoxidil (LDOM) treatment, especially in patients with arterial hypertension or arrhythmia. The objective of this study was to evaluate the safety of LDOM in patients with hypertension or arrhythmia. PATIENTS AND METHODS: Retrospective multicenter study of patients with hypertension or arrhythmia treated with LDOM for any type of alopecia. RESULTS: A total of 254 patients with hypertension [176 women (69.3%) and 78 men (30.7%)] with a mean age of 56.9 years (range 19-82) were included. From them, the dose of LDOM was titrated in 128 patients, allowing the analysis of 382 doses. Patients were receiving a mean of 1.45 (range 0-5) antihypertensive drugs. Systemic AE were detected in 26 cases (6.8%) and included lightheadedness (3.1%), fluid retention (2.6%), general malaise (0.8%), tachycardia (0.8%) and headache (0.5%), leading to LDOM discontinuation in 6 cases (1.5%). Prior treatment with doxazosin (P<0.001), or with three or more antihypertensive drugs (P=0.012) was associated with a higher risk of discontinuation of LDOM. CONCLUSIONS: LDOM treatment showed a favorable safety profile in patients with hypertension or arrhythmia, similar to general population.
Subject(s)
Hypertension , Minoxidil , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Alopecia/drug therapy , Alopecia/chemically induced , Antihypertensive Agents/adverse effects , Arrhythmias, Cardiac/chemically induced , Arrhythmias, Cardiac/drug therapy , Hypertension/drug therapy , Minoxidil/adverse effects , Treatment Outcome , Retrospective StudiesABSTRACT
BACKGROUND AND OBJECTIVE: Systemic adverse effects (AE) are a major concern of low-dose oral minoxidil (LDOM) treatment, especially in patients with arterial hypertension or arrhythmia. The objective of this study was to evaluate the safety of LDOM in patients with hypertension or arrhythmia. PATIENTS AND METHODS: Retrospective multicenter study of patients with hypertension or arrhythmia treated with LDOM for any type of alopecia. RESULTS: A total of 254 patients with hypertension [176 women (69.3%) and 78 men (30.7%)] with a mean age of 56.9 years (range 19-82) were included. From them, the dose of LDOM was titrated in 128 patients, allowing the analysis of 382 doses. Patients were receiving a mean of 1.45 (range 0-5) antihypertensive drugs. Systemic AE were detected in 26 cases (6.8%) and included lightheadedness (3.1%), fluid retention (2.6%), general malaise (0.8%), tachycardia (0.8%) and headache (0.5%), leading to LDOM discontinuation in 6 cases (1.5%). Prior treatment with doxazosin (P<0.001), or with three or more antihypertensive drugs (P=0.012) was associated with a higher risk of discontinuation of LDOM. CONCLUSIONS: LDOM treatment showed a favorable safety profile in patients with hypertension or arrhythmia, similar to general population.
Subject(s)
Hypertension , Minoxidil , Male , Humans , Female , Young Adult , Adult , Middle Aged , Aged , Aged, 80 and over , Minoxidil/adverse effects , Antihypertensive Agents/adverse effects , Alopecia/drug therapy , Alopecia/chemically induced , Hypertension/drug therapy , Arrhythmias, Cardiac/chemically induced , Arrhythmias, Cardiac/drug therapy , Treatment OutcomeSubject(s)
Pneumonia, Viral , Skin , Betacoronavirus , Biopsy , COVID-19 , Coronavirus Infections , Humans , Pandemics , SARS-CoV-2Subject(s)
Alopecia/pathology , Scalp/pathology , Adult , Aged , Aged, 80 and over , Alopecia/metabolism , Female , Humans , Immunohistochemistry , Middle Aged , Scalp/metabolismABSTRACT
No disponible
Subject(s)
Humans , Female , Middle Aged , Leiomyoma, Epithelioid/diagnosis , Hemangioendothelioma, Epithelioid/diagnosis , Angiomatosis, Bacillary/pathology , Cell Proliferation , Breast Neoplasms/radiotherapy , Leiomyoma, Epithelioid/pathology , Epithelioid Cells/pathology , Immunohistochemistry , Diagnosis, DifferentialABSTRACT
No disponible
Subject(s)
Humans , Female , Adult , Alopecia/drug therapy , Hair Follicle/drug effects , Minoxidil/administration & dosage , Minoxidil/metabolism , Antihypertensive Agents/therapeutic useSubject(s)
Alopecia/drug therapy , Minoxidil/administration & dosage , Administration, Oral , HumansSubject(s)
Dermatology , Lupus Erythematosus, Cutaneous , Venereology , Academies and Institutes , Humans , Societies, MedicalABSTRACT
