Tolerance of oral oxybutynin in the treatment of hyperhidrosis.

Oral oxybutynin (OOx) is an effective and safe treatment for the treatment of hyperhidrosis (HH). However, in some patients a loss of efficacy during prolonged treatment has been observed. Analysis of these cases could enable us to identify patients susceptible to OOx tolerance. An alternative treatment might then be considered. To assess tolerance to OOx in the treatment of HH. Secondarily, to assess epidemiological data and the duration of efficacy, together with the probable causes of any loss in this respect. Retrospective study of patients who started treatment with OOx for HH during the period 2007 to 2017 and who either abandoned this treatment due to loss of efficacy or needed higher daily doses to maintain the initial efficacy. Epidemiological data were collected, the duration of the efficacy of OOx was recorded and the possible causes of loss of efficacy were considered. The development of tolerance was suspected in 18 patients (8.5%) of the 211 who had previously responded to OOx. Thirteen patients abandoned OOx due to its lack of efficacy and five had to increase the dose in order to maintain efficacy. In seven patients, tolerance to the drug appeared in the first year of treatment, while in the remaining 11, the tolerance appeared later. Most patients achieved and maintained good control of HH with long-term OOx. However, in some cases the efficacy of the drug decreases. The study analysis did not produce findings enabling us to predict a loss of treatment efficacy.

Delayed-onset of multiple cutaneous infantile hemangiomas due to propranolol: a case report.

Infantile hemangiomas are the most common vascular tumors in childhood. In view of its proven effectiveness in such cases, propranolol is the drug of choice. We present the case of a male infant who started treatment with propranolol shortly after birth due to heart disease. After 7 months, when the patient had suffered various respiratory exacerbations, this treatment was suspended. One week later, multiple skin lesions (ie, multifocal infantile hemangiomas) began to appear, with no extracutaneous involvement. It was decided to resume treatment with propranolol, although at lower doses than before, and the skin lesions improved rapidly, with some disappearing completely. Treatment was definitively withdrawn at age 16 months, with only slight recurrence of the lesions. The case described is of multifocal infantile hemangiomas without extracutaneous involvement appearing beyond the neonatal period after treatment with propranolol beginning in the first days of life. The details of the case support the hypothesis that this drug is not only therapeutic but also plays a prophylactic role against infantile hemangiomas. In turn, this supports the recent proposal that this drug may be useful in preventing the growth and spread of tumors with high angiogenic potential. It is postulated that the inhibition of ß-adrenergic receptors is associated with multiple intracellular processes related to the progression and metastasis of different tumors.

Behaviour, attitudes and awareness concerning sun exposure in adolescents on the Costa del Sol.

BACKGROUND: A history of sunburn and cumulative sun exposure during adolescence are the most important risk factors for the development of skin cancer. Skin cancer can be prevented by reducing sun exposure, particularly during adolescence, which is precisely the age group that could best benefit from primary prevention campaigns. OBJECTIVE: To determine the behaviour, attitudes and understanding of adolescents concerning sun exposure. METHODS: This cross-sectional descriptive study undertaken during 2011 included secondary school adolescents from randomly selected schools on the Costa del Sol, southern Spain. A validated beachside questionnaire was used to record data on demographics, skin colour, phototype, sun exposure habits, sunburns, practices, attitudes and knowledge about the sun. RESULTS: The study involved 270 students, aged 14-17 years, from 11 schools; 50.4% were female, 43.7% were aged 14 years, and 85.9% were Spanish. Most had a light skin colour (49.3%) and phototypes III (42.2%) or IV (34.8%). Most (71%) went to the beach on more than 16 days and 74.4% had had sunburn the previous summer. Sun cream was used by 47.8% and 1.1% wore long sleeves or trousers. Concerning attitudes, 60.7% stated they felt better when they were tanned, and concerning understanding, most were aware of the harmful effects of the sun on the skin. CONCLUSION: Adolescents comprise a special risk group with a positive attitude towards tanning. Further studies are required to assess educational stategies in order to reduce the desire to have a suntan, and improve sun protection practices and habits targeted at this age group.

[Imported tinea cruris (glutealis) caused by Trichophyton rubrum var. raubitschekii in Spain]. / Tinea cruris (glutealis) de importación por Trichophyton rubrum var. raubitschekii en España.

Although Trichophyton raubitschekii was first described by Kane et al. as a distinct species of dermatophyte, it is now classified as a variety of T. rubrum. The variety raubitschekii differs from the other varieties of T. rubrum in morphology, physiology, epidemiology and patterns of infection, but they are indistinguishable using molecular methods. T. rubrum var. raubitschekii is mostly found in Africa, Asia and South America. We present two cases of imported mycosis in two Nigerian men due to T. rubrum var. raubitschekii. The patients have Tinea cruris lesions on the buttocks. These are the first reported cases of this dermatophytosis in Spain.