ABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Skin Diseases, Vesiculobullous/etiology , Coma/complicationsABSTRACT
BACKGROUND: Promoter methylation of tumour suppressor genes (TSGs) has recently been implicated in the pathogenesis of several types of cancer. Regarding melanoma, over 100 genes that contribute to its pathogenesis have been identified to be aberrantly hypermethylated. OBJECTIVES: This is a retrospective observational study that aims to analyse the prevalence of CpG island methylation in a series of primary melanomas, to identify the associations with the main clinicopathological features, and to explore the prognostic significance of methylation in melanoma survival. MATERIALS AND METHODS: DNA methylation was analysed using methylation-specific multiplex ligation-dependent probe amplification in a series of 170 melanoma formalin-fixed paraffin-embedded tumour samples. The relationship between the methylation status, known somatic mutations and clinicopathological features was evaluated. Disease-free survival (DFS) and overall survival (OS) were displayed by the Kaplan-Meier method. RESULTS: In the entire cohort, one or more genes were detected to be methylated in 55% of the patients. The most prevalent methylated genes were RARB 31%, PTEN 24%, APC 16%, CDH13 16%, ESR1 14%, CDKN2A 6% and RASSF1 5%. An association between aberrant methylation and aggressive clinicopathological features was observed (older age, increased Breslow thickness, presence of mitosis and ulceration, fast-growing melanomas, advancing stage and TERT mutations). Furthermore, Kaplan-Meier survival analysis showed a correlation of methylation and poorer DFS and OS. CONCLUSIONS: Aberrant methylation of TSGs is a frequent event in melanoma. It is associated with aggressive clinicopathological features and poorer survival. Epigenetic alterations may represent a significant prognostic marker with utility in routine practice.
Subject(s)
DNA Methylation , Epigenesis, Genetic , Gene Expression Regulation, Neoplastic , Melanoma/genetics , Skin Neoplasms/genetics , Adult , Aged , CpG Islands/genetics , Disease-Free Survival , Female , Humans , Kaplan-Meier Estimate , Male , Melanoma/mortality , Melanoma/pathology , Middle Aged , Mutation , Prognosis , Promoter Regions, Genetic/genetics , Retrospective Studies , Skin/pathology , Skin Neoplasms/mortality , Skin Neoplasms/pathologyABSTRACT
No disponible
Subject(s)
Humans , Psoriasis/therapy , Body Surface Area , Biological Therapy/instrumentation , Biological Therapy/methods , Biological Therapy , Methotrexate/therapeutic use , Polymorphism, Genetic , Polymorphism, Genetic/immunology , Arthritis, Psoriatic/epidemiology , Arthritis, Psoriatic/prevention & control , Immunohistochemistry/methods , Immunohistochemistry , Prostatitis/drug therapy , Receptors, Tumor Necrosis Factor/therapeutic useABSTRACT
No disponible
Subject(s)
Humans , Male , Aged , Anticarcinogenic Agents/administration & dosage , Anticarcinogenic Agents/adverse effects , Anticarcinogenic Agents/therapeutic use , Psoriasis/diagnosis , Psoriasis/immunology , Psoriasis/therapy , Pharmacopoeias as Topic , Pharmaceutical Preparations/administration & dosage , Pharmaceutical Preparations/analysis , Pharmaceutical PreparationsABSTRACT
INTRODUCCIÓN Y OBJETIVOS: La enfermedad injerto contra huésped (EICH) crónica cutánea es una complicación frecuente tras un trasplante de progenitores hematopoyéticos. La fototerapia es una modalidad terapéutica para pacientes con afectación cutánea o para aquellos que precisan altas dosis de corticoesteroides (CE). El objetivo de este estudio es revisar los casos tratados en nuestro servicio y hacer una revisión de la literatura. MATERIAL Y MÉTODOS: Recogida de datos de manera retrospectiva de todos los casos tratados desde marzo de 2011 a octubre de 2014 en el Servicio de Dermatología del Hospital Universitario y Politécnico la Fe de Valencia. RESULTADOS: Recogimos un total de 16 pacientes, 10 tratados con PUVA y 6 con UVB-BE. Nueve pacientes obtuvieron una respuesta completa y 7 una respuesta parcial, aunque 2 recidivaron tras el