Photosensitive rash induced by nivolumab

Abstract The therapeutic approach to metastatic melanoma has revolutionized the clinical course of this disease. Since 2011, different immunotherapeutic drugs have been approved. Nivolumab is a humanized immunoglobulin IgG4 monoclonal antibody that binds to the PD-1 receptor, blocking its interaction with his ligand PD-L1. The authors present a new case of photosensitivity induced by nivolumab. The photo exposed distribution of the eruption, the sun exposure prior to the beginning of the eruption, and the chronological relationship with the beginning of the treatment are data that have allowed us to confirm the suspected clinical diagnosis.

Four years stability of type D personality in patients with moderate to severe psoriasis and its implications for psychological impairment

Abstract Background: Psoriasis is a systemic auto-inflammatory disease that is related to an increased risk of organic and psychological comorbidities. Type D is a stable personality trait in healthy subjects but there is no data regarding its stability in patients with moderate-severe psoriasis. Objectives: To assess the stability of type D personality in patients with moderate to severe psoriasis as well as assessing the influence of type D personality on anxiety and depression. Methods: Prospective cohort study. Forty psoriasis patients with type D personality and sixtysix patients with psoriasis without type D personality were included in the study. Participants completed the DS14 test and HADS at baseline and four years later. Results: At baseline, the prevalence of type D personality was 37.7% and at week 208 it was 27.3%. The stability of type D personality was higher in patients with an incomplete education level and in those who were separated/divorced or windowed. During follow-up, 15% of patients developed type D personality. Male sex, having topical treatment, the presence of previous depression, anxiety, and high levels of negative affectivity at baseline increase the risk of developing type D personality. Study limitations: Sample size, psoriasis severity restricted to moderate and severe and all patients being under treatment for psoriasis. Conclusion The presence of type D personality varies over time in psoriasis patients. Therefore, type D personality is possibly more a state than a trait phenomenon, modified by environmental factors. Type D personality is associated with a higher risk of anxiety.

White starburst-like pattern as a dermoscopic clue in Old World cutaneous leishmaniasis

Abstract: A 70-year-old woman was referred to our dermatological unit by her general practitioner last summer, with a history of a two-month ulcerated purplish lesion on her left arm that spread centrifugally and that unsuccessfully treated with topical corticosteroids. The dermoscopic evaluation revealed an erythematous macula with central ulceration that showed the characteristic called "white starburst-like pattern" and some vascular structures (dotted vessels, polymorphous⁄ atypical vessels). The diagnosis of cutaneous leishmaniasis was made after histopathologic analysis and polymerase chain reaction essay.

Facial extensive ulcer / Úlcera extensa facial

SUMMARY Basosquamous carcinoma (BSC), as described in 1910, is a distinctive variety of skin cancer and its etiology and pathological characteristics have generated much controversy over the years. Currently, BSC is considered a basal cell carcinoma (BCC) subtype with aggressive behavior and greater tendency for recurrence and metastases. We present a clinical case recently reported in our unit.

RESUMO Carcinoma basoescamoso, conforme descrito em 1910, é uma variedade distinta de câncer de pele e sua etiologia e características patológicas têm gerado muita controvérsia ao longo dos anos. Atualmente, BSC é considerado um subtipo de carcinoma de células basais com comportamento agressivo e maior tendência para a recorrência e metástase. Nós apresentamos um caso clínico relatado recentemente em nossa unidade.

Resultados del uso de etanercept en pacientes con psoriasis / Results from the use of etanercept in psoriatic patients

La psoriasis es una enfermedad crónica, inflamatoria, mediada inmunológicamente, con una considerable repercusión en la calidad de vida de los pacientes. Su importancia, además, está dada, entre otros factores, por su elevada prevalencia en la población. Los avances en el conocimiento de la inmunopatología de esta enfermedad y de la biología molecular han permitido el desarrollo de nuevos fármacos que representan una nueva forma de abordar la situación de estos pacientes, y que se encuadran en la denominada terapia biológica. El etanercept se empleó por primera vez en estudios clínicos con seres humanos en 1992 y ya son varios cientos de miles los enfermos tratados en todo el mundo por diferentes afecciones. Actualmente, la Agencia Europea de Evaluación de Medicamentos tiene aprobada la indicación de etanercept en las siguientes enfermedades: 1. Psoriasis en placa en adultos (“adultos con psoriasis en placa, de moderada a grave, que no han respondido o que tienen contraindicada, o no toleran, otra terapia sistémica incluyendo ciclosporina, metotrexato o PUVA”); 2. Psoriasis pediátrica grave en placa. 3. Artritis psoriásica; 4. Artritis reumatoidea; 5. Artritis idiopática juvenil poliarticular; 6. Espondilitis anquilosante. Su utilización en la psoriasis, ya bien conocida, ha hecho que poco a poco empiecen a surgir cuestiones sobre su manejo en situaciones especiales que requieren tener en cuenta las particularidades de su aplicación (lactancia, vacunaciones, infecciones) que abordaremos en este trabajo...