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1.
Actas dermo-sifiliogr. (Ed. impr.) ; 109(1): 24-34, ene.-feb. 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-170868

RESUMO

Las enfermedades inflamatorias y autoinmunes constituyen un desafío terapéutico por frecuencia y complejidad. Su tratamiento se basa en la inmunosupresión del paciente con glucocorticoides, inmunosupresores ahorradores de corticoides y fármacos biológicos, siendo imprescindible por tanto conocer su manejo. Cuando se va a pautar un inmunosupresor es necesario realizar un estudio previo para detectar contraindicaciones, infecciones latentes o determinar la dosis más adecuada del fármaco. Durante el tratamiento se deben realizar controles periódicos para detectar efectos secundarios. Cada fármaco tiene un tiempo de inicio de acción que es preciso conocer, así como una duración o dosis acumulada máxima recomendada. Los dermatólogos estamos habituados al uso estos fármacos inmunosupresores, pero es necesario tener claras las pautas y los controles necesarios con cada uno, para disminuir la variabilidad y evitar efectos adversos potencialmente graves


The treatment of inflammatory and autoimmune diseases is challenging because of their frequency and complexity. Treatment of these diseases is based on the suppression of the patient's immune system using corticosteroids, corticosteroid-sparing immunosuppressive agents, and biologic drugs, making an understanding of the management of immunosuppressive therapy essential. Before an immunosuppressive agent is prescribed, a study must be carried out to identify contraindications, detect latent infections, and determine the most appropriate dose. During treatment, regular monitoring is required to detect adverse effects. The clinician must be familiar with the time lag between start of treatment and onset of the immunosuppressive effect as well as the maximum recommended duration of treatment and cumulative dose for each drug. As dermatologists we are accustomed to using these immunosuppressive agents, but we should have a good knowledge of the guidelines for their use and the monitoring required in each case if we are to reduce variability and avoid potentially serious adverse effects


Assuntos
Humanos , Imunossupressores/administração & dosagem , Dermatopatias/tratamento farmacológico , Doenças Autoimunes/tratamento farmacológico , Inflamação/tratamento farmacológico , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/prevenção & controle , Padrões de Prática Médica , Metotrexato/administração & dosagem , Ciclosporina/administração & dosagem , Azatioprina/administração & dosagem , Ciclofosfamida/administração & dosagem , Conduta do Tratamento Medicamentoso , Monitoramento de Medicamentos/métodos
2.
Actas Dermosifiliogr (Engl Ed) ; 109(1): 24-34, 2018.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-28964393

RESUMO

The treatment of inflammatory and autoimmune diseases is challenging because of their frequency and complexity. Treatment of these diseases is based on the suppression of the patient's immune system using corticosteroids, corticosteroid-sparing immunosuppressive agents, and biologic drugs, making an understanding of the management of immunosuppressive therapy essential. Before an immunosuppressive agent is prescribed, a study must be carried out to identify contraindications, detect latent infections, and determine the most appropriate dose. During treatment, regular monitoring is required to detect adverse effects. The clinician must be familiar with the time lag between start of treatment and onset of the immunosuppressive effect as well as the maximum recommended duration of treatment and cumulative dose for each drug. As dermatologists we are accustomed to using these immunosuppressive agents, but we should have a good knowledge of the guidelines for their use and the monitoring required in each case if we are to reduce variability and avoid potentially serious adverse effects.


Assuntos
Dermatologia/métodos , Imunossupressores/uso terapêutico , Dermatopatias/tratamento farmacológico , Corticosteroides/uso terapêutico , Antirreumáticos/uso terapêutico , Doenças Autoimunes/tratamento farmacológico , Doenças Autoimunes/imunologia , Contraindicações de Medicamentos , Dermatite/tratamento farmacológico , Dermatite/imunologia , Monitoramento de Medicamentos , Humanos , Imunossupressores/efeitos adversos , Dermatopatias/imunologia , Vacinação
3.
Dermatol Online J ; 23(6)2017 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-28633741

RESUMO

Gouty panniculitis is caused by the deposition of urate crystals in the subcutaneous tissue, accompanied by a lobular panniculitis. It presents as subcutaneous nodules, most commonly located on the lower extremities. Being an unusual clinical presentation of gout, the sonographic findings of gouty panniculitis have been scarcely described in the literature. Our report describes the ultrasound features we found in a case of gouty panniculitis and the usefulness of this technique for diagnosis and monitoring of this disease.


Assuntos
Gota/complicações , Paniculite/diagnóstico por imagem , Ultrassonografia , Adulto , Humanos , Masculino , Paniculite/etiologia , Paniculite/patologia
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