ABSTRACT
La inmunosupresión farmacológica de los pacientes trasplantados de órgano solido constituye un importante factor de riesgo tanto para la aparición de queratosis actínicas (QA) como para su progresión a carcinomas escamosos (CE). El tratamiento tanto de las lesiones clínicas como preclínicas en este grupo de pacientes es obligatorio debido a la elevada posibilidad de evolución a CE. Por otra parte, la prevención presenta también un papel importante que debemos tener en cuenta. Existen un gran número de estudios realizados en pacientes inmunocompetentes sobre el tratamiento y la prevención de QA, pero no en pacientes inmunosuprimidos. Esta revisión pretende resumir el conocimiento actual sobre los tratamientos y medidas de prevención de la QA en loas pacientes trasplantados de órgano sólido.(AU)
Pharmacological immunosuppression in solid organ transplant recipients is a significant risk factor in the occurrence of actinic keratosis (AK) and later progression into squamous cell carcinomas (SCC). Treating clinical and preclinical lesions is mandatory in this group of patients due to the high changes of progression into SCC. On the other hand, prevention of AK should be considered because it plays a crucial role.Several studies have been published on immunocompetent patients, as well as on the management and prevention of AK, but not on immunosuppressed patients.This review aims to summarize the current knowledge on the management and prevention measures of AK in solid organ transplant recipients.(AU)
Subject(s)
Humans , Male , Female , Keratosis, Actinic/complications , Organ Transplantation , Immunocompromised Host , Dermatitis , Keratosis, Actinic/drug therapy , Dermatology , Skin Diseases , Carcinoma, Squamous CellABSTRACT
La inmunosupresión farmacológica de los pacientes trasplantados de órgano solido constituye un importante factor de riesgo tanto para la aparición de queratosis actínicas (QA) como para su progresión a carcinomas escamosos (CE). El tratamiento tanto de las lesiones clínicas como preclínicas en este grupo de pacientes es obligatorio debido a la elevada posibilidad de evolución a CE. Por otra parte, la prevención presenta también un papel importante que debemos tener en cuenta. Existen un gran número de estudios realizados en pacientes inmunocompetentes sobre el tratamiento y la prevención de QA, pero no en pacientes inmunosuprimidos. Esta revisión pretende resumir el conocimiento actual sobre los tratamientos y medidas de prevención de la QA en loas pacientes trasplantados de órgano sólido.(AU)
Pharmacological immunosuppression in solid organ transplant recipients is a significant risk factor in the occurrence of actinic keratosis (AK) and later progression into squamous cell carcinomas (SCC). Treating clinical and preclinical lesions is mandatory in this group of patients due to the high changes of progression into SCC. On the other hand, prevention of AK should be considered because it plays a crucial role.Several studies have been published on immunocompetent patients, as well as on the management and prevention of AK, but not on immunosuppressed patients.This review aims to summarize the current knowledge on the management and prevention measures of AK in solid organ transplant recipients.(AU)
Subject(s)
Humans , Male , Female , Keratosis, Actinic/complications , Organ Transplantation , Immunocompromised Host , Dermatitis , Keratosis, Actinic/drug therapy , Dermatology , Skin Diseases , Carcinoma, Squamous CellABSTRACT
Pharmacological immunosuppression in solid organ transplant recipients is a significant risk factor in the occurrence of actinic keratosis (AK) and later progression into squamous cell carcinomas (SCC). Treating clinical and preclinical lesions is mandatory in this group of patients due to the high changes of progression into SCC. On the other hand, prevention of AK should be considered because it plays a crucial role. Several studies have been published on immunocompetent patients, as well as on the management and prevention of AK, but not on immunosuppressed patients. This review aims to summarize the current knowledge on the management and prevention measures of AK in solid organ transplant recipients.
Subject(s)
Carcinoma, Squamous Cell , Keratosis, Actinic , Organ Transplantation , Skin Neoplasms , Humans , Keratosis, Actinic/drug therapy , Skin Neoplasms/epidemiology , Skin Neoplasms/etiology , Skin Neoplasms/prevention & control , Carcinoma, Squamous Cell/etiology , Carcinoma, Squamous Cell/prevention & control , Carcinoma, Squamous Cell/pathology , Immunocompromised Host , Organ Transplantation/adverse effectsABSTRACT
El síndrome periódico asociado al receptor del factor de necrosis tumoral (TRAPS) es una rara enfermedad autosómica dominante que forma parte de los síndromes autoinflamatorios. Se caracteriza por episodios recurrentes de fiebre e inflamación en distintos sitios del organismo, siendo sus principales manifestaciones: las mialgias, el exantema eritematoso migratorio, el edema periorbitario y el dolor abdominal. El diagnóstico se realiza mediante el análisis genético y su pronóstico está determinado por el desarrollo de amiloidosis, secundaria a los episodios inflamatorios repetidos. Los tratamientos más utilizados son los corticoides y los inhibidores del TNF. Durante los últimos años, gracias a un mayor conocimiento de su patogénesis, se han logrado importantes avances en su diagnóstico y tratamiento. Como dermatólogos es importante tener en cuenta que las manifestaciones cutáneas son particularmente importantes en el TRAPS, ya que muchas veces guían al clínico hacia su correcto diagnóstico (AU)
Tumor necrosis factor receptorassociated periodic syndrome (TRAPS) is a rare autosomal dominant disease included in the group of autoinflammatory syndromes. It is characterized by recurrent episodes of fever and inflammation in different regions of the body. The main clinical manifestations are myalgia, migratory erythematous rash, periorbital edema, and abdominal pain. The diagnosis is reached using gene analysis and prognosis depends on the appearance of amyloidosis secondary to the recurrent episodes of inflammation. Tumor necrosis factor inhibitors and corticosteroids are the most widely used treatments. In recent years, significant advances have been made in the diagnosis and treatment of TRAPS, thanks to a better understanding of its pathogenesis. Dermatologists must be aware that the skin manifestations of TRAPS are particularly important, as they are often diagnostic (AU)
Subject(s)
Humans , Hereditary Autoinflammatory Diseases/diagnosis , Hereditary Autoinflammatory Diseases/drug therapy , Tumor Necrosis Factors/immunology , Biomarkers/analysisABSTRACT
Tumor necrosis factor receptor-associated periodic syndrome (TRAPS) is a rare autosomal dominant disease included in the group of autoinflammatory syndromes. It is characterized by recurrent episodes of fever and inflammation in different regions of the body. The main clinical manifestations are myalgia, migratory erythematous rash, periorbital edema, and abdominal pain. The diagnosis is reached using gene analysis and prognosis depends on the appearance of amyloidosis secondary to the recurrent episodes of inflammation. Tumor necrosis factor inhibitors and corticosteroids are the most widely used treatments. In recent years, significant advances have been made in the diagnosis and treatment of TRAPS, thanks to a better understanding of its pathogenesis. Dermatologists must be aware that the skin manifestations of TRAPS are particularly important, as they are often diagnostic.
