RESUMO
BACKGROUND AND OBJECTIVES: Bexarotene has been approved to treat advanced stage cutaneous T-cell lymphomas (CTCL) since 1999. However, very few data have been published on its long-term safety and efficacy profile. The aim of this study is to determine the tolerability to bexarotene and outcomes by collecting the 2nd largest case series to date on its long-term use vs CTCL. MATERIAL AND METHOD: This was a multicenter retrospective review of 216 patients with mycosis fungoides (174), or Sézary syndrome (42) on a 10-year course of bexarotene alone or in combination with other therapies at 19 tertiary referral teaching hospitals. RESULTS: A total of 133 men (62%) and 83 women (38%) were included, with a mean age of 63.5 year (27-95). A total of 45% were on bexarotene monotherapy for the entire study period, 22% started on bexarotene but eventually received an additional therapy, 13% were on another treatment but eventually received bexarotene while the remaining 20% received a combination therapy since the beginning. The median course of treatment was 20.78 months (1-114); and the overall response rate, 70.3%. Complete and partial response rates were achieved in 26% and 45% of the patients, respectively. Treatment was well tolerated, being the most common toxicities hypertriglyceridemia (79%), hypercholesterolemia (71%), and hypothyroidism (52%). No treatment-related grade 5 adverse events were reported. CONCLUSIONS: Our study confirms bexarotene is a safe and effective therapy for the long-term treatment of CTCL.
RESUMO
OBJECTIVE: Patients with nonmelanoma skin cancer (NMSC)-ie, basal cell carcinoma (BCC) or squamous cell carcinoma (SCC)-have an increased risk of developing a second skin cancer. The aim of this study was to describe the frequency, incidence per 1000 person-years, and predictors of a second skin cancer in a cohort of patients with NMSC treated with Mohs micrographic surgery (MMS). MATERIAL AND METHODS: Prospective study of a national cohort of patients with NMSC who underwent MMS at 22 Spanish hospitals between July 2013 and February 2020; case data were recorded in the REGESMOHS registry. The study variables included demographic characteristics, frequency and incidence per 1000 person-years of second skin cancers diagnosed during the study period, and risk factors identified using mixed-effects logistic regression. RESULTS: We analyzed data for 4768 patients who underwent MMS; 4397 (92%) had BCC and 371 (8%) had SCC. Mean follow-up was 2.4 years. Overall, 1201 patients (25%) developed a second skin cancer during follow-up; 1013 of the tumors were BCCs (21%), 154 were SCCs (3%), and 20 were melanomas (0.4%). The incidence was 107 per 1000 person-years (95% CI, 101-113) for any cancer, 90 per 1000 person-years (95% CI, 85-96) for BCC, 14 (95% CI, 12-16) per 1000 person-years for SCC, and 2 (95% CI, 1-3) per 1000 person-years for melanoma. More men than women developed a subsequent skin cancer (738 [61%] vs 463 [39%]). The main risk factors were a history of multiple tumors before diagnosis (relative risk [RR], 4.6; 95% CI, 2.9-7.1), immunosuppression (RR, 2.1; 95% CI, 1.4-3.1), and male sex (RR, 1.6; 95% CI, 1.4-1.9). CONCLUSION: Patients have an increased risk of developing a second tumor after MMS treatment of NMSC. Risk factors are a history of multiple tumors at diagnosis, immunosuppression, and male sex.
