RESUMEN
Kaposi's sarcoma (KS) is an angioproliferative disorder caused by human herpesvirus 8 (HHV-8). Current research efforts have focused on the study of the relative role of KSHV-encoded genes in Kaposi's sarcomagenesis in order to identify novel mechanism-based therapies for patients suffering from this tumor. Although several viral genes have potential for KS pathogenesis, compelling data point to the KSHV-encoded G protein-coupled receptor (vGPCR) as a leading candidate viral gene for the initiation of KS. Interestingly, the oncogenic potential of vGPCR seems to correlate with its capacity to activate the mammalian target of rapamycin (mTOR) signaling pathway. Rapamycin, the prototypical inhibitor of the mTOR signaling pathway, has recently emerged as an effective treatment for KS when administered orally. In this case report, we present an immunocompetent patient with KS lesions treated with topical rapamycin achieving clinical and histologic healing after 16 weeks of treatment. The topical application of rapamycin could be a novel therapeutic option for the treatment of KS.
Asunto(s)
Antibióticos Antineoplásicos/uso terapéutico , Sarcoma de Kaposi/tratamiento farmacológico , Sirolimus/uso terapéutico , Neoplasias Cutáneas/tratamiento farmacológico , Administración Cutánea , Anciano , Antibióticos Antineoplásicos/administración & dosificación , Antibióticos Antineoplásicos/farmacología , Humanos , Masculino , Sarcoma de Kaposi/patología , Sirolimus/administración & dosificación , Sirolimus/farmacología , Neoplasias Cutáneas/patología , Resultado del TratamientoAsunto(s)
Vesícula/virología , Dermatosis de la Mano/virología , Herpes Simple/diagnóstico , Herpes Simple/tratamiento farmacológico , Aciclovir/análogos & derivados , Aciclovir/uso terapéutico , Adulto , Antivirales/uso terapéutico , Vesícula/diagnóstico , Vesícula/tratamiento farmacológico , Diagnóstico Diferencial , Femenino , Dermatosis de la Mano/diagnóstico , Dermatosis de la Mano/tratamiento farmacológico , Humanos , Profármacos/uso terapéutico , Reacción en Cadena en Tiempo Real de la Polimerasa , Recurrencia , Valaciclovir , Valina/análogos & derivados , Valina/uso terapéuticoRESUMEN
BACKGROUND: Necrobiosis lipoidica presents with a distinctive appearance making it an important clinical diagnosis. OBJECTIVE: To describe a case of necrobiosis lipoidica in a patient with type 1 diabetes mellitus, and to discuss differential diagnoses and management. DISCUSSION: Necrobiosis lipoidica is most commonly found on the shins, presenting as a well-defined plaque. Management is challenging and options are discussed. Avoiding ulceration is a key concern.
Asunto(s)
Diabetes Mellitus Tipo 1/complicaciones , Inmunosupresores/uso terapéutico , Necrobiosis Lipoidea/diagnóstico , Necrobiosis Lipoidea/tratamiento farmacológico , Tacrolimus/uso terapéutico , Adulto , Diagnóstico Diferencial , Femenino , Humanos , Úlcera de la Pierna/etiología , Úlcera de la Pierna/prevención & control , Necrobiosis Lipoidea/complicaciones , Factores de RiesgoRESUMEN
BACKGROUND: To our knowledge, there are no large multicenter studies concerning frontal fibrosing alopecia (FFA) that could give clues about its pathogenesis and best treatment. OBJECTIVE: We sought to describe the epidemiology, comorbidities, clinical presentation, diagnostic findings, and therapeutic choices in a large series of patients with FFA. METHODS: This retrospective multicenter study included patients given the diagnosis of FFA. Clinical severity was classified based on the recession of the frontotemporal hairline. RESULTS: In all, 355 patients (343 women [49 premenopausal] and 12 men) with a mean age of 61 years (range 23-86) were included. Early menopause was detected in 49 patients (14%), whereas 46 (13%) had undergone hysterectomy. Severe FFA was observed in 131 patients (37%). Independent factors associated with severe FFA after multivariate analysis were: eyelash loss, facial papules, and body hair involvement. Eyebrow loss as the initial clinical presentation was associated with mild forms. Antiandrogens such as finasteride and dutasteride were used in 111 patients (31%), with improvement in 52 (47%) and stabilization in 59 (53%). LIMITATIONS: The retrospective design is a limitation. CONCLUSIONS: Eyelash loss, facial papules, and body hair involvement were associated with severe FFA. Antiandrogens were the most useful treatment.
