Assuntos
Disparidades em Assistência à Saúde/estatística & dados numéricos , Cobertura do Seguro/economia , Melanoma/epidemiologia , Racismo/estatística & dados numéricos , Sistema de Registros , Neoplasias Cutâneas/epidemiologia , Adulto , Idoso , Feminino , Disparidades em Assistência à Saúde/etnologia , Humanos , Incidência , Masculino , Medicaid/economia , Medicare/economia , Melanoma/diagnóstico , Melanoma/terapia , Pessoa de Meia-Idade , Ohio/epidemiologia , Medição de Risco , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/terapia , Fatores Socioeconômicos , Estados UnidosRESUMO
Diphenylcyclopropenone (DPCP) is widely considered the most effective topical immunotherapy for refractory or extensive alopecia areata (AA), but questions regarding how long to try DPCP therapy before terminating and what factors are prognostic of therapeutic success still remain unanswered. In this retrospective study of 50 AA patients, we evaluated DPCP efficacy and identified patient factors predictive of therapeutic success/failure. The median duration of DPCP treatment was 3 years, with 47% patients experiencing their first regrowth in the first 6 months of DPCP therapy, 20% between 6 months-1 year, and 8% between 1-2 years. In our study, treatment success, defined as ⩾50% terminal hair regrowth, was reached in 71% of alopecia totalis patients and in 56% of alopecia universalis patients. Three factors were statistically significant predictors of poor treatment outcome-extent of hair loss before DPCP treatment, history of thyroid disease, and extent of body hair involvement. Relapse was observed in 44% of patients and significantly associated with history of thyroid disease. Common side effects were itching, rash, and local lymphadenopathy. The results of this study support our belief that DPCP therapy is a viable treatment option, can be successfully accomplished at home, and should not be terminated before 2 years.
Assuntos
Alopecia em Áreas/tratamento farmacológico , Ciclopropanos/uso terapêutico , Fármacos Dermatológicos/uso terapêutico , Administração Cutânea , Adolescente , Adulto , Alopecia/tratamento farmacológico , Alopecia em Áreas/complicações , Criança , Ciclopropanos/administração & dosagem , Ciclopropanos/efeitos adversos , Fármacos Dermatológicos/administração & dosagem , Fármacos Dermatológicos/efeitos adversos , Feminino , Cabelo/crescimento & desenvolvimento , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva , Estudos Retrospectivos , Índice de Gravidade de Doença , Doenças da Glândula Tireoide/complicações , Fatores de Tempo , Resultado do Tratamento , Adulto JovemRESUMO
Granuloma annulare (GA) is a granulomatous dermatosis that rarely presents on the face and is extremely uncommon in the periocular region. We report our experience with the presentation and management of GA lesions on the eyelids of a 17-year-old girl. We performed a review of published literature and identified 13 cases of pediatric periocular GA. One additional case was identified upon review of all pediatric GA cases at the Cleveland Clinic Foundation. Review of these cases suggests that periocular GA is a benign condition that spontaneously regresses within a few months. GA nodules have a predilection for the upper eyelids. A greater incidence is noted in African American children. Awareness of the self-resolving nature of this condition can prevent unnecessary surgical excisions in affected children.
