RESUMEN
Hidradenitis suppurativa (HS) is a chronic inflammatory entity characterized by the appearance of multiple nodules, abscesses, and fistulas, predominantly in apocrine regions. In addition to its dermatological involvement, it is associated with multiple systemic comorbidities. Its treatment is combined: topical pharmacological, systemic pharmacological and surgical. Regarding biologic or small molecule drugs, currently only adalimumab is approved. A narrative review of the literature on biological or small molecule drugs used in the treatment of hidradenitis suppurativa is presented. The arsenal we found is large, with multiple targets: inhibitors of tumor necrosis factor alpha (TNF-alpha), interleukin (IL)-17, IL-23, IL-1, inhibitors of the janus kinase (JAK) pathway, and multiple other drugs in study. New prospective studies and comparative trials are needed to analyze the effectiveness and safety of these treatments, in an entity with a promising future (AU)
La hidradenitis supurativa (HS) es una entidad inflamatoria crónica caracterizada por la aparición de múltiples nódulos, abscesos y fístulas, de predominio en regiones apocrinas. Además de su afectación dermatológica, se asocia a múltiples comorbilidades sistémicas. Su tratamiento es combinado: farmacológico tópico, farmacológico sistémico y quirúrgico. En cuanto a los medicamentos biológicos o de molécula pequeña, actualmente solo se encuentra aprobado adalimumab. En este artículo, se presenta una revisión narrativa de la literatura sobre fármacos biológicos o de molécula pequeña utilizados en el tratamiento de la hidradenitis supurativa. El arsenal que encontramos es numeroso, con múltiples dianas: inhibidores del factor de necrosis tumoral alfa (TNF-alfa), interleucina (IL)-17, IL-23, IL-1, inhibidores de la vía Janus kinasa (JAK) u otros múltiples fármacos en estudio. Son necesarios nuevos estudios prospectivos y ensayos comparativos que analicen la eficacia y seguridad de estos tratamientos, en una entidad con un futuro prometedor (AU)
Asunto(s)
Humanos , Productos Biológicos/uso terapéutico , Factores Biológicos/uso terapéutico , Hidradenitis Supurativa/tratamiento farmacológicoRESUMEN
La hidradenitis supurativa (HS) es una entidad inflamatoria crónica caracterizada por la aparición de múltiples nódulos, abscesos y fístulas, de predominio en regiones apocrinas. Además de su afectación dermatológica, se asocia a múltiples comorbilidades sistémicas. Su tratamiento es combinado: farmacológico tópico, farmacológico sistémico y quirúrgico. En cuanto a los medicamentos biológicos o de molécula pequeña, actualmente solo se encuentra aprobado adalimumab. En este artículo, se presenta una revisión narrativa de la literatura sobre fármacos biológicos o de molécula pequeña utilizados en el tratamiento de la hidradenitis supurativa. El arsenal que encontramos es numeroso, con múltiples dianas: inhibidores del factor de necrosis tumoral alfa (TNF-alfa), interleucina (IL)-17, IL-23, IL-1, inhibidores de la vía Janus kinasa (JAK) u otros múltiples fármacos en estudio. Son necesarios nuevos estudios prospectivos y ensayos comparativos que analicen la eficacia y seguridad de estos tratamientos, en una entidad con un futuro prometedor (AU)
Hidradenitis suppurativa (HS) is a chronic inflammatory entity characterized by the appearance of multiple nodules, abscesses, and fistulas, predominantly in apocrine regions. In addition to its dermatological involvement, it is associated with multiple systemic comorbidities. Its treatment is combined: topical pharmacological, systemic pharmacological and surgical. Regarding biologic or small molecule drugs, currently only adalimumab is approved. A narrative review of the literature on biological or small molecule drugs used in the treatment of hidradenitis suppurativa is presented. The arsenal we found is large, with multiple targets: inhibitors of tumor necrosis factor alpha (TNF-alpha), interleukin (IL)-17, IL-23, IL-1, inhibitors of the janus kinase (JAK) pathway, and multiple other drugs in study. New prospective studies and comparative trials are needed to analyze the effectiveness and safety of these treatments, in an entity with a promising future (AU)
Asunto(s)
Humanos , Productos Biológicos/uso terapéutico , Factores Biológicos/uso terapéutico , Hidradenitis Supurativa/tratamiento farmacológicoRESUMEN
Hidradenitis suppurativa (HS) is a chronic inflammatory entity characterized by the appearance of multiple nodules, abscesses, and fistulas, predominantly in apocrine regions. In addition to its dermatological involvement, it is associated with multiple systemic comorbidities. Its treatment is combined: topical pharmacological, systemic pharmacological and surgical. Regarding biologic or small molecule drugs, currently only adalimumab is approved. A narrative review of the literature on biological or small molecule drugs used in the treatment of hidradenitis suppurativa is presented. The arsenal we found is large, with multiple targets: inhibitors of tumor necrosis factor alpha (TNF-alpha), interleukin (IL)-17, IL-23, IL-1, inhibitors of the janus kinase (JAK) pathway, and multiple other drugs in study. New prospective studies and comparative trials are needed to analyze the effectiveness and safety of these treatments, in an entity with a promising future.
