ABSTRACT
Kaposi's sarcoma (KS) is an angioproliferative disorder caused by human herpesvirus 8 (HHV-8). Current research efforts have focused on the study of the relative role of KSHV-encoded genes in Kaposi's sarcomagenesis in order to identify novel mechanism-based therapies for patients suffering from this tumor. Although several viral genes have potential for KS pathogenesis, compelling data point to the KSHV-encoded G protein-coupled receptor (vGPCR) as a leading candidate viral gene for the initiation of KS. Interestingly, the oncogenic potential of vGPCR seems to correlate with its capacity to activate the mammalian target of rapamycin (mTOR) signaling pathway. Rapamycin, the prototypical inhibitor of the mTOR signaling pathway, has recently emerged as an effective treatment for KS when administered orally. In this case report, we present an immunocompetent patient with KS lesions treated with topical rapamycin achieving clinical and histologic healing after 16 weeks of treatment. The topical application of rapamycin could be a novel therapeutic option for the treatment of KS.
Subject(s)
Antibiotics, Antineoplastic/therapeutic use , Sarcoma, Kaposi/drug therapy , Sirolimus/therapeutic use , Skin Neoplasms/drug therapy , Administration, Cutaneous , Aged , Antibiotics, Antineoplastic/administration & dosage , Antibiotics, Antineoplastic/pharmacology , Humans , Male , Sarcoma, Kaposi/pathology , Sirolimus/administration & dosage , Sirolimus/pharmacology , Skin Neoplasms/pathology , Treatment OutcomeSubject(s)
Blister/virology , Hand Dermatoses/virology , Herpes Simplex/diagnosis , Herpes Simplex/drug therapy , Acyclovir/analogs & derivatives , Acyclovir/therapeutic use , Adult , Antiviral Agents/therapeutic use , Blister/diagnosis , Blister/drug therapy , Diagnosis, Differential , Female , Hand Dermatoses/diagnosis , Hand Dermatoses/drug therapy , Humans , Prodrugs/therapeutic use , Real-Time Polymerase Chain Reaction , Recurrence , Valacyclovir , Valine/analogs & derivatives , Valine/therapeutic useABSTRACT
BACKGROUND: Necrobiosis lipoidica presents with a distinctive appearance making it an important clinical diagnosis. OBJECTIVE: To describe a case of necrobiosis lipoidica in a patient with type 1 diabetes mellitus, and to discuss differential diagnoses and management. DISCUSSION: Necrobiosis lipoidica is most commonly found on the shins, presenting as a well-defined plaque. Management is challenging and options are discussed. Avoiding ulceration is a key concern.
Subject(s)
Diabetes Mellitus, Type 1/complications , Immunosuppressive Agents/therapeutic use , Necrobiosis Lipoidica/diagnosis , Necrobiosis Lipoidica/drug therapy , Tacrolimus/therapeutic use , Adult , Diagnosis, Differential , Female , Humans , Leg Ulcer/etiology , Leg Ulcer/prevention & control , Necrobiosis Lipoidica/complications , Risk FactorsABSTRACT
BACKGROUND: To our knowledge, there are no large multicenter studies concerning frontal fibrosing alopecia (FFA) that could give clues about its pathogenesis and best treatment. OBJECTIVE: We sought to describe the epidemiology, comorbidities, clinical presentation, diagnostic findings, and therapeutic choices in a large series of patients with FFA. METHODS: This retrospective multicenter study included patients given the diagnosis of FFA. Clinical severity was classified based on the recession of the frontotemporal hairline. RESULTS: In all, 355 patients (343 women [49 premenopausal] and 12 men) with a mean age of 61 years (range 23-86) were included. Early menopause was detected in 49 patients (14%), whereas 46 (13%) had undergone hysterectomy. Severe FFA was observed in 131 patients (37%). Independent factors associated with severe FFA after multivariate analysis were: eyelash loss, facial papules, and body hair involvement. Eyebrow loss as the initial clinical presentation was associated with mild forms. Antiandrogens such as finasteride and dutasteride were used in 111 patients (31%), with improvement in 52 (47%) and stabilization in 59 (53%). LIMITATIONS: The retrospective design is a limitation. CONCLUSIONS: Eyelash loss, facial papules, and body hair involvement were associated with severe FFA. Antiandrogens were the most useful treatment.
Subject(s)
Alopecia/drug therapy , Alopecia/pathology , Azasteroids/therapeutic use , Finasteride/therapeutic use , Adult , Age Distribution , Aged , Aged, 80 and over , Alopecia/epidemiology , Biopsy, Needle , Cohort Studies , Dutasteride , Female , Fibrosis/epidemiology , Fibrosis/pathology , Forehead , Humans , Immunohistochemistry , Male , Middle Aged , Multivariate Analysis , Postmenopause/physiology , Retrospective Studies , Risk Assessment , Severity of Illness Index , Sex Distribution , Spain/epidemiology , Treatment Outcome , Young AdultABSTRACT
No disponible
Subject(s)
Humans , Female , Adolescent , Skin Diseases, Vesiculobullous/diagnosis , Microsporum/isolation & purification , Dermatomycoses/diagnosis , Tinea/diagnosis , Risk FactorsSubject(s)
Back Pain/etiology , Pruritus/diagnosis , Chronic Disease , Humans , Male , Middle Aged , Pruritus/complicationsABSTRACT
A female, aged 17 years and with a history of anorexia nervosa, presented with a 3 month history of a large, irregular area of hair loss over the pubis. Physical examination revealed scattered short hairs of varying length, follicular hyperkeratosis and hyperpigmentation throughout the area of alopecia (Figure 1a). A magnified view revealed decreased hair density, broken hairs with different shaft lengths, short vellous hairs and signs of recent haemorrhage (Figure 1b). The remainder of the hairs appeared normal, and her nails did not show any pathological changes. The hair-pull test was negative. Potassium hydroxide (KOH) examination and fungal culture were negative. Biochemical studies, abdominal X-ray and ultrasonography were normal.
