RESUMEN
INTRODUCTION: Atopic dermatitis (AD) is a difficult-to-treat inflammatory skin disease with a high impact on patients' quality of life. Dupilumab, an IL-4 and IL-13 inhibitor, was the first monoclonal antibody approved for the treatment of moderate-to-severe AD and is currently approved in patients aged 6 or older. METHODS: This is a nationwide, multicenter, retrospective, 48-week study designed by the Portuguese Group of AD to assess real-world efficacy and safety of dupilumab for the treatment of AD. RESULTS: A total of 169 patients were enrolled, with a mean disease duration of 22.75 (±11.98) years. The percentage of patients achieving an improvement of at least 75% in Eczema Area and Severity Index (EASI) compared to baseline (EASI75 response) at weeks 12 and 48 was 67.6% and 74.1%, respectively. In the same timepoints, 25.0% and 44.1% achieved an EASI90 response. Patient-reported outcome measures also improved throughout the study period. Regarding safety, 32.0% of the patients developed adverse events, with conjunctivitis (26.6%), persistent facial erythema (4.7%), and arthritis/arthralgia (3.6%) as the more frequently reported. CONCLUSION: Data from real-world populations are crucial to guide clinicians in their daily decisions. This study provides data demonstrating that dupilumab is an effective and safe therapeutic option for AD.
Asunto(s)
Dermatitis Atópica , Anticuerpos Monoclonales Humanizados , Dermatitis Atópica/tratamiento farmacológico , Humanos , Portugal , Calidad de Vida , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Resultado del TratamientoAsunto(s)
Infecciones Oportunistas Relacionadas con el SIDA/inmunología , Síndrome de Inmunodeficiencia Adquirida/diagnóstico , Angiomatosis Bacilar/inmunología , Bartonella/aislamiento & purificación , VIH/aislamiento & purificación , Infecciones Oportunistas Relacionadas con el SIDA/diagnóstico , Infecciones Oportunistas Relacionadas con el SIDA/tratamiento farmacológico , Infecciones Oportunistas Relacionadas con el SIDA/microbiología , Síndrome de Inmunodeficiencia Adquirida/tratamiento farmacológico , Síndrome de Inmunodeficiencia Adquirida/inmunología , Síndrome de Inmunodeficiencia Adquirida/virología , Adulto , Angiomatosis Bacilar/diagnóstico , Angiomatosis Bacilar/tratamiento farmacológico , Angiomatosis Bacilar/microbiología , Antibacterianos/uso terapéutico , Antirretrovirales/uso terapéutico , Bartonella/inmunología , Biopsia , Quimioterapia Combinada/métodos , Humanos , Masculino , Piel/microbiología , Piel/patología , Resultado del TratamientoAsunto(s)
Tejido Adiposo , Enfermedad de la Arteria Coronaria/genética , Interleucina-6/genética , Polimorfismo de Nucleótido Simple/genética , Psoriasis/genética , Calcificación Vascular/genética , Adulto , Estudios de Casos y Controles , Estudios Transversales , Femenino , Homocigoto , Humanos , Masculino , PericardioRESUMEN
BACKGROUND: Psoriasis is a chronic, immune-mediated disease associated with several cardio-metabolic comorbidities, accelerated atherosclerosis and cardiovascular disease (CVD). Other causes beyond systemic inflammation and traditional cardiovascular risk factors (CVRF) may be implicated in the increased risk of CVD observed in these patients. Epicardial adipose tissue (EAT), a type of visceral adipose tissue surrounding the heart and coronary vessels has been implicated in the development of coronary artery disease, by endocrine mechanisms, but particularly by local inflammation. OBJECTIVE: To compare EAT volumes in psoriasis patients and controls using multidetector computed tomography (MDCT) and to analyse if eventual differences were independent from abdominal visceral adiposity; to determine, within psoriasis patients, its relation with subclinical atherosclerosis and other markers of cardiometabolic risk. METHODS: One hundred patients with severe psoriasis, without CVD underwent MDCT, with EAT and abdominal visceral fat (AVF) assessment and coronary artery calcification (CAC) quantification and were compared with 202 control patients. RESULTS: EAT volume was increased in psoriasis patients compared to control subjects, independently from age, sex and AVF, being, on average, 15.2 ± 4.41 mL higher (95% CI: 6.5-26.0, P = 0.001) than in controls. Moreover, psoriasis patients had a statistically significant higher risk of having subclinical atherosclerosis (OR 2.52, 95% CI: 1.23-5.16) than controls, after adjusting for traditional CVRF. Within psoriasis patients EAT volume was associated with subclinical atherosclerosis, independently of age, sex, psoriasis duration, classical CVRF and AVF. CONCLUSION: This study showed that psoriasis was associated with increased EAT volume independently of visceral abdominal fat and with subclinical atherosclerosis. Within psoriasis patients EAT volume was independently associated with CAC. EAT may be another important contributor to the higher cardiovascular risk observed in psoriasis.
