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1.
Clin Exp Med ; 23(8): 4141-4152, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37480404

RESUMO

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with a wide range of clinical manifestations and multifactorial etiologies ranging from environmental to genetic. SLE is associated with dysregulated immunological reactions, with increased immune complex formation leading to end-organ damages such as lupus nephritis, cutaneous lupus, and musculoskeletal disorders. Lupus treatment aims to reduce disease activity, prevent organ damage, and improve long-term patient survival and quality of life. Antimalarial, hydroxychloroquine (HCQ) is used as a first-line systemic treatment for lupus. It has shown profound efficacy in lupus and its associated conditions. However, wide variation in terms of clinical response to this drug has been observed among this group of patients. This variability has limited the potential of HCQ to achieve absolute clinical benefits. Several factors, including genetic polymorphisms of cytochrome P450 enzymes, have been stipulated as key entities leading to this inter-individual variation. Thus, there is a need for more studies to understand the role of genetic polymorphisms in CYP450 enzymes in the clinical response to HCQ. Focusing on the role of genetic polymorphism on whole blood HCQ in lupus disorder, this review aims to highlight up-to-date pathophysiology of SLE, the mechanism of action of HCQ, and finally the role of genetic polymorphism of CYP450 enzymes on whole blood HCQ level as well as clinical response in lupus.


Assuntos
Antirreumáticos , Lúpus Eritematoso Sistêmico , Nefrite Lúpica , Humanos , Hidroxicloroquina/uso terapêutico , Antirreumáticos/uso terapêutico , Qualidade de Vida , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Lúpus Eritematoso Sistêmico/genética , Polimorfismo Genético , Nefrite Lúpica/complicações , Sistema Enzimático do Citocromo P-450/uso terapêutico
3.
Dermatol Ther ; 34(5): e15080, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34351693

RESUMO

Cryotherapy is a standard treatment for warts. Tuberculin immunotherapy is a novel therapeutic option. We compared the efficacy and safety of cryotherapy versus tuberculin immunotherapy in a randomized, assessor-blinded study. 15 patients were treated with intralesional tuberculin and 15 patients received cryotherapy every 2 weeks until complete wart resolution or a maximum of six sessions. Wart diameter, total number of warts and adverse effects were documented. Complete clearance of treated warts was achieved in 13(86.7%) and 11(73.3%) of patients with immunotherapy and cryotherapy respectively. Immunotherapy showed greater wart size reduction (51.88 ± 89.36 mm) than cryotherapy (32.99 ± 36.19 mm), (p = 0.46). Immunotherapy resulted in 64% reduction in total number of warts compared to 23.2% with cryotherapy, p < 0.01. More blisters developed with cryotherapy (46.7%) than immunotherapy (6.7%), (p = 0.01). Compartment syndrome-like features complicate immunotherapy in 1 patient. Tuberculin immunotherapy and cryotherapy are equally effective in treating warts. Immunotherapy has added benefit with resolution of distant warts. Safety profiles were similar except for blisters which were more common with cryotherapy.


Assuntos
Tuberculina , Verrugas , Crioterapia , Humanos , Imunoterapia , Injeções Intralesionais , Resultado do Tratamento , Verrugas/tratamento farmacológico , Verrugas/terapia
5.
Int J Dermatol ; 59(7): 804-812, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32447767

RESUMO

OBJECTIVE: Antibiotics and retinoids have been used for acne vulgaris for decades. Though effective, each has its own drawbacks. Chemical peels have been used for treatment of acne vulgaris with inadequate clinical evidence. We sought to determine the efficacy and safety of Jessner's solution (JS) in comparison with salicylic acid (SA) 30% in the management of acne vulgaris and postacne hyperpigmentation in patients with colored skin. METHODS: A total of 36 subjects (94.5% Fitzpatick Type IV-V) were recruited in this randomized double-blinded, split-face, controlled trial. Each side of the face was randomly assigned for treatment with either JS or SA. Subjects were treated once fortnightly for a total of three sessions. Lesion counting, Michaelsson acne score (MAS), photographs, and postacne hyperpigmentation index (PAHPI) were used to objectively assess the improvement. Complications were assessed during each visit. Statistical analysis was conducted using SPSS v22.0. Significance was set at P = 0.05. RESULTS: At the end of therapy, significant reduction in inflammatory, noninflammatory lesions, MAS, and PAHPI scores (P < 0.001, respectively) were noted in comparison to baseline. Mixed model analysis revealed no significant outcome difference between the two groups. Patients who reported good and very good outcome were 76.4% (JS) and 85.3% (SA). Burning, stinging sensation, and exfoliation were the common complications reported. Postinflammatory hyperpigmentation was reported only once in the JS arm. CONCLUSION: Both JS and SA were equally effective in the treatment of acne vulgaris and reducing postacne hyperpigmentation in patients with colored skin.


Assuntos
Acne Vulgar/tratamento farmacológico , Abrasão Química/métodos , Etanol/uso terapêutico , Hiperpigmentação/tratamento farmacológico , Ceratolíticos/uso terapêutico , Ácido Láctico/uso terapêutico , Resorcinóis/uso terapêutico , Salicilatos/uso terapêutico , Ácido Salicílico/uso terapêutico , Acne Vulgar/complicações , Adulto , Abrasão Química/efeitos adversos , Método Duplo-Cego , Combinação de Medicamentos , Etanol/efeitos adversos , Dermatoses Faciais/tratamento farmacológico , Feminino , Humanos , Hiperpigmentação/etiologia , Ceratolíticos/efeitos adversos , Ácido Láctico/efeitos adversos , Masculino , Dor/induzido quimicamente , Resorcinóis/efeitos adversos , Salicilatos/efeitos adversos , Ácido Salicílico/efeitos adversos , Índice de Gravidade de Doença , Pigmentação da Pele , Resultado do Tratamento , Adulto Jovem
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