ABSTRACT
Glucagon-like-peptide-1 (GLP-1) agonists are an emerging class of medications used to manage type 2 diabetes mellitus (T2DM) and weight loss, with demonstrated efficacy in reducing hemoglobin A1c levels, body mass index, and adverse cardiovascular events. While previous studies have reviewed notable cutaneous adverse effects with other antidiabetic medications, little is known about GLP-1 agonist-induced cutaneous reactions. Nevertheless, rare but significant cutaneous adverse reactions have been reported, including but not limited to dermal hypersensitivity reactions, eosinophilic panniculitis, bullous pemphigoid, and morbilliform drug eruptions. As GLP-1 induced cutaneous reactions are diverse, diagnosis requires clinical suspicion, thorough history-taking, and supportive histopathological findings when available. Management involves cessation of the offending agent with a tailored regimen to address inflammatory and/or immunogenic etiologies as well as irritative symptoms. This review aims to consolidate available information from case reports and case series regarding rare skin-related adverse outcomes due to GLP-1 use, aiming to provide a comprehensive overview of the presentation, pathogenesis, and management for dermatologists and other clinicians.
Subject(s)
Diabetes Mellitus, Type 2 , Drug Eruptions , Glucagon-Like Peptide 1 , Hypoglycemic Agents , Humans , Diabetes Mellitus, Type 2/drug therapy , Glucagon-Like Peptide 1/adverse effects , Glucagon-Like Peptide 1/agonists , Hypoglycemic Agents/adverse effects , Drug Eruptions/etiology , Drug Eruptions/diagnosis , Drug Eruptions/pathology , Skin/pathology , Skin/drug effects , Liraglutide/adverse effects , Liraglutide/therapeutic use , Glucagon-Like Peptide-1 Receptor/agonistsABSTRACT
BACKGROUND: Vitiligo can be challenging to treat and exhibit an unpredictable clinical course. Phototherapy in the form of visible light can achieve both repigmentation and depigmentation outcomes in vitiligo, with minimal associated adverse events. This review focuses on the mechanistic understandings and clinical outcomes of visible light-based treatments for vitiligo. METHODS: Articles were retrieved from PubMed starting from May 1965 until August 2023, yielding 496 unique articles. We conducted title, abstract, and full-text screening to identify articles describing the use of visible light (380-750 nm), either as part of combination therapy or as monotherapy, for repigmentation or depigmentation treatment in vitiligo. RESULTS: Twenty-seven articles met inclusion criteria, offering preclinical and clinical data regarding the utilization of helium-neon laser (red light) and blue light-emitting diodes (LEDs) as methods of repigmentation therapy in vitiligo. Preclinical and clinical data on the utilization of Q-switched ruby laser (694 nm) and frequency-doubled (FD) Nd:YAG laser (532 nm) for vitiligo depigmentation therapy were also identified. CONCLUSION: While limited by small studies and a lack of standardized administration of phototherapy, the evidence for visible light's effectiveness in managing vitiligo is encouraging. Red light therapy using He-Ne lasers and blue light therapy via LEDs can stimulate repigmentation in patients with vitiligo with minimal adverse events. Q-switched ruby and FD Nd:YAG lasers provide viable, visible light depigmentation options, either alone or with topical agents. With limited clinical data, larger studies are needed to validate the efficacy of visible light therapy in treating vitiligo and to better understand its long-term outcomes.
Subject(s)
Lasers, Gas , Lasers, Solid-State , Vitiligo , Humans , Vitiligo/therapy , Phototherapy/methods , Lasers, Solid-State/therapeutic use , Light , Treatment OutcomeABSTRACT
Se describe un caso de Endocarditis Polimicrobiana de posible origen gineco-obstétrico en una paciente de 29 años, con antecedentes de aborto provocado un mes atrás, con deterioro progresivo del estado general. El hemocultivo seriado permitió la recuperación de un Staphylococcus aureus, siendo medicada con antibióticos. Ante la aparición de un nuevo soplo cardíaco se orientó el diagnóstico a una endocarditis infecciosa. El ecocardiograma mostró una verruga en válvula septal de la tricúspidea y en los hemocultivos desarrollaron Staphylococcus aureus y Candida spp. Hubo múltiples fallas orgánicas y la paciente falleció sin dar tiempo a la cirugía.
Subject(s)
Humans , Female , Adult , Staphylococcus aureus , Candida , Abortion, Induced/adverse effects , Endocarditis, Bacterial/diagnosis , Endocarditis, Bacterial/mortality , Endocarditis, Bacterial/therapy , Tricuspid Valve , Fluconazole/therapeutic use , Cephalothin/therapeutic use , Amphotericin B/therapeutic use , Sepsis/complicationsABSTRACT
Se describe un caso de Endocarditis Polimicrobiana de posible origen gineco-obstétrico en una paciente de 29 años, con antecedentes de aborto provocado un mes atrás, con deterioro progresivo del estado general. El hemocultivo seriado permitió la recuperación de un Staphylococcus aureus, siendo medicada con antibióticos. Ante la aparición de un nuevo soplo cardíaco se orientó el diagnóstico a una endocarditis infecciosa. El ecocardiograma mostró una verruga en válvula septal de la tricúspidea y en los hemocultivos desarrollaron Staphylococcus aureus y Candida spp. Hubo múltiples fallas orgánicas y la paciente falleció sin dar tiempo a la cirugía. (AU)
