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Celulite (Flegmão) , Isotretinoína/uso terapêutico , Dermatoses do Couro Cabeludo , Dermatopatias Genéticas , Adolescente , Adulto , Biópsia , Celulite (Flegmão)/diagnóstico , Celulite (Flegmão)/epidemiologia , Celulite (Flegmão)/terapia , Fármacos Dermatológicos/uso terapêutico , Feminino , Saúde Global , Humanos , Masculino , Pessoa de Meia-Idade , Morbidade/tendências , Estudos Multicêntricos como Assunto , Estudos Retrospectivos , Couro Cabeludo , Dermatoses do Couro Cabeludo/diagnóstico , Dermatoses do Couro Cabeludo/epidemiologia , Dermatoses do Couro Cabeludo/terapia , Dermatopatias Genéticas/diagnóstico , Dermatopatias Genéticas/epidemiologia , Dermatopatias Genéticas/terapia , Espanha/epidemiologia , Adulto JovemAssuntos
Inibidores de 5-alfa Redutase/efeitos adversos , Alopecia/tratamento farmacológico , Dutasterida/efeitos adversos , Disfunção Erétil/induzido quimicamente , Finasterida/efeitos adversos , Inibidores de 5-alfa Redutase/uso terapêutico , Dutasterida/uso terapêutico , Finasterida/uso terapêutico , Humanos , Resistência à Insulina , Libido , Masculino , Osteoporose/induzido quimicamente , Hiperplasia Prostática/tratamento farmacológico , Neoplasias da Próstata/prevenção & controleAssuntos
Erupção por Droga/etiologia , Metotrexato/efeitos adversos , Pele/patologia , Adulto , Erupção por Droga/diagnóstico , Humanos , Imunossupressores/administração & dosagem , Imunossupressores/efeitos adversos , Injeções Subcutâneas , Masculino , Metotrexato/administração & dosagem , Psoríase/tratamento farmacológico , Pele/efeitos dos fármacosAssuntos
Neoplasias Ósseas/secundário , Dermatomiosite/diagnóstico , Glucocorticoides/uso terapêutico , Interferon-alfa/uso terapêutico , Melanoma/patologia , Metilprednisolona/uso terapêutico , Neoplasias Cutâneas/patologia , Dermatomiosite/tratamento farmacológico , Dermatomiosite/patologia , Feminino , Humanos , Interferon alfa-2 , Melanoma/tratamento farmacológico , Pessoa de Meia-Idade , Prognóstico , Proteínas Recombinantes/uso terapêutico , Neoplasias Cutâneas/tratamento farmacológico , Resultado do TratamentoRESUMO
BACKGROUND: Alopecia areata (AA) occurs with the apparition of asyntomatic non inflamatory alopecia plaques without scars. We distinguish several variants which are divided into two groups: typical forms (AA in single or multiple plaques) and atypical forms (by its presentation, evolution or paradoxical regrowth). OBJETIVES AND METHODS: We describe the cases of AA treated in our Trichology Unit between January 2000 and December 2011. RESULTS: We obtained 488 cases of AA. 114 (23.36%) were unusual form of AA or had paradoxical regrowth. The most common unusual form of AA was sisaipho type (7.37%), followed by AA for black and blonde hair (5.32%), atypical diffuse forms (4.30%), androgenetic alopecia type and (3.89%) and AA rectangular occipital (0.68%). Furthermore, we found nine cases of paradoxical regrowth (1.84%). CONCLUSIONS: Atypical variants of AA in our series are less than 25% of all cases, although it should be noted that since it is a specialized unit, we may be making a selection bias to be more difficult to diagnose cases or poor outcome.
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Alopecia em Áreas/classificação , Adulto , Alopecia em Áreas/diagnóstico , Dermoscopia/métodos , Diagnóstico Diferencial , Feminino , Seguimentos , Cabelo/crescimento & desenvolvimento , Humanos , Masculino , Prognóstico , Estudos Retrospectivos , Índice de Gravidade de DoençaRESUMO
A Lipschütz ulcer or 'ulcus vulvae acutum' is an acute simple ulceration of the vulva or vagina of non-venereal origin which can be associated with lymphadenopathy. Three cases are described with accompanying clinical photographs. Two cases refer to adolescents, one an infant, all without any history of sexual contact. The cases serve to illustrate a little known but potentially important differential diagnosis of vulval ulceration.
