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ACR Open Rheumatol ; 2020 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-31916703


OBJECTIVE: Sarcoidosis is an idiopathic inflammatory disorder that is difficult to treat. There is accumulating evidence that constitutive activation of Janus kinase-signal transducer and activator of transcription (JAK-STAT) signaling occurs in sarcoidosis and represents a target for treatment. Here we report the efficacy of tofacitinib, a Janus kinase (JAK) inhibitor, in a single patient with multiorgan sarcoidosis. METHODS: A patient with long-standing multiorgan sarcoidosis who was unresponsive to other commonly used therapies, including methotrexate, prednisone, and tumor necrosis factor α blockade, was treated with tofacitinib. RESULTS: Tofacitinib treatment resulted in clinical remission of cutaneous sarcoidosis lesions and resolution of positron emission tomography avid lesions in internal organs after 6 months. An evaluation of lesional tissue and blood before and during treatment showed resolution of granulomatous inflammation and normalization of disease biomarkers. CONCLUSION: This case illustrates the promise of JAK inhibition as a strategy to treat recalcitrant sarcoidosis and suggests that further study of JAK inhibitors in sarcoidosis is needed.

JAAD Case Rep ; 5(10): 923-924, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31649981
Cutis ; 104(2): 118-119, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31603955


Hypergranulation is a frequent complication of dermatologic surgery. Management of postoperative hypergranulation with routine wound care and/or topical silver nitrate often is effective, but refractory cases can be challenging given the paucity of treatment options. We present an alternative treatment of refractory hypergranulation using timolol ophthalmic gel forming solution.

J Am Acad Dermatol ; 2019 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-31349047
Clin Dermatol ; 33(6): 657-71, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26686017


The changes in immune response that occur with age play a significant role in disease presentation and patient management. Evolution of the innate and adaptive immune systems throughout life, influenced partly by hormonal changes associated with puberty, plays a role in the differences between pediatric and adult response to disease. We review a series of manifestations of dermatologic infectious diseases spanning bacterial, viral, and fungal origins that can be seen in both pediatric and adult age groups and highlight similarities and differences in presentation and disease course. Therapeutic options are also discussed for these infectious diseases, with particular attention to variations in management between these population subgroups, given differences in pharmacokinetics and side effect profiles.

Antibacterianos/uso terapêutico , Eritema Infeccioso/diagnóstico , Doença de Lyme/diagnóstico , Staphylococcus aureus Resistente à Meticilina , Dermatopatias Infecciosas/diagnóstico , Dermatopatias Infecciosas/tratamento farmacológico , Acrodermatite/epidemiologia , Acrodermatite/virologia , Adolescente , Adulto , Antibacterianos/farmacologia , Criança , Pré-Escolar , Infecções Comunitárias Adquiridas/tratamento farmacológico , Humanos , Lactente , Doença de Lyme/complicações , Doença de Lyme/tratamento farmacológico , Molusco Contagioso/complicações , Molusco Contagioso/tratamento farmacológico , Síndrome de Linfonodos Mucocutâneos/diagnóstico , Síndrome de Linfonodos Mucocutâneos/tratamento farmacológico , Dermatopatias Infecciosas/complicações , Dermatopatias Infecciosas/epidemiologia , Dermatopatias Infecciosas/microbiologia , Infecções Cutâneas Estafilocócicas/tratamento farmacológico , Infecções Cutâneas Estafilocócicas/microbiologia , Tinha do Couro Cabeludo/diagnóstico , Tinha do Couro Cabeludo/tratamento farmacológico , Tinha do Couro Cabeludo/epidemiologia