Real-world effectiveness and safety of apremilast in psoriasis at 52 weeks: a retrospective, observational, multicentre study by the Spanish Psoriasis Group.

BACKGROUND: Little has been published on the real-world effectiveness and safety of apremilast in psoriasis. OBJECTIVES: To evaluate the effectiveness, safety and drug survival of apremilast at 52 weeks in patients with moderate to severe plaque psoriasis or palmoplantar psoriasis in routine clinical practice. METHODS: Retrospective, multicentre study of adult patients with moderate to severe plaque psoriasis or palmoplantar psoriasis treated with apremilast from March 2016 to March 2018. RESULTS: We studied 292 patients with plaque psoriasis and 85 patients with palmoplantar psoriasis. The mean (SD) Psoriasis Area and Severity Index (PASI) score was 10.7 (7.0) at baseline and 3.0 (4.2) at 52 weeks. After 12 months of treatment, 73.6% of patients had a PASI score of 3 or less. In terms of relative improvement by week 52, 49.7% of patients achieved PASI-75 (≥75% reduction in PASI score) and 26.5% achieved PASI-90. The mean physician global assessment score for palmoplantar psoriasis fell from 4.2 (5.2) at baseline to 1.3 (1.3) at week 52. Overall drug survival after 1 year of treatment with apremilast was 54.9 %. The main reasons for treatment discontinuation were loss of efficacy (23.9%) and adverse events (15.9%). Almost half of the patients in our series (47%) experienced at least one adverse event. The most common events were gastrointestinal problems. CONCLUSIONS: Apremilast may be a suitable alternative for the treatment of moderate to severe psoriasis and palmoplantar psoriasis. Although the drug has a good safety profile, adverse gastrointestinal effects are common.

[Etanercept in childhood psoriasis]. / Etanercept en psoriasis infantil.

We present the case of a 10-year old male child with severe incapacitating psoriasis resistant to multiple treatments. He was treated with etanercept successfully in our Dermatology Department. The use of etanercept in children and adolescents with severe psoriasis has been recently approved by the European Medicines Agency. Thus, it has become the first and only biological drug authorized for its use in the child population.

Patient and Physician Satisfaction with Calcipotriol and Betamethasone Dipropionate Aerosol Foam in the Treatment of Plaque Psoriasis on the Body. / Satisfacción del paciente y el médico con la espuma en aerosol de calcipotriol y dipropionato de betametasona para el tratamiento de la psoriasis vulgar en el cuerpo.

BACKGROUND AND OBJECTIVE: Calcipotriol and betamethasone dipropionate (Cal/BD) aerosol foam is more effective in the treatment of plaque psoriasis than earlier formulations incorporating this combination of active ingredients. The aim of this study was to evaluate patient and physician satisfaction with Cal/BD aerosol foam in the treatment of plaque psoriasis on the body. MATERIAL AND METHODS: Retrospective observational study of 446 patients with plaque psoriasis affecting no more than 30% of the body surface area who had received treatment with Cal/BD aerosol foam for 4 weeks. The patients rated their satisfaction with the treatment using the TSQM-9 (Treatment Satisfaction Questionnaire for Medication) and the physicians on a 5-point Likert scale. RESULTS: Patients were highly satisfied with Cal/BD aerosol in terms of its ability to treat their condition (84%), relieve their symptoms (84.4%), and act rapidly (82.8%). With respect to convenience, the patients gave high ratings to ease of use (91.8%), ease of planning (93.9%), and ease of following instructions (89.9%). Global satisfaction was also high, with 85% of patients expressing that they were satisfied, very satisfied, or extremely satisfied with the treatment. Of the physicians, 85.7% stated that they were quite or very satisfied with the treatment. CONCLUSION: Both patients and physicians expressed high satisfaction with the use of Cal/BD aerosol foam for the treatment of plaque psoriasis on the body.