INTRODUCCIÓN: A pesar de que los únicos fármacos con indicación aprobada en nuestro país para la alopecia androgénica (AGA) son minoxidil tópico y finasterida oral, es común la utilización de numerosas terapias fuera de indicación, provocando una gran variabilidad en el manejo de estos pacientes. El objetivo principal de este trabajo fue describir los hábitos de prescripción de los dermatólogos en España en AGA masculina (MAGA) y AGA femenina (FAGA). MATERIAL Y MÉTODOS: Estudio descriptivo transversal mediante cuestionarios digitales autocumplimentados por dermatólogos que ejercen en territorio español. RESULTADOS: Se incluyeron las respuestas de un total de 241 dermatólogos. En MAGA los tratamientos más utilizados fueron en este orden: minoxidil tópico (98%), finasterida oral (96%), nutricosméticos (44%), finasterida tópica (37%), dutasterida oral (33%), plasma rico en plaquetas (14%) y láser de baja potencia (8%). En FAGA premenopáusica: minoxidil tópico (98%), anticonceptivos orales (81%), nutricosméticos (72%), acetato de ciproterona (58%), finasterida oral (39%), finasterida tópica (39%), espironolactona (27%), plasma rico en plaquetas (20%), dutasterida oral (20%), flutamida oral (18%) y láser de baja potencia (7%). En FAGA posmenopáusica: minoxidil tópico (98%), finasterida oral (84%), nutricosméticos (68%), finasterida tópica (50%), dutasterida oral (35%), plasma rico en plaquetas (21%), espironolactona (16%), acetato de ciproterona (16%), flutamida oral (9%) y láser de baja potencia (9%). Como limitaciones de nuestro estudio, no se incluyeron terapias novedosas para AGA como minoxidil oral o microinyecciones de dutasterida. CONCLUSIONES: Los agentes terapéuticos más utilizados en MAGA y FAGA posmenopáusica por los dermatólogos en España fueron minoxidil tópico, finasterida oral y nutricosméticos, mientras que en FAGA premenopáusica fueron minoxidil tópico, anticonceptivos orales y nutricosméticos
BACKGROUND: Topical minoxidil and oral finasteride are the only drugs approved for the treatment of androgenetic alopecia (AGA) in Spain. However, the management of this condition is highly variable because numerous treatments are used off-label. The main aim of this study was to describe the prescribing habits of dermatologists in Spain for male AGA (MAGA) and female AGA (FAGA). MATERIAL AND METHODS: Descriptive cross-sectional study using online questionnaires completed by dermatologists working in Spain. RESULTS: The responses of 241 dermatologists were analyzed. The most common treatments prescribed for MAGA were minoxidil (98%), oral finasteride (96%), nutricosmetics (44%), topical finasteride (37%), oral dutasteride (33%), platelet-rich plasma (14%), and low-level laser therapy (8%). For premenopausal FAGA, the most common treatments were topical minoxidil (98%), oral contraceptives (81%), nutricosmetics (72%), cyproterone acetate (58%), oral finasteride (39%), topical finasteride (39%), spironolactone (27%), platelet-rich plasma (20%), oral dutasteride (20%), oral flutamide (18%), and low-level laser therapy (7%). Finally, for postmenopausal FAGA, the most common treatments prescribed were topical minoxidil (98%), oral finasteride (84%), nutricosmetics (68%), topical finasteride (50%), oral dutasteride (35%), platelet-rich plasma (21%), spironolactone (16%), cyproterone acetate (16%), oral flutamide (9%), and low-level laser therapy (9%). A limitation of our study is that we did not analyze novel AGA treatments such as oral minoxidil and dutasteride mesotherapy. CONCLUSIONS:The most common treatments prescribed for AGA by dermatologists in Spain are topical minoxidil, oral finasteride, and nutricosmetics for MAGA and postmenopausal FAGA and topical minoxidil, oral contraceptives, and nutricosmetics for premenopausal FAGA
Subject(s)
Humans , Prescriptions/statistics & numerical data , Alopecia/epidemiology , Laser-Doppler Flowmetry/methods , Dermatologists/statistics & numerical data , Cross-Sectional Studies , Alopecia/therapy , Finasteride/administration & dosage , Dutasteride/administration & dosage , Minoxidil/administration & dosage , Surveys and Questionnaires , Spain/epidemiologyABSTRACT
