Assuntos
Adenocarcinoma Sebáceo/cirurgia , Cirurgia de Mohs , Nevo/cirurgia , Neoplasias das Glândulas Sebáceas/cirurgia , Neoplasias Cutâneas/cirurgia , Adenocarcinoma Sebáceo/patologia , Biópsia , Feminino , Humanos , Pessoa de Meia-Idade , Nevo/patologia , Couro Cabeludo , Neoplasias das Glândulas Sebáceas/patologia , Neoplasias Cutâneas/patologia , Tomografia Computadorizada por Raios XAssuntos
Síndromes Neoplásicas Hereditárias/genética , Síndromes Neoplásicas Hereditárias/patologia , Dermatopatias Papuloescamosas/patologia , Neoplasias Cutâneas/genética , Neoplasias Cutâneas/patologia , Proteínas Supressoras de Tumor/genética , Biópsia por Agulha , Enzima Desubiquitinante CYLD , Diagnóstico Diferencial , Dermatoses Faciais/genética , Dermatoses Faciais/patologia , Dermatoses Faciais/terapia , Feminino , Regulação da Expressão Gênica , Humanos , Pessoa de Meia-Idade , Mutação , Síndromes Neoplásicas Hereditárias/terapia , Doenças Raras , Dermatoses do Couro Cabeludo/genética , Dermatoses do Couro Cabeludo/patologia , Dermatoses do Couro Cabeludo/terapia , Dermatopatias Papuloescamosas/diagnóstico , Dermatopatias Papuloescamosas/terapia , Neoplasias Cutâneas/terapia , Visitas de PreceptoriaRESUMO
Tumor necrosis factor-? (TNF-?) inhibitors are biologic agents that are currently in wide use for the treatment of psoriasis as well as other inflammatory diseases. Following reports of thrombocytopenia as a potential adverse effect of anti-TNF-? therapy, we performed a retrospective study to determine the frequency of thrombocytopenia, defined as a platelet count <50x109 cells/L, in a cohort of 187 psoriatic patients treated with anti-TNF-? agents over a nine-year period. Although none of our patients met serologic criteria for thrombocytopenia or displayed clinical manifestations of thrombocytopenia, two patients developed platelet counts below 100×109 cells/L. Thrombocytopenia induced by anti-TNF-? agents is a potential adverse effect, it is a rare occurrence that will require further investigation in large, placebo-controlled, double-blind, prospective studies.
Assuntos
Anti-Inflamatórios/efeitos adversos , Anticorpos Monoclonais/efeitos adversos , Imunoglobulina G/efeitos adversos , Psoríase/tratamento farmacológico , Trombocitopenia/induzido quimicamente , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Adalimumab , Adulto , Idoso , Anti-Inflamatórios/uso terapêutico , Anticorpos Monoclonais/uso terapêutico , Anticorpos Monoclonais Humanizados , Contagem de Células Sanguíneas , Etanercepte , Feminino , Humanos , Imunoglobulina G/uso terapêutico , Infliximab , Masculino , Pessoa de Meia-Idade , Contagem de Plaquetas , Psoríase/imunologia , Psoríase/patologia , Receptores do Fator de Necrose Tumoral/uso terapêutico , Estudos Retrospectivos , Trombocitopenia/epidemiologia , Fator de Necrose Tumoral alfa/metabolismo , Adulto JovemRESUMO
Candida krusei is an emerging fungal pathogen found primarily in immunocompromised patients. Intrinsic resistance to fluconazole and decreasing susceptibility to other anti-fungal agents are problematic. When colonization occurs, dissemination may follow rapidly. We present a case of a patient with acute lymphoblastic leukemia who, despite being treated prophylactically with fluconazole, developed disseminated C. krusei.
Assuntos
Candidíase Cutânea/diagnóstico , Candidíase Cutânea/imunologia , Fungemia/diagnóstico , Fungemia/imunologia , Hospedeiro Imunocomprometido , Leucemia Aguda Bifenotípica/complicações , Antifúngicos/uso terapêutico , Candida , Candidíase Cutânea/prevenção & controle , Fluconazol/uso terapêutico , Fungemia/prevenção & controle , Humanos , Leucemia Aguda Bifenotípica/imunologia , Masculino , Adulto JovemAssuntos
Antivirais/efeitos adversos , Interferon-alfa/efeitos adversos , Polietilenoglicóis/efeitos adversos , Sarcoidose/induzido quimicamente , Dermatopatias/induzido quimicamente , Humanos , Interferon alfa-2 , Masculino , Pessoa de Meia-Idade , Proteínas Recombinantes , Abuso de Substâncias por Via Intravenosa , VeiasRESUMO
Vogt-Koyanagi-Harada (VKH) syndrome is an inflammatory condition characterized by bilateral uveitis, vitiligo, poliosis, alopecia, and dysacousia. The syndrome results from a T cell mediated autoimmune attack on melanocytes in genetically susceptible individuals. We present a case of VKH syndrome and propose that the alopecia and poliosis described in the original reports by ophthalmologists could instead be alopecia areata with re-growth of white hair.
Assuntos
Alopecia em Áreas/complicações , Alopecia em Áreas/patologia , Síndrome Uveomeningoencefálica/complicações , Síndrome Uveomeningoencefálica/patologia , Adulto , Feminino , HumanosRESUMO
BACKGROUND: The number of cosmetic procedures performed annually is on the rise and is being performed by more specialties. PURPOSE: We sought to determine the relative outpatient cosmetic procedure experience of dermatology and other specialties. We also examined demographic data of patients who underwent cosmetic procedures. METHODS: Demographics and data from the National Ambulatory Medical Care Survey (NAMCS) were analyzed to estimate the number of visits for office-based cosmetic procedures from 1995 to 2003 by specialty and type of procedure. RESULTS: In order of decreasing frequency, the percentage of all cosmetic procedures performed in the outpatient setting by specialty was as follows: dermatology (48%), plastic surgery (38%), general surgery (>4%), otolaryngology (>3%), ophthalmology (>3%), facial plastic surgery (1%), family practice (<1%), pediatrics (<1%), and internal medicine (<1%). Most cosmetic procedures were performed on white, female patients in the 40- to 59-year-old age group. There was a mean of 55 visits per 1,000 whites and 27 visits per 1,000 nonwhites. Chemical peels and soft tissue fillers were the two most common procedures. CONCLUSIONS: Dermatology as a specialty performs more office-based cosmetic procedures than other specialties. On a per-physician basis, dermatologists and plastic surgeons have far more experience with cosmetic procedures than other physicians.