Asunto(s)
Productos Biológicos , Hidradenitis Supurativa , Humanos , Hidradenitis Supurativa/tratamiento farmacológico , Hidradenitis Supurativa/complicaciones , Estudios Prospectivos , Adalimumab/uso terapéutico , Factor de Necrosis Tumoral alfa , Productos Biológicos/farmacología , Productos Biológicos/uso terapéuticoRESUMEN
Hidradenitis suppurativa (HS) is a chronic inflammatory entity characterized by the appearance of multiple nodules, abscesses, and fistulas, predominantly in apocrine regions. In addition to its dermatological involvement, it is associated with multiple systemic comorbidities. Its treatment is combined: topical pharmacological, systemic pharmacological and surgical. Regarding biologic or small molecule drugs, currently only adalimumab is approved. A narrative review of the literature on biological or small molecule drugs used in the treatment of hidradenitis suppurativa is presented. The arsenal we found is large, with multiple targets: inhibitors of tumor necrosis factor alpha (TNF-alpha), interleukin (IL)-17, IL-23, IL-1, inhibitors of the janus kinase (JAK) pathway, and multiple other drugs in study. New prospective studies and comparative trials are needed to analyze the effectiveness and safety of these treatments, in an entity with a promising future.
Asunto(s)
Productos Biológicos , Hidradenitis Supurativa , Humanos , Hidradenitis Supurativa/tratamiento farmacológico , Hidradenitis Supurativa/complicaciones , Estudios Prospectivos , Adalimumab/uso terapéutico , Factor de Necrosis Tumoral alfa , Productos Biológicos/farmacología , Productos Biológicos/uso terapéuticoRESUMEN
Objetivo: Los pacientes diagnosticados de cáncer queratinocítico (carcinoma basocelular y carcinoma epidermoide cutáneo) o cáncer cutáneo no melanoma (CCNM) tienen un riesgo aumentado de desarrollar una segunda neoplasia cutánea. Nuestro objetivo es describir la frecuencia, tasa de incidencia y factores de riesgo predisponentes para desarrollar una segunda neoplasia cutánea en una cohorte de pacientes tratados mediante cirugía micrográfica de Mohs (CMM). Material y métodos: Estudio prospectivo de una cohorte nacional de pacientes incluidos para realización de CMM para tratar CCNM en 22 centros españoles (julio 2013-febrero 2020) REGESMOHS. Las variables analizadas incluyen las características demográficas, la frecuencia de aparición de segundas neoplasias cutáneas, sus tasas de incidencia y factores de riesgo, y se estimaron utilizando un modelo de regresión logístico multivariante de efectos mixtos. Resultados: Fueron intervenidos 4.768 pacientes: 4.397 (92%) carcinomas basocelulares, y 371 (8%) carcinomas epidermoides. El tiempo medio de seguimiento fue de 2,4 años. Se diagnosticó un nuevo tumor durante el seguimiento en 1.201 pacientes (25%); 1.013 (21%) fueron carcinomas basocelulares, 154 (3%) carcinomas epidermoides cutáneos, 20 melanomas (0,4%) La tasa de incidencia fue de 107 (101-113) por 1.000 personas/año para cualquier tumor; 90 (85-96) para el carcinoma basocelular, 14 (12-16) para el carcinoma epidermoide cutáneo y 2 (1-3) para el melanoma. El riesgo de nueva neoplasia fue mayor en varones que en mujeres 738 (61%) vs. 463 (39%). Los factores de riesgo más significativos fueron la historia de múltiples tumores previos al diagnóstico (RR: 4,6; IC 95%: 2,9-7,1); la inmunosupresión (RR: 2,1; IC 95%: 1,4-3,1) y paciente varón (RR: 1,6; IC 95%: 1,4-1,9) (AU)
