ABSTRACT
No disponible
Subject(s)
Humans , Female , Aged , Acute Generalized Exanthematous Pustulosis/diagnosis , Angiogenesis Inhibitors/adverse effects , Protein Kinase Inhibitors/adverse effects , Carcinoma, Hepatocellular/drug therapyABSTRACT
La literatura del pioderma gangrenoso periestomal (PGP) es escasa, y las series publicadas tienen un número de pacientes limitado. En dicho contexto es difícil determinar la frecuencia de la enfermedad, así como sus factores de riesgo, y valorar la eficacia de los distintos tratamientos disponibles. Presentamos una serie de casos de PGP diagnosticados en nuestro centro entre los años 2013 y 2014 y revisamos las características clínicas y la respuesta terapéutica. Se incluyeron un total de 4 pacientes, 3 de los cuales estaban diagnosticados de enfermedad inflamatoria intestinal, mientras que uno de los casos se asoció a carcinoma de recto. Tres pacientes presentaron evolución favorable tras el tratamiento inicial con tacrolimus 0,1% en pomada (2 casos en monoterapia y uno asociado a otros inmunosupresores), con recurrencia en todos ellos tras la suspensión del tratamiento precisando reintroducción o cambio de tratamiento
The literature on peristomal pyoderma gangrenosum (PPD) is scarce, and studies to date have included few patients. It is therefore difficult to determine the incidence of PPD, investigate risk factors, or evaluate the effectiveness of the different treatments available. We report on a series of 4 patients diagnosed with PPD at our hospital in 2013 and 2014, and review the clinical characteristics and responses to treatment. Three of the patients had inflammatory bowel disease and 1 had rectal cancer. Three patients responded favorably to initial treatment with 0.1% tacrolimus ointment (administered as monotherapy in 2 cases and combined with immunosuppressants in the other). However, on withdrawal of tacrolimus, the disease recurred in all 3 patients, requiring treatment reintroduction or modification
Subject(s)
Humans , Male , Female , Pyoderma Gangrenosum/diagnosis , Pyoderma Gangrenosum/epidemiology , Pyoderma Gangrenosum/therapy , Surgical Stomas/trends , Surgical Stomas , Tacrolimus/analysis , Tacrolimus/therapeutic use , Autoimmune Diseases/diagnosis , Autoimmune Diseases/epidemiology , Autoimmune Diseases/therapy , Observational Study , Retrospective StudiesABSTRACT
The literature on peristomal pyoderma gangrenosum (PPD) is scarce, and studies to date have included few patients. It is therefore difficult to determine the incidence of PPD, investigate risk factors, or evaluate the effectiveness of the different treatments available. We report on a series of 4 patients diagnosed with PPD at our hospital in 2013 and 2014, and review the clinical characteristics and responses to treatment. Three of the patients had inflammatory bowel disease and 1 had rectal cancer. Three patients responded favorably to initial treatment with 0.1% tacrolimus ointment (administered as monotherapy in 2 cases and combined with immunosuppressants in the other). However, on withdrawal of tacrolimus, the disease recurred in all 3 patients, requiring treatment reintroduction or modification.
