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1.
J Am Acad Dermatol ; 86(1): 104-112, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34416294

RESUMO

BACKGROUND: The heterogeneous course of moderate-to-severe atopic dermatitis necessitates treatment flexibility. OBJECTIVE: We evaluated the maintenance of abrocitinib-induced response with continuous abrocitinib treatment, dose reduction or withdrawal, and response to treatment reintroduction following flare (JAK1 Atopic Dermatitis Efficacy and Safety [JADE] REGIMEN: National Clinical Trial 03627767). METHODS: Patients with moderate-to-severe atopic dermatitis responding to open-label abrocitinib 200 mg monotherapy for 12 weeks were randomly assigned in a 1:1:1 ratio to blinded abrocitinib (200 or 100 mg) or placebo for 40 weeks. Patients experiencing flare received rescue treatment (abrocitinib 200 mg plus topical therapy). RESULTS: Of 1233 patients, 798 responders to induction (64.7%) were randomly assigned. The flare probability during maintenance was 18.9%, 42.6%, and 80.9% with abrocitinib 200 mg, abrocitinib 100 mg, and placebo, respectively. Among patients with flare in the abrocitinib 200 mg, abrocitinib 100 mg, and placebo groups, 36.6%, 58.8%, and 81.6% regained investigator global assessment 0/1 response, respectively, and 55.0%, 74.5%, and 91.8% regained eczema area and severity index response, respectively, with rescue treatment. During maintenance, 63.2% and 54.0% of patients receiving abrocitinib 200 and 100 mg, respectively, experienced adverse events. LIMITATIONS: The definition of protocol-defined flare was not established, limiting the generalizability of findings. CONCLUSION: Induction treatment with abrocitinib was effective; most responders continuing abrocitinib did not flare. Rescue treatment with abrocitinib plus topical therapy effectively recaptured response.


Assuntos
Dermatite Atópica , Dermatite Atópica/tratamento farmacológico , Método Duplo-Cego , Humanos , Janus Quinase 1 , Pirimidinas , Retratamento , Índice de Gravidade de Doença , Sulfonamidas , Resultado do Tratamento
2.
Dermatol Online J ; 26(10)2020 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-33147662

RESUMO

Pseudoatrophoderma colli is a rare entity described in the same time period as confluent and reticular papillomatosis of Gougerot-Carteaud and the two conditions have certain similarities. Pseudoatrophoderma colli is clinically characterized by lesions with an atrophic and wrinkled appearance, which are mainly located on the trunk and neck (hence the name colli). Few references exist in the literature and most of them are very old. Histopathological findings are nonspecific, showing mild hyperkeratosis, thinning of the stratum granulosum, and acanthosis and papillomatosis in some areas. In the papillary dermis there is vascular dilatation with a sparse inflammatory lymphohistiocytic perivascular infiltrate. Fragmentation of elastic tissue has been described only in one case. There is no specific treatment, with variable responses to diverse therapies including ultraviolet light, vitamin A, lactic acid and minocycline. We describe in detail two patients with pseudoatrophoderma colli and show histology. The first patient was treated with minocycline 100mg per day for two months and the second patient was treated with lymecycline 600mg per day for three months and 300mg per day for another two months. Both patients demonstrated a good response within the first month of treatment.


Assuntos
Dermatopatias/patologia , Pele/patologia , Adulto , Biópsia , Feminino , Humanos , Papiloma/patologia
3.
Stem Cell Res Ther ; 10(1): 249, 2019 08 09.
Artigo em Inglês | MEDLINE | ID: mdl-31399041

RESUMO

BACKGROUND: The generation of functional human epidermal melanocytes (HEM) from stem cells provides an unprecedented source for cell-based therapy in vitiligo. Despite the important efforts exerted to obtain melanin-producing cells from stem cells, pre-clinical results still lack the safety and scalability characteristics essential for their translational application. METHODS: Here, we report a rapid and efficient protocol based on defined culture conditions capable of differentiating adult adipose-derived stem cells (ADSC) to scalable amounts of proliferative melanocyte precursors (PreMel) within 30 days. PreMel were characterized in vitro through qPCR, Western blot, flow cytometry, biochemical assays, and in vivo assays in immunocompromised mice (NOD.Cg-Prkdcscid Il2rgtm1Wjl/SzJ, or NSG). RESULTS: After 30 days of differentiation, the stem cell-derived PreMel were defined as CD105neg CD73low according to immunophenotypic changes in comparison with parental stem cell markers. In addition, expression of microphthalmia-associated transcription factor (MITF), active tyrosinase (TYR), and the terminal differentiation-involved premelanosome protein (PMEL) were detected. Furthermore, PreMel had the potential to synthesize melanin and package it into melanosomes both in vitro and in vivo in NSG mice skin. CONCLUSIONS: This study proposes a rapid and scalable protocol for the generation of proliferative melanocyte precursors (PreMel) from ADSC. These PreMel display the essential functional characteristics of bona fide HEM, opening a new path for an autologous cellular therapy for vitiligo patients.