Satisfacción del paciente y el médico con la espuma en aerosol de calcipotriol y dipropionato de betametasona para el tratamiento de la psoriasis vulgar en el cuerpo / Patient and Physician Satisfaction with Calcipotriol and Betamethasone Dipropionate Aerosol Foam in the Treatment of Plaque Psoriasis on the Body

Antecedentes y objetivo: La formulación de calcipotriol y dipropionato de betametasona (Cal/BD) en espuma para el tratamiento de la psoriasis vulgar presenta una alternativa galénica y una mayor eficacia respecto a presentaciones anteriores. El objetivo de este estudio fue evaluar la satisfacción de pacientes y médicos con este tratamiento para la psoriasis corporal. Material y métodos: Estudio observacional retrospectivo en el que se incluyeron 446 pacientes con psoriasis en placas con una superficie de afectación máxima del 30% tratados con Cal/BD en espuma durante las 4 semanas previas. Los pacientes valoraron la satisfacción con el tratamiento mediante el cuestionario TSQM-9 (Treatment Satisfaction Questionnaire for Medication) y los médicos mediante una escala Likert de 5 puntos. Resultados: En la evaluación de la eficacia de la medicación, los pacientes mostraron una alta satisfacción con la capacidad de Cal/BD en espuma en el tratamiento de su psoriasis (84%), alivio de síntomas (84,4%) y rapidez de acción (82,8%). Respecto a la comodidad en usar la medicación, el 91,8% de los pacientes valoraron positivamente la facilidad de uso, el 93,9% la facilidad en la planificación y el 89,9% la facilidad en el seguimiento de la posología. Globalmente, el 85% de los pacientes se mostraron satisfechos/sumamente satisfechos con el tratamiento. Respecto a la satisfacción con el tratamiento por parte de los médicos, el 85,7% se mostraron muy/bastante satisfechos. Conclusión: Cal/BD en espuma mostró altas tasas de satisfacción por parte de pacientes y médicos en el tratamiento de la psoriasis vulgar en el cuerpo

Background and objective: Calcipotriol and betamethasone dipropionate (Cal/BD) aerosol foam is more effective in the treatment of plaque psoriasis than earlier formulations incorporating this combination of active ingredients. The aim of this study was to evaluate patient and physician satisfaction with Cal/BD aerosol foam in the treatment of plaque psoriasis on the body. Material and methods: Retrospective observational study of 446 patients with plaque psoriasis affecting no more than 30% of the body surface area who had received treatment with Cal/BD aerosol foam for 4 weeks. The patients rated their satisfaction with the treatment using the TSQM-9 (Treatment Satisfaction Questionnaire for Medication) and the physicians on a 5-point Likert scale. Results: Patients were highly satisfied with Cal/BD aerosol in terms of its ability to treat their condition (84%), relieve their symptoms (84.4%), and act rapidly (82.8%). With respect to convenience, the patients gave high ratings to ease of use (91.8%), ease of planning (93.9%), and ease of following instructions (89.9%). Global satisfaction was also high, with 85% of patients expressing that they were satisfied, very satisfied, or extremely satisfied with the treatment. Of the physicians, 85.7% stated that they were quite or very satisfied with the treatment. Conclusion: Both patients and physicians expressed high satisfaction with the use of Cal/BD aerosol foam for the treatment of plaque psoriasis on the body

[Adalimumab: the molecule and manufacturing procedure]. / Adalimumab: la molécula y el proceso de obtención.

Adalimumab is a fully human monoclonal antibody targeted toward tumor necrosis factor alpha (TNF-alpha). TNF-alpha is proinflammatory cytokine involved in the pathogenesis of many inflammatory diseases, as the psoriasis. The production process of adalimumab is complex and it is based in the called phague display technology.

[Autologous hematopoietic stem cell transplantation followed by oral bexarotene in a patient with advanced mycosis fungoides]. / Trasplante autólogo de progenitores hematopoyéticos seguido de bexaroteno oral en paciente con micosis fungoide avanzada.

We describe the case of a 17-year-old patient with rapidly progressing and aggressive mycosis fungoides, with multiple cutaneous tumors and large cell transformation. She was initially treated with 3 cycles of high-dose chemotherapy with mega-CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) without response, leading to the decision to undertake autologous hematopoietic stem cell transplantation. Partial remission of the disease was achieved with this treatment and subsequent introduction of oral bexarotene led to complete remission, which has been maintained for more than 3 years with good tolerance of oral therapy. We discuss the advantages and disadvantages of autologous hematopoietic stem cell transplantation and the use of oral bexarotene.

[Eruptive pseudoangiomatosis: study of 7 cases]. / Pseudoangiomatosis eruptiva: 7 casos clínicos.