Subject(s)
Alopecia/diagnosis , Pubic Symphysis , Trichotillomania/diagnosis , Adolescent , Cognitive Behavioral Therapy , Diagnosis, Differential , Female , Humans , Trichotillomania/therapyABSTRACT
Glomovenous malformations are disseminated variants of cutaneous glomus tumors. These malformations are subdivided into regional or localized, disseminated, and congenital plaque-like forms. The congenital plaque-like form is the rarest variant. Most treatment modalities have been disappointing in the treatment of large glomangiomas, leading to high recurrence rates. We report a case of a 34-year-old man with a congenital plaque-like glomangioma on his left arm and forearm treated successfully with sequential pulsed-dye neodymium yttrium aluminum garnet laser.
Subject(s)
Glomus Tumor , Laser Therapy/methods , Skin Neoplasms , Adult , Glomus Tumor/congenital , Glomus Tumor/pathology , Glomus Tumor/surgery , Humans , Male , Skin Neoplasms/congenital , Skin Neoplasms/pathology , Skin Neoplasms/surgeryABSTRACT
The management of venous malformation (VM) located on genitalia is complex and challenging. Surgical excision and sclerotherapy are the first-lines therapeutic options, but in certain areas such as the genitalia can be too aggressive. We present a case of VM on the glans penis treated successfully with dual wavelength 595 and 1064 nm laser system.
Subject(s)
Lasers, Dye/therapeutic use , Lasers, Solid-State/therapeutic use , Penile Diseases/therapy , Penis/blood supply , Skin Diseases, Vascular/therapy , Vascular Malformations/therapy , Adolescent , Anti-Bacterial Agents/therapeutic use , Anti-Inflammatory Agents/therapeutic use , Fusidic Acid/therapeutic use , Humans , Male , Prednisolone/therapeutic useSubject(s)
Cyclosporine/adverse effects , Facial Dermatoses/chemically induced , Heart Transplantation , Immunosuppressive Agents/adverse effects , Postoperative Complications/chemically induced , Sebaceous Glands/pathology , Cyclosporine/administration & dosage , Cyclosporine/therapeutic use , Humans , Hyperplasia , Immunosuppressive Agents/administration & dosage , Immunosuppressive Agents/therapeutic use , Male , Middle AgedABSTRACT
Azathioprine (AZA) is an imidazole derivative of mercaptopurine. It antagonizes purine metabolism, and it may inhibit synthesis of DNA, RNA, and proteins. The 6-thioguanine nucleotides appear to mediate the majority of AZAs immunosuppressive and toxic effects. While cutaneous adverse side-effects are not uncommon, perforating dermatosis has not been reported in association to AZA. We speculate that immunological disorders induced by AZA in susceptible individuals could be related to perforating dermatosis.
Subject(s)
Pyoderma Gangrenosum/diagnosis , Adolescent , Humans , Leg/pathology , Male , Pyoderma Gangrenosum/therapySubject(s)
Intervertebral Disc Degeneration/diagnosis , Intervertebral Disc Displacement/diagnosis , Paresthesia/diagnosis , Pruritus/etiology , Thoracic Vertebrae/pathology , Aged , Chronic Disease , Diagnosis, Differential , Female , Humans , Magnetic Resonance Imaging , Paresthesia/complications , Paresthesia/therapySubject(s)
Antibodies, Monoclonal/adverse effects , Eyelashes/drug effects , Hair Diseases/chemically induced , Adenocarcinoma/drug therapy , Adenocarcinoma/secondary , Adenocarcinoma/surgery , Antibodies, Monoclonal/administration & dosage , Antibodies, Monoclonal/pharmacology , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Camptothecin/administration & dosage , Camptothecin/analogs & derivatives , Colorectal Neoplasms/drug therapy , Colorectal Neoplasms/surgery , ErbB Receptors/antagonists & inhibitors , ErbB Receptors/physiology , Eyelashes/growth & development , Female , Fluorouracil/administration & dosage , Humans , Leucovorin/administration & dosage , Liver Neoplasms/drug therapy , Liver Neoplasms/secondary , Liver Neoplasms/surgery , Middle Aged , Neoadjuvant Therapy , Neoplasm Proteins/antagonists & inhibitors , PanitumumabABSTRACT
A congenital smooth muscle hamartoma is a rare, benign proliferation of smooth muscle bundles in the dermis that is usually diagnosed in the neonatal period or infancy. Surgical excision is the first-line therapeutic option, but in certain areas such as the face, surgery may be too aggressive, and different treatments should be considered. We present the case of a congenital smooth muscle hamartoma on the face treated using pulsed dye laser with good response.