Assuntos
Úlcera Cutânea/patologia , Doenças da Vulva/patologia , Adolescente , Antibacterianos/uso terapêutico , Feminino , Ácido Fusídico/uso terapêutico , Humanos , Lactente , Úlcera Cutânea/tratamento farmacológico , Cremes, Espumas e Géis Vaginais , Doenças da Vulva/tratamento farmacológicoRESUMO
OBJECTIVES: The aim of this study was to test the efficacy of latanoprost in eyelash alopecia areata (AA). DESIGN: This study is a 2-year prospective, non-blinded, non-randomized, bilateral eyelash alopecia controlled study. SETTING: The setting of this study was Trichology Unit, Virgen Macarena University Hospital, Seville, Spain. PATIENTS: We conducted a survey of 54 subjects with AA universalis treated with the protocol of the Trichology Unit of our Department. Control group comprised 10 subjects who received injections of 0.5 mg/cm(2) of triamcinolone acetonide (TAC) in their eyebrows and 1 mg/cm(2) of TAC injections in affected scalp. The treatment group included 44 subjects who received the same treatment as the control group in scalp and eyebrows but they also applied a drop of latanoprost 0.005% (50 microg/mL) ophthalmic solution in their eyelid margins every night. Subjects were reviewed every 3 months for 2 years. RESULTS: Forty subjects finished the study and four subjects were lost to follow-up. In the treatment arm of this study, the course was well tolerated and uncomplicated. Both investigators and patients evaluated the regrowth. The results we obtained were: complete regrowth in 17.5%, moderate regrowth in 27.5%, slight regrowth in 30% and without response in 25%. Moderate and total regrowth constituted a cosmetically acceptable response. The therapy was continuous and the response remained without any side effects. No patients had cosmetically acceptable eyelash regrowth in the control group. CONCLUSIONS: Latanoprost may be an effective drug in the treatment of eyelash AA because it induces acceptable responses (total and moderate) in 45% of the patients. A formal, blinded prospective unilateral controlled study will permit further understanding about this promising therapeutic agent for eyelash AA.
Assuntos
Alopecia em Áreas/tratamento farmacológico , Fármacos Dermatológicos/administração & dosagem , Pestanas/efeitos dos fármacos , Pestanas/crescimento & desenvolvimento , Prostaglandinas F Sintéticas/administração & dosagem , Adolescente , Adulto , Criança , Fármacos Dermatológicos/efeitos adversos , Cor de Olho , Feminino , Seguimentos , Humanos , Latanoprosta , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Prostaglandinas F Sintéticas/efeitos adversos , Resultado do Tratamento , Adulto JovemRESUMO
Introducción y objetivos. La psoriasis es una enfermedad inflamatoria cutánea de naturaleza inmunológica mediada por citoquinas de tipo Th1. El tratamiento con anticuerpos anti-factor de necrosis tumoral α (TNF-α) (infliximab) ha proporcionado respuestas clínicas significativas; sin embargo, los mecanismos implicadosen la curación no están bien aclarados. El objetivo del presente trabajo es evaluar las variaciones de la histología y en la expresión de marcadores de proliferación y apoptosis, en biopsias cutáneas secuenciales de pacientes con psoriasis tratados con in fliximab. Material y métodos. Se estudiaron biopsias de piel (sana y lesionada) de 3 pacientes afectados de psoriasis generalizada moderada-grave (índice de área y gravedad de la soriasis [PASI]: 35 de media) tratados con infusiones por vía intravenosa de infliximab (5 mg/kg) en las semanas 0, 2 y 6. Las biopsias se realizaron en los días 0, 14 y 28, y fueron procesadas para estudio histológico convencional e inmunohistoquímico con marcadores de apoptosisTP53, BCL-2 y anticaspasas 3 y 8 y de proliferación celular Ki67. Resultados. El tratamiento con infliximab se asoció con una significativa mejoría clínica en los 3 pacientes (PASI medio: 21,6 a los 14 días y 13,9 a las 6 semanas), que se correlacionó con la desaparición progresiva de las lesiones histológicas, con disminución de la proliferación epidérmica. Sin embargo, no observamos imágenes de apoptosis ni obtuvimos positividad con los anticuerpos anticaspasas. La expresión de TP53 disminuyó a las2 semanas del inicio del tratamiento, siendo similar a la piel normal a los 28 días. Conclusiones. La respuesta clínica e histológica de la psoriasis con infliximab no se asoció a un incremento significativo en los marcadores de apoptosis evaluados (AU)