tratamiento. Diez pacientes pudieron disminuir la dosis de CE durante el tratamiento y 3 pudieron disminuir el número de otros inmunosupresores. No se presentaron efectos adversos graves. CONCLUSIONES: La fototerapia es una buena opción terapéutica para pacientes con EICH crónica con gran afectación cutánea, para aquellos que no responden al tratamiento tópico o para pacientes corticodependientes. Su mayor beneficio es el de ser un tratamiento dirigido a la piel que permite ahorrar CE y que presenta un buen perfil de seguridad. La pauta de tratamiento se realiza de manera individualizada y, según nuestra experiencia, con dosis iniciales y dosis máximas por sesión menores que para otras enfermedades
INTRODUCTION AND OBJECTIVES: Cutaneous chronic graft-vs-host disease (GVHD) is a common complication of hematopoietic stem cell transplantation. Phototherapy is a therapeutic option for patients with skin involvement and for those who require high doses of corticosteroids. We analyze the cases treated in our department and review the literature. MATERIAL AND METHODS: All patients with GVHD treated with phototherapy in the dermatology department of Hospital Universitario y Politécnico la Fe in Valencia, Spain between March 2011 and October 2014 were identified. Data were gathered retrospectively. RESULTS: There were 16 patients: 10 treated with psoralen-UV-A and 6 with narrowband-UV-B. Complete response was achieved in 9 patients and partial response in 7; 2 patients with partial responses relapsed after treatment. Ten patients were able to decrease their dose of corticosteroids during treatment, and a further 3 decreased the number of other immunosuppressant drugs. No serious adverse effects occurred. CONCLUSIONS: Phototherapy is a good therapeutic option for patients with chronic GVHD with extensive cutaneous involvement, as well as for those who fail to respond to topical treatment or who have become steroid-dependent. The main benefits are that, as the treatment targets the skin, it reduces corticosteroid requirements and has a good safety profile. Treatment must be individualized and, in our experience, both the initial dose and the maximum dose per session can be lower than for other diseases
Subject(s)
Female , Humans , Male , Graft vs Host Disease/classification , Graft vs Host Disease/diagnosis , Graft vs Host Disease/therapy , Adrenal Cortex Hormones/therapeutic use , PUVA Therapy/instrumentation , PUVA Therapy/methods , PUVA Therapy , Phototherapy/trends , Phototherapy , Retrospective Studies , Granulocyte-Macrophage Progenitor Cells/pathology , RecurrenceABSTRACT
INTRODUCTION AND OBJECTIVES: Cutaneous chronic graft-vs-host disease (GVHD) is a common complication of hematopoietic stem cell transplantation. Phototherapy is a therapeutic option for patients with skin involvement and for those who require high doses of corticosteroids. We analyze the cases treated in our department and review the literature. MATERIAL AND METHODS: All patients with GVHD treated with phototherapy in the dermatology department of Hospital Universitario y Politécnico la Fe in Valencia, Spain between March 2011 and October 2014 were identified. Data were gathered retrospectively. RESULTS: There were 16 patients: 10 treated with psoralen-UV-A and 6 with narrowband-UV-B. Complete response was achieved in 9 patients and partial response in 7; 2 patients with partial responses relapsed after treatment. Ten patients were able to decrease their dose of corticosteroids during treatment, and a further 3 decreased the number of other immunosuppressant drugs. No serious adverse effects occurred. CONCLUSIONS: Phototherapy is a good therapeutic option for patients with chronic GVHD with extensive cutaneous involvement, as well as for those who fail to respond to topical treatment or who have become steroid-dependent. The main benefits are that, as the treatment targets the skin, it reduces corticosteroid requirements and has a good safety profile. Treatment must be individualized and, in our experience, both the initial dose and the maximum dose per session can be lower than for other diseases.
