Series of Fourteen Cases of Topical Imiquimod 5% in Lentigo Maligna: Treatment Modalities and Clues for Detecting Recurrences. / [Artículo traducido] Serie de 14 casos de tratamiento con imiquimod tópico al 5% en lentigo maligno: modalidades terapéuticas y claves para detectar recidivas.

Topical imiquimod has been used off-label as monotherapy or adjuvant treatment for lentigo maligna. Our aim is to describe treatment modalities, clinical outcomes, and management of recurrence in patients receiving imiquimod for lentigo maligna. Patients from our unit with lentigo maligna or lentigo maligna melanoma treated with imiquimod 5% as monotherapy or in combination with surgery were included in this study. Fourteen cases were recruited (85.7% lentigo maligna and 14.3% lentigo maligna melanoma). Eight patients (57.1%) received imiquimod without surgery, and six (42.9%) underwent narrow excision before beginning treatment. During the follow-up period, pigmentation reappeared in 6 patients (4 postinflammatory hyperpigmentation and 2 relapses). Relapses were managed with very narrow excision (1 mm margin) and retreatment with imiquimod 5%. All imiquimod modalities showed well-tolerated side effects and low recurrence rates, with long periods of follow-up. Imiquimod appears to be a versatile option for treating LM in suitable candidates.

Series of Fourteen Cases of Topical Imiquimod 5% in Lentigo Maligna: Treatment Modalities and Clues for Detecting Recurrences.

Topical imiquimod has been used off-label as monotherapy or adjuvant treatment for lentigo maligna. Our aim is to describe treatment modalities, clinical outcomes, and management of recurrence in patients receiving imiquimod for lentigo maligna. Patients from our unit with lentigo maligna or lentigo maligna melanoma treated with imiquimod 5% as monotherapy or in combination with surgery were included in this study. Fourteen cases were recruited (85.7% lentigo maligna and 14.3% lentigo maligna melanoma). Eight patients (57.1%) received imiquimod without surgery, and six (42.9%) underwent narrow excision before beginning treatment. During the follow-up period, pigmentation reappeared in 6 patients (4 postinflammatory hyperpigmentation and 2 relapses). Relapses were managed with very narrow excision (1mm margin) and retreatment with imiquimod 5%. All imiquimod modalities showed well-tolerated side effects and low recurrence rates, with long periods of follow-up. Imiquimod appears to be a versatile option for treating LM in suitable candidates.

Series of Fourteen Cases of Topical Imiquimod 5% in Lentigo Maligna: Treatment Modalities and Clues for Detecting Recurrences / Serie de 14 casos de tratamiento con imiquimod tópico al 5% en lentigo maligno: modalidades terapéuticas y claves para detectar recidivas

Topical imiquimod has been used off-label as monotherapy or adjuvant treatment for lentigo maligna. Our aim is to describe treatment modalities, clinical outcomes, and management of recurrence in patients receiving imiquimod for lentigo maligna. Patients from our unit with lentigo maligna or lentigo maligna melanoma treated with imiquimod 5% as monotherapy or in combination with surgery were included in this study. Fourteen cases were recruited (85.7% lentigo maligna and 14.3% lentigo maligna melanoma). Eight patients (57.1%) received imiquimod without surgery, and six (42.9%) underwent narrow excision before beginning treatment. During the follow-up period, pigmentation reappeared in 6 patients (4 postinflammatory hyperpigmentation and 2 relapses). Relapses were managed with very narrow excision (1mm margin) and retreatment with imiquimod 5%. All imiquimod modalities showed well-tolerated side effects and low recurrence rates, with long periods of follow-up. Imiquimod appears to be a versatile option for treating LM in suitable candidates (AU)

Imiquimod tópico ha sido utilizado como monoterapia o tratamiento adyuvante fuera de indicación para el lentigo maligno (LM). Nuestro objetivo es describir las modalidades de tratamiento, los resultados clínicos y el manejo de la recidiva en los pacientes que reciben imiquimod para lentigo maligno. Se incluyó en este estudio a los pacientes de nuestra unidad con lentigo maligno o lentigo maligno melanoma tratados con imiquimod 5% en régimen de monoterapia o junto con cirugía. Se seleccionaron 14 casos (el 85,7% de lentigo maligno y el 14,3% de lentigo maligno melanoma). Ocho pacientes (57,1%) recibieron imiquimod sin cirugía, y seis (42,9%) fueron sometidos a resección antes de iniciar el tratamiento. Durante el periodo de seguimiento, reapareció la pigmentación en seis pacientes (cuatro con hiperpigmentación postinflamatoria y dos recidivas). Las recidivas fueron tratadas con un margen de resección muy estrecho (1mm) y retratamiento con imiquimod 5%. Todas las modalidades de imiquimod reflejaron buena tolerancia de efectos secundarios y bajas tasas de recidiva. Imiquimod parece ser una opción muy versátil para tratar LM en candidatos idóneos (AU)

[Artículo traducido] Serie de 14 casos de tratamiento con imiquimod tópico al 5% en lentigo maligno: modalidades terapéuticas y claves para detectar recidivas / Series of Fourteen Cases of Topical Imiquimod 5% in Lentigo Maligna: Treatment Modalities and Clues for Detecting Recurrences