Objective: Patients with nonmelanoma skin cancer (NMSC)ie, basal cell carcinoma (BCC) or squamous cell carcinoma (SCC)have an increased risk of developing a second skin cancer. The aim of this study was to describe the frequency, incidence per 1000 person-years, and predictors of a second skin cancer in a cohort of patients with NMSC treated with Mohs micrographic surgery (MMS). Material and methods: Prospective study of a national cohort of patients with NMSC who underwent MMS at 22 Spanish hospitals between July 2013 and February 2020; case data were recorded in the REGESMOHS registry. The study variables included demographic characteristics, frequency and incidence per 1000 person-years of second skin cancers diagnosed during the study period, and risk factors identified using mixed-effects logistic regression. Results: We analyzed data for 4768 patients who underwent MMS; 4397 (92%) had BCC and 371 (8%) had SCC. Mean follow-up was 2.4 years. Overall, 1201 patients (25%) developed a second skin cancer during follow-up; 1013 of the tumors were BCCs (21%), 154 were SCCs (3%), and 20 were melanomas (0.4%). The incidence was 107 per 1000 person-years (95% CI, 101-113) for any cancer, 90 per 1000 person-years (95% CI, 85-96) for BCC, 14 (95% CI, 12-16) per 1000 person-years for SCC, and 2 (95% CI, 1-3) per 1000 person-years for melanoma. More men than women developed a subsequent skin cancer (738 [61%] vs 463 [39%]). The main risk factors were a history of multiple tumors before diagnosis (relative risk [RR], 4.6; 95% CI, 2.9-7.1), immunosuppression (RR, 2.1; 95% CI, 1.4-3.1), and male sex (RR, 1.6; 95% CI, 1.4-1.9). Conclusion: Patients have an increased risk of developing a second tumor after MMS treatment of NMSC. Risk factors are a history of multiple tumors at diagnosis, immunosuppression, and male sex (AU)
Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Neoplasias Cutáneas/epidemiología , Carcinoma Basocelular/epidemiología , Carcinoma de Células Escamosas/epidemiología , Cirugía de Mohs , Neoplasias Primarias Secundarias/epidemiología , Neoplasias Cutáneas/cirugía , Carcinoma Basocelular/cirugía , Carcinoma de Células Escamosas/cirugía , Estudios Prospectivos , Estudios de Cohortes , Factores de Riesgo , Incidencia , España/epidemiologíaRESUMEN
Objective: Patients with nonmelanoma skin cancer (NMSC)ie, basal cell carcinoma (BCC) or squamous cell carcinoma (SCC)have an increased risk of developing a second skin cancer. The aim of this study was to describe the frequency, incidence per 1000 person-years, and predictors of a second skin cancer in a cohort of patients with NMSC treated with Mohs micrographic surgery (MMS). Material and methods: Prospective study of a national cohort of patients with NMSC who underwent MMS at 22 Spanish hospitals between July 2013 and February 2020; case data were recorded in the REGESMOHS registry. The study variables included demographic characteristics, frequency and incidence per 1000 person-years of second skin cancers diagnosed during the study period, and risk factors identified using mixed-effects logistic regression. Results: We analyzed data for 4768 patients who underwent MMS; 4397 (92%) had BCC and 371 (8%) had SCC. Mean follow-up was 2.4 years. Overall, 1201 patients (25%) developed a second skin cancer during follow-up; 1013 of the tumors were BCCs (21%), 154 were SCCs (3%), and 20 were melanomas (0.4%). The incidence was 107 per 1000 person-years (95% CI, 101-113) for any cancer, 90 per 1000 person-years (95% CI, 85-96) for BCC, 14 (95% CI, 12-16) per 1000 person-years for SCC, and 2 (95% CI, 1-3) per 1000 person-years for melanoma. More men than women developed a subsequent skin cancer (738 [61%] vs 463 [39%]). The main risk factors were a history of multiple tumors before diagnosis (relative risk [RR], 4.6; 95% CI, 2.9-7.1), immunosuppression (RR, 2.1; 95% CI, 1.4-3.1), and male sex (RR, 1.6; 95% CI, 1.4-1.9). Conclusion: Patients have an increased risk of developing a second tumor after MMS treatment of NMSC. Risk factors are a history of multiple tumors at diagnosis, immunosuppression, and male sex (AU)
