[Mexican treatment goals for plaque psoriasis]. / Metas mexicanas de tratamiento de psoriasis en placas.

Psoriasis is a chronic inflammatory disease with a worldwide prevalence between 6 and 39% in moderate to severe forms. In European countries like Germany and England was identified that only one third of patients with moderate to severe forms will receive systemic management, this fact motivated to integrate into Europe an international consensus on treatment goals with the aim of providing support to the dermatologist by algorithms that serve as a therapeutic guide that allows you to gain control short and long term effects of this disease. The European group met to develop the definitions of severity of psoriasis, treatment goals for moderate to severe disease, and optimization options and / or therapeutic transition than a paper published in 2011 was obtained. In Mexico a working group of experts on biological therapy (GTEB), made up of 10 members and an extended group of 150 dermatologists' voters in the country for the purpose of issuing Mexico's position on the proposals of the European group was formed. In this document the findings of the Working Group of Experts on Biological Therapy in Mexico are listed.

La psoriasis es una enfermedad crónica inflamatoria, con una prevalencia mundial entre 6 y 39% en las formas moderadas a severas. En países europeos como Alemania e Inglaterra se identificó que solo la tercera parte de los pacientes que padecen formas moderadas a severas reciben manejo sistémico; este hecho motivó la integración en Europa de un consenso internacional sobre metas de tratamiento con el objetivo de brindar apoyo al dermatólogo con algoritmos que sirvan como guía terapéutica para lograr el control a corto y largo plazo de esta enfermedad. El grupo europeo se reunió para elaborar las definiciones de severidad de la psoriasis, las metas de tratamiento en la enfermedad moderada a severa, entre otros temas, de lo que se obtuvo un documento publicado en el 2011. En México se conformó un grupo de trabajo de expertos en terapia biológica (GTEB), formado por 10 integrantes y un grupo extendido de 150 dermatólogos votantes del país, con la finalidad de emitir la posición de México sobre las propuestas del grupo europeo. En el presente documento se enumeran las conclusiones del grupo de trabajo de expertos en terapia biológica en México.

Recurrent Toxic Epidermal Necrolysis Syndrome: A Report of Two Cases.

An 81-year-old male and a 47-year-old female experienced recurrent severe bullous dermatosis secondary to an intake of drugs and alternative medicines indicated for arthralgias. The first patient had previously presented with Stevens-Johnson/toxic epidermal necrolysis (TEN) overlap syndrome in 2007 secondary to ingestion of trimethoprim/sulfamethoxazole indicated for a urinary tract infection; 6 years later, he presented with the same syndrome 2 days after ingestion of oral naproxen tablets 250 mg twice daily. The second patient had presented 5 years previously with TEN after receiving trimethoprim/sulfamethoxazole. In 2014, she presented with arthralgias and received a xenobiotic oral called 'miracle pills' (dosage is unknown); 3 weeks later, she again experienced TEN. Both patients were treated with intravenous immunoglobulin 400 mg/kg/day; duration of treatment was 5 days for the first patient and 3 days for the second. However, the male patient died from severe sepsis; the female patient experienced a favorable outcome. There are many risk factors for the development of cutaneous adverse drug reactions; a history of allergic reactions is one important risk factor, and both patients had it. This article reviews the scientific literature on this topic and analyzes the possible causes, including infectious processes, immunological defects, and immunogenetic factors.