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2.
Actas dermo-sifiliogr. (Ed. impr.) ; 111(6): 487-495, jul.-ago. 2020. tab, ilus, graf
Artigo em Espanhol | IBECS | ID: ibc-199505

RESUMO

ANTECEDENTES Y OBJETIVO: La alopecia frontal fibrosante (AFF) es un tipo de alopecia cicatricial cuya incidencia está en aumento. Detallamos las características demográficas y clínicas, y los tratamientos utilizados en los pacientes con AFF atendidos en la consulta de tricología de un hospital de complejidad intermedia. MATERIAL Y MÉTODO: Se recopilaron de forma retrospectiva los datos de todos los pacientes diagnosticados de AFF atendidos en la consulta de Tricología del Hospital Universitario Infanta Sofía desde mayo de 2016 hasta mayo de 2018. Se evaluó la asociación entre la gravedad, el patrón clínico y la necesidad del tratamiento oral con el resto de las características de los pacientes. RESULTADOS: Se incluyeron un total de 75 pacientes (73 mujeres y 2 varones). El diagnóstico en la mayoría de los casos fue clínico, y se realizó estudio histológico en 13 pacientes (17,3%). La mediana de la edad de inicio del cuadro fue de 61 [12] años. En 70 casos (93,3%) se observó afectación de las cejas y en 7 pacientes (9,6%) se objetivaron signos de liquen orogenital. Asociaban hipotiroidismo 11 casos (14,7%) y en 15 (20,0%) se observaron signos de rosácea. Solo 5 (21,7%) de los pacientes con patrón lineal presentaban retroceso grave. En los pacientes inestables y/o sintomáticos (24 casos) se instauró tratamiento oral (con inhibidores de la 5 alfa reductasa, hidroxicloroquina, corticoides o isotretinoína) o intralesional con corticoides, logrando la estabilización en 18 pacientes (75,0%). Un total de 10 pacientes de los 15 que presentaban signos de rosácea, y 10 de los 20 pacientes que presentaban pápulas faciales precisaron tratamiento sistémico. CONCLUSIÓN: La mayoría de nuestros pacientes son mujeres posmenopáusicas. Hemos encontrado un aumento de la proporción de casos con un liquen orogenital en relación con la población general, y una menor gravedad en los pacientes con un patrón lineal. Se ha objetivado la presencia de pápulas faciales con más frecuencia en pacientes más jóvenes, y una mayor probabilidad de necesitar tratamiento oral en los pacientes con rosácea y con pápulas faciales


BACKGROUND AND OBJECTIVE: Frontal fibrosing alopecia is an increasingly common form of scarring alopecia. The aim of this study was to describe the demographic and clinical characteristics of patients with FFA seen at the trichology unit of a medium-sized regional hospital and to report on treatments used. MATERIAL AND METHOD: We reviewed the medical records of all patients with FFA seen at the trichology unit of Hospital Universitario Infanta Sofía in Madrid, Spain between May 2016 and May 2018. We analyzed associations between disease severity, clinical patterns, need for oral medications, and other characteristics. RESULTS: Seventy-five patients (73 women and 2 men) were studied. Diagnosis was clinical in most cases and 13 cases (17.3%) were confirmed histologically. Median (interquartile range) age at reported onset of symptoms was 61 (12) years. Involvement of the eyebrows was recorded in 70 patients (93.3%) and signs of oral and genital lichen planus in 7 (9.6%). Eleven patients (14.7%) had hypothyroidism and 15 (20.0%) had signs of rosacea. Only 5 of the patients who presented a linear pattern (21.7%) had severe hairline recession. Patients with unstable and/or symptomatic disease (n = 24) were treated with oral medications (5-alpha reductase inhibitors, hydroxychloroquine, corticosteroids, and isotretinoin) or intralesional corticosteroids. Eighteen patients (75.0%) achieved disease stability. Ten of the 15 patients with signs of rosacea and 10 of those with facial papules required systemic treatment. CONCLUSION: Most of the patients in this series of FFA were postmenopausal women. The prevalence of oral and genital lichen planus was higher than that observed in the general population. Patients with a linear pattern had less severe disease. Facial papules were more common in younger patients and both facial papules and rosacea were associated with a greater need for oral treatment


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Alopecia/diagnóstico , Alopecia/terapia , Índice de Gravidade de Doença , Estudos Retrospectivos , Estudos Transversais , Fatores de Risco
4.
Actas Dermosifiliogr (Engl Ed) ; 111(6): 487-495, 2020.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-32417453

