ABSTRACT
Childhood-onset psoriasis generally follows an indolent course but patients with moderate or severe disease may require systemic treatment. The aim of this study was to determine the relative proportion of children and young people aged up to 21 years with moderate to severe psoriasis in the BIOBADADERM registry and to analyze the characteristics of these patients, treatments used, and adverse events. Of the 3946 patients in the registry, 24 were aged 21 years or younger. They had mean age of 16.1 years on starting treatment. When the registry was started, they had a Psoriasis Area and Severity Index of 9.4 and 67% were being treated with a conventional systemic drug. Treatment was discontinued in 14 patients (58%) due to adverse events or a loss or lack of effectiveness. In conclusion, the BIOBADADERM registry shows that young people account for a small proportion of psoriasis patients receiving systemic treatment, and they are more likely to be treated using conventional systemic drugs.
Subject(s)
Biological Products , Psoriasis , Adolescent , Biological Products/therapeutic use , Child , Humans , Psoriasis/chemically induced , Psoriasis/drug therapy , Psoriasis/epidemiology , RegistriesABSTRACT
BACKGROUND: Methotrexate (MTX) is frequently used in the treatment of moderate-to-severe psoriasis, however, there is limited data on health-related quality-of-life (HRQoL), psoriasis clinical outcomes and hepatic fibrosis in MTX-treated patients in routine clinical practice. OBJECTIVES: To investigate the impact of moderate-to-severe psoriasis in MTX-treated patients in Spain regarding to HRQoL, psoriasis clinical data and risk of hepatic fibrosis. METHODS: Observational, non-interventional, cross-sectional, retrospective, multicentre study, performed in Spain in moderate-to-severe plaque psoriasis patients treated with MTX > 16 weeks prior to inclusion. RESULTS: Despite ongoing treatment, 17.1% of 457 evaluable patients reported moderate-to-extreme impact on HRQoL (DLQI > 5); 21.4% BSA > 5 and 35.2% moderate-to-severe pruritus (VAS ≥ 4). Persistent severe psoriasis (PASI ≥ 10 and/or DLQI ≥ 10) was observed in 10.7%. Hepatic steatosis was identified in 64.1% of patients (HSI ≥ 36) and 37.2% of the patients were at-risk of advanced fibrosis which was associated to the MTX treatment duration. CONCLUSIONS: The study identified unmet needs in moderate-to-severe plaque psoriasis patients treated with MTX, revealing a significant proportion of sub-optimally controlled patients in terms of HRQoL and different domains of the disease. This study also found patients at-risk of advanced fibrosis, with evidence suggesting a correlation between longer exposures to MTX and higher risk of advanced fibrosis.
Subject(s)
Dermatologic Agents , Psoriasis , Cross-Sectional Studies , Dermatologic Agents/adverse effects , Humans , Liver Cirrhosis , Methotrexate/therapeutic use , Psoriasis/chemically induced , Psoriasis/drug therapy , Quality of Life , Retrospective Studies , Severity of Illness Index , Treatment OutcomeABSTRACT
ANTECEDENTES Y OBJETIVOS: Las guías sobre el tratamiento de la psoriasis habitualmente no incluyen las recomendaciones acerca de cuál debe ser la primera línea de tratamiento sistémico o biológico. Los objetivos de este estudio fueron describir las tendencias en la prescripción del primer fármaco biológico y comparar la retirada de los fármacos y las tasas de efectos adversos a lo largo de los 10 años de seguimiento. MATERIAL Y MÉTODOS: Se utilizó el registro Biobadaderm para determinar cuál fue el primer fármaco biológico indicado en pacientes con psoriasis naïve para biológicos, así como cuál es la tasa de efectos adversos y los motivos de suspensión de los fármacos. Los resultados obtenidos se compararon en tres periodos distintos de tiempo (2008-2010, 2011-2014, 2015-2018). RESULTADOS: Los fármacos anti-TNF fueron los biológicos prescritos con mayor frecuencia entre los años 2008 y 2010. Ustekinumab se convirtió en el tratamiento biológico más indicado a partir de 2014. El motivo principal de suspensión de los tratamientos fueron los efectos adversos, la falta de eficacia y la remisión de la enfermedad. La probabilidad de suspender los fármacos por uno de estos motivos fue cada vez menor si se compara con el periodo de tiempo previo. CONCLUSIONES: El presente estudio identifica cuáles fueron las tendencias en la prescripción del primer fármaco biológico en la práctica clínica habitual entre los años 2008 y 2018. Sugiere que los dermatólogos estamos cada vez más seguros en cuanto al perfil de seguridad y somos cada vez más exigentes en cuanto a la eficacia de los fármacos
BACKGROUND AND OBJECTIVES: Current psoriasis guidelines do not usually include recommendations about first line classical or biologic treatment. The objectives of this study were: to describe shifts in the prescription of the first biological treatment, and to compare treatment withdrawal and rates of adverse events over ten years. MATERIAL AND METHODS: Biobadaderm registry was analyzed to describe: first biological prescription in bio-naïve patients, adverse events rate and reasons for drug withdrawal comparing three periods of time (2008-2010, 2011-2014, 2015-2018). RESULTS: Anti-TNF drugs were the most prescribed biological drug from 2008 to 2010. Ustekinumab has become the most prescribed first biologic since 2014. The main reasons for drug discontinuation were adverse events, lack of efficacy and remission. In each period any treatment was less likely to be discontinued due to any of these three reasons comparing to the previous period. CONCLUSIONS: The present study identifies trends in prescription of the first biological antipsoriatic drug in clinical practice from 2008 to 2018. It suggests that we have become more comfortable with the safety profile and more exigent with the efficacy of the drugs
Subject(s)
Humans , Female , Adult , Middle Aged , Biological Therapy/methods , Psoriasis/therapy , Biological Products/adverse effects , Cohort Studies , Immunosuppressive Agents/adverse effects , Biological Products/therapeutic use , Withholding Treatment , Prospective Studies , Psoriasis/diagnosis , Statistics, Nonparametric , Confidence Intervals , Antibodies, Monoclonal/adverse effects , Interleukin-17/antagonists & inhibitorsABSTRACT
BACKGROUND AND OBJECTIVES: Current psoriasis guidelines do not usually include recommendations about first line classical or biologic treatment. The objectives of this study were: to describe shifts in the prescription of the first biological treatment, and to compare treatment withdrawal and rates of adverse events over ten years. MATERIAL AND METHODS: Biobadaderm registry was analyzed to describe: first biological prescription in bio-naïve patients, adverse events rate and reasons for drug withdrawal comparing three periods of time (2008-2010, 2011-2014, 2015-2018). RESULTS: Anti-TNF drugs were the most prescribed biological drug from 2008 to 2010. Ustekinumab has become the most prescribed first biologic since 2014. The main reasons for drug discontinuation were adverse events, lack of efficacy and remission. In each period any treatment was less likely to be discontinued due to any of these three reasons comparing to the previous period. CONCLUSIONS: The present study identifies trends in prescription of the first biological antipsoriatic drug in clinical practice from 2008 to 2018. It suggests that we have become more comfortable with the safety profile and more exigent with the efficacy of the drugs.