Objetivo: Los pacientes diagnosticados de cáncer queratinocítico (carcinoma basocelular y carcinoma epidermoide cutáneo) o cáncer cutáneo no melanoma (CCNM) tienen un riesgo aumentado de desarrollar una segunda neoplasia cutánea. Nuestro objetivo es describir la frecuencia, tasa de incidencia y factores de riesgo predisponentes para desarrollar una segunda neoplasia cutánea en una cohorte de pacientes tratados mediante cirugía micrográfica de Mohs (CMM). Material y métodos: Estudio prospectivo de una cohorte nacional de pacientes incluidos para realización de CMM para tratar CCNM en 22 centros españoles (julio 2013-febrero 2020) REGESMOHS. Las variables analizadas incluyen las características demográficas, la frecuencia de aparición de segundas neoplasias cutáneas, sus tasas de incidencia y factores de riesgo, y se estimaron utilizando un modelo de regresión logístico multivariante de efectos mixtos. Resultados: Fueron intervenidos 4.768 pacientes: 4.397 (92%) carcinomas basocelulares, y 371 (8%) carcinomas epidermoides. El tiempo medio de seguimiento fue de 2,4 años. Se diagnosticó un nuevo tumor durante el seguimiento en 1.201 pacientes (25%); 1.013 (21%) fueron carcinomas basocelulares, 154 (3%) carcinomas epidermoides cutáneos, 20 melanomas (0,4%) La tasa de incidencia fue de 107 (101-113) por 1.000 personas/año para cualquier tumor; 90 (85-96) para el carcinoma basocelular, 14 (12-16) para el carcinoma epidermoide cutáneo y 2 (1-3) para el melanoma. El riesgo de nueva neoplasia fue mayor en varones que en mujeres 738 (61%) vs. 463 (39%). Los factores de riesgo más significativos fueron la historia de múltiples tumores previos al diagnóstico (RR: 4,6; IC 95%: 2,9-7,1); la inmunosupresión (RR: 2,1; IC 95%: 1,4-3,1) y paciente varón (RR: 1,6; IC 95%: 1,4-1,9) (AU)
Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Neoplasias Cutáneas/epidemiología , Carcinoma Basocelular/epidemiología , Carcinoma de Células Escamosas/epidemiología , Cirugía de Mohs , Neoplasias Primarias Secundarias/epidemiología , Neoplasias Cutáneas/cirugía , Carcinoma Basocelular/cirugía , Carcinoma de Células Escamosas/cirugía , Estudios Prospectivos , Estudios de Cohortes , Factores de Riesgo , Incidencia , España/epidemiologíaRESUMEN
OBJECTIVE: Patients with nonmelanoma skin cancer (NMSC)-ie, basal cell carcinoma (BCC) or squamous cell carcinoma (SCC)-have an increased risk of developing a second skin cancer. The aim of this study was to describe the frequency, incidence per 1000 person-years, and predictors of a second skin cancer in a cohort of patients with NMSC treated with Mohs micrographic surgery (MMS). MATERIAL AND METHODS: Prospective study of a national cohort of patients with NMSC who underwent MMS at 22 Spanish hospitals between July 2013 and February 2020; case data were recorded in the REGESMOHS registry. The study variables included demographic characteristics, frequency and incidence per 1000 person-years of second skin cancers diagnosed during the study period, and risk factors identified using mixed-effects logistic regression. RESULTS: We analyzed data for 4768 patients who underwent MMS; 4397 (92%) had BCC and 371 (8%) had SCC. Mean follow-up was 2.4 years. Overall, 1201 patients (25%) developed a second skin cancer during follow-up; 1013 of the tumors were BCCs (21%), 154 were SCCs (3%), and 20 were melanomas (0.4%). The incidence was 107 per 1000 person-years (95% CI, 101-113) for any cancer, 90 per 1000 person-years (95% CI, 85-96) for BCC, 14 (95% CI, 12-16) per 1000 person-years for SCC, and 2 (95% CI, 1-3) per 1000 person-years for melanoma. More men than women developed a subsequent skin cancer (738 [61%] vs 463 [39%]). The main risk factors were a history of multiple tumors before diagnosis (relative risk [RR], 4.6; 95% CI, 2.9-7.1), immunosuppression (RR, 2.1; 95% CI, 1.4-3.1), and male sex (RR, 1.6; 95% CI, 1.4-1.9). CONCLUSION: Patients have an increased risk of developing a second tumor after MMS treatment of NMSC. Risk factors are a history of multiple tumors at diagnosis, immunosuppression, and male sex.