Subject(s)
Graft vs Host Disease/drug therapy , Graft vs Host Disease/radiotherapy , PUVA Therapy , Ultraviolet Therapy , Adrenal Cortex Hormones/therapeutic use , Adult , Aged , Allografts , Child, Preschool , Chronic Disease , Combined Modality Therapy , Female , Ficusin/adverse effects , Ficusin/therapeutic use , Graft vs Host Disease/etiology , Hematopoietic Stem Cell Transplantation/adverse effects , Humans , Male , Middle Aged , PUVA Therapy/adverse effects , Photosensitizing Agents/adverse effects , Photosensitizing Agents/therapeutic use , Recurrence , Retrospective Studies , Ultraviolet Therapy/adverse effectsABSTRACT
With this case report we want to emphasize the importance of performing a thorough physical examination of the burn and detailed review of the patient's history. This is a challenging case because it deals with an uncommon disease nowadays, pellagra, which presents lesions with an appearance very similar to burns; on the other hand the management of pellagra is different to the management of the common burns we are used to handling day-to-day. With this case report we will be able to revise the broad list of different injuries that can bring up an issue related to a correct diagnosis, caused by a large diversity of different etiologies with cutaneous expression. We will look over the diagnostic process of pellagra, management, treatment and results in this patient.
Subject(s)
Burns/diagnosis , Pellagra/diagnosis , Diagnosis, Differential , Ill-Housed Persons , Humans , Male , Middle AgedABSTRACT
No disponible
Subject(s)
Humans , Male , Young Adult , Erythema/etiology , Calorific Power/adverse effects , ComputersSubject(s)
Erythema/etiology , Hot Temperature/adverse effects , Microcomputers , Thigh/injuries , Female , Humans , Male , Melanosis/etiology , Young AdultABSTRACT
La sarna noruega es una forma particular de sarna mucho más frecuente en pacientes inmunodeprimidos que en la población general. Se caracteriza por la gran cantidad de parásitos que albergan las lesiones, motivo por el cual es altamente contagiosa y difícil de tratar. Presentamos el caso de una paciente VIH con sarna noruega, que respondió muy bien al tratamiento oral con ivermectina en dosis única, junto con la aplicación tópica de queratolíticos. Describimos las características clínicas de esta forma de sarna, discutimos el uso de ivermectina en el tratamiento de la sarna y destacamos su utilidad en casos de sarna noruega (AU)
Subject(s)
Adult , Female , Humans , Mite Infestations/complications , Mite Infestations/drug therapy , Ivermectin/therapeutic use , Scabies/drug therapy , Keratosis/complications , Keratosis/drug therapy , Keratolytic Agents/administration & dosage , Keratolytic Agents/therapeutic use , Hand Dermatoses/complications , Hand Dermatoses/physiopathology , Skin Diseases/complications , Skin Diseases/drug therapyABSTRACT
Kaposi's sarcoma is frequently associated to other primary neoplasias, especially those arising from mononuclear-phagocytic system. A case of Kaposi's sarcoma associated to Hodgkin's disease is presented.
Subject(s)
Hodgkin Disease/complications , Sarcoma, Kaposi/complications , Skin Neoplasms/complications , Adult , Disease Susceptibility , Female , Hodgkin Disease/diagnosis , Hodgkin Disease/immunology , Humans , Sarcoma, Kaposi/immunology , Skin Neoplasms/immunologyABSTRACT
We present a 45 years old male with dermatomyositis refractory to eight months of standard treatment who responded to plasma exchange. The efficacy of the procedure is estimated from clinical follow-up (increase in strength) and serum creatine-kinase activity (decrease from 3,380 to 44 u/ml.) after five sessions of plasma exchange. The therapeutic indications for PE are reviewed in dermatological diseases with emphasis on cases where the response to steroids or cytotoxic drugs is inadequate.
