ABSTRACT
Wegener's granulomatosis (WG) is a multisystemic vasculitis, with skin involvement in 14% of cases and with palpable purpura, subcutaneous nodules and necrotic papules as the common features.(1) We present a patient diagnosed with WG who had multiple whitish papules similar to those of malignant atrophic papulosis (Degos' disease), which appeared during a flare of his disease. Lesions of malignant atrophic papulosis are said to be pathognomonic; nevertheless, various diseases with similar clinical lesions have been described. To our knowledge, this is the first reported case of such lesions in a patient with WG, and we suggest WG should be included in the differential diagnosis of Degos' disease.
Subject(s)
Granulomatosis with Polyangiitis/diagnosis , Malignant Atrophic Papulosis/diagnosis , Aged , Biopsy , Diagnosis, Differential , Granulomatosis with Polyangiitis/pathology , Humans , Male , Malignant Atrophic Papulosis/pathologyABSTRACT
In recent years, a series of new drugs have been developed through the application of molecular biology. These drugs act by blocking specific molecules of the immune system and have been developed to act on specific targets that play an important role in the pathophysiology of the diseases in which their therapeutic use has now been approved. Over time, experience has been accumulated in the use of these drugs in the treatment of skin diseases for which they have not been approved but in which the pathophysiology suggests that they could also be effective. The use of these drugs is increasing in difficult-to-treat cases of skin diseases for which the drugs are not approved. The second part of this review of off-label use of biologic agents in dermatology considers the use of etanercept, efalizumab, alefacept, rituximab, basiliximab, omalizumab, and cetuximab.
Subject(s)
Biological Products/therapeutic use , Skin Diseases/drug therapy , Alefacept , Antibodies, Anti-Idiotypic , Antibodies, Monoclonal/therapeutic use , Antibodies, Monoclonal, Humanized , Antibodies, Monoclonal, Murine-Derived , Basiliximab , Cetuximab , Daclizumab , Drug Approval , Etanercept , Humans , Immunoglobulin G/therapeutic use , Omalizumab , Receptors, Tumor Necrosis Factor/therapeutic use , Recombinant Fusion Proteins/therapeutic use , RituximabABSTRACT
En los últimos años han aparecido una serie de nuevos fármacos desarrollados por biología molecular. Estos medicamentos actúan bloqueando moléculas específicas del sistema inmunológico y se desarrollan para actuar sobre dianas específicas que tienen un papel importante en la fisiopatología de determinadas enfermedades para cuyo tratamiento son aprobadas. Con el tiempo se ha ido adquiriendo experiencia con estos medicamentos en el tratamiento de dermatosis para las que no han sido diseñados, pero para las que, por compartir un mismo mecanismo fisiopatológico, pueden ser útiles. El empleo de estos medicamentos en el tratamiento de casos difíciles de numerosas enfermedades dermatológicas para las cuales no están aprobados es creciente. Esta segunda parte de la revisión analiza el uso, fuera de indicación, en el tratamiento de la dermatosis de los siguientes fármacos biológicos: etanercept, efalizumab, alefacept, rituximab, daclizumab, basiliximab, omalizumab y cetuximab
In recent years, a series of new drugs have been developed through the application of molecular biology. These drugs act by blocking specific molecules of the immune system and have been developed to act on specific targets that play an important role in the pathophysiology of the diseases in which their therapeutic use has now been approved. Over time, experience has been accumulated in the use of these drugs in the treatment of skin diseases for which they have not been approved but in which the pathophysiology suggests that they could also be effective. The use of these drugs is increasing in difficult-to-treat cases of skin diseases for which the drugs are not approved. The second part of this review of off-label use of biologic agents in dermatology considers the use of etanercept, efalizumab, alefacept, rituximab, basiliximab, omalizumab, and cetuximab
Subject(s)
Humans , Biological Therapy/methods , Skin Diseases/drug therapy , Drug Approval , Lymphocyte Function-Associated Antigen-1 , CD58 Antigens , Antigens, CD20 , Immunoglobulin E , Interleukin-2/antagonists & inhibitors , ErbB Receptors/antagonists & inhibitors , Tumor Necrosis Factor-alpha/antagonists & inhibitorsABSTRACT
En los últimos años el armamento terapéutico de los dermatólogos se ha incrementado como consecuencia de la introducción de múltiples fármacos biológicos. En Dermatología los inmunomoduladores están aprobados únicamente para la psoriasis. No obstante todos estos medicamentos han abierto nuevas posibilidades de tratamiento para numerosas dermatosis inflamatorias. La eficacia y el perfil de seguridad de estos fármacos puede considerarse mejor al de los inmunosupresores clásicos, dado que actúan sobre mecanismos inmunológicos más específicos, siendo muy probable que en los próximos años estos medicamentos biológicos adquieran un importante papel en el campo de la Dermatología. Este artículo, primera parte de la revisión de usos fuera de indicación de fármacos biológicos en Dermatología, describe los anticuerpos antifactor de necrosis tumoral (TNF): infliximab y adalimumab
