Granuloma anular pseudolinfomatoso: una variante poco conocida / Pseudolymphomatous Granuloma Annulare: A Little-Known Variant

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Respuesta a omalizumab en 3 casos de urticaria solar / Response to Omalizumab in Solar Urticaria: Report of 3 Cases

Se presentan 3 pacientes con urticaria solar que o no habían respondido adecuadamente o presentaban limitaciones a los tratamientos de primera línea (antihistamínicos H1 a dosis altas o fototerapia), que fueron tratados con omalizumab. Dos de ellos mejoraron clínicamente con un aumento muy importante de la tolerancia a la luz, uno de ellos con clara mejoría de la calidad de vida. El otro paciente no mejoró y desarrolló una reacción local leve a la medicación inyectada. Omalizumab puede ser por tanto una alternativa terapéutica potencialmente útil y segura en urticarias solares graves no respondedoras al tratamiento convencional (AU)

We report 3 cases of solar urticaria in which there was no response or limited response to first-line treatments with high-dose H1 antihistamines or phototherapy. The patients were then treated with omalizumab. Symptoms improved in 2 patients, whose tolerance to sunlight increased considerably; quality of life clearly improved for 1 of these patients. The third experienced no improvement and developed a mild local reaction to the injected medication. We conclude that omalizumab may offer a potentially safe, useful alternative for patients with solar urticaria who do not respond to conventional therapy (AU)

Response to Omalizumab in Solar Urticaria: Report of 3 Cases. / Respuesta a omalizumab en 3 casos de urticaria solar.

We report 3 cases of solar urticaria in which there was no response or limited response to first-line treatments with high-dose H1 antihistamines or phototherapy. The patients were then treated with omalizumab. Symptoms improved in 2 patients, whose tolerance to sunlight increased considerably; quality of life clearly improved for 1 of these patients. The third experienced no improvement and developed a mild local reaction to the injected medication. We conclude that omalizumab may offer a potentially safe, useful alternative for patients with solar urticaria who do not respond to conventional therapy.

Comparison of phenotype, comorbidities, therapy and adverse events between psoriatic patients with and without psoriatic arthritis. Biobadaderm registry.

BACKGROUND: There are a limited number of studies comparing psoriasis patients without psoriatic arthritis (PsA) to those with arthritis. Previous results are controversial. OBJECTIVES: To perform a comparative analysis of the phenotype, baseline comorbidities, therapeutic profile and incidence of adverse events (particularly overall adverse events, infections and infestations, malignancies and psychiatric disorders) among psoriatic patients with/without PsA. METHODS: All the patients on the Biobadaderm registry, a prospective inception cohort of psoriasis patients on systemic therapy, were included. Patients were divided into two groups: those with psoriasis without arthritis at the time of entry into the cohort (Pso group) and those with psoriasis and psoriatic arthritis (PsA group) at entry. Patients were followed until the censorship date (last visit in a lost-to-follow-up patient, or 10 November 2015, whichever occurred first). We excluded all the patients who developed any kind of signs and/or symptoms of joint involvement during the follow-up. A descriptive analysis was performed. We estimated incidence ratios (IRR) of adverse events during systemic treatment using a mixed-effects Poisson regression. RESULTS: We included 2120 patients: 1871 (88%) patients with psoriasis without arthritis and 249 (12%) with psoriasis and PsA. The follow-up time was 5020 patients-year in the Pso group and 762 patients-year in the PsA group. Patients with PsA had more comorbidities, particularly hypertension and liver disease; used a higher number of systemic therapies, particularly anti-TNFα drugs and combination therapy; and presented more adverse events (IRR adjusted = 1.29; 95% CI: [1.05-1.58]), particularly serious adverse events (IRR adjusted = 1.51; 95% CI: [1.01-2.26]) and infections/infestations (IRR adjusted = 1.88; 95% CI: [1.27-2.79]), independently of the associated comorbidities and present/past therapies. CONCLUSIONS: Given the differences between patients with psoriasis alone or with psoriasis associated with PsA, patients with psoriasis and PsA should be followed and managed more closely and with specific attention.

¿Cicatriz o tumor? / A scar or a tumor?

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Pioderma gangrenoso tras cirugía de cadera / Pyoderma gangrenosum following a hip surgical procedure

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Uso de terapia de vacío en el Hospital Infantil La Fe de Valencia (España): experiencia y resultados / Experience and results with the use of vacuum assisted therapy at the children’s Hospital La Fe, Valencia (Spain)

El uso de la terapia de vacío en el tratamiento de heridas complejas y de evolución tórpida tiene sus inicios en los años cuarenta. Sin embargo, la experiencia con su utilización en la población infantil es mucho más reciente. En la actualidad no disponemos de estudios científicos contrastados y con nivel de evidencia A para emitir conclusiones firmes en estos casos; a pesar de ello, la experiencia clínica acumulada hasta el momento es satisfactoria en la mayoría de los casos. En la gestión sanitaria moderna, el control de recursos y costes es hoy en día un pilar fundamental; es por ello que contar con una terapia de estas características constituye un recurso de gran valor, sobre todo cuando la intención es minimizar la estancia hospitalaria y a la vez mejorar la calidad de vida del paciente, lo cual es especialmente importante cuando se trata de niños. Presentamos la experiencia en el uso de terapia de vacío en pacientes pediátricos del Servicio de Cirugía Plástica y Reconstructiva del Hospital La Fe de Valencia, España, entre los años 2007 y 2010 (AU)

Vacuum assisted therapy in complex and complicated wounds has been used since the 40s; however, it has only been applied in paediatric patients recently. To our best knowledge there are not A level evidence studies in this field, although experience in its use has been shown to be satisfactory in the majority of cases. Due to the importance in health management of controlling costs and resources, this therapy represents a useful tool, specially when we try to reduce hospital stay and improve quality of life, which is very important in children. We report our experience in the use of vacuum therapy in paediatric patients in the Plastic and Reconstructive Surgery Department in La Fe University Hospital, Valencia, Spain, between 2007 and 2010 (AU)

Experiencia en la utilización del sistema de terapia de presión negativa Renasys® en el Hospital La Fe, Valencia, España / Our experience using negative-pressure therapy Renasys® at the Hospital La Fe, Valencia, Spain

La terapia de vacío ha demostrado ser útil y eficaz en el tratamiento de múltiples tipos de heridas. Su uso está ampliamente difundido en los servicios de Cirugía Plástica y constituye una herramienta a tener en cuenta en el manejo de heridas tanto agudas como crónicas; permitiendo la curación total de las mismas o consiguiendo un lecho adecuado para una cobertura posterior. Presentamos nuestra experiencia con el sistema de terapiade vacío Renasys® (Smith&Nephew, Spain) en el Hospital Universitario La Fe en Valencia (España) a lo largo del último año, demostrando su utilidad en heridas de distinta etiología y características (AU)

Vacumm therapy has shown to be useful and effective in different types of wounds. Its use is common in the Plastic Surgery Departments and it is a very important tool in the acute and chronic wounds management; it achieves the healing of the wounds or it gives an adequate bed for the posterior coverage. We report our experience in the use of vacuum therapy Renasys® (Smith&Nephew, Spain) in the Plastic and Reconstructive Surgery Department in La Fe University Hospital, Valencia (Spain) in the last year, showing the utility of vacuum therapy in different etiology and types of wounds (AU)