ABSTRACT
BACKGROUND: An intermittent short course of cyclosporin A (CyA) therapy is a good choice in the treatment of severe psoriasis. Nevertheless, some severe or resistant patients might benefit from long-term treatment. Adverse effects of long-term use of CyA are investigated and the results are compared with the literature. PATIENTS AND METHODS: A retrospective study of adverse effects of CyA treatment in a group of 53 patients suffering from psoriasis. The mean treatment time was 31.4 +/- 23.2 months with a minimum of 4 months to a maximum of 95 months, with very few short interruptions of treatment (from 2 to 5 months in five patients). RESULTS: The group consisted of 29 women and 24 men, ranging in age from 18 to 65 years, with an average age of 44.49 years. Arterial hypertension appeared in 45.3% of patients during treatment. Pharmacological treatment was required in 32% of these patients to control the condition. Serum creatinine levels were transiently elevated in 11.3% of the cases, but withdrawal of treatment was required in none of them. DISCUSSION: Long-term CyA treatment might be necessary in some patients and this study shows that it could be sustained with a close follow-up. This involves regular visits depending on each patient, as well as common test protocol and clinical evaluation. In conclusion, this retrospective study seems to confirm the relative safety of long-term CyA treatment when patients are adequately monitored.
Subject(s)
Cyclosporine/therapeutic use , Dermatologic Agents/therapeutic use , Immunosuppressive Agents/therapeutic use , Psoriasis/drug therapy , Adolescent , Adult , Aged , Chronic Disease , Cyclosporine/adverse effects , Dermatologic Agents/adverse effects , Female , Humans , Immunosuppressive Agents/adverse effects , Male , Middle Aged , Retrospective StudiesSubject(s)
Sweet Syndrome/chemically induced , Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Sweet Syndrome/diagnosis , Sweet Syndrome/therapyABSTRACT
Cutaneous diseases are often found in obese patients but, to our knowledge, mucinous disorders have not been previously reported in association with obesity. Two cases of localized lichen myxoedematosus (papular mucinosis) in two women with morbid obesity are described. Both patients underwent a low-calorie diet for a 1-year period in one case, and for 4 months in the other one, as the only treatment. There was complete resolution of cutaneous lesions at the same time that an important weight loss was observed. Nevertheless, although spontaneous regression is not frequent, it could not be disregarded in either of these two cases.
Subject(s)
Mucinoses/etiology , Obesity, Morbid/complications , Skin Diseases, Papulosquamous/etiology , Adult , Female , Humans , Middle Aged , Mucinoses/pathology , Skin Diseases, Papulosquamous/pathologySubject(s)
Gastritis/microbiology , Helicobacter Infections , Helicobacter pylori , Psoriasis/microbiology , Adult , Female , HumansSubject(s)
Clobetasol/analogs & derivatives , Lichen Sclerosus et Atrophicus/pathology , Nails/pathology , Administration, Topical , Adult , Anti-Inflammatory Agents/therapeutic use , Clobetasol/therapeutic use , Diagnosis, Differential , Glucocorticoids , Humans , Lichen Sclerosus et Atrophicus/drug therapy , MaleABSTRACT
OBJECTIVE: The aim of the present study was to find out whether emotional stress is related to palmoplantar pustulosis (PPP). SUBJECTS AND METHODS: Our 21 patients with palmoplantar pustulosis and 21 age- and sex-matched controls were studied with the help of a psychological interview and two psychological tests: Eysenk's Personality Questionnaire for Adults (EPQ-A) and Inventory of Situations and Response of Anxiety (ISRA). RESULTS: Anxiety, ranging from moderate to severe was higher in PPP patients than in controls (P < 0.001). CONCLUSION: Our findings seem to indicate that stress may be related to exacerbation of the palmoplantar pustulosis.
