RESUMO
No disponible
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Dermatopatias Vesiculobolhosas/etiologia , Coma/complicaçõesRESUMO
BACKGROUND: Promoter methylation of tumour suppressor genes (TSGs) has recently been implicated in the pathogenesis of several types of cancer. Regarding melanoma, over 100 genes that contribute to its pathogenesis have been identified to be aberrantly hypermethylated. OBJECTIVES: This is a retrospective observational study that aims to analyse the prevalence of CpG island methylation in a series of primary melanomas, to identify the associations with the main clinicopathological features, and to explore the prognostic significance of methylation in melanoma survival. MATERIALS AND METHODS: DNA methylation was analysed using methylation-specific multiplex ligation-dependent probe amplification in a series of 170 melanoma formalin-fixed paraffin-embedded tumour samples. The relationship between the methylation status, known somatic mutations and clinicopathological features was evaluated. Disease-free survival (DFS) and overall survival (OS) were displayed by the Kaplan-Meier method. RESULTS: In the entire cohort, one or more genes were detected to be methylated in 55% of the patients. The most prevalent methylated genes were RARB 31%, PTEN 24%, APC 16%, CDH13 16%, ESR1 14%, CDKN2A 6% and RASSF1 5%. An association between aberrant methylation and aggressive clinicopathological features was observed (older age, increased Breslow thickness, presence of mitosis and ulceration, fast-growing melanomas, advancing stage and TERT mutations). Furthermore, Kaplan-Meier survival analysis showed a correlation of methylation and poorer DFS and OS. CONCLUSIONS: Aberrant methylation of TSGs is a frequent event in melanoma. It is associated with aggressive clinicopathological features and poorer survival. Epigenetic alterations may represent a significant prognostic marker with utility in routine practice.
Assuntos
Metilação de DNA , Epigênese Genética , Regulação Neoplásica da Expressão Gênica , Melanoma/genética , Neoplasias Cutâneas/genética , Adulto , Idoso , Ilhas de CpG/genética , Intervalo Livre de Doença , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Melanoma/mortalidade , Melanoma/patologia , Pessoa de Meia-Idade , Mutação , Prognóstico , Regiões Promotoras Genéticas/genética , Estudos Retrospectivos , Pele/patologia , Neoplasias Cutâneas/mortalidade , Neoplasias Cutâneas/patologiaRESUMO
No disponible
Assuntos
Humanos , Psoríase/terapia , Superfície Corporal , Terapia Biológica/instrumentação , Terapia Biológica/métodos , Terapia Biológica , Metotrexato/uso terapêutico , Polimorfismo Genético , Polimorfismo Genético/imunologia , Artrite Psoriásica/epidemiologia , Artrite Psoriásica/prevenção & controle , Imuno-Histoquímica/métodos , Imuno-Histoquímica , Prostatite/tratamento farmacológico , Receptores do Fator de Necrose Tumoral/uso terapêuticoRESUMO
No disponible
Assuntos
Humanos , Masculino , Idoso , Anticarcinógenos/administração & dosagem , Anticarcinógenos/efeitos adversos , Anticarcinógenos/uso terapêutico , Psoríase/diagnóstico , Psoríase/imunologia , Psoríase/terapia , Farmacopeias como Assunto , Preparações Farmacêuticas/administração & dosagem , Preparações Farmacêuticas/análise , Preparações FarmacêuticasRESUMO
INTRODUCCIÓN Y OBJETIVOS: La enfermedad injerto contra huésped (EICH) crónica cutánea es una complicación frecuente tras un trasplante de progenitores hematopoyéticos. La fototerapia es una modalidad terapéutica para pacientes con afectación cutánea o para aquellos que precisan altas dosis de corticoesteroides (CE). El objetivo de este estudio es revisar los casos tratados en nuestro servicio y hacer una revisión de la literatura. MATERIAL Y MÉTODOS: Recogida de datos de manera retrospectiva de todos los casos tratados desde marzo de 2011 a octubre de 2014 en el Servicio de Dermatología del Hospital Universitario y Politécnico la Fe de Valencia. RESULTADOS: Recogimos un total de 16 pacientes, 10 tratados con PUVA y 6 con UVB-BE. Nueve pacientes obtuvieron una respuesta completa y 7 una respuesta parcial, aunque 2 recidivaron tras