RESUMO

BACKGROUND AND OBJECTIVE: Frontal fibrosing alopecia is an increasingly common form of scarring alopecia. The aim of this study was to describe the demographic and clinical characteristics of patients with FFA seen at the trichology unit of a medium-sized regional hospital and to report on treatments used. MATERIAL AND METHOD: We reviewed the medical records of all patients with FFA seen at the trichology unit of Hospital Universitario Infanta Sofía in Madrid, Spain between May 2016 and May 2018. We analyzed associations between disease severity, clinical patterns, need for oral medications, and other characteristics. RESULTS: Seventy-five patients (73 women and 2 men) were studied. Diagnosis was clinical in most cases and 13 cases (17.3%) were confirmed histologically. Median (interquartile range) age at reported onset of symptoms was 61 (12) years. Involvement of the eyebrows was recorded in 70 patients (93.3%) and signs of oral and genital lichen planus in 7 (9.6%). Eleven patients (14.7%) had hypothyroidism and 15 (20.0%) had signs of rosacea. Only 5 of the patients who presented a linear pattern (21.7%) had severe hairline recession. Patients with unstable and/or symptomatic disease (n=24) were treated with oral medications (5-alpha reductase inhibitors, hydroxychloroquine, corticosteroids, and isotretinoin) or intralesional corticosteroids. Eighteen patients (75.0%) achieved disease stability. Ten of the 15 patients with signs of rosacea and 10 of those with facial papules required systemic treatment. CONCLUSION: Most of the patients in this series of FFA were postmenopausal women. The prevalence of oral and genital lichen planus was higher than that observed in the general population. Patients with a linear pattern had less severe disease. Facial papules were more common in younger patients and both facial papules and rosacea were associated with a greater need for oral treatment.


Assuntos
Testa , Líquen Plano , Alopecia/tratamento farmacológico , Feminino , Humanos , Líquen Plano/tratamento farmacológico , Masculino , Estudos Retrospectivos , Espanha
7.
Clin Exp Dermatol ; 42(4): 410-412, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28247530

RESUMO

It is well known that primary systemic amyloidosis [light chain (AL) amyloidosis] is associated with hidden dyscrasia or multiple myeloma. Acquired cutis laxa (cutis laxa acquisita; CLA) has also been described in patients with plasma cell dyscrasias, including multiple myeloma. We report a case in which haemorrhagic oral bullae were the first sign of an undiagnosed primary systemic amyloidosis related to multiple myeloma IgG-λ and previously diagnosed CLA. There is only one report in literature of this rare triple association; however, in that case the patient did not have oral mucosal involvement or bullous amyloidosis.

9.
Actas dermo-sifiliogr. (Ed. impr.) ; 105(3): 263-270, abr. 2014. ilus, tab, mapas
Artigo em Espanhol | IBECS | ID: ibc-121154

RESUMO

En 1936 Covisa y Bejarano publicaron su tratado titulado Elementos de Dermatología. El libro destacaba por su modernidad, al dejar atrás los debates nosológicos que caracterizaban a la Dermatología del siglo anterior, y al agrupar las enfermedades por su etiología y patogenia, apoyándose en los avances científicos y técnicos de la época. Era también el primer texto adaptado a la realidad española, y no una simple adaptación de un texto extranjero. Sin embargo, la Guerra Civil iniciada ese mismo año determinó el futuro de los autores y del propio libro. Covisa y Bejarano tuvieron una intensa participación en la administración sanitaria y universitaria de la Segunda República y se vieron obligados a exiliarse a América. El libro tuvo escasa distribución por librerías en aquel difícil momento, y tampoco se realizarían nuevas ediciones. Nunca sabremos qué habría sucedido de no haber estallado la guerra, pero creemos justo recordar esta importante obra


In 1936, Covisa and Bejarano published a treatise entitled Elementos de Dermatología (The Elements of Dermatology). In this surprisingly modern book they abandoned the nosological debates characteristic of the 19th century and instead classified diseases according to their etiology and pathogenesis based on the scientific and technical advances of the time. Moreover, unlike other books available at the time, which were essentially adaptations of foreign texts, this was the first medical work to reflect the reality of Spanish medicine. However, the future of both the book and its authors was to be determined by the start of the Spanish Civil War in the same year. Covisa and Bejarano, who were both extremely active in the public health system and medical education during the Second Republic, were obliged to seek exile in America. Due to the difficulties of the time, very few copies of the book reached the public and no new editions were ever printed. We will never know what would have happened if the war had not started, but we believe that this important work should be remembered


Assuntos
Humanos , Dermatologia/história , História da Medicina , Livros de Texto como Assunto/história
10.
Actas Dermosifiliogr ; 105(3): 263-70, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24674985

RESUMO

In 1936, Covisa and Bejarano published a treatise entitled Elementos de Dermatología (The Elements of Dermatology). In this surprisingly modern book they abandoned the nosological debates characteristic of the 19th century and instead classified diseases according to their etiology and pathogenesis based on the scientific and technical advances of the time. Moreover, unlike other books available at the time, which were essentially adaptations of foreign texts, this was the first medical work to reflect the reality of Spanish medicine. However, the future of both the book and its authors was to be determined by the start of the Spanish Civil War in the same year. Covisa and Bejarano, who were both extremely active in the public health system and medical education during the Second Republic, were obliged to seek exile in America. Due to the difficulties of the time, very few copies of the book reached the public and no new editions were ever printed. We will never know what would have happened if the war had not started, but we believe that this important work should be remembered.


Assuntos
Dermatologia/história , Editoração/história , História do Século XX , Dermatopatias/história , Espanha
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