Subject(s)
Immunosuppressive Agents/therapeutic use , Pyoderma Gangrenosum/diagnosis , Pyoderma Gangrenosum/drug therapy , Tacrolimus/therapeutic use , Humans , Inflammatory Bowel Diseases/complications , Rectal Neoplasms/complications , Risk FactorsSubject(s)
Blister/etiology , Dermatitis, Photoallergic/etiology , Erythema/etiology , Aged , Forearm , Humans , Male , Morus/adverse effectsABSTRACT
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Subject(s)
Humans , Skin Ulcer/complications , Arthritis, Rheumatoid/complications , Felty Syndrome/diagnosis , Risk FactorsABSTRACT
Introducción y objetivos: La mayoría de hospitales españoles no dispone de dermatólogo de guardia. El objetivo del estudio fue conocer el perfil de paciente que acude a Urgencias por un proceso dermatológico y de manera secundaria analizar la capacidad resolutiva del dermatólogo de guardia. Material y métodos: Estudio prospectivo que incluyó pacientes con afección dermatológica atendidos en Urgencias de un hospital con residente de Dermatología de guardia durante un periodo de 2 meses. Se recogió sexo, edad, diagnóstico, días de evolución, justificación o no de la consulta urgente, procedencia, destino tras la asistencia y motivo principal de la consulta. Para analizar la capacidad resolutiva del dermatólogo de guardia se valoró el porcentaje de altas directas, las pruebas complementarias realizadas y el porcentaje de revisitas. Resultados: Se atendieron 861 pacientes 58% mujeres y 42% varones (14,4 pacientes al día). Se realizaron 131 diagnósticos distintos, siendo los más frecuentes celulitis infecciosa, urticaria aguda y herpes zóster. Solo la mitad del total de consultas tenían un motivo urgente justificado (el 95% de los pacientes menores de 30 años acudió sin motivo urgente justificado, frente al 6% de pacientes mayores de 65 años, p<0,005). El dermatólogo de guardia dio el alta directa al 58% de los pacientes y se registró un porcentaje de revisitas <1%. En 4 de cada 5 urgencias atendidas no se requirió ninguna prueba complementaria. Conclusiones: El perfil de paciente con enfermedad urgente dermatológica es variable. En la mitad de las consultas no se encontró un motivo justificado de urgencia, especialmente en pacientes jóvenes. El dermatólogo de guardia presentó una alta capacidad resolutiva (AU)
Introduction and objectives: Most Spanish hospitals do not have an on-call dermatologist. The primary objective of our study was to determine the profile of patients visiting our hospitals emergency department for dermatologic conditions; our secondary objective was to analyze the case-resolving capacity of the on-call dermatologist. Material and methods: Prospective study that included patients with dermatologic conditions treated in the emergency department of a hospital with an on-call dermatology resident during a 2-month period. We collected data on sex, age, diagnosis, days since onset, whether or not the emergency visit was justified, referral (self-referral or other), continued care, and the main reason for the visit. To analyze the case-resolving capacity of the on-call dermatologist we assessed the percentage of direct discharges, the diagnostic tests performed, and the percentage of revisits. Results: The on-call dermatologist attended 861 patients (14.4 patients per day), of whom 58% were women and 42% men. In total, 131 different diagnoses were made; the most common were infectious cellulitis, acute urticaria, and herpes zoster. Only half of the visits were justifiable as emergencies (95% of patients < 30 years of age had conditions that did not justify emergency care, compared to 6% of patients > 65 years, P <0 .005). The on-call dermatologist discharged 58% of the patients directly and the revisit rate was 1%. In 4 of 5 emergency visits no diagnostic tests were required. Conclusions: The profile of patients seeking emergency dermatologic care is variable. Half of the emergency visits were not justified, and unjustified visits were especially common in younger patients. The case-resolving capacity of the on-call dermatologist was high (AU)
Subject(s)
Humans , Male , Female , Emergency Medicine/methods , Emergency Medicine/trends , Dermatology/education , Skin Diseases/complications , Cellulite/complications , Communicable Diseases/complications , Communicable Diseases/diagnosis , Prospective Studies , Dermatitis/complications , Dermatitis/diagnosis , Eczema/complications , Eczema/diagnosis , Angioedema/complications , Urticaria/complicationsABSTRACT
INTRODUCTION AND OBJECTIVES: Most Spanish hospitals do not have an on-call dermatologist. The primary objective of our study was to determine the profile of patients visiting our hospital's emergency department for dermatologic conditions; our secondary objective was to analyze the case-resolving capacity of the on-call dermatologist. MATERIAL AND METHODS: Prospective study that included patients with dermatologic conditions treated in the emergency department of a hospital with an on-call dermatology resident during a 2-month period. We collected data on sex, age, diagnosis, days since onset, whether or not the emergency visit was justified, referral (self-referral or other), continued care, and the main reason for the visit. To analyze the case-resolving capacity of the on-call dermatologist we assessed the percentage of direct discharges, the diagnostic tests performed, and the percentage of revisits. RESULTS: The on-call dermatologist attended 861 patients (14.4 patients per day), of whom 58% were women and 42% men. In total, 131 different diagnoses were made; the most common were infectious cellulitis, acute urticaria, and herpes zoster. Only half of the visits were justifiable as emergencies (95% of patients <30 years of age had conditions that did not justify emergency care, compared to 6% of patients >65 years, P<.005). The on-call dermatologist discharged 58% of the patients directly and the revisit rate was 1%. In 4 of 5 emergency visits no diagnostic tests were required. CONCLUSIONS: The profile of patients seeking emergency dermatologic care is variable. Half of the emergency visits were not justified, and unjustified visits were especially common in younger patients. The case-resolving capacity of the on-call dermatologist was high.