Background and objectives. Psoriasis is an inflammatory skin disease of immunologic nature that is mediated by T-helper-1 cytokines. Clinical response to treatment with antitumor necrosis factor (TNF) α antibodies (infliximab) has been significant; however, the mechanisms for clearance of lesions have not been elucidated. The aim of the present study was to assess variations in the histology and expression of proliferation and apoptotic markers in sequential skin biopsies of patients with psoriasis treated with infliximab. Material and methods. We studied skin biopsies (of lesioned and healthy skin) from 3 patients with extensive moderate-to-severe psoriasis (mean psoriasis area and severity index [PASI] score, 35) treated with intravenous infliximab infusions (5 mg/kg) at weeks 0, 2, and 6. Biopsies were taken on days 0, 14, and 28, and were processed for conventional histological and immunohistochemical study. The apoptotic markers used were TP53, B-cell lymphoma 2 protein, anticaspase 3, and anticaspase 8. The cell proliferation marker used was Ki67. Results. Treatment with infliximab was associated with a significant clinical improvement in 3 patients (mean PASI score, 21.6 at 14 days and 13.9 at 6 weeks), which correlated with the progressive disappearance of histological lesions with a decrease in epidermal proliferation. However, apoptosis was not observed, and the samples tested negative for anticaspase antibodies. Expression of TP53 decreased 2 weeks after starting treatment, and was similar to that in normal skin at 28 days. Conclusions. Clinical and histological response of psoriasis to infliximab was not associated with a significant increase in the apoptotic markers assessed (AU)
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Humanos , Anticorpos Monoclonais/farmacocinética , Psoríase/tratamento farmacológico , Fatores de Necrose Tumoral/antagonistas & inibidores , Biomarcadores/análise , Fator de Indução de Apoptose/análise , Caspases/antagonistas & inibidores , Genes p53RESUMO
BACKGROUND AND OBJECTIVES: Psoriasis is an inflammatory skin disease of immunologic nature that is mediated by T-helper-1 cytokines. Clinical response to treatment with antitumor necrosis factor (TNF) alpha antibodies (infliximab) has been significant; however, the mechanisms for clearance of lesions have not been elucidated. The aim of the present study was to assess variations in the histology and expression of proliferation and apoptotic markers in sequential skin biopsies of patients with psoriasis treated with infliximab. MATERIAL AND METHODS: We studied skin biopsies (of lesioned and healthy skin) from 3 patients with extensive moderate-to-severe psoriasis (mean psoriasis area and severity index [PASI] score, 35) treated with intravenous infliximab infusions (5 mg/kg) at weeks 0, 2, and 6. Biopsies were taken on days 0, 14, and 28, and were processed for conventional histological and immunohistochemical study. The apoptotic markers used were TP53, B-cell lymphoma 2 protein, anticaspase 3, and anticaspase 8. The cell proliferation marker used was Ki67. RESULTS: Treatment with infliximab was associated with a significant clinical improvement in 3 patients (mean PASI score, 21.6 at 14 days and 13.9 at 6 weeks), which correlated with the progressive disappearance of histological lesions with a decrease in epidermal proliferation. However, apoptosis was not observed, and the samples tested negative for anticaspase antibodies. Expression of TP53 decreased 2 weeks after starting treatment, and was similar to that in normal skin at 28 days. CONCLUSIONS: Clinical and histological response of psoriasis to infliximab was not associated with a significant increase in the apoptotic markers assessed.
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Anticorpos Monoclonais/uso terapêutico , Apoptose/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Psoríase/tratamento farmacológico , Psoríase/patologia , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Adulto , Biomarcadores/análise , Feminino , Humanos , Imuno-Histoquímica , Infliximab , Masculino , Pessoa de Meia-Idade , Psoríase/imunologiaRESUMO
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Masculino , Pessoa de Meia-Idade , Humanos , Hemangiossarcoma/patologia , Couro Cabeludo/patologia , Neoplasias Cutâneas/patologia , Neoplasias Induzidas por Radiação/patologiaRESUMO
INTRODUCTION: Phototherapy is effective for mycosis fungoides. Narrow band UVB (UVB1) therapy is being used as an alternative to PUVA therapy for its efficacy and less adverse events. The objective of the study was to determine the efficacy of narrow band UVB therapy in early stage mycosis fungoides. METHODS: It is a retrospective study of 23 patients with stage IB mycosis fungoides that have received UVB1 therapy following the phototherapy protocol of the Spanish Photobiology Group. RESULTS: Thirteen patients (57 %) had a complete response, eight patients (35 %) had a partial response and two patients (8 %) did not respond. Half of the patients with complete response (n = 6) relapsed after one year of follow-up. CONCLUSIONS: We consider that UVB1 therapy is a good alternative for treatment of early stage mycosis fungoides, although the disease-free period is short.