Description of Patients Treated with Biologic Drugs as First-Line Systemic Therapy in the BIOBADADERM Registry Between 2008 and 2016. / Descripción de los pacientes que reciben biológicos como primer tratamiento sistémico en el registro BIOBADADERM durante el periodo 2008-2016.

INTRODUCTION AND OBJECTIVES: Biologic drugs are usually prescribed as second-line treatment for psoriasis, that is, after the patient has first been treated with a conventional psoriasis drug. There are, however, cases where, depending on the characteristics of the patient or the judgement of the physician, biologics may be chosen as first-line therapy. No studies to date have analyzed the demographics or clinical characteristics of patients in this setting or the safety profile of the agents used. The main aim of this study was to characterize these aspects of first-line biologic therapy and compare them to those observed for patients receiving biologics as second-line therapy. MATERIAL AND METHOD: We conducted an observational study of 181 patients treated in various centers with a systemic biologic drug as first-line treatment for moderate to severe psoriasis between January 2008 and November 2016. All the patients were registered in the Spanish Registry of Adverse Events Associated with Biologic Drugs in Dermatology. RESULTS: The characteristics of the first- and second-line groups were very similar, although the patients receiving a biologic as first-line treatment for their psoriasis were older. No differences were observed for disease severity (assessed using the PASI) or time to diagnosis. Hypertension, diabetes, and liver disease were all more common in the first-line group. There were no differences between the groups in terms of reasons for drug withdrawal or occurrence of adverse effects. CONCLUSIONS: No major differences were found between patients with psoriasis receiving biologic drugs as first- or second-line therapy, a finding that provides further evidence of the safety of biologic therapy in patients with psoriasis.

Reacción cutánea granulomatosa a tinte rojo de tatuaje / Granulomatous skin reaction to a red pigment tattoo

Presentamos un varón de 46 años de edad que a los 4 meses de aplicarse un tatuaje en la pierna derecha presentó prurito, escozor y sobreelevación en el área de aplicación del tinte rojo. La biopsia realizada muestra granulomas formados por histiocitos y células plasmáticas alrededor con depósito de pigmento rojo. Las pruebas percutáneas fueron negativas, así como el parcheado a los diferentes componentes de la tinta roja aportada por el paciente (AU)

A 46 year old man presented to our clinic with a 4 months history of stinging, itching and raising of a red tattoo in his right leg. Histopathology showed granulomata composed by histiocytes, surrounded by red pigment-laden plasma cells. Patch tests were negative (AU)

[Epidemiologic study of 20 cases of pemphigus at Hospital Clínico Universitario Virgen de la Victoria de Málaga, Spain]. / Estudio epidemiológico de 20 casos de pénfigo en el Hospital Clínico Universitario Virgen de la Victoria de Málaga.

INTRODUCTION: Pemphigus comprises a group of autoimmune blistering diseases that affect the skin and mucous membranes. Its clinical and epidemiologic features vary according to geographic location and ethnic background. OBJECTIVE: An exhaustive search of the literature reveals very few reports of the epidemiology of pemphigus in setting. Our aim, thus, was to conduct a retrospective study of the clinical and epidemiologic features of pemphigus at a secondary care hospital in Málaga, Spain. MATERIAL AND METHODS: We studied 20 patients diagnosed with pemphigus in our department over a period of 13 years (January 1995 to January 2008). RESULTS: We analyzed a large variety of clinical and epidemiologic parameters including sex; age; type of pemphigus; time since onset; associated symptoms; type, morphology, and location of lesions at the time of diagnosis; extent of skin and mucosal involvement; treatment received; treatment-related adverse effects and complications; number of hospital admissions; and patient outcome. CONCLUSIONS: Except for minor differences, our results are in agreement with published data on pemphigus regarding sex, age, and clinical presentation. According to our results, male sex is a predictor of poor prognosis as it is associated with poorer response to treatment and a higher rate of adverse effects and hospital admission.

Estudio epidemiológico de 20 casos de pénfigo en el Hospital Clínico Universitario Virgen de la Victoria de Málaga / Epidemiologic Study of 20 Cases of Pemphigus at Hospital Clínico Universitario Virgen de la Victoria de Málaga, Spain

Introducción: Los pénfigos son un grupo de enfermedades ampollosas autoinmunes que afectan a la piel y a las membranas mucosas. Sus características clínicas y epidemiológicas son variables en función de factores geográficos y étnicos. Objetivo: Si hacemos una búsqueda bibliográfica exhaustiva encontramos escasos trabajos sobre epidemiología del pénfigo en nuestro medio. El objetivo de nuestro estudio es determinar las características clínicas y epidemiológicas del pénfigo en un hospital de segundo nivel de Málaga (España), de una manera retrospectiva. Material y métodos: El estudio incluyó 20 pacientes diagnosticados de pénfigo en nuestro Servicio en un periodo de 13 años, comprendido entre enero de 1995 y enero de 2008. Resultados: Se analizaron un extenso número de parámetros clínicos y epidemiológicos, incluyendo sexo, edad, tipo de pénfigo, tiempo de evolución de la enfermedad hasta el momento del diagnóstico, sintomatología asociada, tipo, morfología y localización de las lesiones en el momento del diagnóstico, afectación de piel y mucosas, tipo de tratamiento realizado, efectos adversos y complicaciones debidas a la terapia, número de ingresos hospitalarios y evolución final de los pacientes. Conclusiones: Aunque con pequeñas diferencias, nuestros resultados están en buena consonancia con los ya existentes en la literatura en lo relativo al sexo, la edad y el perfil clínico de la enfermedad. Según nuestros datos ser varón es un factor de mal pronóstico, puesto que se asocia a una peor respuesta de la enfermedad al tratamiento y a mayor tasa de efectos secundarios y frecuencia de ingresos hospitalarios (AU)

Introduction: Pemphigus comprises a group of autoimmune blistering diseases that affect the skin and mucous membranes. Its clinical and epidemiologic features vary according to geographic location and ethnic background. Objective: An exhaustive search of the literature reveals very few reports of the epidemiology of pemphigus in setting. Our aim, thus, was to conduct a retrospective study of the clinical and epidemiologic features of pemphigus at a secondary care hospital in Málaga, Spain. Material and methods: We studied 20 patients diagnosed with pemphigus in our department over a period of 13 years (January 1995 to January 2008). Results: We analyzed a large variety of clinical and epidemiologic parameters including sex; age; type of pemphigus; time since onset; associated symptoms; type, morphology, and location of lesions at the time of diagnosis; extent of skin and mucosal involvement; treatment received; treatment-related adverse effects and complications; number of hospital admissions; and patient outcome. Conclusions: Except for minor differences, our results are in agreement with published data on pemphigus regarding sex, age, and clinical presentation. According to our results, male sex is a predictor of poor prognosis as it is associated with poorer response to treatment and a higher rate of adverse effects and hospital admission (AU)