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Soto-Moreno A, Cuenca-Barrales C, Arias-Santiago S, García-Vidal JA, Medina-Mirapeix F, Molina-Leyva A. Safety and Effectiveness of Percutaneous Ultrasound-Guided Galvanic Current in Tunnels of Patients with Hidradenitis Suppurativa: A Pilot Study. Dermatol Ther (Heidelb) 2024:10.1007/s13555-024-01149-5. [PMID: 38676840 DOI: 10.1007/s13555-024-01149-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 03/22/2024] [Indexed: 04/29/2024] Open
Abstract
INTRODUCTION The recurrent nature of hidradenitis suppurativa (HS), even under maintained systemic treatment, makes it necessary to have effective local treatments; however, the response to these therapies is variable (44-81%). The application of galvanic current (GC) has demonstrated its utility in humans in treating lesions structurally similar to those of HS. With this background, the main objective of this study was to evaluate the efficacy and safety of ultrasound-guided percutaneous GC in inflamed and/or draining tunnels of HS. METHODS This was an open study (one-way repeated measures design over time). Patients were evaluated at 4 and 12 weeks after receiving GC. A combined clinical response at week 12 (absence of suppuration/inflammation on examination and clinical interview) was considered the principal variable of efficacy. Adverse effects potentially associated with GC were reported by telephone and at each visit. RESULTS Twenty-six patients were included, with a male/female ratio of 5:8. The mean age was 35.84 (13.14) years. At 12 weeks after the administration of GC, a complete response was achieved in 77% (20/26) of the treated lesions. No serious adverse effects were observed, and the mean procedural pain assessed by the numeric rating scale was 0.03 (0.2). CONCLUSION GC has proven to be effective and well tolerated in inflamed and draining tunnels of patients with HS.
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Affiliation(s)
- Alberto Soto-Moreno
- Department of Dermatology, Hidradenitis Suppurativa Unit, Hospital Universitario Virgen de las Nieves, Fuerzas Armadas Avenue, Number 15, 18012, Granada, Spain
| | - Carlos Cuenca-Barrales
- Department of Dermatology, Hidradenitis Suppurativa Unit, Hospital Universitario Virgen de las Nieves, Fuerzas Armadas Avenue, Number 15, 18012, Granada, Spain.
- TECe19-Dermatología Clínica y Traslacional, Granada Institute for Biosanitary Research, Granada, Spain.
| | - Salvador Arias-Santiago
- Department of Dermatology, Hidradenitis Suppurativa Unit, Hospital Universitario Virgen de las Nieves, Fuerzas Armadas Avenue, Number 15, 18012, Granada, Spain
- TECe19-Dermatología Clínica y Traslacional, Granada Institute for Biosanitary Research, Granada, Spain
| | | | | | - Alejandro Molina-Leyva
- Department of Dermatology, Hidradenitis Suppurativa Unit, Hospital Universitario Virgen de las Nieves, Fuerzas Armadas Avenue, Number 15, 18012, Granada, Spain
- TECe19-Dermatología Clínica y Traslacional, Granada Institute for Biosanitary Research, Granada, Spain
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Ureña-Paniego C, Haselgruber S, Soto-Moreno A, Cuenca-Barrales C, Arias-Santiago S, Molina-Leyva A. Eligibility in a cohort of patients with hidradenitis suppurativa treated with bimekizumab: Lessons and pitfalls in a real-world setting. J Eur Acad Dermatol Venereol 2024. [PMID: 38411288 DOI: 10.1111/jdv.19921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 02/15/2024] [Indexed: 02/28/2024]
Affiliation(s)
- C Ureña-Paniego
- Dermatology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - S Haselgruber
- Dermatology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - A Soto-Moreno
- Dermatology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - C Cuenca-Barrales
- Dermatology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
- Hidradenitis Suppurativa Clinic, Hospital Universitario Virgen de las Nieves, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - S Arias-Santiago
- Dermatology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - A Molina-Leyva
- Dermatology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
- Hidradenitis Suppurativa Clinic, Hospital Universitario Virgen de las Nieves, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- European Hidradenitis Suppurativa Foundation, Dessau-Roßlau, Germany
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Montero-Vilchez T, Rodriguez-Pozo JA, Cuenca-Barrales C, Sanabria-de-la-Torre R, Torres-de-Pinedo JM, Arias-Santiago S. Stratum Corneum Hydration As a Potential Marker of Response to Dupilumab in Atopic Dermatitis: A Prospective Observational Study. Dermatitis 2023. [PMID: 37695812 DOI: 10.1089/derm.2023.0176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
Background: Dupilumab is an effective treatment for atopic dermatitis (AD) and it also restores skin barrier function. Nevertheless, early changes in epidermal barrier parameters related to sustained treatment response or treatment failure are not known. So, the objective of this study is to evaluate whether changes in skin barrier function after 16 weeks dupilumab treatment could predict sustained treatment response or treatment failure. Materials and Methods: A prospective observational study was conducted that included patients with AD starting dupilumab. Clinical scores, patient-reported outcome measures (PROMs), and skin barrier function parameters were assessed at baseline and after 16 weeks treatment. Patients were followed until they failed to dupilumab or until the end of the study period. Participants were divided into 2 groups: patients with treatment failure and those with sustained treatment response. Results: In total, 32 patients with AD were included in the study, with a mean age of 28.03 years (standard deviation 10.65), being 20 (60.6%) females. In total, 22 (66.7%) patients sustained dupilumab response during the study period and only 10 (33.3%) failed to treatment. After 16 weeks treatment, clinical scores were improved in both groups. Patients with sustained treatment response increased stratum corneum hydration (SCH) on noninvolved skin (34.25 arbitrary units [AU] vs 44.90AU, P = 0.001) and on eczematous lesions (20.71 AU vs 40.94 AU, P < 0.001) and also decreased transepidermal water loss (TEWL) on eczematous lesions (28.22 g/[m2·h] vs 14.83 g/[m2·h], P = 0.002). Patients with treatment failure did not change TEWL or SCH. SCH after 16 weeks treatment on noninvolved skin (odds ratio [OR] = 0.83, P = 0.018) and SCH after 16 weeks treatment on eczematous lesions (OR = 0.86, P = 0.028) were related to dupilumab failure. Conclusion: SCH could be used as a predictive biomarker of dupilumab response in patients with AD.
