ABSTRACT
BACKGROUND: The long-term efficacy of corticosteroids to prevent atopic dermatitis (AD) relapses has partially been addressed in children. This study compared an intermittent dosing regimen of fluticasone propionate (FP) cream 0.05% with its vehicle base in reducing the risk of relapse in children with stabilized AD. METHODS: A randomized controlled, multicentric, double-blind trial was conducted. Children (2-10 years) with mild/moderate AD (exclusion criteria: >30% affected body surface area and/or head) were enrolled into an Open-label Stabilization Phase (OSP) of up to 2 weeks on twice daily FP. Those who achieved treatment success entered the Double-blind Maintenance Phase (DMP). They were randomly allocated to receive FP or vehicle twice-weekly on consecutive days for 16 weeks. The primary study endpoint was relapse rate; time to relapse and severity of disease were also studied. Kaplan-Meier estimates were calculated. RESULTS: Fifty-four patients (29 girls) entered the OSP (23 mild AD) and 49 (26 girls) continued into the DMP. Mean age was 5.5 (SD: 2.8) and 5.1 (SD: 2.3) yrs for FP and vehicle groups, respectively. Four patients withdrew from the DMP (two in every group). Patients treated with FP twice weekly had a 2.7 fold lower risk of experiencing a relapse than patients treated with vehicle (relative risk 2.72, SD: 1.28; p = 0.034). FP was also superior to vehicle for delaying time to relapse. Both treatment therapies were well tolerated. CONCLUSION: This long-term study shows that twice weekly FP provides an effective maintenance treatment to control the risk of relapse in children with AD
No disponible
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Anti-Inflammatory Agents/therapeutic use , Dermatitis, Atopic/drug therapy , Fluticasone/therapeutic use , Secondary Prevention/methods , Double-Blind MethodABSTRACT
BACKGROUND: The long-term efficacy of corticosteroids to prevent atopic dermatitis (AD) relapses has partially been addressed in children. This study compared an intermittent dosing regimen of fluticasone propionate (FP) cream 0.05% with its vehicle base in reducing the risk of relapse in children with stabilized AD. METHODS: A randomized controlled, multicentric, double-blind trial was conducted. Children (2-10 years) with mild/moderate AD (exclusion criteria: >30% affected body surface area and/or head) were enrolled into an Open-label Stabilization Phase (OSP) of up to 2 weeks on twice daily FP. Those who achieved treatment success entered the Double-blind Maintenance Phase (DMP). They were randomly allocated to receive FP or vehicle twice-weekly on consecutive days for 16 weeks. The primary study endpoint was relapse rate; time to relapse and severity of disease were also studied. Kaplan-Meier estimates were calculated. RESULTS: Fifty-four patients (29 girls) entered the OSP (23 mild AD) and 49 (26 girls) continued into the DMP. Mean age was 5.5 (SD: 2.8) and 5.1 (SD: 2.3) yrs for FP and vehicle groups, respectively. Four patients withdrew from the DMP (two in every group). Patients treated with FP twice weekly had a 2.7 fold lower risk of experiencing a relapse than patients treated with vehicle (relative risk 2.72, SD: 1.28; p=0.034). FP was also superior to vehicle for delaying time to relapse. Both treatment therapies were well tolerated. CONCLUSION: This long-term study shows that twice weekly FP provides an effective maintenance treatment to control the risk of relapse in children with AD.
