RESUMO
La dermatitis atópica (DA) corresponde a la enfermedad inflamatoria crónica de la piel más frecuente en la infancia. Su aparición parece ser el resultado de la interacción entre la predisposición genética y múltiples factores ambientales. Además, la disfunción de la barrera cutánea jugaría un rol esencial en las exacerbaciones de la presentación clínica. Los probióticos corresponden a microorganismos vivos cuya administración en la cantidad adecuada es beneficiosa para la salud del paciente. La administración oral de probióticos muestra diversos efectos positivos tanto en la homeostasis del tubo digestivo como en el sistema inmune. Recientemente, numerosos investigadores se han enfocado en el efecto de los probióticos en la supresión de la respuesta alérgica, y han evaluado su efecto profiláctico y/o terapéutico en DA, asma y alergias alimentarias. La suplementación prenatal con probióticos para la prevención primaria de DA se ha estudiado en diversos ensayos clínicos con cierta evidencia que sustenta su eficacia. Dado que los probióticos son reconocidos como un ingrediente seguro de los alimentos, éstos podrían ofrecer una alternativa para reducir la respuesta alérgica en una mujer embarazada de un niño con alto riesgo de DA.
Atopic dermatitis (AD) is the most frequent chronic inflammatory skin desease in childhood. Its onset seems to be the result of the interaction between genetic predispose and multiple environmental factors. Furthermore, barrier dysfunction of atopic skin is likely to play an essential role in the exacerbation of clinical presentation. Probiotics are live microorganisms which when in adequate amounts confer health benefits to the patient. Orally administered probiotics exhibit many positive effects on gut homeostasis and immune system. Recently, many researchers have focused on the suppressive effect of probiotic agents on allergic responses, and have evaluated its prophylactic and/or therapeutic efficacy for AD, asthma and food allergy. Prenatal probiotic supplementation for primary prevention of pediatric AD has been studied in clinical trials with some evidence to support its efficacy. Because probiotics are recognized as safe food ingredients, they may offer an alternative to reduce allergic responses for pregnant women carrying high-risk children for AD.
Assuntos
Humanos , Criança , Dermatite Atópica/prevenção & controle , Prevenção Primária , Probióticos/administração & dosagem , Aleitamento Materno , Eczema/prevenção & controle , Intestinos/microbiologiaRESUMO
Introducción: El Herpes Labial Recurrente supone una condición inmunológica alterada, tal como una hiperactividad de células T-reguladoras CD4+CD25+ (Treg). Éstas ejercen control sobre la tolerancia periférica y reducen el riesgo inmunopatológico, suprimiendo otras líneas celulares. Por ende, la supresión ejercida sobre la reacción inmune antiviral podría afectar negativamente el curso de la infección. Este contexto ha impulsado la búsqueda de nuevas alternativas inmunomoduladoras como la Equinácea purpúrea. Dada su propiedad inmunosupresora, se propone en el tratamiento del Herpes Labial Recurrente. Metodología: Estudio clínico prospectivo que analiza las subpoblaciones linfocitarias en 12 pacientes con Herpes Labial Recurrente, antes y después de recibir Equinácea purpúrea (30 gotas tres veces al día durante siete días).Resultados: En comparación con individuos sanos, los pacientes presentan una respuesta aumentada de células Treg. Esta condición se reduce significativamente tras recibir Equinácea purpúrea (515 + 145 y 432 + 113 cel/mm3 antes y después del tratamiento, respectivamente, p < 0,005). Conclusión: La hiperactividad de células Treg podría explicar el estado de inmunosupresión de estos pacientes y favorecería la persistencia viral. Se propone esta fitomedicina como una alternativa inmunoterapéutica beneficiosa.
Background: Recurrent Herpes Labialis patients may suffer from immunological alterations, such as CD4+CD25+Regulatory-T Cell (Treg) hyperactivity. These cells control peripheral tolerance and reduce immunopathology risk by suppressing other immunological cells. Hence, the Treg cell suppression on the antiviral immune reaction may perturb adversely the herpes infection outcome. This scenario has forced physicians to explore new immunomodulatory alternatives in Phytomedicine, such as Echinacea purpurea. Regarding the immunosuppressive property, it has been challenged to be employed in the Recurrent Herpes Labialis management. Methods: Clinical prospective study that analyzed lymphocytic subpopulation profile in twelve patients with Recurrent Herpes Labialis, before and after receiving E. purpurea (30 drops three times a day during seven days). Results: Comparing to healthy subjects, patients presented an enlarged Treg cell response. This condition became significantly reduced after receiving E. purpurea. (515 + 145 and 432 + 113 cel, before and after treatment respectively, p < 0.005). Conclusion: The intensified Treg cell activity may elucidate the immune suppression these patients undergo, aiding the viral persistence and survival. This proposes E. purpurea asa beneficial immunotherapeutic alternative.