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Affiliation(s)
- Trinidad Montero-Vilchez
- From the Dermatology Department, Virgen de las Nieves University Hospital, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | | | - Carlos Cuenca-Barrales
- From the Dermatology Department, Virgen de las Nieves University Hospital, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Raquel Sanabria-de-la-Torre
- From the Dermatology Department, Virgen de las Nieves University Hospital, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | | | - Salvador Arias-Santiago
- From the Dermatology Department, Virgen de las Nieves University Hospital, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Dermatology Department, Faculty of Medicine, University of Granada, Granada, Spain
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Fernandez-Crehuet P, Haselgruber S, Padial-Gomez A, Vasquez-Chinchay F, Fernandez-Ballesteros MD, López-Riquelme I, Jimenez-Gallo D, Segura-Palacios JM, Contreras-Steyls M, Osorio-Gómez GF, Hernández-Rodríguez JC, Sanchez-Diaz M, Cuenca-Barrales C, Arias-Santiago S, Molina-Leyva A. Short-Term Effectiveness, Safety, and Potential Predictors of Response of Secukinumab in Patients with Severe Hidradenitis Suppurativa Refractory to Biologic Therapy: A Multicenter Observational Retrospective Study. Dermatol Ther (Heidelb) 2023; 13:1029-1038. [PMID: 36892752 DOI: 10.1007/s13555-023-00906-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 02/14/2023] [Indexed: 03/10/2023] Open
Abstract
INTRODUCTION Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease. Biologic drugs have a key role in the long-term anti-inflammatory treatment of moderate to severe patients due to their immunomodulatory properties. The aim of this study is to evaluate the effectiveness and safety of secukinumab in patients with moderate to severe HS after 16 weeks of treatment, and to explore potential predictors of clinical response to the drug. METHODS Multicenter observational retrospective study. Patients treated with secukinumab 300 mg every 2 or 4 weeks who had completed at least 16 weeks of follow-up from nine hospitals based in southern Spain (Andalusia) were included in this study. Treatment effectiveness was assessed using the Hidradenitis Suppurativa Clinical Response (HiSCR). Information about adverse events was collected, the therapeutic burden of the patients was calculated as the summation of systemic medical treatments and surgical interventions (excluding incision and drainage) experienced until the start of secukinumab treatment. RESULTS Forty-seven patients with severe HS were included for analysis. At week 16, 48.9% (23/47) of patients achieved HiSCR. Adverse events were present in 6.4% (3/47) of the patients. The multivariate analysis showed that female sex and, to a lesser extent, lower body mass index (BMI) and a lower therapeutic burden were potentially associated with a higher probability of HiSCR achievement. CONCLUSIONS Favorable short-term effectiveness and safety of secukinumab in the treatment of severe HS patients were observed. Female sex, lower BMI and a lower therapeutic burden may be associated with a higher probability of achieving HiSCR.
