RESUMEN
BACKGROUND: Platelet-rich plasma (PRP) has emerged as a promising treatment for androgenetic alopecia (AGA). In spite of the several studies previously reported, to date, a standardized protocol for PRP preparation and application, as well as a standard method for evaluating results has not been established. AIMS: The aim of this study is to propose a standardized method for preparation and application of PRP for male AGA (MAGA) and female AGA (FAGA) and assess its safety and efficacy as a co-adjuvant therapy. MATERIALS AND METHODS: Seventy-eight patients, 19 men and 59 women with AGA Grades II-IV in Ebling's scale, currently on treatment with topical minoxidil and/or oral finasteride for more than a year without improvement, were included in this study. PRP was prepared using a single spin method, and injected in affected areas for 3 monthly sessions, followed by 3 bimonthly sessions. A decrease of at least one grade in Ebling's scale was considered a successful result. RESULTS: After the 6° session, 71.4% of MAGA and 73.4% of FAGA patients reached a successful outcome while 21.4% and 16.3%, respectively, remained without changes. Only 7.1% of MAGA and 10.2% of FAGA presented worsening of their condition. CONCLUSIONS: PRP together with a periodical application protocol can be considered effective as a coadjuvant therapy in patients who no longer respond to pharmacological treatments. Ebling's scale was a practical and reliable parameter to allow a better evaluation in both MAGA and FAGA.
RESUMEN
The coexistence of features of chronic cutaneous lupus erythematosus and scleroderma in the same skin lesions is very infrequent and has only been reported in 3 patients. This exceedingly rare condition has been named "sclerodermiform linear lupus erythematosus." We describe a new case of this dermatosis. Although the cause remains obscure, possible explanations include mosaicism following Blaschko's lines or the transfer of microchimerisms that mount a chronic graft-versus-host-like reaction. We suggest that these features may be a distinct clinicopathologic disorder characterized by an initial lichenoid reaction followed by the production of excessive, abnormal connective tissue.
Asunto(s)
Enfermedades Autoinmunes , Lupus Eritematoso Discoide/complicaciones , Esclerodermia Localizada/complicaciones , Adulto , Humanos , Lupus Eritematoso Discoide/patología , Esclerodermia Localizada/patologíaRESUMEN
En este artículo revisamos los diferentes productos de relleno y los posibles efectos adversos que pueden causar.Los productos de relleno se clasifican en permanentes y no permanentes. A su vez los permanentes se dividen en: gel de polímero homogéneo, suspensiónde microesferas o fragmentos de polímeros insolubles y líquido reabsorbible y suspensión de microesferas de polímero lentamente degradabley líquido reabsorbible. Entre los no permanentes encontramos los geles de colágeno, los de ácido hialurónico, los formados por microesferas dehidroxiapatita cálcica en un gel de carboximetilcelulosa y los formados por una combinación de ácido hialurónico y dextranómeros.La mayoría de los efectos adversos producidos por estas sustancias son leves y transitorios pero también se han descrito efectos graves como reaccionesde hipersensibilidad y presencia de siliconomas en el lugar de inyección y a distancia incluso al cabo de muchos años. Aunque es frecuente encontraruna reacción a cuerpo extraño a nivel histológico no es tan frecuente que se manifieste clínicamente.Para reducir las reacciones adversas es importante realizar estudios a largo plazo de estos productos y que estos procedimientos se realicen en centrosmédicos por especialistas debidamente formados
The different types of filler materials and their side effects are reviewed in this paper.Filler materials are divided in permanent and non permanent products. Three main permanent fillers types exist: a homogenously built polymer gel, asuspension of insoluble polymer fragments or microspheres with reasorbable liquid, and a suspension of slowly degradable polymer microsphereswith resorbable liquid. No permanent fillers include collagen gels, hyaluronic acid gels, calcium hydroxyapatite microespheres suspended in carboxy-methylcellulose gel and dextran beads suspended in hyaluronic acid.Most adverse reactions are mild and transient; however responses of greater significance like hypersensitivity can occur as well as delay appear of silicono-mas in the treated area or migrated to other areas. Foreign body reaction can be expected at the histologic level and, more rarely, at the clinical level.To minimize these reactions testing and long-term follow-up of new products should be required and, these procedures should take place in a medicalsetting by trained specialists