Asunto(s)
Carcinoma Basocelular , Carcinoma de Células Escamosas , Melanoma , Neoplasias Basocelulares , Neoplasias Cutáneas , Carcinoma Basocelular/epidemiología , Carcinoma Basocelular/patología , Carcinoma Basocelular/cirugía , Carcinoma de Células Escamosas/epidemiología , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/cirugía , Estudios de Cohortes , Femenino , Humanos , Masculino , Melanoma/complicaciones , Cirugía de Mohs , Estudios Prospectivos , Factores de Riesgo , Neoplasias Cutáneas/epidemiología , Neoplasias Cutáneas/etiología , Neoplasias Cutáneas/cirugíaRESUMEN
No disponible
Asunto(s)
Humanos , Trasplante , Dermatología/métodos , Terapia de Inmunosupresión , Factores de Riesgo , Diagnóstico Precoz , Calidad de la Atención de SaludRESUMEN
No disponible
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Foliculitis/inducido químicamente , Foliculitis/diagnóstico , Exantema/inducido químicamente , Sobreinfección/complicaciones , Infecciones Bacterianas/complicaciones , Cuero Cabelludo/patología , Exantema/complicaciones , Clorhidrato de Erlotinib/administración & dosificación , Clorhidrato de Erlotinib/efectos adversos , Staphylococcus aureus/aislamiento & purificaciónRESUMEN
Eosinophilic folliculitis (EF) is an idiopathic dermatitis included in the spectrum of eosinophilic pustular follicular reactions. Demodex folliculorum has been implicated as contributing to the pathogenesis of human immunodeficiency virus-associated EF, but it has not been described outside this context. We present an immunocompetent 65-year-old white man with a 5-year history of recurrent pruritic erythematous and oedematous lesions on his face, neck and scalp. Histopathologically, an eosinophilic microabcess with Demodex folliculorum mite within a pilosebaceous follicle was seen, and considered the causal agent. There were also accumulations of eosinophil granules on collagen bundles, and flame figure formations in the dermis. We believe that 'eosinophilic follicular reaction' is an appropriate term to describe this case of EF induced by D. folliculorum and thus distinguish it from the idiopathic form of EF. Moreover, this case suggests that D. folliculorum can sometimes induce an eosinophilic immune reaction.
Asunto(s)
Eosinofilia/etiología , Foliculitis/etiología , Infestaciones por Ácaros/patología , Anciano , Humanos , MasculinoRESUMEN
No disponible
Asunto(s)
Humanos , Melanoma/patología , Estadificación de Neoplasias/métodos , Diagnóstico Diferencial , Estudios de Seguimiento , Selección de Paciente , Factores de Riesgo , Biomarcadores de Tumor/análisisRESUMEN
No disponible
Asunto(s)
Humanos , Femenino , Anciano de 80 o más Años , Eritema/diagnóstico , Leishmaniasis Cutánea/diagnóstico , Cara , CuelloAsunto(s)
Eritema/diagnóstico , Dermatosis Facial/diagnóstico , Leishmaniasis Cutánea/diagnóstico , Dermatosis del Cuero Cabelludo/diagnóstico , Anciano de 80 o más Años , Anticuerpos Antiprotozoarios/sangre , Antiprotozoarios/uso terapéutico , Eritema/tratamiento farmacológico , Eritema/parasitología , Eritema/patología , Dermatosis Facial/tratamiento farmacológico , Dermatosis Facial/parasitología , Dermatosis Facial/patología , Reacciones Falso Negativas , Femenino , Humanos , Cuerpos de Inclusión/parasitología , Leishmania infantum/inmunología , Leishmaniasis Cutánea/tratamiento farmacológico , Leishmaniasis Cutánea/parasitología , Leishmaniasis Cutánea/patología , Meglumina/uso terapéutico , Antimoniato de Meglumina , Compuestos Organometálicos/uso terapéutico , Dermatosis del Cuero Cabelludo/tratamiento farmacológico , Dermatosis del Cuero Cabelludo/parasitología , Dermatosis del Cuero Cabelludo/patología , Coloración y EtiquetadoRESUMEN
No disponible