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Affiliation(s)
| | - Sofía Haselgruber
- Hospital Universitario Virgen de las Nieves, IBS Granada, Granada, Spain.,Hidradenitis Suppurativa Clinic, Granada, Spain
| | - Alicia Padial-Gomez
- Dermatology Department, Hospital Universitario de Jerez de la Frontera, Jerez de la Frontera, Spain
| | | | | | - Irene López-Riquelme
- Dermatology Department, Hospital Universitario Regional de Málaga, Málaga, Spain
| | | | | | | | | | | | - Manuel Sanchez-Diaz
- Hospital Universitario Virgen de las Nieves, IBS Granada, Granada, Spain.,Hidradenitis Suppurativa Clinic, Granada, Spain
| | - Carlos Cuenca-Barrales
- Hospital Universitario Virgen de las Nieves, IBS Granada, Granada, Spain.,Hidradenitis Suppurativa Clinic, Granada, Spain
| | - Salvador Arias-Santiago
- Hospital Universitario Virgen de las Nieves, IBS Granada, Granada, Spain.,Hidradenitis Suppurativa Clinic, Granada, Spain
| | - Alejandro Molina-Leyva
- Hospital Universitario Virgen de las Nieves, IBS Granada, Granada, Spain.,Hidradenitis Suppurativa Clinic, Granada, Spain.,European Hidradenitis Suppurativa Foundation, Dessau-Roßlau, Germany
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Sánchez-Díaz M, Salvador-Rodríguez L, Cuenca-Barrales C, Arias-Santiago S, Molina-Leyva A. Potential Predictors of Cardiovascular Risk Improvement in Patients with Hidradenitis Suppurativa Treated with Adalimumab: A Pivotal Study of Factors Associated with Carotid Intima-Media Thickness Reduction. Dermatol Ther (Heidelb) 2023; 13:817-826. [PMID: 36787042 PMCID: PMC9984601 DOI: 10.1007/s13555-023-00898-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 01/30/2023] [Indexed: 02/15/2023] Open
Abstract
INTRODUCTION Hidradenitis suppurativa (HS) has been linked to higher cardiovascular risk (CVR) due to its inflammatory burden. There is little evidence on how biologic treatment could modify the cardiovascular risk of patients with HS. The aims of the present study were to explore the modification of CVR in patients under adalimumab treatment and to explore the potential factors associated with CVR improvement. METHODS A prospective longitudinal study was performed. A cohort of patients with HS treated with adalimumab was followed up. Carotid intima-media thickness (IMT) and other clinical and biochemical CVR factors were collected at baseline and 32 weeks after starting the treatment. RESULTS Twenty-seven patients with severe HS were included. Overall, there were no differences in IMT between baseline (633 μm) and 32 weeks follow-up (634 μm). However, 40.7% (11/27) of the patients presented an improvement in IMT. This group (IMT responders) had a higher prevalence of dyslipidemia, diabetes mellitus, higher HbA1c levels, consumed more tobacco, and had higher BMI at baseline. Moreover, these patients had lower IHS4 scores at baseline and tended to have a greater IMT basal value, indicating a higher burden of subclinical atherosclerosis. CONCLUSIONS Adalimumab treatment might benefit a subset of patients with HS in terms of cardiovascular risk reduction. In light of the results of the present study patients with classical cardiovascular risk factors, and those with higher burden of subclinical atherosclerosis and with less inflammatory load, may be more likely to improve their IMT during adalimumab treatment.
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Affiliation(s)
- Manuel Sánchez-Díaz
- grid.411380.f0000 0000 8771 3783Dermatology Unit, Hospital Universitario Virgen de las Nieves, IBS Granada, Avenida de las Fuerzas Armadas 2, 18014 Granada, Spain
| | - Luis Salvador-Rodríguez
- grid.411380.f0000 0000 8771 3783Dermatology Unit, Hospital Universitario Virgen de las Nieves, IBS Granada, Avenida de las Fuerzas Armadas 2, 18014 Granada, Spain
| | - Carlos Cuenca-Barrales
- grid.411380.f0000 0000 8771 3783Dermatology Unit, Hospital Universitario Virgen de las Nieves, IBS Granada, Avenida de las Fuerzas Armadas 2, 18014 Granada, Spain ,grid.411380.f0000 0000 8771 3783Hidradenitis Suppurativa Clinic, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Salvador Arias-Santiago
- Dermatology Unit, Hospital Universitario Virgen de las Nieves, IBS Granada, Avenida de las Fuerzas Armadas 2, 18014, Granada, Spain. .,Dermatology Department, School of Medicine, University of Granada, Granada, Spain.