Assuntos
Tecido Adiposo/citologia , Diferenciação Celular , Melanócitos/metabolismo , 5'-Nucleotidase/metabolismo , Adolescente , Adulto , Animais , Linhagem da Célula , Endoglina/metabolismo , Feminino , Humanos , Melaninas/metabolismo , Melanócitos/citologia , Melanócitos/transplante , Camundongos , Camundongos Endogâmicos NOD , Fator de Transcrição Associado à Microftalmia/metabolismo , Pessoa de Meia-Idade , Monofenol Mono-Oxigenase/metabolismo , Pele/patologia , Células-Tronco/citologia , Células-Tronco/metabolismo , Vitiligo/patologia , Vitiligo/terapia , Adulto Jovem , Antígeno gp100 de Melanoma/metabolismo
4.
Medwave ; 16(10): e6598, 2016 Nov 09.
Artigo em Espanhol, Inglês | MEDLINE | ID: mdl-27922587

RESUMO

Tineas are frequent infections caused by dermatophytes that are able to invade keratinized tissue, causing rounded, erythematous, scaly lesions. Nonetheless, in tinea incognito the lesions are modified because of inappropriate use of topical corticosteroids or calcineurin inhibitors, making it difficult to diagnose. We present a case of a 12-year-old male child that presents with erythematous lesions on the right eyebrow, which at first was diagnosed as a contact dermatitis, so corticosteroids were indicated. The lesions became more inflammatory and a fungus culture was requested, which was positive for Tricophyton mentagrophytes. The conclusion of this report is that tineas can mimic other dermatologic conditions therefore caution should be taken when prescribing topical corticosteroids or calcineurin inhibitors without diagnostic certainty because if lesions are caused by tinea, diagnosis and treatment may become more difficult.


Las tiñas son infecciones frecuentes causadas por dermatofitos, capaces de invadir tejido queratinizado, produciendo placas anulares, eritematosas y descamativas. Sin embargo, en la tiña incógnita esta clínica es modificada por el uso inapropiado de corticoides o inhibidores de calcineurina tópicos, dificultando su diagnóstico. Presentamos el caso de un paciente masculino de 12 años, con lesiones eritematosas localizadas en la región ciliar derecha. Se interpretó como una dermatitis de contacto y se indicaron corticoides tópicos, pero evolucionó con lesiones más inflamatorias. Se obtuvo un cultivo de hongos positivo para Tricophyton mentagrophytes. De este reporte se concluye que las tiñas pueden imitar otras condiciones dermatológicas. Por ende, se debe tener precaución al indicar corticoides o inhibidores de calcineurina tópicos sin una certeza diagnóstica. Ello, debido a que en el caso de corresponder a una tiña, se alteran las características clínicas, dificultando el diagnóstico y manejo.


Assuntos
Dermatomicoses/diagnóstico , Tinha/diagnóstico , Trichophyton/isolamento & purificação , Criança , Dermatomicoses/patologia , Humanos , Masculino , Tinha/patologia
5.
Rev Latinoam Microbiol ; 48(1): 14-6, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-17357569

RESUMO

In the last decade, a significant increase in the antimicrobial resistance of clinical specimens of Propionibacterium acnes to first line antibiotics used for acne treatment, has been informed in Europe and in the USA. No information about strains isolated from Latin-American countries is available. The antimicrobial susceptibility of 53 strains of P. acnes isolated from skin specimens of inflammatory acne patients, at the clinical Hospital University of Chile was tested. All isolates were susceptible to penicillin, minocycline, and nadifloxacin. Erythromycin and clindamycin resistance was found in 3.8 and 1.9% isolates respectively. Resistance to lymecycline was observed in one isolate, which was intermediate to tetracycline and doxycycline.


Assuntos
Acne Vulgar/microbiologia , Resistência a Medicamentos , Infecções por Bactérias Gram-Positivas/microbiologia , Propionibacterium acnes/efeitos dos fármacos , Antibacterianos/classificação , Antibacterianos/farmacologia , Farmacorresistência Bacteriana Múltipla , Humanos , Propionibacterium acnes/isolamento & purificação
6.
Rev Med Chil ; 133(3): 302-6, 2005 Mar.
Artigo em Espanhol | MEDLINE | ID: mdl-15880184

RESUMO

BACKGROUND: Genital herpes, a sexually transmitted disease caused by herpes simplex virus type 2 (HSV-2), is found in 3.8% of all sexually transmitted diseases (STD) in Chile. AIM: To determine the seroprevalence of herpes simplex virus type 2 (HSV-2) and to identify an association between HSV-2 and HIV-1, other STD, and to study its demographic characteristics. MATERIAL AND METHODS: A cross-sectional study at two STD public clinics in Santiago was conducted among 200 consecutive patients. Samples were tested for HSV-2, HIV-1, syphilis and hepatitis B virus surface antigen. RESULTS: The seroprevalence for HSV-2 was 43%. Four patients had a history of genital herpes. There was a strong association between HSV-2 infection and HIV-1 positivity (OR=8.7, 95% CI 3.4-22.4, p <0.001) and the condition of being a sexual worker (OR=4.5, 95% CI 1.7-11.9, p <0.01). CONCLUSIONS: The high association with HIV-1 and sexual workers, emphasizes the need of having HSV-2 specific diagnostic tests, counseling on sign and symptom recognition and taking preventive measures.


Assuntos
Herpes Genital/epidemiologia , Herpesvirus Humano 2 , Adolescente , Adulto , Idoso , Chile/epidemiologia , Métodos Epidemiológicos , Feminino , Soropositividade para HIV/diagnóstico , Soropositividade para HIV/virologia , HIV-1 , Herpes Genital/virologia , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Sífilis/diagnóstico
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