In recent years, the therapeutic armamentarium available to dermatologists has been extended thanks to the development of numerous biologic agents. In our field, immunomodulators--although currently only approved for psoriasis--have given rise to new therapeutic possibilities in a number of inflammatory skin diseases. Since these new agents have more specific immunologic mechanisms of action, their efficacy and safety is an improvement on traditional immunosuppressants. Consequently, it is very likely that they will play an important role in dermatology in the next few years. This article, the first part of a review of off-label use of biologic agents in dermatology, describes the anti-tumor necrosis factor-a antibodies, infliximab and adalimumab
Subject(s)
Male , Female , Humans , Skin Diseases/drug therapy , Nonprescription Drugs/pharmacology , Nonprescription Drugs/therapeutic use , Sarcoidosis/drug therapy , Antibodies, Monoclonal/therapeutic use , Granuloma Annulare/drug therapy , PUVA Therapy , Psoriasis/drug therapy , Scleroderma, Localized/complications , Scleroderma, Localized/drug therapy , Adjuvants, Immunologic/therapeutic use , Homeopathic Prescription/trends , Drug Prescriptions/standards , Immunosuppressive Agents/therapeutic use , Necrobiosis Lipoidica/drug therapy , Hidradenitis Suppurativa/drug therapy , Pyoderma Gangrenosum/drug therapy , Sweet Syndrome/drug therapyABSTRACT
In recent years, the therapeutic armamentarium available to dermatologists has been extended thanks to the development of numerous biologic agents. In our field, immunomodulators--although currently only approved for psoriasis--have given rise to new therapeutic possibilities in a number of inflammatory skin diseases. Since these new agents have more specific immunologic mechanisms of action, their efficacy and safety is an improvement on traditional immunosuppressants. Consequently, it is very likely that they will play an important role in dermatology in the next few years. This article, the first part of a review of off-label use of biologic agents in dermatology, describes the anti-tumor necrosis factor-alpha antibodies, infliximab and adalimumab.
Subject(s)
Antibodies, Monoclonal/therapeutic use , Skin Diseases/drug therapy , Adalimumab , Antibodies, Monoclonal, Humanized , Drug Prescriptions/standards , Graft vs Host Disease/drug therapy , Humans , InfliximabABSTRACT
Tumour necrosis factor (TNF) blockers represent an exciting advance in the management of psoriasis. However, the safety profile of these drugs is not completely established. We present a review of the literature, and report on eight patients: two with the unexpected appearance of psoriasis, and the remaining six with exacerbation and change in morphology of their existing psoriasis, all of which occurred during treatment with the TNF blockers adalimumab, etanercept and infliximab. The two new cases, neither of whom had any personal or family history of psoriasis, developed pustular psoriasis on the palms and/or soles. The other six patients, previously diagnosed with severe chronic plaque psoriasis (four patients), generalized pustular psoriasis (one) and erythrodermic psoriasis (one), developed eruptive guttate psoriasis between 15 days and 18 months after the beginning of therapy. These patients had never before presented guttate-type psoriatic lesions, and the lesions appeared in areas of the body that were free of psoriatic plaques at baseline.
Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Antirheumatic Agents/therapeutic use , Psoriasis/drug therapy , Psoriasis/pathology , Receptors, Tumor Necrosis Factor/antagonists & inhibitors , Adalimumab , Adult , Antibodies, Monoclonal/therapeutic use , Antibodies, Monoclonal, Humanized , Etanercept , Female , Humans , Immunoglobulin G/therapeutic use , Infliximab , Male , Middle Aged , Receptors, Tumor Necrosis Factor/therapeutic use , Treatment OutcomeSubject(s)
Thrombophlebitis/pathology , Aged , Female , Humans , Remission, Spontaneous , Skin/pathology , Thorax/blood supply , Thrombophlebitis/therapyABSTRACT
No disponible
No disponible
Subject(s)
Female , Middle Aged , Humans , Thrombophlebitis/complications , Thrombophlebitis/diagnosis , Anti-Inflammatory Agents/therapeutic use , Breast Diseases/complications , Breast Diseases/diagnosis , Breast/pathologyABSTRACT
El síndrome constitucional es un cuadro de gran importancia en pacientes mayores debido a su elevada frecuencia y su gravedad. Este síndrome puede tener distintas etiologías. Las más frecuentes son enfermedades orgánicas, pero también puede deberse a fármacos. Aunque la fluoxetina causa con frecuencia alteraciones gastrointestinales como efecto adverso, sólo existe un estudio que la asocie con el síndrome constitucional. Presentamos un caso de síndrome constitucional secundario a fluoxetina en una mujer de 80 años. (AU)