| | - Alejandro Molina-Leyva
- grid.411380.f0000 0000 8771 3783Dermatology Unit, Hospital Universitario Virgen de las Nieves, IBS Granada, Avenida de las Fuerzas Armadas 2, 18014 Granada, Spain ,grid.411380.f0000 0000 8771 3783Hidradenitis Suppurativa Clinic, Hospital Universitario Virgen de las Nieves, Granada, Spain ,European Hidradenitis Suppurativa Foundation (EHSF), Dessau-Roßlau, Germany
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van Straalen KR, Tzellos T, Alavi A, Benhadou F, Cuenca-Barrales C, Daxhelet M, Daoud M, Efthymiou O, Giamarellos-Bourboulis EJ, Guillem P, Gulliver W, Jemec GBE, Katoulis A, Koenig A, Lazaridou E, Lowes MA, Marzano AV, Matusiak Ł, Molina-Leyva A, Moltrasio C, Pinter A, Potenza C, Prens EP, Romaní J, Saunte DML, Sayed CJ, Skroza N, Stergianou D, Szepietowski JC, Trigoni A, Vilarrasa E, Kyrgidis A, Zouboulis CC, van der Zee HH. External validation of the IHS4-55 in a European antibiotic-treated HS cohort. Dermatology 2023:000528968. [PMID: 36630943 DOI: 10.1159/000528968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 12/09/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Previously, a new dichotomous outcome was developed, calculated as 55% reduction in the International Hidradenitis Suppurativa 4 score (IHS4-55). It was validated in datasets of adalimumab and placebo treated HS patients. External validation is an important aspect of clinical outcomes. OBJECTIVES We aimed to externally validate the novel dichotomous IHS4-55 in a non-biologic treated dataset of HS patients. METHODS Data from a previously published European-wide prospective clinical study of antibiotic treatment of HS patients was used to assess the association of IHS4-55 achievement with individual reduction in inflammatory nodules, abscesses and draining tunnels. Moreover, the associations between IHS4-55 positivity and achievement of the minimal clinically important differences (MCID) for Dermatology Life Quality Index (DLQI), numerical rating scale (NRS) Pain, and NRS Pruritus were analyzed. RESULTS Data was obtained from 283 individual patients, of which 36.4% (103/283) were treated with clindamycin and rifampicin and 63.6% (180/283) with tetracyclines for 12 weeks. Achievers of the IHS4-55 demonstrated a significant reduction the counts of inflammatory nodules, abscesses, and draining tunnels (all p<0.001). Additionally, IHS4-55 achievers had an odds ratio (OR) for achieving the minimal clinically important difference (MCID) of DLQI, NRS Pain and NRS Pruritus of 2.16 (95% CI 1.28-3.65, p<0.01), 1.79 (95% CI 1.10-2.91, p<0.05), and 1.95 (95% CI 1.18-3.22, p<0.01), respectively. CONCLUSIONS This study shows the external validity of the novel IHS4-55 by demonstrating a significant association between IHS4-55 achievement and a reduction in inflammatory lesion counts as well as achievement of MCIDs for DLQI, NRS Pain and NRS Pruritus in an antibiotic-treated cohort. These findings support the use of the IHS4-55 as a novel primary outcome measure in clinical trials.
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Cuenca-Barrales C, Montero-Vilchez T, Krajewski PK, Szepietowski JC, Matusiak L, Arias-Santiago S, Molina-Leyva A. Sexual Dysfunction and Quality of Life in Patients with Hidradenitis Suppurativa and Their Partners. Int J Environ Res Public Health 2022; 20:ijerph20010389. [PMID: 36612709 PMCID: PMC9819626 DOI: 10.3390/ijerph20010389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/21/2022] [Accepted: 12/22/2022] [Indexed: 05/13/2023]
Abstract
Hidradenitis suppurativa (HS) is a chronic skin disease that profoundly affects patients' quality of life (QoL) and sexuality. Few data are available on the impact of HS on patients' partners. We aimed to explore the QoL and sexual function of patients' partners and the factors associated with their impairment and to compare the QoL and sexual function of single patients and those in a stable relationship. We conducted a cross-sectional study at Hospital Universitario Virgen de las Nieves (Granada, Spain) and at the Wroclaw Medical University (Wroclaw, Poland). Patients over the age of 16 years attending their scheduled follow-up and their partners, if any, were included. The Dermatology Life Quality Index (DLQI) and the Family Dermatology Life Quality Index (FDLQI) were used to estimate the QoL of patients and partners, respectively. The FSFI-6 was used to determine sexual dysfunction in women and the IIEF-5 for erectile dysfunction in men. Thirty-four single patients and twenty-eight patients in a stable relationship and their partners were included. Patients had a very large impact (DLQI 12.5 ± 7.5) and their partners a moderate impact (FDLQI 10.3 ± 7.1) in their QoL due to HS. Women with HS had a high prevalence of sexual dysfunction (13/32, 40.6%) and men of erectile dysfunction (19/30, 63.3%). Male partners also had a high prevalence of erectile dysfunction (10/17, 58.8%), while only one female partner had sexual dysfunction (1/11, 9.1%). Factors related to disease severity, intensity of symptoms and body mass index were associated with poorer QoL in partners and time of disease evolution with greater erectile dysfunction in male partners. In conclusion, HS not only profoundly affects the QoL and sexuality of patients but also of their partners. Several risk factors have been identified, which should be taken into account in the holistic approach of the disease.