Subject(s)
Psoriasis/diagnosis , Psoriasis/psychology , Adult , Age Distribution , Anxiety/diagnosis , Anxiety/psychology , Case-Control Studies , Cohort Studies , Female , Humans , Incidence , Male , Middle Aged , Personality , Psoriasis/epidemiology , Reference Values , Risk Assessment , Risk Factors , Sensitivity and Specificity , Sex Distribution , Spain/epidemiology , Stress, Psychological , Surveys and QuestionnairesABSTRACT
La queratosis seborreica es uno de los tumores epidérmicos benignos más frecuentes encontrados en la práctica clínica. Su transformación maligna es excepcional. Presentamos el caso de la aparición inusual de dos queratosis seborreicas irritadas simétricas en los brazos de un trasplantado renal (AU)
Subject(s)
Adult , Male , Humans , Keratosis, Seborrheic/diagnosis , Keratosis, Seborrheic/etiology , Kidney Transplantation/adverse effects , Keratosis, Seborrheic/surgerySubject(s)
Contraceptives, Oral/adverse effects , Sweet Syndrome/chemically induced , Adult , Drug Therapy, Combination , Female , Follow-Up Studies , Humans , Menstruation Disturbances/drug therapy , Mometasone Furoate , Prednisone/administration & dosage , Pregnadienediols/administration & dosage , Sweet Syndrome/drug therapy , Treatment OutcomeABSTRACT
El conocimiento y correcto empleo de las diferentes técnicas de radioterapia suponen una gran ayuda en el manejo de los pacientes con carcinomas basocelulares. En nuestro Servicio continuamos empleando la técnica de radioterapia de contacto para estas neoplasias en un número elevado de enfermos. Hemos recogido los datos referentes a los tumores tratados durante los años 1997, 1998 y 1999, un total de 279, y hemos analizado los datos epidemiológicos de la muestra, edad, sexo y fototipo, así como tamaño, tipo clínico, localización, cicatrización y recidivas de los tumores. Empleamos una técnica desarrollada por nuestro equipo, consistente en tres sesiones de 10 Gy, hasta un total de 30 Gy, lo cual supone un buen balance entre la comodidad del enfermo y los resultados médicos en tasas de curación y resultado estético de las cicatrices. Los pacientes tratados fueron en su mayoría de pelo oscuro en la edad adulta y ojos claros. Hemos tratado lesiones de 0,5 a 3,5 cm de diámetro con un 5% de recidivas y un 22,3% de cicatrices imperceptibles (AU)
Subject(s)
Carcinoma, Basal Cell/therapy , Radiotherapy/methodsABSTRACT
Paracoccidioidomycosis is a common fungal infection in Latin America. Few cases have been described in non-endemic countries and their diagnosis without the correct suspicion, bearing in mind that the latency period might be up to 60 years, may not be easy. We report the case of a 59-year-old man who worked as a taxi driver for 25 years in Venezuela. Cutaneous paracoccidioidomycosis was diagnosed one year after he returned to Spain. No internal signs or symptoms of the disease were found and cell-mediated immunity showed no depression. Our case suggested us to consider direct cutaneous infection, although respiratory tract is believed to be the most frequent portal of entry for this infection.
Subject(s)
Paracoccidioidomycosis , Humans , Male , Middle Aged , Paracoccidioidomycosis/diagnosis , Paracoccidioidomycosis/drug therapy , Paracoccidioidomycosis/pathology , Skin/pathologyABSTRACT
Las linfangiectasias cutáneas se han descrito clásicamente como una rara complicación tras mastectomía radical o tratamiento radioterápico o quirúrgico de carcinomas de cervix con o sin linfadenectomía. El principal factor desencadenante que se ha barajado es la obstrucción linfática profunda. Con posterioridad han aparecido en la literatura algunos casos cuyos antecedentes parecen tener más relación con factores locales en la matriz intercelular dérmica, que con daño profundo del sistema linfático.Describimos el caso de un linfangioma adquirido localizado en vulva tras una histerectomía radical con radioterapia posterior debido a un carcinoma de cervix y discutiremos la etiopatogenia de esta entidad (AU)
Subject(s)
Female , Middle Aged , Humans , Lymphangiectasis/etiology , Hysterectomy/adverse effects , Lymphangiectasis/diagnosis , Lymphangiectasis/pathology , Lymphangiectasis/radiotherapy , Vulva/pathology , Postoperative Complications , Carcinoma, Squamous Cell/surgery , Lymph Node Excision/methods , Radiotherapy/methodsABSTRACT
Only a few reports of primary cutaneous rhabdoid tumors have been published. We describe the case of a 3-month-old female patient who developed a rhabdoid type cutaneous sarcomatoid neoplasm in her upper back, close to a benign myofibromatous proliferation of infancy. The lesion was studied both by light microscopy and immunohistochemically. Flow cytometry was performed showing a DNA diploid profile of the malignant tumor. The pathological findings suggest a mesenchymal origin (hemangiopericytic or myofibroblastic type) for both tumors. The patient was surgically treated, but she died nine months later.
