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1.
Ann Acad Med Singap ; 53(2): 113-116, 2024 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-38920235

RESUMO

Ribonucleic acid (RNA) therapeutics hold great potential for the advancement of dermatological treatments due to, among other reasons, the possibility of treating previously undruggable targets, high specificity with minimal side effects, and ability to include multiple RNA targets in a single product. Although there have been research relating to RNA therapeutics for decades, there have not been many products translated for clinical use until recently. This may be because of challenges to the application of RNA therapeutics, including the dearth of effective modes of delivery to the target, and rapid degradation of RNA in the human body and environment. This article aims to provide insight on (1) the wide-ranging possibilities of RNA therapeutics in the field of dermatology as well as (2) how key challenges can be addressed, so as to encourage the development of novel dermatological treatments. We also share our experience on how RNA therapeutics have been applied in the management of hypertrophic and keloid scars.


Assuntos
Queloide , Humanos , Queloide/terapia , Cicatriz Hipertrófica/terapia , Cicatriz Hipertrófica/tratamento farmacológico , RNA/uso terapêutico , Dermatologia/métodos , Dermatopatias/terapia , Dermatopatias/tratamento farmacológico , Terapia Genética/métodos
3.
Exp Dermatol ; 33(1): e15012, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38284204

RESUMO

Phototherapy is a useful treatment modality for atopic dermatitis (AD). This is a prospective randomised double-blind study comparing the clinical efficacy of combined ultraviolet-A (UVA)/narrowband ultraviolet-B (NBUVB) versus NBUVB phototherapy in the treatment of chronic AD. Patients with moderate-to-severe AD were randomised to receive either UVA/NBUVB or NBUVB phototherapy twice weekly over 12 weeks. At baseline, weeks 6 and 12, Eczema Area And Severity Index (EASI), itch score and adverse effects were assessed. At baseline and week 12, disease-related quality of life was evaluated using the Dermatology Life Quality Index (DLQI). Nine patients were randomised to receive UVA/NBUVB and 10 received NBUVB. At week 12, both groups showed significant improvement in EASI and itch scores (p < 0.05). Significant improvement in DLQI was seen in the UVA/NBUVB arm (p = 0.009) with a trend towards improvement in the NBUVB arm (p = 0.11). The efficacy of both modalities were comparable, as were reported adverse effects aside from skin dryness which was higher in the NBUVB arm (40% vs. 0%, p = 0.033). Combined UVA/NBUVB and NBUVB phototherapy have comparable clinical efficacy and safety in the treatment of chronic AD. NBUVB may induce greater skin dryness.


Assuntos
Dermatite Atópica , Eczema , Terapia Ultravioleta , Humanos , Dermatite Atópica/radioterapia , Estudos Prospectivos , Método Duplo-Cego , Qualidade de Vida , Terapia Ultravioleta/efeitos adversos , Fototerapia , Prurido/etiologia , Prurido/radioterapia , Resultado do Tratamento
5.
JAAD Case Rep ; 21: 116-118, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35242960
7.
Am J Dermatopathol ; 42(2): 136-139, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31725486

RESUMO

We report an unusual case of a 49-year-old woman who presented with persistent papulonodules over bilateral fingers and inframammary region in conjunction with features of connective tissue disease including symmetrical polyarthritis and Raynaud phenomenon. Skin biopsy showed an upper-to-mid dermal proliferation of bland spindled cells with thickened collagen bundles and occasional multinucleated giant cells. Dermal blood vessels were only marginally increased. On immunohistochemistry, both the spindled cells and multinucleated giant cells stained negatively for smooth muscle actin. Some of the spindled cells stained positively with CD68 and CD163, whereas the multinucleated giant cells stained negatively for both stains. Elastic fibers were absent on elastic Van Gieson. The clinical and histopathologic features raise a diagnostic dilemma between fibroblastic rheumatism and multinucleate cell angiohistiocytoma. The patient responded well to cyclosporine and methotrexate therapy, with gradual improvement of the finger nodules.


Assuntos
Fibroblastos/patologia , Células Gigantes/patologia , Doenças Reumáticas/diagnóstico , Dermatopatias/diagnóstico , Neoplasias Cutâneas/diagnóstico , Antirreumáticos/uso terapêutico , Ciclosporina/uso terapêutico , Diagnóstico Diferencial , Feminino , Hemangioma/diagnóstico , Hemangioma/tratamento farmacológico , Hemangioma/patologia , Histiocitoma/diagnóstico , Histiocitoma/tratamento farmacológico , Histiocitoma/patologia , Humanos , Imunossupressores/uso terapêutico , Metotrexato/uso terapêutico , Pessoa de Meia-Idade , Doenças Reumáticas/tratamento farmacológico , Doenças Reumáticas/patologia , Dermatopatias/tratamento farmacológico , Dermatopatias/patologia , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/patologia
8.
J Crohns Colitis ; 12(12): 1505-1507, 2018 Nov 28.
Artigo em Inglês | MEDLINE | ID: mdl-30169620

RESUMO

The introduction of ustekinumab, an interleukin [IL]12/23 p40 inhibitor, to the therapeutic armamentarium of Crohn's disease has provided a much needed treatment option for patients who have failed conventional biologics with anti-tumour necrosis factor [TNF] and anti-integrin agents. Despite targeting two major cytokine pathways, the side effect profile of ustekinumab appears to be favourable in clinical trials. In particular, the risk of tuberculosis infection was observed to be lower than in patients who have received anti-TNF agents. The risk of non-tuberculosis mycobacterium infection, however, remains unknown. Here, we report the first case of a patient with Crohn's disease who developed Mycobacterium abscessus infection while on ustekinumab treatment.


Assuntos
Amicacina/administração & dosagem , Cefoxitina/administração & dosagem , Doença de Crohn , Doenças do Íleo , Subunidade p40 da Interleucina-12/antagonistas & inibidores , Infecções por Mycobacterium não Tuberculosas , Ustekinumab , Antibacterianos/administração & dosagem , Anticorpos Monoclonais Humanizados/administração & dosagem , Anticorpos Monoclonais Humanizados/efeitos adversos , Doença de Crohn/complicações , Doença de Crohn/tratamento farmacológico , Esquema de Medicação , Feminino , Humanos , Doenças do Íleo/complicações , Doenças do Íleo/tratamento farmacológico , Injeções Subcutâneas , Imageamento por Ressonância Magnética/métodos , Pessoa de Meia-Idade , Infecções por Mycobacterium não Tuberculosas/diagnóstico por imagem , Infecções por Mycobacterium não Tuberculosas/etiologia , Micobactérias não Tuberculosas/isolamento & purificação , Coxa da Perna , Resultado do Tratamento , Ustekinumab/administração & dosagem , Ustekinumab/efeitos adversos
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