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Affiliation(s)
- Carlos Cuenca-Barrales
- Hidradenitis Suppurativa Clinic, Dermatology Department, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain
- TECe19-Dermatología Clínica y Traslacional Investigation Group, Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
| | - Trinidad Montero-Vilchez
- Hidradenitis Suppurativa Clinic, Dermatology Department, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain
- TECe19-Dermatología Clínica y Traslacional Investigation Group, Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
| | - Piotr K Krajewski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland
| | - Jacek C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland
| | - Lukasz Matusiak
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland
| | - Salvador Arias-Santiago
- Hidradenitis Suppurativa Clinic, Dermatology Department, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain
- TECe19-Dermatología Clínica y Traslacional Investigation Group, Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
- School of Medicine, Department of Dermatology, University of Granada, 18016 Granada, Spain
- Correspondence:
| | - Alejandro Molina-Leyva
- Hidradenitis Suppurativa Clinic, Dermatology Department, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain
- TECe19-Dermatología Clínica y Traslacional Investigation Group, Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
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Cuenca-Barrales C, Montero-Vílchez T, Sanchez-Diaz M, Rodríguez-Pozo JÁ, Díaz-Calvillo P, Martinez-Lopez A, Arias-Santiago S, Molina-Leyva A. Patterns of Surgical Recurrence in Patients with Hidradenitis Suppurativa. Dermatology 2022; 239:255-261. [PMID: 36470224 DOI: 10.1159/000527400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 10/01/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Surgery is an essential part of hidradenitis suppurativa (HS) treatment. Understanding and reducing surgical recurrence are crucial to obtaining the best results in patients' treatment. OBJECTIVE The aim of the study was to characterize surgical recurrences in a cohort of patients with HS treated with wide excision and second-intention healing. METHODS A prospective nested case-control study was conducted. A cohort of patients with HS treated with wide excision and second-intention healing was monitored for 68 weeks. The surgical procedure was classified as case (recurrence) or control (no recurrence). The type of recurrence was classified according to the elementary lesion in tunnel or abscess and inflammatory nodule (AN) recurrence. Sociodemographic and clinical data likely related to recurrence and the type of recurrence were evaluated. RESULTS Sixty-three patients were included, receiving a total of 82 surgical procedures. The mean age of the patients was 36.18 years, and the surgical site presented a Hurley stage II severity in 79.26% (65/82) of the interventions. Tunnel recurrence was observed in 8.5% (7/82) and AN recurrence in 15.85% (13/82) of the interventions. Obesity was associated with a higher risk of recurrence, for both tunnel and AN recurrence. Hurley III at the surgical site, a history of pilonidal sinus, and higher International Hidradenitis Suppurativa Severity Score System (IHS4) after surgery and at week 68 increased the risk of tunnel recurrence. CONCLUSION We propose classifying surgical recurrence based on the elemental type of lesion. Tunnel recurrence could originate in the depth of the surgical scar and could be associated with both surgical site factors and inflammatory load. AN recurrence could originate in the borders of the surgical scar and may particularly benefit from preoperative ultrasound.
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Affiliation(s)
- Carlos Cuenca-Barrales
- Dermatology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain.,Instituto de Investigación Biosanitaria GRANADA, Granada, Spain
| | - Trinidad Montero-Vílchez
- Dermatology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain, .,Instituto de Investigación Biosanitaria GRANADA, Granada, Spain,
| | - Manuel Sanchez-Diaz
- Dermatology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | | | - Pablo Díaz-Calvillo
- Dermatology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Antonio Martinez-Lopez
- Dermatology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain.,Instituto de Investigación Biosanitaria GRANADA, Granada, Spain
| | - Salvador Arias-Santiago
- Dermatology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain.,Instituto de Investigación Biosanitaria GRANADA, Granada, Spain
| | - Alejandro Molina-Leyva
- Dermatology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain.,Instituto de Investigación Biosanitaria GRANADA, Granada, Spain.,European Hidradenitis Suppurativa Foundation (EHSF), Dessau-Roßlau, Germany.,Grupo Español de Hidradenitis Supurativa, Academia Española de Dermatología y Venereologia, Madrid, Spain
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Sánchez-Díaz M, Salvador-Rodríguez L, Cuenca-Barrales C, Arias-Santiago S, Molina-Leyva A. Exploring the role of systemic immune-inflammation index and neutrophil-lymphocyte ratio in cardiovascular risk stratification for patients with hidradenitis suppurativa: A cross-sectional study. J Dermatol 2022; 49:1238-1244. [PMID: 36000267 DOI: 10.1111/1346-8138.16558] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 07/28/2022] [Accepted: 08/06/2022] [Indexed: 11/29/2022]
Abstract
Hidradenitis suppurativa (HS) is a chronic inflammatory disease of the hair follicle that has previously been associated with a higher cardiovascular risk (CVR). Although different methods have been described for CVR stratification in HS, there is little evidence about the role of hemogram indexes in CVR in HS. Given its potential convenience, the aim of this study was to assess the role of the hemogram indexes systemic immune-inflammation index (SII) and neutrophil-lymphocyte ratio (NLR) in CVR stratification for patients with HS. A cross-sectional study was performed to assess the role of SII and NLR in CVR stratification in patients with moderate to severe HS who were candidates for biologic therapy. SII, NLR, carotid intima-media thickness, and other clinical and biochemical CVR factors were assessed before the start of the treatment. Fifty patients were included. The male:female ratio was 3:2, and the mean International Hidradenitis Suppurativa Severity Score System score was 21.6. After multivariate analysis, SII correlated with higher values of systolic blood pressure, metabolic syndrome, and higher risk of insulin resistance (p < 0.05). NLR was associated with insulin resistance (p < 0.05). These associations were independent of age, sex, body mass index, severity of the disease, and tobacco consumption. The implementation of SII and NLR in daily practice may be of benefit for identifying patients with HS at higher risk of high blood pressure, insulin resistance, or metabolic syndrome. Since these indexes are simple to calculate, they could be used as a screening tool in HS-specific units.
