Asunto(s)
Hamartoma/congénito , Extremidad Inferior/patología , Músculo Liso/patología , Dolor/etiología , Preescolar , Diagnóstico Diferencial , Hamartoma/diagnóstico , Hamartoma/metabolismo , Humanos , Hiperpigmentación/diagnóstico , Hiperpigmentación/metabolismo , Hiperpigmentación/patología , Masculino , Dolor/diagnóstico , Enfermedades de la Piel/patologíaAsunto(s)
Eosinofilia/patología , Foliculitis/patología , Cuero Cabelludo/patología , Enfermedades Cutáneas Vesiculoampollosas/patología , Enfermedades de la Piel/patología , Antiinfecciosos/administración & dosificación , Antiinfecciosos/uso terapéutico , Dapsona/administración & dosificación , Dapsona/uso terapéutico , Diagnóstico Diferencial , Eosinofilia/inmunología , Foliculitis/inmunología , Glucocorticoides/administración & dosificación , Glucocorticoides/uso terapéutico , Humanos , Lactante , Masculino , Prednisolona/administración & dosificación , Prednisolona/uso terapéutico , Cuero Cabelludo/inmunología , Enfermedades de la Piel/inmunología , Enfermedades Cutáneas Vesiculoampollosas/inmunología , Resultado del TratamientoRESUMEN
Many studies have found that screening and treatment of latent tuberculosis (TB) before starting treatment with tumour necrosis factor (TNF)-a inhibitors reduces associated TB infections. The new T-cell interferon-a release assay (TIGRA), is more specific and sensitive for detection of latent TB compared with the tuberculin skin test (TST). We report results of TIGRA in our first 63 patients commencing TNF-a inhibitors for severe psoriasis. Of the 63 patients, 5 (7.9%) had a positive TIGRA result and were started on treatment for latent TB. We found that the only risk factor for TB associated with a positive TIGRA was a history of travel to countries with high TB incidence. To our knowledge, this is the first study to identify the background risk (7.9%) of latent TB in an endemic UK population. This result emphasizes the importance of TIGRA testing to reduce the risk of TB in patients treated with TNF-a inhibitor.
Asunto(s)
Interferón-alfa/análisis , Tuberculosis Latente/diagnóstico , Psoriasis/tratamiento farmacológico , Linfocitos T/inmunología , Factor de Necrosis Tumoral alfa/antagonistas & inhibidores , Adolescente , Adulto , Anciano , Femenino , Humanos , Inmunosupresores/efectos adversos , Interferón-alfa/metabolismo , Tuberculosis Latente/inmunología , Masculino , Tamizaje Masivo/métodos , Persona de Mediana Edad , Mycobacterium tuberculosis , Psoriasis/inmunología , Factores de Riesgo , Índice de Severidad de la Enfermedad , Viaje , Prueba de Tuberculina/métodos , Reino Unido , Adulto JovenRESUMEN
Giant congenital melanocytic naevi remain a challenge to clinicians and histopathologists with respect to observation for malignant change and interpretation of histology findings, respectively. We report a 5-year-old boy with a giant bathing trunk naevus who, after multiple previous skin biopsies, developed lymphadenopathy. Biopsy from the lymph nodes demonstrated collections of naevomelanocytes within the lymph node. Interpretation of these findings and subsequent management is discussed.
Asunto(s)
Nevo Pigmentado/patología , Neoplasias Cutáneas/patología , Transformación Celular Neoplásica , Preescolar , Humanos , Metástasis Linfática/patología , Masculino , Nevo Pigmentado/congénito , Neoplasias Cutáneas/congénitoAsunto(s)
Anticuerpos Monoclonales/uso terapéutico , Ciclosporina/uso terapéutico , Fármacos Dermatológicos/uso terapéutico , Inmunosupresores/uso terapéutico , Psoriasis/tratamiento farmacológico , Proteínas Recombinantes de Fusión , Anciano , Basiliximab , Quimioterapia Combinada , Humanos , MasculinoRESUMEN
Myrmecia are viral warts that result from the coalescence of plantar or palmar warts into large plaques. Treatment of these warts involves physical or chemical destruction of the verrucae, potent keratolytics or immunotherapy. Imiquimod 5% cream is a novel topical immunomodulator that has been used successfully in the treatment of genital and common warts. We report its successful use in a 35-year-old immunocompetent man who had had resistant plantar warts for 15 years.