INTRODUCTION: Eruptive pseudoangiomatosis consists in the acute development of small vascular lesions in the face and extremities that resolve in several weeks without scarring. Lesions are described as 3-4 mm asymptomatic macules and papules with peripheral whitish halo that blanch upon pressure. Initially it was considered a disease limited to children but it has also been described in adults. It overlaps with the entity known in Japan as <>, possibly caused by an insect named Culex pipiens pallens. METHODS: We report a serie of 7 patients that consulted for lesions compatible with eruptive pseudoangiomatosis. We performed a detailed clinical history and histological, microbiological and serological studies. Follow-up time was up to 4 years. RESULTS: Eighty-five percent of patients were women and the mean age was 62 years. All cases appeared in spring/summer and 71 % relapsed. Lesions predominated in the face and extremities and the outbreak lasted 2-4 weeks. The anamnesis did not disclose any specific etiologic agent in any of the cases. Complete laboratory tests including serologies and cultures were negative or within normal limits. Histological study revealed vascular dilatation in all cases with endothelial cell protrusion and a peripheral lymphohistiocytic infiltrate. CONCLUSIONS: Currently, the etiology of this entity is not well established although it probably represents a reactive disorder to different etiologic processes.

Etanercept en psoriasis infantil / Etanercept in childhood psoriasis

Exponemos el caso de un varón de 10 años con una psoriasis grave incapacitante y resistente a múltiples tratamientos, que hemos tratado con etanercept con éxito en nuestro Servicio de Dermatología. El uso de etanercept en niños y adolescentes con psoriasis grave ha sido recientemente aprobado por la Agencia Europea del Medicamento, por lo que se convierte en el primer y único fármaco biológico autorizado para su utilización en la población infantil (AU)

We present the case of a 10-year old male child with severe incapacitating psoriasis resistant to multiple treatments. He was treated with etanercept successfully in our Dermatology Department. The use of etanercept in children and adolescents with severe psoriasis has been recently approved by the European Medicines Agency. Thus, it has become the first and only biological drug authorized for its use in the child population (AU)

Hiperplasia gingival secundaria a everolimus / Gingival Hyperplasia Secondary to Everolimus Therapy

No disponible

Molusco contagioso sobre tatuaje / Molluscum Contagiosum Over a Tattoo

No disponible

No disponible

Adalimumab: la molécula y el proceso de obtención / Adalimumab: the molecule and manufacturing procedure

Adalimumab es un anticuerpo monoclonal totalmente humano y dirigido contra el factor de necrosis tumoral alfa (TNF-α). El TNF-α es una citocina proinflamatoria, implicada en la Etiopatogenia de múltiples entidades, entre ellas la psoriasis. El mecanismo de obtención de adalimumab es complejo y se basa en la denominada técnica de selección mediante presentación en fagos (AU)

Adalimumab is a fully human monoclonal antibody targeted toward tumor necrosis factor alpha (TNF-α). El TNF-α is proinflammatory cytokine envolved in the patogenesis of many inflammatory diseases, as the psoriasis. The production process of adalimumab is complex and it is based in the called phague display technology (AU)

Dermatitis alérgica de contacto causadapor pulsera de madera de cocobolo / Allergic contact dermatitis caused by a cocobolo wood bracelet

Exponemos un caso de dermatitis alérgica de contacto causado por una pulsera hecha con madera de Cocobolo (Dalbergia retusa). Dicha madera seextrae de un árbol nativo de Centroamérica. El estudio epicutáneo realizado con alergenos específicos (obtusaquinona) confirmó la naturaleza alérgica de la reacción. Cada vez hay más publicaciones de dermatitis alérgica de contacto en personas que manipulan objetos de madera acabada fuera delambiente profesional. Al igual que en los casos ocupacionales, las maderas tropicales son frecuentemente las responsables de estos cuadros (AU)

We present a case of contact dermatitis due to a bracelet made in Cocobolo wood (Dalbergia retusa). This wood is obtained from a tree native of CentralAmerica. The epicutaneous study performed with specific allergens (obtusaquinone) confirmed the allergic nature of this reaction. There are moreand more reported cases about contact dermatitis in people who use finished wood objects outside of their work environment. As in occupationalcases, woods that have most often been described as responsible for these infrequent cases are those known as “exotic” woods from tropical trees (AU)

Trasplante autólogo de progenitores hematopoyéticos seguido de bexaroteno oral en paciente con micosis fungoide avanzada / Autologous hematopoietic stem cell transplantation folowed by oral bexarotene in a patient with advanced mycosis fungoides