Subject(s)
Mesenchymoma/pathology , Neoplasms, Multiple Primary/pathology , Rhabdoid Tumor/pathology , Skin Neoplasms/pathology , Biomarkers, Tumor/analysis , Cell Separation , DNA, Neoplasm/analysis , Fatal Outcome , Female , Flow Cytometry , Humans , Immunoenzyme Techniques , Infant , Mesenchymoma/chemistry , Mesenchymoma/genetics , Mesenchymoma/surgery , Neoplasms, Multiple Primary/chemistry , Neoplasms, Multiple Primary/genetics , Neoplasms, Multiple Primary/surgery , Ploidies , Rhabdoid Tumor/chemistry , Rhabdoid Tumor/genetics , Rhabdoid Tumor/surgery , Skin Neoplasms/chemistry , Skin Neoplasms/genetics , Skin Neoplasms/surgeryABSTRACT
Primary cutaneous mucormycosis is a deep fungal infection, mainly seen in diabetics and immunocompromised subjects. Rapid diagnosis and therapy are necessary to avoid fatal outcome. We describe the complete histopathological and microbiological studies of primary cutaneous mucormycosis in a 74-year-old man with several risk factors, such as chronic obstructive pulmonary disease, respiratory acidosis, hemolytic anemia, myelodysplastic syndrome and iatrogenic diabetes, due to corticosteroid therapy. He developed two cutaneous necrotic scars on his left leg. Mucormycosis was suspected and specimens from surgical débridement were histopathologically and microbiologically studied confirming the clinical diagnosis. Amphotericin B was given topically and intravenously resulting in complete healing of the ulcer. Risk factors and microbiological studies are compared with those in the current literature. It is necessary in certain cases to suspect mucormycosis infections in diabetics, immunocompromised subjects and even in healthy individuals. Rapid diagnosis and treatment are important, but they should be based on complete histopathological and microbiological studies, to establish the genus of the causal agent.
Subject(s)
Dermatomycoses/pathology , Leg Ulcer/pathology , Mucormycosis/pathology , Aged , Diagnosis, Differential , Humans , Leg Ulcer/microbiology , Male , Mucormycosis/microbiology , Rhizopus/isolation & purificationSubject(s)
PUVA Therapy , Scleroderma, Localized/drug therapy , Abdomen , Humans , Male , Scleroderma, Localized/pathologyABSTRACT
The ultrastructure was studied of 2 cases of proliferative fasciitis (PF) which affected the fascia and subcutaneous fat. Two basic cell types were observed in the lesions: fibroblast-like, and giant cells. The fibroblast-like cells had myofibroblastic ultrastructural characteristics. The giant cells showed a well-developed, rough endoplasmic reticulum, irregularly distributed filaments and clear lipid droplets in their cytoplasms. Ultrastructurally, the giant cells seemed to belong to a cellular line capable of synthesizing ground substances and extracellular fibers, but with a modified phenotype. A consistent feature was the presence of nodular aggregates of numerous proliferating perivascular cells. Transitional forms between perivascular, fibroblast-like, and giant cells were observed. Our hypothesis is that perivascular cells (activated pericytes) are the source of the fibroblast-like and giant cells in proliferative fasciitis.
Subject(s)
Fascia/ultrastructure , Fasciitis/pathology , Fascia/pathology , Fasciitis/diagnosis , Fasciitis/etiology , Humans , Male , Microscopy, Electron , Middle AgedABSTRACT
Se estudia la endemia hanseniana en la provincia de Santa Cruz de Tenerife, con cifras parciales cada 5 años. Analizamos los datos de enfermos activos en control, fallecidos, nuevos casos por año, índices de prevalencia e incidencia así como las formas clínicas. Después de 25 años, los índices de prevalencia han disminuido en un 50 por ciento. Todavia seguimos observado casos nuevos, en número de 4 a 6 por año, con una incidencia actual del 0'004 X 1.000.
