Liquen plano generalizado tratado con ultravioleta B de banda estrecha: resultados en 10 pacientes y revisión de la literatura / Generalized Licen Planus Treated With Narrowband UV-B Phototherapy: Results From 10 Patients and a Review of the Literature

El liquen plano en su forma generalizada (LPG) es en ocasiones difícil de tratar. Cuando fallan los tratamientos tópicos y sistémicos más utilizados como corticoides y antihistamínicos orales la fototerapia se plantea como alternativa. En el momento actual y dadas sus ventajas se utiliza con más frecuencia el ultravioleta B de banda estrecha (UVB-BE). En este trabajo presentamos los resultados en 10 pacientes con LPG tratados con UVB-BE. Para ello realizamos un estudio prospectivo en el que se incluyeron pacientes adultos afectados de LPG en más del 20% de su superficie corporal. Se obtuvo respuesta completa en 8 de los pacientes (80%) con una tasa de recidiva del 25% (2/8). Estos resultados son similares a la literatura revisada. La fototerapia con UVB-BE es ampliamente utilizada como alternativa a los tratamientos sistémicos en el LPG, sin embargo, existen pocos estudios publicados en la literatura sobre sus resultados

Generalized lichen planus can be difficult to treat. One alternative for patients who do not respond to common topical and systemic treatments, such as corticosteroids and oral antihistamines, is phototherapy. Narrowband UV-B phototherapy offers several advantages and is currently the main treatment modality. In this study, we present the results corresponding to 10 patients with generalized lichen planus treated with narrowband UV-B phototherapy. We performed a prospective study of adult patients with generalized lichen planus affecting more than 20% of their body surface area. A complete response was observed in 8 patients (80%) and the disease recurred in 2 of these (recurrence rate, 25%). These rates are similar to those reported in the literature reviewed. Narrowband UV-B phototherapy is a widely used alternative to systemic treatments in GLP, but there are very few reports of its results in the literatura

Generalized Licen Planus Treated With Narrowband UV-B Phototherapy: Results From 10 Patients and a Review of the Literature. / Liquen plano generalizado tratado con ultravioleta B de banda estrecha: resultados en 10 pacientes y revisión de la literatura.

Generalized lichen planus can be difficult to treat. One alternative for patients who do not respond to common topical and systemic treatments, such as corticosteroids and oral antihistamines, is phototherapy. Narrowband UV-B phototherapy offers several advantages and is currently the main treatment modality. In this study, we present the results corresponding to 10 patients with generalized lichen planus treated with narrowband UV-B phototherapy. We performed a prospective study of adult patients with generalized lichen planus affecting more than 20% of their body surface area. A complete response was observed in 8 patients (80%) and the disease recurred in 2 of these (recurrence rate, 25%). These rates are similar to those reported in the literature reviewed. Narrowband UV-B phototherapy is a widely used alternative to systemic treatments in GLP, but there are very few reports of its results in the literature.

Mohs micrographic surgery in the elderly: comparison of tumours, surgery and first-year follow-up in patients younger and older than 80 years old in REGESMOHS.

BACKGROUND: The elderly population is increasing and more patients in this group undergo Mohs micrographic surgery (MMS). The few publications investigating MMS in elderly people conclude that it is a safe procedure; however, these are single-centre studies without a comparison group. OBJECTIVE: To compare the characteristics of patients, tumours, MMS and 1-year follow-up in patients younger than 80 years, with patients older than 80 years at the time of surgery. METHODS: Data was analysed from REGESMOHS, a prospective cohort study of patients treated with MMS. The participating centres were 19 Spanish hospitals where at least one MMS is performed per week. Data on characteristics of the patient, tumour and surgery were recorded. Follow-up data were collected from two visits; the first within 1 month postsurgery and the second within the first year. RESULTS: From July 2013 to October 2016, 2575 patients that underwent MMS were included in the registry. Of them, 1942 (75.4%) were aged <80 years and 633 (24.6%) were ≥80 years old. In the elderly, the tumour size was significantly higher with a higher proportion of squamous cell carcinoma. Regarding surgery, elderly more commonly had tumours with deeper invasion and required a higher number of Mohs surgery stages, leaving larger defects and requiring more time in the operating room. Despite this, the incidence of postoperative complications was the same in both groups (7%) and there were no significant differences in proportion of relapses in the first-year follow-up. CONCLUSION: The risk of short-term complications and relapses were similar in elderly and younger groups. MMS is a safe procedure in the elderly.

Lesiones cutáneas y deilidad muscular en una niña de 11 años de edad / Skin lesions and muscle weakness in an 11-year-old girl

La dermatomiositis es una miopatia inflamatoria idiopática con unos hallazgos cutáneos característicos. En 1975, Bohan y Peter establecen por primera vez una serie de criterios clínicos para ayudar al diagnóstico y clasificación de la dermatomiositis y la polimiositis. Cuatro de los 5 criterios guardan relación con la afección muscular: la debilidad muscular proximal y simétrica de cintura escapular y pelviana, la elevación de enzimas musculares séricas, los cambios electromiográficos y la biopsia muscular compatible. El quinto criterio es compatible con lesiones cutáneas características. La patogenia de esta enfermedad está poco clara. La dermatomiositis es una enfermedad sistémica que frecuentemente afecta al esófago y los pulmones, siendo menos común la afectación cardiaca. La calcinosis es una complicación que se observa especialmente en niños y adolescentes. La terapia dirigida a la inflamación muscular incluye el uso de corticoterapia sistémica, acompañada o no por otros agentes inmunosupresores. La clínica cutánea se puede tratar con la prohibición de exposición solar, corticoides tópicos, antipalúdicos, metrotexato, micofenolato de mofetil y/o inmunoglobulinas intravenosas

Dermatomyositis is an idiopathic inflammatory myopathy associated with characteristic cutaneous findings. In 1975, Bohan and Peter first suggested a set of criteria to aid in the diagnosis and classification of dermatomyositis and polymyositis. Four of the five criteria are related to the muscle disease, as follows: progressive proximal symmetrical weakness, elevated muscle enzymes, an abnormal finding on electromyogram, and an abnormal finding on the muscle biopsy sample. The fifth criterion was compatibles kin disease. The pathogenesis of the cutaneous disease is poorly understood. Dermatomyositis is a systemic disorder that frequently affects the esophagus and lungs and, less commonly, may affect the heart. Calcinosisis a complication that is observed most often in children or adolescents. Therapy for the muscle component involves the use of corticosteroids with or without an immunosuppressive agent. The skin disease is treated with sun avoidance, sun screens, topical corticosteroids, antimalarial agents, methotrexate, mycophenolate mofetil and/or intravenous immuneglobulin. The prognosis depends on the severity of the myopathy, the presence of a malignancy, and/or the presence of cardiopulmonary involvement