Exponemos el caso de una paciente de 17 años que presentó una micosis fungoide de evolución rápida y agresiva, con múltiples tumores cutáneos y transformación fenotípica celular a linfoma de células grandes. Fue tratada inicialmente con 3 ciclos de quimioterapia en dosis altas (MEGA-CHOP) sin respuesta, por lo que se decidió realizar un trasplante autólogo de progenitores hematopoyéticos. Este tratamiento consiguió una remisión parcial de la enfermedad, y con la posterior introducción del bexaroteno oral se logró la remisión completa, que se ha mantenido durante más de 3 años con muy buena tolerancia al bexaroteno oral. Analizamos las ventajas y desventajas de la utilización del trasplante autólogo de progenitores hematopoyéticos y del uso de bexaroteno oral (AU)

We describe the case of a 17-year-old patient with rapidly progressing and aggressive mycosis fungoides, with multiple cutaneous tumors and large cell transformation. She was initially treated with 3 cycles of high-dose chemotherapy with mega-CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) without response, leading to the decision to undertake autologous hematopoietic stem cell transplantation. Partial remission of the disease was achieved with this treatment and subsequent introduction of oral bexarotene led to complete remission, which has been maintained for more than 3 years with good tolerance of oral therapy. We discuss the advantages and disadvantages of autologous hematopoietic stem cell transplantation and the use of oral bexarotene (AU)

Pseudoangiomatosis eruptiva: 7 casos clínicos / Eruptive pseudoangiomatosis: study of 7 cases

Introducción. La pseudoangiomatosis eruptiva consiste en la aparición aguda de lesiones de aspecto angiomatoso de pequeño tamaño en cara y extremidades y su desaparición en el curso de varias semanas sin dejar cicatriz residual. Las lesiones se describen como máculo-pápulas de 3-4 mm, con un halo blanquecino periférico, asintomáticas y que blanquean a la vitropresión. En un principio se pensaba que era un cuadro limitado a niños, pero posteriormente se ha descrito también en adultos. Se considera superponible a un cuadro conocido en Japón como erythema punctatum Higuchi y posiblemente causado por un insecto denominado Culex pipiens pallens. Métodos. Presentamos una serie de 7 pacientes que consultaron en nuestro Servicio por un cuadro compatible con la pseudoangiomatosis eruptiva. Se les realizó una historia clínica detallada, estudio histológico, microbiológico y serológico. El seguimiento fue de hasta 4 años. Resultados. El 85 % de los pacientes fueron mujeres, y la edad media fue de 62 años. Todos los casos se iniciaron en los meses de primavera/verano y el 71 % sufrieron recidivas. Las localizaciones predominantes fueron la cara y las extremidades y la duración del brote fue de 2 a 4 semanas. La historia clínica no permitió establecer un agente desencadenante en ninguno de los casos. Las analíticas, estudios histológicos, serologías y cultivos estuvieron dentro de los rangos de normalidad. En las imágenes histológicas apreciamos en todos los casos dilatación vascular, con cierta protrusión de las células endoteliales hacia la luz del vaso y un infiltrado de predominio linfohistiocitario periférico. Conclusiones. Hoy en día la etiología de este cuadro clínico sigue sin estar bien establecida, aunque probablemente suponga una manifestación clínico-patológica reactiva a distintos procesos etiológicos

Introduction. Eruptive pseudoangiomatosis consists in the acute development of small vascular lesions in the face and extremities that resolve in several weeks without scarring. Lesions are described as 3-4 mm asymptomatic macules and papules with peripheral whitish halo that blanch upon pressure. Initially it was considered a disease limited to children but it has also been described in adults. It overlaps with the entity known in Japan as «erythema punctatum Higuchi», possibly caused by an insect named Culex pipiens pallens. Methods. We report a serie of 7 patients that consulted for lesions compatible with eruptive pseudoangiomatosis. We performed a detailed clinical history and histological, microbiological and serological studies. Follow-up time was up to 4 years. Results. Eighty-five percent of patients were women and the mean age was 62 years. All cases appeared in spring/summer and 71 % relapsed. Lesions predominated in the face and extremities and the outbreak lasted 2-4 weeks. The anamnesis did not disclose any specific etiologic agent in any of the cases. Complete laboratory tests including serologies and cultures were negative or within normal limits. Histological study revealed vascular dilatation in all cases with endothelial cell protrusion and a peripheral lymphohistiocytic infiltrate. Conclusions. Currently, the etiology of this entity is not well established although it probably represents a reactive disorder to different etiologic processes