Asunto(s)
Alopecia/tratamiento farmacológico , Alopecia/patología , Azaesteroides/uso terapéutico , Finasterida/uso terapéutico , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Alopecia/epidemiología , Biopsia con Aguja , Estudios de Cohortes , Dutasterida , Femenino , Fibrosis/epidemiología , Fibrosis/patología , Frente , Humanos , Inmunohistoquímica , Masculino , Persona de Mediana Edad , Análisis Multivariante , Posmenopausia/fisiología , Estudios Retrospectivos , Medición de Riesgo , Índice de Severidad de la Enfermedad , Distribución por Sexo , España/epidemiología , Resultado del Tratamiento , Adulto JovenRESUMEN
No disponible
Asunto(s)
Humanos , Femenino , Adolescente , Enfermedades Cutáneas Vesiculoampollosas/diagnóstico , Microsporum/aislamiento & purificación , Dermatomicosis/diagnóstico , Tiña/diagnóstico , Factores de RiesgoAsunto(s)
Dermatomicosis/diagnóstico , Dermatosis de la Mano/diagnóstico , Microsporum , Enfermedades Cutáneas Vesiculoampollosas/diagnóstico , Adolescente , Dermatomicosis/complicaciones , Femenino , Dermatosis de la Mano/microbiología , Humanos , Enfermedades Cutáneas Vesiculoampollosas/microbiologíaRESUMEN
Glomovenous malformations are disseminated variants of cutaneous glomus tumors. These malformations are subdivided into regional or localized, disseminated, and congenital plaque-like forms. The congenital plaque-like form is the rarest variant. Most treatment modalities have been disappointing in the treatment of large glomangiomas, leading to high recurrence rates. We report a case of a 34-year-old man with a congenital plaque-like glomangioma on his left arm and forearm treated successfully with sequential pulsed-dye neodymium yttrium aluminum garnet laser.
Asunto(s)
Tumor Glómico , Terapia por Láser/métodos , Neoplasias Cutáneas , Adulto , Tumor Glómico/congénito , Tumor Glómico/patología , Tumor Glómico/cirugía , Humanos , Masculino , Neoplasias Cutáneas/congénito , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/cirugíaRESUMEN
A female, aged 17 years and with a history of anorexia nervosa, presented with a 3 month history of a large, irregular area of hair loss over the pubis. Physical examination revealed scattered short hairs of varying length, follicular hyperkeratosis and hyperpigmentation throughout the area of alopecia (Figure 1a). A magnified view revealed decreased hair density, broken hairs with different shaft lengths, short vellous hairs and signs of recent haemorrhage (Figure 1b). The remainder of the hairs appeared normal, and her nails did not show any pathological changes. The hair-pull test was negative. Potassium hydroxide (KOH) examination and fungal culture were negative. Biochemical studies, abdominal X-ray and ultrasonography were normal.
Asunto(s)
Alopecia/diagnóstico , Sínfisis Pubiana , Tricotilomanía/diagnóstico , Adolescente , Terapia Cognitivo-Conductual , Diagnóstico Diferencial , Femenino , Humanos , Tricotilomanía/terapiaRESUMEN
Azathioprine (AZA) is an imidazole derivative of mercaptopurine. It antagonizes purine metabolism, and it may inhibit synthesis of DNA, RNA, and proteins. The 6-thioguanine nucleotides appear to mediate the majority of AZAs immunosuppressive and toxic effects. While cutaneous adverse side-effects are not uncommon, perforating dermatosis has not been reported in association to AZA. We speculate that immunological disorders induced by AZA in susceptible individuals could be related to perforating dermatosis.
