Malformaciones capilares tratadas con aplicación secuencial de láser de colorante pulsado y Nd:YAG: estudio retrospectivo / Capillary Malformations Treated With Sequential Pulsed Dye and Nd:YAG Laser Therapy: A Retrospective Study

INTRODUCCIÓN Y OBJETIVO: Las malformaciones capilares son las malformaciones vasculares más frecuentes en la infancia. El tratamiento de elección sigue siendo el láser de colorante pulsado (LCP), sin embargo, la resolución completa con este habitualmente no se consigue, motivo por el que se siguen buscando otras alternativas terapéuticas. En este estudio comunicamos nuestra experiencia con el láser dual secuencial de LCP y Nd:YAG. MATERIAL Y MÉTODOS: Se efectuó un estudio retrospectivo y descriptivo de los pacientes con malformaciones capilares tratados con el láser dual de LCP y Nd:YAG desde 2006 hasta 2011. Cuatro dermatólogos valoraron el grado de eficacia en una escala del 10 al 0. Se analizó la posibilidad de factores predictores de mejor respuesta al tratamiento: sexo, color de la lesión, existencia de hipertrofia asociada y tamaño de la malformación. Se recogieron igualmente los efectos secundarios. RESULTADOS: Se incluyeron 71 pacientes, presentando el conjunto de ellos una mejoría estadísticamente significativa tras el tratamiento. Las malformaciones de coloración violácea que tenían hipertrofia asociada y las de menor tamaño se asociaron con una mejor respuesta. Se produjeron efectos adversos en un 26,76% de los pacientes, siendo la presencia de zonas atróficas puntuales el más frecuente. CONCLUSIONES: Consideramos que el láser dual de LCP y Nd:YAG es una alternativa eficaz para el tratamiento de malformaciones capilares en paciente seleccionados

INTRODUCTION AND OBJECTIVE: Capillary malformations are the most common vascular malformations in childhood. The current treatment of choice is pulsed dye laser (PDL) therapy, but this frequently does not result in complete resolution. The search for alternative treatment strategies thus continues. In this study we describe our experience with the use of sequential dual-wavelength PDL and Nd:YAG laser therapy in patients with capillary malformations. MATERIAL AND METHODS: We conducted a retrospective, descriptive study of patients with capillary malformations treated with dual-wavelength PDL and Nd:YAG laser therapy between 2006 and 2011. Four dermatologists rated the effectiveness of treatment on a scale of 10 to 0. We also investigated the potential value of the following factors as predictors of better treatment response: sex, malformation size and color, and presence of associated hypertrophy. Adverse effects were also analyzed. RESULTS: We studied 71 patients and most of them experienced a statistically significant improvement after treatment. More favorable responses were observed for violaceous malformations, lesions with associated hypertrophy, and smaller lesions. Adverse effects were reported for 26.76% of patients, and the most common effect was the appearance of isolated areas of skin atrophy. CONCLUSIONS: We consider that sequential dual-wavelength PDL and ND:YAG laser therapy is an effective alternative for treating capillary malformations in selected patients

Capillary Malformations Treated With Sequential Pulsed Dye and Nd:YAG Laser Therapy: A Retrospective Study. / Malformaciones capilares tratadas con aplicación secuencial de láser de colorante pulsado y Nd:YAG: estudio retrospectivo.

INTRODUCTION AND OBJECTIVE: Capillary malformations are the most common vascular malformations in childhood. The current treatment of choice is pulsed dye laser (PDL) therapy, but this frequently does not result in complete resolution. The search for alternative treatment strategies thus continues. In this study we describe our experience with the use of sequential dual-wavelength PDL and Nd:YAG laser therapy in patients with capillary malformations. MATERIAL AND METHODS: We conducted a retrospective, descriptive study of patients with capillary malformations treated with dual-wavelength PDL and Nd:YAG laser therapy between 2006 and 2011. Four dermatologists rated the effectiveness of treatment on a scale of 10 to 0. We also investigated the potential value of the following factors as predictors of better treatment response: sex, malformation size and color, and presence of associated hypertrophy. Adverse effects were also analyzed. RESULTS: We studied 71 patients and most of them experienced a statistically significant improvement after treatment. More favorable responses were observed for violaceous malformations, lesions with associated hypertrophy, and smaller lesions. Adverse effects were reported for 26.76% of patients, and the most common effect was the appearance of isolated areas of skin atrophy. CONCLUSIONS: We consider that sequential dual-wavelength PDL and ND:YAG laser therapy is an effective alternative for treating capillary malformations in selected patients.

Verrugas extragenitales tratadas con sinecatequinas en pomada / Extragenital Warts Treated With Sinecatechins Ointment

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[Extracorporeal photopheresis in dermatology]. / Fotoféresis extracorpórea en Dermatología.

Extracorporeal photochemotherapy or photopheresis is an immunomodulatory therapy that combines leukapheresis with phototherapy. Blood from the patient is processed to give a leukocyte-rich plasma, which is then treated ex vivo with a photosensitizer and ultraviolet A radiation before reinfusion back into the patient. The exact mechanism of action of photopheresis has not been fully elucidated although it is thought that induction of leukocyte apoptosis and formation of dendritic cells is essential for the development of an immune response to pathogenic cells. Extracorporeal photophoresis was initially used for treating cutaneous T-cell lymphoma. Since then, in view of its efficacy and safety, it has been used in a number of cutaneous and noncutaneous diseases with uneven results, which can in part be explained by the different patient selection criteria, therapy regimens, and follow-up protocols used in different hospitals.

Fotoféresis extracorpórea en Dermatología / Extracorporeal Photopheresis in Dermatology

La fotoquimioterapia extracorpórea o fotoféresis es una terapia inmunomoduladora que combina la leucoféresis con la fototerapia. Después de la separación de un plasma rico en leucocitos, se administra ex vivo un fotosensibilizante junto con radiación ultravioleta A y posteriormente se reinfunde en el paciente. El mecanismo de acción exacto de la fotoféresis no se conoce completamente, aunque se piensa que la inducción de apoptosis de linfocitos y la formación de células dendríticas desempeña un papel fundamental en el desarrollo de una respuesta inmunológica contra las células patógenas. Esta terapia se utilizó inicialmente para el tratamiento del linfoma cutáneo de células T. Desde entonces, basándose en su eficacia y seguridad, se ha empleado en múltiples patologías tanto cutáneas como no cutáneas, con resultados variables. Los distintos centros han utilizado diferentes criterios de selección de pacientes, pautas de tratamiento y protocolos de monitorización, lo que podría contribuir a la diferencia de resultados (AU)

Extracorporeal photochemotherapy or photopheresis is an immunomodulatory therapy that combines leukapheresis with phototherapy. Blood from the patient is processed to give a leukocyte-rich plasma, which is then treated ex vivo with a photosensitizer and ultraviolet A radiation before reinfusion back into the patient. The exact mechanism of action of photopheresis has not been fully elucidated although it is thought that induction of leukocyte apoptosis and formation of dendritic cells is essential for the development of an immune response to pathogenic cells. Extracorporeal photophoresis was initially used for treating cutaneous T-cell lymphoma. Since then, in view of its efficacy and safety, it has been used in a number of cutaneous and noncutaneous diseases with uneven results, which can in part be explained by the different patient selection criteria, therapy regimens, and follow-up protocols used in different hospitals (AU)

Erupción cutánea tras toma de amoxicilina en paciente con fiebre y odinofagia / No disponible

No disponible