Subject(s)
Anti-Inflammatory Agents/therapeutic use , Dermatitis, Atopic/drug therapy , Fluticasone/therapeutic use , Secondary Prevention/methods , Child , Child, Preschool , Double-Blind Method , Female , Humans , MaleABSTRACT
No disponible
Subject(s)
Humans , Female , Child , Pilomatrixoma/diagnosis , Skin Neoplasms/diagnosis , Diagnosis, DifferentialSubject(s)
Hair Diseases/pathology , Pilomatrixoma/pathology , Skin Neoplasms/pathology , Child , Female , HumansABSTRACT
La alopecia sifilítica es una manifestación infrecuente de la sífilis, que solo aparece en un 4% de los pacientes. Presentamos 5 casos de alopecia sifilítica y realizamos una revisión de la literatura. Todos los pacientes eran varones, con edades comprendidas entre los 31 y los 46 años. Las lesiones consistían en múltiples placas alopécicas de predominio en la región parietooccipital, irregulares, no cicatriciales, que adoptaban el característico patrón apolillado o en trasquilones. Un paciente comenzó con una alopecia difusa asociada a múltiples lesiones eritematosas y descamativas en el cuero cabelludo. En los 2 casos en que se realizó biopsia cutánea se detectó, mediante tinciones inmunohistoquímicas, la presencia de numerosas espiroquetas en el folículo piloso. Todos los pacientes en seguimiento clínico mejoraron sus lesiones tras el tratamiento. Los dermatólogos deben estar alerta ante esta manifestación infrecuente de la enfermedad, que todavía adquiere mayor relevancia clínica cuando aparece de forma aislada (AU)
Syphilitic alopecia occurs in only 4% of patients with syphilis. We present 5 cases of this uncommon manifestation and review the corresponding literature. All of the patients in our series were men aged between 31 and 46 years. The lesions, which were located mainly in the parieto-occipital area of the scalp, manifested as multiple, irregular, non scarring patches of alopecia that adopted a characteristic patchy moth-eaten pattern. One patient initially presented diffuse alopecia with multiple erythematous scaling lesions. Immunohistochemical staining revealed the presence of numerous spirochetes in the hair follicles in the 2 patients in whom skin biopsy was performed. The lesions improved with treatment in all the patients who attended follow-up. Dermatologists should maintain a high level of clinical suspicion for this uncommon manifestation of syphilis, particularly when it is the only symptom (AU)
Subject(s)
Humans , Male , Adult , Alopecia/complications , Alopecia/diagnosis , Alopecia/therapy , Syphilis, Cutaneous/complications , Syphilis, Cutaneous/diagnosis , Immunohistochemistry/methods , Immunohistochemistry , AIDS Serodiagnosis , HIV Infections/complications , Keratosis/complications , Biopsy/methods , BiopsyABSTRACT
No disponible
Subject(s)
Humans , Male , Infant, Newborn , Nevus, Pigmented/congenital , Nail Diseases/diagnosis , Diagnosis, DifferentialABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Infant, Newborn , Melanosis/diagnosis , Skin Diseases, Vesiculobullous/diagnosis , Diagnosis, DifferentialABSTRACT
Syphilitic alopecia occurs in only 4% of patients with syphilis. We present 5 cases of this uncommon manifestation and review the corresponding literature. All of the patients in our series were men aged between 31 and 46 years. The lesions, which were located mainly in the parieto-occipital area of the scalp, manifested as multiple, irregular, nonscarring patches of alopecia that adopted a characteristic patchy moth-eaten pattern. One patient initially presented diffuse alopecia with multiple erythematous scaling lesions. Immunohistochemical staining revealed the presence of numerous spirochetes in the hair follicles in the 2 patients in whom skin biopsy was performed. The lesions improved with treatment in all the patients who attended follow-up. Dermatologists should maintain a high level of clinical suspicion for this uncommon manifestation of syphilis, particularly when it is the only symptom.
Subject(s)
Alopecia/etiology , Syphilis, Cutaneous/complications , Adult , Humans , Male , Middle AgedSubject(s)
Humans , Male , Child , Hair Diseases/diagnosis , Hair Diseases/drug therapy , Alopecia Areata/complications , Trichophyton , Trichophyton/isolation & purification , Griseofulvin/therapeutic use , Microsporum , Microsporum/isolation & purification , Hair/microbiology , Hair/pathology , Hair Diseases/microbiology , Hair Diseases/physiopathology , Hair Diseases , Scalp , Scalp/injuries , Scalp/pathologySubject(s)
Dermoscopy , Hair/pathology , Tinea Capitis/pathology , Child , Child, Preschool , Humans , MaleSubject(s)
Humans , Female , Child , Onychomycosis/diagnosis , Onychomycosis/therapy , Eczema/complications , Eczema/diagnosis , Eczema/therapy , Antifungal Agents/therapeutic use , Diagnosis, Differential , Arthrodermataceae/isolation & purification , Arthrodermataceae/pathogenicity , Antifungal Agents/metabolism , Microscopy/methods , MicroscopyABSTRACT
No disponible
No disponible
Subject(s)
Humans , Male , Adolescent , Fibrosis/diagnosis , Osteopoikilosis/diagnosis , Sclerosis/diagnosis , Bone Diseases/diagnosisSubject(s)
Osteopoikilosis/diagnosis , Skin Diseases/diagnosis , Adolescent , Humans , Male , SyndromeABSTRACT
No disponible
No disponible