el tratamiento. Diez pacientes pudieron disminuir la dosis de CE durante el tratamiento y 3 pudieron disminuir el número de otros inmunosupresores. No se presentaron efectos adversos graves. CONCLUSIONES: La fototerapia es una buena opción terapéutica para pacientes con EICH crónica con gran afectación cutánea, para aquellos que no responden al tratamiento tópico o para pacientes corticodependientes. Su mayor beneficio es el de ser un tratamiento dirigido a la piel que permite ahorrar CE y que presenta un buen perfil de seguridad. La pauta de tratamiento se realiza de manera individualizada y, según nuestra experiencia, con dosis iniciales y dosis máximas por sesión menores que para otras enfermedades
INTRODUCTION AND OBJECTIVES: Cutaneous chronic graft-vs-host disease (GVHD) is a common complication of hematopoietic stem cell transplantation. Phototherapy is a therapeutic option for patients with skin involvement and for those who require high doses of corticosteroids. We analyze the cases treated in our department and review the literature. MATERIAL AND METHODS: All patients with GVHD treated with phototherapy in the dermatology department of Hospital Universitario y Politécnico la Fe in Valencia, Spain between March 2011 and October 2014 were identified. Data were gathered retrospectively. RESULTS: There were 16 patients: 10 treated with psoralen-UV-A and 6 with narrowband-UV-B. Complete response was achieved in 9 patients and partial response in 7; 2 patients with partial responses relapsed after treatment. Ten patients were able to decrease their dose of corticosteroids during treatment, and a further 3 decreased the number of other immunosuppressant drugs. No serious adverse effects occurred. CONCLUSIONS: Phototherapy is a good therapeutic option for patients with chronic GVHD with extensive cutaneous involvement, as well as for those who fail to respond to topical treatment or who have become steroid-dependent. The main benefits are that, as the treatment targets the skin, it reduces corticosteroid requirements and has a good safety profile. Treatment must be individualized and, in our experience, both the initial dose and the maximum dose per session can be lower than for other diseases
Assuntos
Feminino , Humanos , Masculino , Doença Enxerto-Hospedeiro/classificação , Doença Enxerto-Hospedeiro/diagnóstico , Doença Enxerto-Hospedeiro/terapia , Corticosteroides/uso terapêutico , Terapia PUVA/instrumentação , Terapia PUVA/métodos , Terapia PUVA , Fototerapia/tendências , Fototerapia , Estudos Retrospectivos , Células Progenitoras de Granulócitos e Macrófagos/patologia , RecidivaRESUMO
INTRODUCTION AND OBJECTIVES: Cutaneous chronic graft-vs-host disease (GVHD) is a common complication of hematopoietic stem cell transplantation. Phototherapy is a therapeutic option for patients with skin involvement and for those who require high doses of corticosteroids. We analyze the cases treated in our department and review the literature. MATERIAL AND METHODS: All patients with GVHD treated with phototherapy in the dermatology department of Hospital Universitario y Politécnico la Fe in Valencia, Spain between March 2011 and October 2014 were identified. Data were gathered retrospectively. RESULTS: There were 16 patients: 10 treated with psoralen-UV-A and 6 with narrowband-UV-B. Complete response was achieved in 9 patients and partial response in 7; 2 patients with partial responses relapsed after treatment. Ten patients were able to decrease their dose of corticosteroids during treatment, and a further 3 decreased the number of other immunosuppressant drugs. No serious adverse effects occurred. CONCLUSIONS: Phototherapy is a good therapeutic option for patients with chronic GVHD with extensive cutaneous involvement, as well as for those who fail to respond to topical treatment or who have become steroid-dependent. The main benefits are that, as the treatment targets the skin, it reduces corticosteroid requirements and has a good safety profile. Treatment must be individualized and, in our experience, both the initial dose and the maximum dose per session can be lower than for other diseases.