BACKGROUND: Topical minoxidil and oral finasteride are the only drugs approved for the treatment of androgenetic alopecia (AGA) in Spain. However, the management of this condition is highly variable because numerous treatments are used off-label. The main aim of this study was to describe the prescribing habits of dermatologists in Spain for male AGA (MAGA) and female AGA (FAGA). MATERIAL AND METHODS: Descriptive cross-sectional study using online questionnaires completed by dermatologists working in Spain. RESULTS: The responses of 241 dermatologists were analyzed. The most common treatments prescribed for MAGA were minoxidil (98%), oral finasteride (96%), nutricosmetics (44%), topical finasteride (37%), oral dutasteride (33%), platelet-rich plasma (14%), and low-level laser therapy (8%). For premenopausal FAGA, the most common treatments were topical minoxidil (98%), oral contraceptives (81%), nutricosmetics (72%), cyproterone acetate (58%), oral finasteride (39%), topical finasteride (39%), spironolactone (27%), platelet-rich plasma (20%), oral dutasteride (20%), oral flutamide (18%), and low-level laser therapy (7%). Finally, for postmenopausal FAGA, the most common treatments prescribed were topical minoxidil (98%), oral finasteride (84%), nutricosmetics (68%), topical finasteride (50%), oral dutasteride (35%), platelet-rich plasma (21%), spironolactone (16%), cyproterone acetate (16%), oral flutamide (9%), and low-level laser therapy (9%). A limitation of our study is that we did not analyze novel AGA treatments such as oral minoxidil and dutasteride mesotherapy. CONCLUSIONS: The most common treatments prescribed for AGA by dermatologists in Spain are topical minoxidil, oral finasteride, and nutricosmetics for MAGA and postmenopausal FAGA and topical minoxidil, oral contraceptives, and nutricosmetics for premenopausal FAGA.
Subject(s)
Alopecia/drug therapy , Dermatology , Practice Patterns, Physicians' , Cross-Sectional Studies , Drug Prescriptions/statistics & numerical data , Female , Humans , Male , Private Practice , Public Sector , Self Report , SpainSubject(s)
Acanthoma/drug therapy , Aminolevulinic Acid/analogs & derivatives , Photochemotherapy , Photosensitizing Agents/administration & dosage , Skin Neoplasms/drug therapy , Acanthoma/pathology , Administration, Cutaneous , Aged , Aminolevulinic Acid/administration & dosage , Female , Humans , Male , Middle Aged , Remission Induction , Skin Neoplasms/pathology , Treatment OutcomeABSTRACT
INTRODUCTION: Dermatological complaints have been estimated to represent up to 5-10% of all the visits to emergency departments. The main objective of our study was to determine how affected is the Health related Quality of Life (HRQL) in a series of patients attending an emergency department due to skin symptoms. PATIENTS AND METHODS: A prospective study during one month (July 2016) was conducted in a hospital with full-time on-call dermatologists. The Short-Form SF-12v2 Health Survey and the Dermatology Life Quality Index (DLQI) were offered to all the patients over 18 years old attending the emergency department with cutaneous complaints. Clinical and epidemiological characteristics were also collected. RESULTS: In total 108 patients completed the study. Mean age found was 45.1 ± 16.1 years. Mean DLQI score found was 10.56 ± 6.12. Fifty-three patients (49%) had a score of 11 or higher in the DLQI questionnaire. Most affected subscales were "Symptoms and Feelings" in DLQI scale and "Overall Health" and "Vitality" for the SF-12. A very significant difference (p < 0.0001) was found between women's (12.4 ± 5.7) and men's (7.5 ± 5.6) DLQI mean score (mean difference of 4.9; 95% confidence interval of the difference: 2.7-7.1). CONCLUSIONS: Patients visiting emergency units with cutaneous complaints seem to feel a moderate-large impact on their quality of life which is mainly related to the symptoms and feelings that they are experiencing. This impact is significantly higher among women
INTRODUCCIÓN: Los problemas dermatólogicos suponen hasta un 5-10% de todas las visitas a los servicios de urgencias. El principal objetivo de nuestro estudio fue determinar la calidad de vida relacionada con la salud en una serie amplia de pacientes que acudieron a un servicio de urgencias por sintomatología cutánea. PACIENTES Y MÉTODOS: Se realizó un estudio prospectivo de un mes de duración (julio de 2016) en un hospital terciario con dermatólogo de guardia a tiempo completo. La versión corta del Cuestionario de Salud SF-12v2 y del cuestionario DLQI fueron entregados a todos los pacientes mayores de edad que acudieron al servicio de urgencias con problemas dermatológicos. Se recogió información clínica y epidemiológica de todos los pacientes. RESULTADOS: En total, 108 pacientes completaron el