Assuntos
Humanos , Antivirais/uso terapêutico , Echinacea/uso terapêutico , Echinacea/química , Herpes Labial/tratamento farmacológico , Preparações de Plantas/uso terapêutico , Antivirais/farmacologia , Echinacea/farmacologia , Herpes Labial/imunologia , Herpes Simples/tratamento farmacológico , Herpesvirus Humano 1 , Imunomodulação , Estudos Multicêntricos como Assunto , Estudos Prospectivos , Preparações de Plantas/farmacologia , Recidiva/prevenção & controle , Linfócitos T ReguladoresRESUMO
Los micosis superficiales corresponden o las afecciones de piel, pelos, uñas y mucosas por diversos especies de hongos. Sus principales agentes etiológicos corresponden a dermatofitos, levaduras del género Candiada y Malassezia sp. El objetivo de nuestro trabajo fue caracterizar y analizar las dermatomicosis superficiales según género, poro lo cual se realizó un estudio retrospectivo durante el periodo comprendido entre enero de 1999 y diciembre de 2006 en el Laboratorio de Dermatología del Hospital Clínico de la Universidad de Chile. En el período observado se analizaron 30.590 registros de pacientes. El porcentaje de resultados positivos fue menor en mujeres que en hombres, tanto para micológicos (56% vs 66%, P < 0,00 1) como para cultivos (32% vs 39%, P < 0,00 1). Se observó que las mujeres tuvieron significativamente más presencia de levaduras en el examen micológico directo, desarrollo de Candida sp en el cultivo y mayor afectación de uñas de manos que los hombres.
Superficial mycosis (SM) includes various fungi species that affect skin, hair, nails and mucous membranes. The main a etiologic agents are dermatophytes, and Candida and Malassezia sp, yeasts. The aim of this study is to characterize SM and analyze its relation with gender. A retrospective study was realized in the Laboratory of Dermatology, University of Chile Clinical Hospital, between January 1999 and December 2006. 30,590 patient charts were reviewed. Women showed o lower percentage of positive results thon men in direct microscopic tests (56% vs, 66%, P < 0,00 1) and culture tests (32% vs, 39%, P < 0,00 1). Women had significantly higher yeast counts in direct microscopic tests, higher frequency of Candida sp. in cultures, and greater involvement of finger nails than men.
Assuntos
Humanos , Masculino , Adolescente , Adulto , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Dermatomicoses/epidemiologia , Fungos/isolamento & purificação , Técnicas de Cultura , Candida/isolamento & purificação , Chile/epidemiologia , Dermatomicoses/diagnóstico , Dermatomicoses/microbiologia , Microsporum/isolamento & purificação , Estudos Retrospectivos , Fatores Sexuais , Trichophyton/isolamento & purificaçãoRESUMO
BACKGROUND: There is an increase in the incidence of malignant melanoma in Chile. Previous studies have shown that the density and size of acquired melanocytic nevi (AMN) are a risk factor for developing malignant melanoma. AIM: To assess the number and anatomical distribution of acquired melanocytic nevi in Chilean adolescents. MATERIAL AND METHODS: The number of AMN was counted in 30 anatomical sites in 201 Chilean school children (111 females), aged from 11 to 15 years. The number of small AMN (2-4.9 mm) and large AMN (>5 mm of diameter) was determined. RESULTS: Mean AMN number per person was 32.7 (95% confidence interval (CI) 30.7-42.3) in males and 29 (95% CI 271-38.6) in females (p =NS). Males had a higher number of AMN in the face, neck and trunk. Females had a higher number of AMN in the upper and lower limbs. Older children, adolescents with history of sunburns and with lighter skin had a higher number of total, small and large nevi. CONCLUSIONS: The average number of AMN found in this study is similar to that reported in the literature. The differences in site distribution between males and females may be explained by a different sun exposure pattern.
Assuntos
Melanoma/epidemiologia , Neoplasias Induzidas por Radiação/epidemiologia , Nevo Pigmentado/patologia , Pobreza , Neoplasias Cutâneas/epidemiologia , Adolescente , Análise de Variância , Criança , Chile/epidemiologia , Feminino , Humanos , Masculino , Melanoma/patologia , Neoplasias Induzidas por Radiação/patologia , Nevo Pigmentado/epidemiologia , Neoplasias Cutâneas/patologia , Queimadura Solar/complicações , Queimadura Solar/patologia , Luz Solar/efeitos adversosRESUMO
Background: There is an increase in the incidence of malignant melanoma in Chile. Previous studies have shown that the density and size of acquired melanocytic nevi (AMN) are a risk factor for developing malignant melanoma. Aim: To assess the number and anatomical distribution of acquired melanocytic nevi in Chilean adolescents. Material and methods: The number of AMN was counted in 30 anatomical sites in 201 Chilean school children (111 females), aged from 11 to 15 years. The number oí small AMN (2-4.9 mm) and large AMN (>5 mm ofdiameter) was determined. Results: Mean AMN number per person was 32.7 (95 percent confidence interval (CI) 30.7-42.3) in males and 29 (95 percent CI 271-38.6) in females (p =NS). Males had a higher number of AMN in the face, neck and trunk. Females had a higher number of AMN in the upper and lower limbs. Older children, adolescents with history of sunburns and with lighter skin had a higher number of total, small and large nevi. Conclusions: The average number ofAMNfound in this study is similar to that reported in the literature. The differences in site distribution between males and femalesmay be explainedby a differentsun exposurepattern.