Subject(s)
Dermatology , Medical Staff, Hospital/statistics & numerical data , Skin Diseases/therapy , Adolescent , Adult , Aged , Child , Child, Preschool , Emergencies , Female , Hospitals, Teaching , Humans , Infant , Male , Middle Aged , Prospective Studies , Tertiary Healthcare , Workforce , Young AdultABSTRACT
Chemotherapy using taxanes have been useful in the treatment of several types of solid tumors. Nail abnormalities have been reported primarily with the use of docetaxel, but also with low dose, weekly paclitaxel. We report a patient with 20-nail onycolysis associated with the use of paclitaxel that resolved after stopping the medication and then recurred after the use of docetaxel, but spared all the nails of a paretic hand.
Subject(s)
Antineoplastic Agents, Phytogenic/adverse effects , Brain Neoplasms/secondary , Breast Neoplasms/pathology , Onycholysis/chemically induced , Peripheral Nervous System Diseases/chemically induced , Taxoids/adverse effects , Antibodies, Monoclonal/administration & dosage , Antibodies, Monoclonal, Humanized , Antineoplastic Agents, Phytogenic/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Brain Neoplasms/complications , Brain Neoplasms/drug therapy , Breast Neoplasms/drug therapy , Breast Neoplasms/radiotherapy , Breast Neoplasms/surgery , Capecitabine , Carboplatin/administration & dosage , Combined Modality Therapy , Deoxycytidine/administration & dosage , Deoxycytidine/analogs & derivatives , Docetaxel , Fatal Outcome , Female , Fluorouracil/administration & dosage , Fluorouracil/analogs & derivatives , Hand/innervation , Humans , Lapatinib , Middle Aged , Paclitaxel/administration & dosage , Paresis/etiology , Quinazolines/administration & dosage , Taxoids/administration & dosage , Trastuzumab , Vinblastine/administration & dosage , Vinblastine/analogs & derivatives , VinorelbineABSTRACT
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Subject(s)
Female , Humans , Male , Papilloma/immunology , Papillomavirus Infections/immunology , Papillomavirus Vaccines/immunology , Papillomavirus Vaccines/metabolism , Papillomavirus Vaccines/therapeutic use , Immunocompetence/physiology , Biopsy/instrumentation , Biopsy/methods , Immunocompetence/immunology , Secondary Prevention/methods , Cervix Uteri , Uterine Neoplasms/immunology , Uterine Neoplasms/prevention & control , Effectiveness , 50303Subject(s)
Humans , Male , Middle Aged , Drug Eruptions/diagnosis , Ibuprofen/adverse effects , /diagnosisABSTRACT
Granuloma annulare is a dermatosis of unknown cause that is generally self-limiting and has several clinical forms of presentation. It may be associated with pruritus or present asymptomatically. The disseminated variant of the disease accounts for 15 % of all cases. Most authors consider that the duration of this form is longer and that treatment response is worse than for localized forms. A range of therapeutic options have been tried for this disease with a wide range of outcomes. We present a patient with disseminated granuloma annulare who started treatment with dapsone after several therapeutic failures. With dapsone therapy, her cutaneous symptoms showed a clear improvement without any relevant side effects. We then review reports in the literature of cases of disseminated granuloma annulare treated with dapsone.