Assuntos
Carcinoma Basocelular , Carcinoma de Células Escamosas , Melanoma , Neoplasia de Células Basais , Neoplasias Cutâneas , Carcinoma Basocelular/epidemiologia , Carcinoma Basocelular/patologia , Carcinoma Basocelular/cirurgia , Carcinoma de Células Escamosas/epidemiologia , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Estudos de Coortes , Feminino , Humanos , Masculino , Melanoma/complicações , Cirurgia de Mohs , Estudos Prospectivos , Fatores de Risco , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/etiologia , Neoplasias Cutâneas/cirurgiaRESUMO
No disponible
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Humanos , Feminino , Idoso , Neoplasias Nasais/cirurgia , Rinoplastia/métodos , Procedimentos de Cirurgia Plástica/métodos , Retalhos Cirúrgicos , Cartilagem/transplante , Técnicas de SuturaAssuntos
Carcinoma Basocelular/cirurgia , Cartilagem da Orelha/transplante , Recidiva Local de Neoplasia/cirurgia , Neoplasias Nasais/cirurgia , Nariz/cirurgia , Rinoplastia/métodos , Neoplasias Cutâneas/cirurgia , Transplante de Pele/métodos , Idoso , Feminino , Humanos , Cirurgia de Mohs , Transplante AutólogoRESUMO
No disponible
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Humanos , Masculino , Pessoa de Meia-Idade , Eosinofilia/etiologia , Foliculite/etiologia , Linfoma Cutâneo de Células T/complicações , Dermatopatias Vesiculobolhosas/etiologia , Neoplasias Cutâneas/complicações , Gamopatia Monoclonal de Significância Indeterminada/complicações , Interferon-alfa/uso terapêutico , Complexo CD3/análise , Antígenos CD4/análise , Terapia PUVA , Indução de Remissão , Subpopulações de Linfócitos T , Tetra-Hidronaftalenos/uso terapêuticoAssuntos
Eosinofilia/etiologia , Foliculite/etiologia , Linfoma Cutâneo de Células T/complicações , Gamopatia Monoclonal de Significância Indeterminada/complicações , Dermatopatias Vesiculobolhosas/etiologia , Neoplasias Cutâneas/complicações , Bexaroteno , Complexo CD3/análise , Antígenos CD4/análise , Eosinofilia/diagnóstico , Eosinofilia/patologia , Foliculite/diagnóstico , Foliculite/patologia , Humanos , Interferon-alfa/uso terapêutico , Linfoma Cutâneo de Células T/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Terapia PUVA , Indução de Remissão , Dermatopatias Vesiculobolhosas/diagnóstico , Dermatopatias Vesiculobolhosas/patologia , Neoplasias Cutâneas/tratamento farmacológico , Subpopulações de Linfócitos T/química , Subpopulações de Linfócitos T/imunologia , Tetra-Hidronaftalenos/uso terapêuticoRESUMO
No disponible
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Micose Fungoide/diagnóstico , Linfoma Cutâneo de Células T/diagnóstico , Neoplasias Cutâneas/diagnóstico , BiópsiaAssuntos
Micose Fungoide/patologia , Neoplasias Cutâneas/patologia , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Acute generalized exanthematous pustulosis (AGEP) is a rare, severe, pustular, cutaneous reaction. We report a case in which a patient developed AGEP after the intake of 3 different antitussive agents containing dextromethorphan as the only ingredient in common.
Assuntos
Pustulose Exantematosa Aguda Generalizada/etiologia , Antitussígenos/efeitos adversos , Dextrometorfano/efeitos adversos , Pustulose Exantematosa Aguda Generalizada/patologia , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Psoríase/diagnósticoAssuntos
Humanos , Masculino , Feminino , Micose Fungoide/terapia , Terapia Ultravioleta , Estudos RetrospectivosRESUMO
No disponible
No disponible
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Humanos , Feminino , Adulto , Paniculite/complicações , Gota/complicações , Hiperuricemia/complicações , Alopurinol/uso terapêuticoRESUMO
The nasal pyramid is frequently affected by nonmelanoma skin cancer. Sometimes the aggressiveness of tumours entails the extirpation of the mucosa, the cartilage, and the nasal skin. Reconstruction of the cartilaginous portion can be a surgical challenge. We demonstrate that titanium mesh can be an effective substitute for the cartilaginous portion of the nose in nasal reconstruction. We present five patients with nasal basal cell carcinoma who were treated by Mohs micrographic surgery. The partial loss of the cartilaginous structure was replaced by a 0.1 mm fenestrated titanium mesh. We have not observed any rejection or other complication in any of our patients. Good functional and aesthetic results have been obtained. Because of its biocompatibility, titanium mesh is a useful substitute for nasal cartilage. It avoids harvesting natural cartilage, reduces the risk of graft necrosis, and prevents morbidity in the donor area.
Assuntos
Carcinoma Basocelular/cirurgia , Neoplasias Nasais/cirurgia , Rinoplastia/métodos , Telas Cirúrgicas , Titânio , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Deformidades Adquiridas Nasais/cirurgia , Retalhos Cirúrgicos , Resultado do TratamentoRESUMO
La alopecia frontal fibrosante posmenopáusica es una variante clínica diferenciada del liquen plano pilaris que afecta a mujeres de edad avanzada. Kossard describió esta alteración en 1994 como una recesión progresiva de la línea de implantación del pelo en la zona frontal, recesión que frecuentemente afecta a las cejas con alopecia cicatricial. No tiene un tratamiento efectivo, pero frecuentemente se estabiliza con el tiempo (AU)
Progressive frontal fibrosing alopecia is a clinically distinct variant of lichen planopilaris, which affects elderly women. This condition was described in postmenopausal women by Kossard in 1994 as progressive frontal hairline recession associated with scarring and frequently involving the eyebrows. No effective treatment has emerged for this condition but the alopecia may stabilize with time (AU)