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Affiliation(s)
- Manuel Sánchez-Díaz
- Dermatology Unit, Hospital Universitario Virgen de las Nieves, IBS Granada, Granada, Spain
| | | | - Carlos Cuenca-Barrales
- Dermatology Unit, Hospital Universitario Virgen de las Nieves, IBS Granada, Granada, Spain
| | - Salvador Arias-Santiago
- Dermatology Unit, Hospital Universitario Virgen de las Nieves, IBS Granada, Granada, Spain.,Dermatology Department, School of Medicine, University of Granada, Granada, Spain
| | - Alejandro Molina-Leyva
- Dermatology Unit, Hospital Universitario Virgen de las Nieves, IBS Granada, Granada, Spain.,Hidradenitis Suppurativa Clinic, Hospital Universitario Virgen de las Nieves, Granada, Spain
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10
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Cuenca-Barrales C, Montero-Vílchez T, Sánchez-Díaz M, Martínez-López A, Rodríguez-Pozo JÁ, Díaz-Calvillo P, Arias-Santiago S, Molina-Leyva A. Intralesional Treatments in Hidradenitis Suppurativa: A Systematic Review. Dermatology 2022; 238:1084-1091. [PMID: 35477143 DOI: 10.1159/000524121] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 03/13/2022] [Indexed: 11/19/2022] Open
Abstract
Hidradenitis suppurativa (HS) is an inflammatory chronic disease with difficult management. In some scenarios, intralesional (IL) treatments could be useful. However, the scientific evidence available is limited and heterogeneous. We aimed to synthesize the available scientific evidence on IL treatments in HS. We conducted a systematic review in July 2021. The clinical databases reviewed included MEDLINE and Embase. All types of epidemiological studies and case series with at least 10 patients were included; reviews, guidelines, protocols, conference abstracts, case series with less than 10 patients, and case reports were excluded. Fifteen articles representing 599 patients and 1,032 lesions were included for review. Corticosteroid injections were the most reported treatment. They showed effectiveness for the treatment of acute inflammatory lesions and fistulas in terms of reduction of lesion counts, symptoms, and signs of inflammation and were safe in general terms. Light-based therapies were the other main treatment group, including photodynamic therapy and 1,064-nm diode laser. They were also effective, but more local and systemic adverse events were reported. Other treatments included botulinum toxin type B and punch-trocar-assisted cryoinsufflation (cryopunch). They were effective and safe, although were reported anecdotally. The main limitation of the systematic review was the general quality of the articles included. In conclusion, IL treatments such as corticosteroid injections and light-based therapies seem to be effective and safe for both acute inflammatory lesions and fistulas, although more prospective studies, with higher sample sizes and with standardized outcomes are needed to provide more scientific evidence on the subject.
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Affiliation(s)
- Carlos Cuenca-Barrales
- Hidradenitis Suppurativa Clinic, Dermatology Department of Hospital Universitario Virgen de las Nieves, Granada, Spain, .,TECe19-Dermatología Clínica y Traslacional Investigation Group, Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain,
| | - Trinidad Montero-Vílchez
- Hidradenitis Suppurativa Clinic, Dermatology Department of Hospital Universitario Virgen de las Nieves, Granada, Spain.,TECe19-Dermatología Clínica y Traslacional Investigation Group, Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Manuel Sánchez-Díaz
- Hidradenitis Suppurativa Clinic, Dermatology Department of Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Antonio Martínez-López
- Hidradenitis Suppurativa Clinic, Dermatology Department of Hospital Universitario Virgen de las Nieves, Granada, Spain.,TECe19-Dermatología Clínica y Traslacional Investigation Group, Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Juan Ángel Rodríguez-Pozo
- Hidradenitis Suppurativa Clinic, Dermatology Department of Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Pablo Díaz-Calvillo
- Hidradenitis Suppurativa Clinic, Dermatology Department of Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Salvador Arias-Santiago
- Hidradenitis Suppurativa Clinic, Dermatology Department of Hospital Universitario Virgen de las Nieves, Granada, Spain.,TECe19-Dermatología Clínica y Traslacional Investigation Group, Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,University of Granada, Granada, Spain
| | - Alejandro Molina-Leyva
- Hidradenitis Suppurativa Clinic, Dermatology Department of Hospital Universitario Virgen de las Nieves, Granada, Spain.,TECe19-Dermatología Clínica y Traslacional Investigation Group, Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
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11
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Cuenca-Barrales C, Ruiz-Carrascosa J, Ruiz-Villaverde R. FR - ¿Deben ser consideradas las estrías un factor predisponente de Koebner en psoriasis? Actas Dermo-Sifiliográficas 2022; 113:190-191. [DOI: 10.1016/j.ad.2020.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 03/05/2020] [Accepted: 04/21/2020] [Indexed: 11/15/2022] Open
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12