Asunto(s)
Tejido Adiposo/patología , Calcinosis/patología , Vasos Coronarios/patología , Pericardio/patología , Psoriasis/patología , Adulto , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Persona de Mediana Edad , Tomografía Computarizada por Rayos XAsunto(s)
Ciclosporina/efectos adversos , Inmunosupresores/efectos adversos , Psoriasis/complicaciones , Psoriasis/tratamiento farmacológico , Sífilis/complicaciones , Sífilis/diagnóstico , Ciclosporina/administración & dosificación , Humanos , Inmunosupresores/administración & dosificación , Masculino , Persona de Mediana EdadAsunto(s)
Melanosis/patología , Enfermedades de la Vulva/patología , Adulto , Dermis/patología , Femenino , HumanosRESUMEN
The authors decided to evaluate the possible use of methyl-aminolevulinate photodynamic therapy (MAL-PDT) as adjunctive therapy for morpheaform basal cell carcinoma prior to standard surgical excision in order to reduce tumor size and volume and to facilitate surgical treatment. It was observed that MAL-PDT may be an option as an adjunctive therapy prior to standard surgical excision of morpheaform basal cell carcinoma, leading to less invasive surgery.
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Carcinoma Basocelular/tratamiento farmacológico , Neoplasias Cutáneas/tratamiento farmacológico , Ácido Aminolevulínico/análogos & derivados , Carcinoma Basocelular/cirugía , Quimioterapia Adyuvante , Cromosomas Artificiales Bacterianos , Neoplasias Faciales/tratamiento farmacológico , Neoplasias Faciales/cirugía , Humanos , Fármacos Fotosensibilizantes/uso terapéutico , Neoplasias Cutáneas/cirugíaRESUMEN
Foscarnet is used to treat herpes viruses, including drug-resistant cytomegalovirus (CMV) and herpes simplex viruses types 1 and 2 (HSV-1 and HSV-2). There are some reports of intravenous foscarnet-induced penile and vulvar ulceration. The authors report a case of the development of severe penile ulcers after the initiation of intravenous foscarnet therapy.
Asunto(s)
Antivirales/efectos adversos , Foscarnet/efectos adversos , Enfermedades del Pene/inducido químicamente , Inhibidores de la Transcriptasa Inversa/efectos adversos , Úlcera/inducido químicamente , Síndrome de Inmunodeficiencia Adquirida/tratamiento farmacológico , Adulto , Humanos , Masculino , Enfermedades del Pene/patología , Úlcera/patologíaRESUMEN
Linear IgA bullous disease is a rare autoimmune subepidermal blistering disease characterized by linear deposition of IgA along the basement membrane zone. We report a clinical case of a rare association of Linear IgA bullous disease and Crohn's disease. Parallel clinical improvement of both cutaneous and intestinal disease was observed with dapsone treatment.
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Enfermedad de Crohn/complicaciones , Inmunoglobulina A/inmunología , Enfermedades Cutáneas Vesiculoampollosas/complicaciones , Adulto , Enfermedad de Crohn/inmunología , Humanos , Masculino , Enfermedades Cutáneas Vesiculoampollosas/inmunología , Enfermedades Cutáneas Vesiculoampollosas/patologíaRESUMEN
Tungiasis is an endemic disease in certain poor areas around the world. Imported infestations in travelers are becoming more frequent and can lead to considerable morbidity. We report a case of a 50 year-old-man who returned from a trip to Guinea-Bissau with an infection caused by Tunga penetrans.
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Labio/patología , Mucosa Bucal/patología , Neurilemoma/diagnóstico , Niño , Humanos , Masculino , Neurilemoma/patologíaAsunto(s)
Inmunoglobulinas Intravenosas/administración & dosificación , Poliarteritis Nudosa/inmunología , Poliarteritis Nudosa/terapia , Enfermedades de la Piel/inmunología , Enfermedades de la Piel/terapia , Femenino , Humanos , Persona de Mediana Edad , Poliarteritis Nudosa/complicaciones , Enfermedades de la Piel/etiologíaRESUMEN
Nimesulide is a new nonsteroidal anti-inflammatory (NSAID) drug with antipyretic and analgesic properties. Because of its favorable tolerability profile it appears to be a preferred alternative, especially in NSAID-sensitive patients. We report a case of acute generalized exanthematous pustulosis (AGEP) in a 50-year-old woman that was attributed to the ingestion of nimesulide. To the best of our knowledge there have been no previous reports of AGEP induced by the ingestion of nimesulide in the medical literature. Nimesulide should be added to the list of agents associated with this serious adverse drug reaction.