estudio. La edad media de nuestra muestra fue de 45,1±16,1 años. La puntuación media del DLQI fue 10,56±6,12. Del total, 33 pacientes (49%) tuvieron una puntuación de 11 o más en el DLQI. Las subescalas más afectadas fueron la de «síntomas y sentimientos» para el DLQI y las de «salud general» y «vitalidad» para el SF-12. Se encontró una diferencia muy significativa (p < 0,0001) entre las puntuaciones totales del DLQI en mujeres (12,4±5,7) y hombres (7,5±5,6), con una diferencia media de 4,9 (intervalo de confianza al 95%: 2,7-7,1). CONCLUSIONES: Los pacientes que acuden a los servicios de urgencias con problemas dermatológicos parecen tener una afectación moderada-grave en su calidad de vida, debido principalmente a los síntomas que están experimentando. Este impacto es significativamente mayor en las mujeres
Subject(s)
Humans , Skin Diseases/epidemiology , Emergency Treatment/statistics & numerical data , Emergency Service, Hospital/statistics & numerical data , Quality of Life , Sickness Impact Profile , Prospective Studies , Morbidity SurveysABSTRACT
INTRODUCTION: Dermatological complaints have been estimated to represent up to 5-10% of all the visits to emergency departments. The main objective of our study was to determine how affected is the Health related Quality of Life (HRQL) in a series of patients attending an emergency department due to skin symptoms. PATIENTS AND METHODS: A prospective study during one month (July 2016) was conducted in a hospital with full-time on-call dermatologists. The Short-Form SF-12v2 Health Survey and the Dermatology Life Quality Index (DLQI) were offered to all the patients over 18 years old attending the emergency department with cutaneous complaints. Clinical and epidemiological characteristics were also collected. RESULTS: In total 108 patients completed the study. Mean age found was 45.1±16.1 years. Mean DLQI score found was 10.56±6.12. Fifty-three patients (49%) had a score of 11 or higher in the DLQI questionnaire. Most affected subscales were "Symptoms and Feelings" in DLQI scale and "Overall Health" and "Vitality" for the SF-12. A very significant difference (p<0.0001) was found between women's (12.4±5.7) and men's (7.5±5.6) DLQI mean score (mean difference of 4.9; 95% confidence interval of the difference: 2.7-7.1). CONCLUSIONS: Patients visiting emergency units with cutaneous complaints seem to feel a moderate-large impact on their quality of life which is mainly related to the symptoms and feelings that they are experiencing. This impact is significantly higher among women.
Subject(s)
Emergency Service, Hospital , Patients/psychology , Quality of Life , Skin Diseases/psychology , Adolescent , Adult , Aged , Attitude to Health , Diagnosis-Related Groups , Emotions , Female , Health Surveys , Humans , Male , Middle Aged , Patients/statistics & numerical data , Prospective Studies , Severity of Illness Index , Skin Diseases/epidemiology , Socioeconomic Factors , Spain/epidemiology , Young AdultABSTRACT
BACKGROUND: Frontal fibrosing alopecia (FFA) is a chronic scarring alopecia with an unpredictable evolution. There are no current classifications of this disease that may predict its prognosis. OBJECTIVE: To analyse the differences in clinical presentation and evolution of FFA patients and to create a clinical and prognostic classification. METHODS: We conducted a retrospective analytical study of FFA patients. Clinical characteristics of frontal hairline recession were used as the sorting variable between patterns of presentation. A cohort of 106 patients homogenously treated with oral dutasteride and topical corticosteroid was followed 12 months. RESULTS: In all, 242 female patients with a mean age of 61.4 years were included. Patients were classified into three clinical patterns [118 (48.8%) patients as pattern I (linear), 109 patients (45%) as pattern II (diffuse) and 15 patients (6.2%) as pattern III (double line)]. Stabilization was achieved in 37.3% of the 106 patients treated with oral dutasteride and topical corticosteroid. Pattern III patients had less hairline recession and eyebrow involvement at the diagnosis and after treatment. LIMITATIONS: Retrospective design. CONCLUSIONS: Frontal fibrosing alopecia patients can be classified into three different clinical patterns with different prognosis. Pattern III patients have the best prognosis, while pattern II patients have the worst prognosis.