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Montero-Vilchez T, Martinez-Lopez A, Cuenca-Barrales C, Quiñones-Vico MI, Sierra-Sanchez A, Molina-Leyva A, Gonçalo M, Cambil-Martin J, Arias-Santiago S. Assessment of hand hygiene strategies on skin barrier function during COVID-19 pandemic: a randomized clinical trial. Contact Dermatitis 2021; 86:276-285. [PMID: 34954837 DOI: 10.1111/cod.14034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/20/2021] [Accepted: 12/23/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION COVID-19 has increased the frequency of hand washing. There is scarce evidence regarding the impact of different hand hygiene procedures on skin barrier function in clinical practice. OBJECTIVE To compare the impact on skin barrier function of different hand hygiene measures in health care workers in daily practice. METHODS A randomized controlled clinical trial was conducted. Participants were randomized to sanitize their hands with water and soap, alcohol-based hand sanitizers (ABHS) or disinfectant wipes during their 8-hour work-shift. Epidermal barrier functional parameters, like transepidermal water loss (TEWL), and the microbial load were assessed before and immediately after the workday. Tolerance and acceptability of each product were recorded after work. RESULTS Sixty-two participants were included and 20, 21 and 21 were randomized respectively to use water and soap, ABHS and disinfectant wipes. After the 8-hour shift, TEWL increase was higher with disinfectant wipes than with soaps or ABHS (+5.45vs + 3.87vs-1.46 g·h-1 ·m-2 respectively, P = .023). Bacteria and fungi colony-forming unit (CFU) count reduction was lower for water and soap group than for ABHS and disinfectant wipes. Disinfectant wipes were considered more difficult to use (P = .013) compared to water and soap and ABHS. CONCLUSION Daily hand hygiene with ABHS showed the lowest rates of skin barrier disruption and the highest reduction of CFU. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Trinidad Montero-Vilchez
- Department of Dermatology, Virgen de las Nieves University Hospital, Granada, Spain.,Biosanitary Institute of Granada (ibs.GRANADA), Granada, Spain
| | - Antonio Martinez-Lopez
- Department of Dermatology, Virgen de las Nieves University Hospital, Granada, Spain.,Biosanitary Institute of Granada (ibs.GRANADA), Granada, Spain
| | - Carlos Cuenca-Barrales
- Department of Dermatology, Virgen de las Nieves University Hospital, Granada, Spain.,Biosanitary Institute of Granada (ibs.GRANADA), Granada, Spain
| | - Maria I Quiñones-Vico
- Biosanitary Institute of Granada (ibs.GRANADA), Granada, Spain.,Cell Production and Tissue Engineering Unit, Virgen de las Nieves University Hospital, Andalusian Network of Design and Translation of Advanced Therapies, Granada, Spain.,Department of Dermatology, Faculty of Medicine, University of Granada, Granada, Spain
| | - Alvaro Sierra-Sanchez
- Cell Production and Tissue Engineering Unit, Virgen de las Nieves University Hospital, Andalusian Network of Design and Translation of Advanced Therapies, Granada, Spain
| | - Alejandro Molina-Leyva
- Department of Dermatology, Virgen de las Nieves University Hospital, Granada, Spain.,Biosanitary Institute of Granada (ibs.GRANADA), Granada, Spain
| | - Margarida Gonçalo
- Serviço de Dermatologia, Centro Hospitalar e Universitário de Coimbra, Coimbra.,Serviço de Dermatologia. Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal
| | | | - Salvador Arias-Santiago
- Department of Dermatology, Virgen de las Nieves University Hospital, Granada, Spain.,Biosanitary Institute of Granada (ibs.GRANADA), Granada, Spain.,Cell Production and Tissue Engineering Unit, Virgen de las Nieves University Hospital, Andalusian Network of Design and Translation of Advanced Therapies, Granada, Spain.,Department of Dermatology, Faculty of Medicine, University of Granada, Granada, Spain
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13
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Sáenz-Guirado S, Cuenca-Barrales C, Vega-Castillo J, Linares-Gonzalez L, Ródenas-Herranz T, Molina-Leyva A, Ruiz-Villaverde R. Combined versus conventional photodynamic therapy with 5-aminolaevulinic acid nanoemulsion (BF-200 ALA) for actinic keratosis: A randomized, single-blind, prospective study. Photodermatol Photoimmunol Photomed 2021; 38:334-342. [PMID: 34773302 DOI: 10.1111/phpp.12753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 10/20/2021] [Accepted: 11/01/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Photodynamic therapy (PDT) has become one of the most effective therapies for the treatment of actinic keratosis, allowing the removal of more than one lesion in a single session. However, the pain sustained by the patient during treatment and local skin reactions can limit its use. OBJECTIVES To determine the efficacy and safety of combined PDT (daylight PDT followed by conventional PDT) vs conventional PDT 12 weeks after treatment. METHODS The study was performed as a randomized, single-center, non-inferiority clinical trial with two parallel groups. A total of 51 patients with grade I and II AKs on the scalp or face were randomized. Twenty-five patients received one session of combined PDT (combPDT), and 26 patients received one session of conventional PDT (cPDT). The primary endpoint was the reduction of AKs, 12 weeks after treatment. The secondary endpoint was the reduction in pain and local skin reaction. RESULTS The reduction rate of grade I and II AKs was similar in combPDT and cPDT, showing no statistically significant differences between both groups, 76.67% vs 86.63% [P = .094] and 80.48% vs 83.08% [P = .679], respectively. However, pain was significantly lower in the combPDT group (2.56 vs 5, P < .01), as were local skin reactions. CONCLUSIONS CombPDT has proven to be as effective as cPDT for the treatment of grade I and II AKs located on the scalp and face. Furthermore, combPDT has been shown to be considerably more tolerable than cPDT, causing only mild local skin reactions.