Subject(s)
Dapsone/therapeutic use , Granuloma Annulare/drug therapy , Aged , Female , HumansABSTRACT
El granuloma anular es una dermatosis de causa desconocida, habitualmente autorresolutiva, con varias formas clínicas de presentación. Puede asociar prurito o manifestarse de forma asintomática. La variante diseminada de la enfermedad supone el 15 % de los casos, y para la mayoría de los autores su duración es mayor y la respuesta al tratamiento peor que en las formas localizadas. Se han propuesto múltiples opciones terapéuticas para esta patología, con resultados muy variables. Presentamos el caso de una paciente con granuloma anular generalizado que tras varios fracasos terapéuticos inició tratamiento con dapsona, obteniéndose una clara mejoría de la clínica cutánea hasta su total resolución, sin efectos secundarios significativos. Aportamos una revisión de los casos de granuloma anular diseminado tratados con dapsona hallados en la literatura
Granuloma annulare is a dermatosis of unknown cause that is generally self-limiting and has several clinical forms of presentation. It may be associated with pruritus or present asymptomatically. The disseminated variant of the disease accounts for 15 % of all cases. Most authors consider that the duration of this form is longer and that treatment response is worse than for localized forms. A range of therapeutic options have been tried for this disease with a wide range of outcomes. We present a patient with disseminated granuloma annulare who started treatment with dapsone after several therapeutic failures. With dapsone therapy, her cutaneous symptoms showed a clear improvement without any relevant side effects. We then review reports in the literature of cases of disseminated granuloma annulare treated with dapsone
Subject(s)
Female , Aged , Humans , Dapsone/pharmacokinetics , Granuloma Annulare/drug therapy , Granuloma Annulare/diagnosis , Granuloma Annulare/etiologyABSTRACT
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Subject(s)
Male , Middle Aged , Humans , Mastocytosis/complications , Mastocytosis/diagnosis , Mastocytosis/therapy , Mastocytosis, Cutaneous/diagnosis , Mastocytosis, Cutaneous/therapy , Biopsy/methods , Skin Diseases, Infectious/complications , Skin Diseases, Infectious/diagnosis , Skin Diseases, Infectious/etiology , Tachycardia/complications , Fibroma/complications , Fibroma/diagnosis , Skin Diseases, Infectious/pathologySubject(s)
Foot Dermatoses/diagnosis , Mycosis Fungoides/diagnosis , T-Lymphocytes/pathology , Diagnosis, Differential , Female , Foot Dermatoses/pathology , Foot Dermatoses/radiotherapy , Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor , Humans , Lichen Planus/diagnosis , Middle Aged , Mycosis Fungoides/complications , Mycosis Fungoides/pathology , Mycosis Fungoides/radiotherapy , Pruritus/etiology , T-Lymphocytes/chemistryABSTRACT
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Subject(s)
Female , Middle Aged , Humans , Erythema/diagnosis , Mycosis Fungoides/diagnosis , Diagnosis, Differential , FootABSTRACT
Pyoderma gangrenosum is an extraintestinal manifestation of inflammatory bowel disease that can be therapeutically troublesome. We comment on the case of a patient with clinically inactive ulcerative colitis who progressively developed necrotic lesions on both tibial aspects of his legs, which corresponded both clinically and histologically to pyoderma gangrenosum. Treatment with steroids and azathioprine could not control this complication. A single dose of infliximab 5 mg/kg was given, achieving an impressive response of the skin lesions followed by complete healing 3 months later. Infliximab can be useful in the management of refractory extraintestinal manifestations of inflammatory bowel disease.