Imiquimod tópico ha sido utilizado como monoterapia o tratamiento adyuvante fuera de indicación para el lentigo maligno (LM). Nuestro objetivo es describir las modalidades de tratamiento, los resultados clínicos y el manejo de la recidiva en los pacientes que reciben imiquimod para lentigo maligno. Se incluyó en este estudio a los pacientes de nuestra unidad con lentigo maligno o lentigo maligno melanoma tratados con imiquimod 5% en régimen de monoterapia o junto con cirugía. Se seleccionaron 14 casos (el 85,7% de lentigo maligno y el 14,3% de lentigo maligno melanoma). Ocho pacientes (57,1%) recibieron imiquimod sin cirugía, y seis (42,9%) fueron sometidos a resección antes de iniciar el tratamiento. Durante el periodo de seguimiento, reapareció la pigmentación en seis pacientes (cuatro con hiperpigmentación postinflamatoria y dos recidivas). Las recidivas fueron tratadas con un margen de resección muy estrecho (1mm) y retratamiento con imiquimod 5%. Todas las modalidades de imiquimod reflejaron buena tolerancia de efectos secundarios y bajas tasas de recidiva. Imiquimod parece ser una opción muy versátil para tratar LM en candidatos idóneos (AU)

Topical imiquimod has been used off-label as monotherapy or adjuvant treatment for lentigo maligna. Our aim is to describe treatment modalities, clinical outcomes, and management of recurrence in patients receiving imiquimod for lentigo maligna. Patients from our unit with lentigo maligna or lentigo maligna melanoma treated with imiquimod 5% as monotherapy or in combination with surgery were included in this study. Fourteen cases were recruited (85.7% lentigo maligna and 14.3% lentigo maligna melanoma). Eight patients (57.1%) received imiquimod without surgery, and six (42.9%) underwent narrow excision before beginning treatment. During the follow-up period, pigmentation reappeared in 6 patients (4 postinflammatory hyperpigmentation and 2 relapses). Relapses were managed with very narrow excision (1mm margin) and retreatment with imiquimod 5%. All imiquimod modalities showed well-tolerated side effects and low recurrence rates, with long periods of follow-up. Imiquimod appears to be a versatile option for treating LM in suitable candidates (AU)

Use of barbed suture in total hip prosthesis. Prospective randomized study. / Utilización de sutura barbada en prótesis total de cadera. Estudio prospectivo aleatorizado.

INTRODUCTION: The correct closure of the surgical wound is an important step in the procedure of a total hip prosthesis implantation (total hip arthroplasty, THA), which aims to a correct healing of the wound and minimize the risk of complications. The objective of our study is to determine if the use of a bidirectional barbed suture decreases the closing time after THA, in the fascial and subcutaneous plane, when compared to the conventional suture polyglactin 910. The hypothesis is that there is no difference in closing time when comparing both sutures. MATERIAL AND METHOD: Prospective single blind randomized study comparing two groups: study group with the use of bidirectional continuous barbed suture (Quill™) (Gr. Q) and a control group (Gr. V) using discontinuous polyglactin 91 suture (Vicryl™). Closure was performed in two planes (fascial and subcutaneous) simultaneously by two surgeons. The exclusion criteria were: previous surgeries on the same hip, revision surgeries, major deformities and allergies to suture components. The variables under study were: 1) fascia closure time, subcutaneous and global; 2) surgical wound infection; and 3) dehiscence. RESULTS: 82 patients (39 Gr. Q, 43 Gr. V) were included. The global closing time was shorter in Gr. Q (5 min 59 sec) compared to Gr. V (7.01 min), (p < 0.04). They showed differences in subcutaneous closure: Gr. Q shorter time with a 37 seconds difference (p = 0.048). Differences in fascial plane were not observed. Superficial infection was observed in one Gr. Q patient and another in Gr. V; one case of deep infection in Gr. Q (p = 0.29). One patient presented dehiscence of the wound in Gr. Q (p = 0.3). However, these differences did not show statistical significance. CONCLUSIONS: The use of a barbed suture allows a shorter closing time compared to the conventional one. However, despite this decrease in time, no differences were found in terms of the appearance of infection or wound dehiscence.

Fístula mamilar como una posible manifestación de una hidradenitis supurativa / Mammillary Fistula as a Possible Manifestation of Hidradenitis Suppurativa

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Nefropatía por aciclovir en un paciente con sospecha de toxicidad por opioides: caso clínico / Acyclovir nephropathy in a patient with suspected opioid toxicity: case report

El tratamiento actual de la neuritis herpética, basado en la evidencia, comprende la administración precoz de antivirales y analgésicos que según su intensidad pueden ser opioides potentes. No es común realizar en forma rutinaria la monitorización de la función renal a pesar de que existen reportes sobre insuficiencia renal secundaria al uso de antivirales. Presentamos un caso de nefrotoxicidad por aciclovir, en donde la manifestación clínica principal fue la alteración del estado de consciencia que fue interpretado como toxicidad por opioides. Se trata de una paciente femenina de 49 años con cuadro de neuritis herpética en tratamiento analgésico con morfina y codeína, quien desarrolló deterioro agudo del estado de consciencia e insuficiencia renal aguda, requiriendo hemodiálisis. Consideramos relevante este caso, con la intención de resaltar la importancia de la monitorización de la función renal en los pacientes que reciben terapia con estos medicamentos (AU)

Based on the evidence, the current management of herpes zoster and its sequela post-herpetic neuralgia (PHN) relies upon the early onset of antiviral agents and analgesics, and depending on the severity of the pain those can be strong opioids. It is uncommon to monitor the renal function in patients with this treatment, even though there are reports of nephrotoxicity secondary to the antiviral use. We presented a case of a 49-year-old woman who was admitted for herpes zoster treatment, and developed renal insufficiency following a treatment with acyclovir. The main clinical manifestation was a change in the neurologic status, which was first interpreted as opioid toxicity. The patient was treated with hemodialysis obtaining full recovery. We consider this report relevant as it stresses the importance of monitoring the renal function in patients receiving this type of medication (AU)