Subject(s)
Biological Products , Psoriasis , Drug Prescriptions , Humans , Psoriasis/drug therapy , Registries , Tumor Necrosis Factor InhibitorsABSTRACT
No disponible
Subject(s)
Humans , Female , Adult , Necrobiosis Lipoidica/diagnosis , Diabetes Mellitus, Type 1/complications , Clobetasol/administration & dosage , Triamcinolone Acetonide/administration & dosage , Diagnosis, DifferentialABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Histiocytoma, Benign Fibrous , Microscopy, Confocal/instrumentation , Microscopy, Confocal/methods , Histiocytoma, Benign Fibrous/surgery , Diagnosis, Differential , Ultrasonography, Doppler, Color/instrumentation , Ultrasonography, Doppler, Color/methods , Ultrasonography, Doppler, ColorSubject(s)
Histiocytoma, Benign Fibrous/diagnostic imaging , Skin Neoplasms/diagnostic imaging , Ultrasonography, Doppler , Abdomen , Adult , Arm , Carcinoma, Squamous Cell , Female , Histiocytoma, Benign Fibrous/blood supply , Humans , Male , Middle Aged , Neoplasms, Second Primary/diagnostic imaging , Pharyngeal Neoplasms , Skin Neoplasms/blood supplyABSTRACT
No disponible
Subject(s)
Humans , Female , Adult , Hyperpigmentation/pathology , Axilla/anatomy & histology , Axilla/physiopathology , Groin/anatomy & histology , Groin/physiopathology , Pruritus/complications , Pruritus/diagnosis , Epidermolysis Bullosa Simplex/complications , Epidermolysis Bullosa Simplex/diagnosis , Biopsy/instrumentation , Biopsy/methods , Epidermolysis Bullosa Simplex/physiopathology , Malignant Atrophic Papulosis/complications , Malignant Atrophic Papulosis/diagnosisABSTRACT
Hidradenitis suppurativa (HS) is a chronic, recurrent inflammatory disease affecting the skin folds. Multiple therapeutic options have been proposed for severe cases, but persistent responses are rarely seen. Important complications of HS are uncommon, and usually seen only in severe and unresponsive disease. Amyloid A (AA) amyloidosis is secondary to inflammatory chronic diseases, and is an uncommon complication of dermatological diseases. Only a few cases related with HS have been reported. We report the case of a 37-year-old patient who developed AA amyloidosis secondary to severe HS.
Subject(s)
Amyloidosis/etiology , Hidradenitis Suppurativa/complications , Kidney Diseases/etiology , Adult , Chronic Disease , Female , Humans , Nephrotic Syndrome/etiologySubject(s)
Acute Generalized Exanthematous Pustulosis/etiology , Allergens/adverse effects , Dermatitis, Allergic Contact/etiology , Thiazoles/adverse effects , Acute Generalized Exanthematous Pustulosis/diagnosis , Acute Generalized Exanthematous Pustulosis/drug therapy , Acute Generalized Exanthematous Pustulosis/pathology , Adult , Allergens/isolation & purification , Cosmetics/adverse effects , Cosmetics/chemistry , Cyclosporine/therapeutic use , Dermatitis, Allergic Contact/diagnosis , Dermatitis, Allergic Contact/drug therapy , Dermatitis, Allergic Contact/pathology , Dermatologic Agents/therapeutic use , Female , Humans , Prednisone/therapeutic useSubject(s)
Folliculitis/microbiology , Pseudomonas Infections , Pseudomonas aeruginosa , Child , Female , Humans , RecurrenceABSTRACT
Eosinophilic polymorphic and pruritic eruption associated with radiotherapy (EPPER) is a rare entity that appears in oncological patients after radiotherapy. We describe two patients with breast tumour who presented with EPPER in a different area from the one that had been irradiated. One of them needed different types of treatment, topical and systemic corticosteroids, antihistamines and narrowband ultraviolet B. The other one responded to the application of topical corticosteroids. We suggested that this eruption could be more frequent than has been reported.