Assuntos
Doença Enxerto-Hospedeiro/tratamento farmacológico , Doença Enxerto-Hospedeiro/radioterapia , Terapia PUVA , Terapia Ultravioleta , Corticosteroides/uso terapêutico , Adulto , Idoso , Aloenxertos , Pré-Escolar , Doença Crônica , Terapia Combinada , Feminino , Ficusina/efeitos adversos , Ficusina/uso terapêutico , Doença Enxerto-Hospedeiro/etiologia , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Terapia PUVA/efeitos adversos , Fármacos Fotossensibilizantes/efeitos adversos , Fármacos Fotossensibilizantes/uso terapêutico , Recidiva , Estudos Retrospectivos , Terapia Ultravioleta/efeitos adversosRESUMO
With this case report we want to emphasize the importance of performing a thorough physical examination of the burn and detailed review of the patient's history. This is a challenging case because it deals with an uncommon disease nowadays, pellagra, which presents lesions with an appearance very similar to burns; on the other hand the management of pellagra is different to the management of the common burns we are used to handling day-to-day. With this case report we will be able to revise the broad list of different injuries that can bring up an issue related to a correct diagnosis, caused by a large diversity of different etiologies with cutaneous expression. We will look over the diagnostic process of pellagra, management, treatment and results in this patient.
Assuntos
Queimaduras/diagnóstico , Pelagra/diagnóstico , Diagnóstico Diferencial , Pessoas Mal Alojadas , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
No disponible
Assuntos
Humanos , Masculino , Adulto Jovem , Eritema/etiologia , Poder Calorífico/efeitos adversos , ComputadoresRESUMO
La sarna noruega es una forma particular de sarna mucho más frecuente en pacientes inmunodeprimidos que en la población general. Se caracteriza por la gran cantidad de parásitos que albergan las lesiones, motivo por el cual es altamente contagiosa y difícil de tratar. Presentamos el caso de una paciente VIH con sarna noruega, que respondió muy bien al tratamiento oral con ivermectina en dosis única, junto con la aplicación tópica de queratolíticos. Describimos las características clínicas de esta forma de sarna, discutimos el uso de ivermectina en el tratamiento de la sarna y destacamos su utilidad en casos de sarna noruega (AU)
Assuntos
Adulto , Feminino , Humanos , Infestações por Ácaros/complicações , Infestações por Ácaros/tratamento farmacológico , Ivermectina/uso terapêutico , Escabiose/tratamento farmacológico , Ceratose/complicações , Ceratose/tratamento farmacológico , Ceratolíticos/administração & dosagem , Ceratolíticos/uso terapêutico , Dermatoses da Mão/complicações , Dermatoses da Mão/fisiopatologia , Dermatopatias/complicações , Dermatopatias/tratamento farmacológicoRESUMO
Kaposi's sarcoma is frequently associated to other primary neoplasias, especially those arising from mononuclear-phagocytic system. A case of Kaposi's sarcoma associated to Hodgkin's disease is presented.
Assuntos
Doença de Hodgkin/complicações , Sarcoma de Kaposi/complicações , Neoplasias Cutâneas/complicações , Adulto , Suscetibilidade a Doenças , Feminino , Doença de Hodgkin/diagnóstico , Doença de Hodgkin/imunologia , Humanos , Sarcoma de Kaposi/imunologia , Neoplasias Cutâneas/imunologiaRESUMO
We present a 45 years old male with dermatomyositis refractory to eight months of standard treatment who responded to plasma exchange. The efficacy of the procedure is estimated from clinical follow-up (increase in strength) and serum creatine-kinase activity (decrease from 3,380 to 44 u/ml.) after five sessions of plasma exchange. The therapeutic indications for PE are reviewed in dermatological diseases with emphasis on cases where the response to steroids or cytotoxic drugs is inadequate.