RESUMEN
The management of venous malformation (VM) located on genitalia is complex and challenging. Surgical excision and sclerotherapy are the first-lines therapeutic options, but in certain areas such as the genitalia can be too aggressive. We present a case of VM on the glans penis treated successfully with dual wavelength 595 and 1064 nm laser system.
Asunto(s)
Láseres de Colorantes/uso terapéutico , Láseres de Estado Sólido/uso terapéutico , Enfermedades del Pene/terapia , Pene/irrigación sanguínea , Enfermedades Cutáneas Vasculares/terapia , Malformaciones Vasculares/terapia , Adolescente , Antibacterianos/uso terapéutico , Antiinflamatorios/uso terapéutico , Ácido Fusídico/uso terapéutico , Humanos , Masculino , Prednisolona/uso terapéuticoAsunto(s)
Ciclosporina/efectos adversos , Dermatosis Facial/inducido químicamente , Trasplante de Corazón , Inmunosupresores/efectos adversos , Complicaciones Posoperatorias/inducido químicamente , Glándulas Sebáceas/patología , Ciclosporina/administración & dosificación , Ciclosporina/uso terapéutico , Humanos , Hiperplasia , Inmunosupresores/administración & dosificación , Inmunosupresores/uso terapéutico , Masculino , Persona de Mediana EdadAsunto(s)
Anticuerpos Monoclonales/efectos adversos , Pestañas/efectos de los fármacos , Enfermedades del Cabello/inducido químicamente , Adenocarcinoma/tratamiento farmacológico , Adenocarcinoma/secundario , Adenocarcinoma/cirugía , Anticuerpos Monoclonales/administración & dosificación , Anticuerpos Monoclonales/farmacología , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Camptotecina/administración & dosificación , Camptotecina/análogos & derivados , Neoplasias Colorrectales/tratamiento farmacológico , Neoplasias Colorrectales/cirugía , Receptores ErbB/antagonistas & inhibidores , Receptores ErbB/fisiología , Pestañas/crecimiento & desarrollo , Femenino , Fluorouracilo/administración & dosificación , Humanos , Leucovorina/administración & dosificación , Neoplasias Hepáticas/tratamiento farmacológico , Neoplasias Hepáticas/secundario , Neoplasias Hepáticas/cirugía , Persona de Mediana Edad , Terapia Neoadyuvante , Proteínas de Neoplasias/antagonistas & inhibidores , PanitumumabAsunto(s)
Degeneración del Disco Intervertebral/diagnóstico , Desplazamiento del Disco Intervertebral/diagnóstico , Parestesia/diagnóstico , Prurito/etiología , Vértebras Torácicas/patología , Anciano , Enfermedad Crónica , Diagnóstico Diferencial , Femenino , Humanos , Imagen por Resonancia Magnética , Parestesia/complicaciones , Parestesia/terapiaAsunto(s)
Errores Diagnósticos , Infiltración Neutrófila , Piodermia Gangrenosa/diagnóstico , Infección de la Herida Quirúrgica/diagnóstico , Antibacterianos/uso terapéutico , Fracturas Óseas/cirugía , Ingle/patología , Ingle/cirugía , Humanos , Leucocitosis/etiología , Masculino , Persona de Mediana Edad , Prednisona/uso terapéutico , Piodermia Gangrenosa/tratamiento farmacológico , Piodermia Gangrenosa/patología , Dehiscencia de la Herida Operatoria , Tórax/patología , Lesiones de CodoRESUMEN
A congenital smooth muscle hamartoma is a rare, benign proliferation of smooth muscle bundles in the dermis that is usually diagnosed in the neonatal period or infancy. Surgical excision is the first-line therapeutic option, but in certain areas such as the face, surgery may be too aggressive, and different treatments should be considered. We present the case of a congenital smooth muscle hamartoma on the face treated using pulsed dye laser with good response.