Assuntos
Adolescente , Criança , Feminino , Humanos , Masculino , Melanoma/epidemiologia , Neoplasias Induzidas por Radiação/epidemiologia , Nevo Pigmentado/patologia , Pobreza , Neoplasias Cutâneas/epidemiologia , Análise de Variância , Chile/epidemiologia , Melanoma/patologia , Neoplasias Induzidas por Radiação/patologia , Nevo Pigmentado/epidemiologia , Neoplasias Cutâneas/patologia , Queimadura Solar/complicações , Queimadura Solar/patologia , Luz Solar/efeitos adversosRESUMO
BACKGROUND: Psoriasis has a moderate or severe course in 25% of patients, requiring systemic therapy that is not always successful. Infliximab is a human-murine monoclonal anti tumor necrosis alpha (TNF-alpha) antibody. This mediator has a role in the pathogenesis of psoriasis. AIM: To evaluate the use of infliximab in psoriatic patients resistant to conventional therapies. MATERIAL AND METHODS: An open prospective study including eight patients with extensive plaque or erythrodermic psoriasis. They were treated with infliximab 5 mg/kg/dose on weeks 0,2 and 6. Patients were evaluated every 2 weeks for a median lapse of 50.1 weeks. Physical examination, PASI scores (Psoriasis Area Severity Index) and a photographic control, were done in each visit. RESULTS: All the patients responded in the first 10 weeks of follow-up. The mean reduction in PASI score was 86.6%. Six patients received fourth infusion of infliximab at 37.3 weeks, on average. The most common adverse events were pruritus and headache. CONCLUSIONS: This group of patients with extensive plaque or erythrodermic psoriasis resistant to conventional therapies, had a good response to infliximab.
Assuntos
Anticorpos Monoclonais/uso terapêutico , Fármacos Dermatológicos/uso terapêutico , Psoríase/tratamento farmacológico , Adulto , Anticorpos Monoclonais/efeitos adversos , Fármacos Dermatológicos/efeitos adversos , Feminino , Seguimentos , Humanos , Infliximab , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
Background: Psoriasis has a moderate or severe course in 25% of patients, requiring systemic therapy that is not always successful. Infliximab is a human-murine monoclonal anti tumor necrosis alpha (TNF-a) antibody. This mediator has a role in the pathogenesis of psoriasis. Aim: To evaluate the use of infliximab in psoriatic patients resistant to conventional therapies. Material and Methods: An open prospective study including eight patients with extensive plaque or erythrodermic psoriasis. They were treated with infliximab 5 mg/kg/dose on weeks 0,2 and 6. Patients were evaluated every 2 weeks for a median lapse of 50.1 weeks. Physical examination, PASI scores (Psoriasis Area Severity Index) and a photographic control, were done in each visit. Results: All the patients responded in the first 10 weeks of follow-up. The mean reduction in PASI score was 86.6%. Six patients received fourth infusion of infliximab at 37.3 weeks, on average. The most common adverse events were pruritus and headache. Conclusions: This group of patients with extensive plaque or erythrodermic psoriasis resistant to conventional therapies, had a good response to infliximab.
Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Anticorpos Monoclonais/uso terapêutico , Fármacos Dermatológicos/uso terapêutico , Psoríase/tratamento farmacológico , Anticorpos Monoclonais/efeitos adversos , Fármacos Dermatológicos/efeitos adversos , Seguimentos , Estudos Prospectivos , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
El cáncer cutáneo ha aumentado en las últimas décadas en Chile. En noviembre, 2003, se realizó una campaña de prevención de cáncer de piel en nuestro hospital, que tuvo por objetivos educar a la gente de los riesgos de una alta exposición solar, como también, la detección precoz de lesiones malignas. Se registraron datos importantes sobre el conocimiento y conducta de las personas frente a este tema y se detectaron lesiones malignas en personas de alto riesgo. Un total de 2.142 personas asistieron a la campaña, de las cuales un 73,6 por ciento fueron mujeres y 26,4 hombres. El promedio de edad de los asistentes fue de 47,2 años. Un 91,5 por ciento declaró saber de la relación entre la radiación solar y cáncer de piel; sin embargo, solamente un 41,2 por ciento declara usar bloqueador solar. Mujeres, personas con pieles de fenotipos más claros y personas de mayor nivel educacional declaran usar más bloqueador solar. El examen físico para la detección de lesiones malignas fue realizado en 806 personas. Lesiones premalignas y malignas fueron detectadas en 145 personas (12,3 por ciento de queratosis actínica, 6,2 por ciento carcinoma basocelular, 0,24 por ciento de carcinoma espinocelular, 1,12 por ciento enfermedad de Bowen y 1,73 por ciento melanoma maligno). El grupo de personas con lesiones premalignas y malignas fue de mayor edad, de fenotipos de piel más claros y principalmente varones. Este tipo de campaña nos ayuda a reducir las tasas de mortalidad y morbilidad de cáncer de piel en nuestro país.