Topical Immunotherapy for Actinic Keratosis and Field Cancerization.

This comprehensive review delves into various immunotherapeutic approaches for the management of actinic keratoses (AKs), precancerous skin lesions associated with UV exposure. Although there are treatments whose main mechanism of action is immune modulation, such as imiquimod or diclofenac, other treatments, apart from their main effect on dysplastic cells, exert some immunological action, which in the end contributes to their efficacy. While treatments like 5-fluorouracil, imiquimod, photodynamic therapy, and nicotinamide are promising in the management of AKs, especially in immunocompetent individuals, their efficacy is somewhat reduced in solid organ transplant recipients due to immunosuppression. The analysis extends to optimal combination, focusing on cryoimmunotherapy as the most relevant. New immunotherapies include resimiquimod, ingenol disoxate, N-phosphonacetyl-L-aspartate (PALA), or anti-PD1 that have shown promising results, although more studies are needed in order to standardize their use.

Nd:YAG Q-switched laser for the treatment of a hemicorporal epidermal nevus: A safe and effective option.

Epidermal nevi are benign proliferations of the epidermis for which different treatments have been used with disappointing results due to their recurrences and anesthetic scars. Topical therapies have generally been ineffective and surgical treatment provides more definitive results, but with high risk of scarring. In recent years, multiple laser modalities have been described for the treatment of these lesions. In the literature, there are no reported cases of treatment of these lesions with Neodymium-doped Yttrium aluminum garnet (Nd:YAG) laser. We present the case of a 3-year-old patient with a hemicorporal epidermal nevus treated with Nd:YAG laser at an early stage with good results.

Accelerated photoaging induced by voriconazole treated with Q-switched Nd:YAG laser: case report and review of the literature.

Voriconazole is an antifungal agent mainly used against aspergillosis. Given its wide spectrum of action and limited adverse effects, it has replaced amphotericin B as the drug of choice in the prophylactic treatment of immunocompromised patients. Several adverse effects are caused by this drug with dermatological reactions accounting for 6% of the total. Such reactions include cheilitis, erythema, erosions, discoid lupus erythematosus, erythema multiforme, photosensitivity reactions, pseudoporphyria, accelerated photoaging and skin cancer. There are few reports on the accelerated photoaging caused by voriconazole and its effective treatment. Here we present the case of a 6-year-old child with a history of chronic granulomatous disease under prolonged treatment with voriconazole, who developed accelerated photoaging lesions secondary to the chronic use of this antifungal agent. Treatment was initiated using Q-switched Nd:YAG laser with good results.