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Affiliation(s)
| | | | | | | | | | | | - Ricardo Ruiz-Villaverde
- Department of Dermatology, University Hospital San Cecilio, Granada, Spain.,Instituto biosanitario de Granada, IBS, Granada, Spain
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14
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Cuenca-Barrales C, Ruiz-Carrascosa J, Ruiz-Villaverde R. WITHDRAWN: RF - Should Striae be Considered a Predisposing Factor for Koebner Phenomenon in Psoriasis? Actas Dermo-Sifiliográficas (English Edition) 2021. [DOI: 10.1016/j.adengl.2021.11.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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15
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Cuenca-Barrales C, Baselga-Torres E, del Boz-González J, Vicente A, Palencia-Pérez S, Campos-Domínguez M, Valdivieso-Ramos M, Martín-Santiago A, Montserrat-García M, Azón-Masoliver A, Feito-Rodríguez M, Domínguez-Cruz J, Roé-Crespo E, Salas-Márquez C, Giacaman A, Lorente-Lavirgen A, Quintana-Castanedo L, de Vega-Martínez M, García-Doval I, Bernabéu-Wittel J. Baseline Description of the Spanish Academy of Dermatology Infantile Haemangioma Nationwide Prospective Cohort. Comparison of Patients Treated with Propranolol in Routine Clinical Practice with Previous Pivotal Clinical Trial Data. Actas Dermo-Sifiliográficas (English Edition) 2021. [DOI: 10.1016/j.adengl.2021.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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16
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Montero-Vilchez T, Valenzuela-Amigo A, Cuenca-Barrales C, Arias-Santiago S, Leyva-García A, Molina-Leyva A. The Role of Oral Contraceptive Pills in Hidradenitis Suppurativa: A Cohort Study. Life (Basel) 2021; 11:life11070697. [PMID: 34357069 PMCID: PMC8307628 DOI: 10.3390/life11070697] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 07/11/2021] [Accepted: 07/12/2021] [Indexed: 12/16/2022] Open
Abstract
There is a need to establish the role of antiandrogens as an alternative or concomitant therapy for hidradenitis suppurativa (HS). Thus, the objectives of this study are (1) to assess the effectiveness of oral contraceptive pills (OCPs) at week 12 in HS women, and (2) to describe the clinical profile of patients receiving oral contraceptive pills (OCPs). A prospective observational study was designed. This study included 100 participants, 50 women with HS who started OCPs for the first time at our HS Clinic and 50 participants without OCP treatment. The main outcome of interest was the percentage of reduction in total abscess and inflammatory nodule (AN) count at week 12. Thirty-three women received combined OCPs and 17 non-combined OCP. HS patients with OCPs treatment were younger (31.7 vs. 40.9 years, p < 0.001), thinner (28.62 vs. 33.35 kg/m2), and have a higher number of areas affected (2.32 vs. 1.38, p = 0.02) than those without OCPs. After 12-weeks of treatment, it was observed that the percentage of AN reduction was higher in HS women receiving OCP than in patients without OCP (53.9% vs. 38.42%, p = 0.049). It was observed that OCP prescription (β = 3.79, p = 0.034) and concomitant therapy (β = 3.91, p = 0.037) were independently associated with a higher % AN when controlling for disease duration, concomitant therapy, and treatment with/without OCP (R2 = 0.67). The factors potentially associated with the percentage AN reduction at week 12 in HS women treated with OCPs were disease duration (β = -1.327, p = 0.052), concomitant therapy (β = 11.04, p = 0.079), and HS worsening with the menstrual cycle (β = 10.55, p = 0.087). In conclusion, OCPs might be effective for improving AN count in women with HS. Women whose HS worsens in relation to the menstrual cycle and have a shorter disease may benefit more from the therapeutic effect of OCPs.
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Affiliation(s)
- Trinidad Montero-Vilchez
- Dermatology, Hidradenitis Suppurativa Clinic, Hospital Universitario Virgen de las Nieves, 18012 Granada, Spain; (T.M.-V.); (C.C.-B.); (A.M.-L.)
- Instituto de Investigación Biosanitaria Granada, 18012 Granada, Spain
| | - Andrea Valenzuela-Amigo
- Nursing Department, Faculty of Nursing, University of Granada, 18012 Granada, Spain; (A.V.-A.); (A.L.-G.)
| | - Carlos Cuenca-Barrales
- Dermatology, Hidradenitis Suppurativa Clinic, Hospital Universitario Virgen de las Nieves, 18012 Granada, Spain; (T.M.-V.); (C.C.-B.); (A.M.-L.)
- Instituto de Investigación Biosanitaria Granada, 18012 Granada, Spain
| | - Salvador Arias-Santiago
- Dermatology, Hidradenitis Suppurativa Clinic, Hospital Universitario Virgen de las Nieves, 18012 Granada, Spain; (T.M.-V.); (C.C.-B.); (A.M.-L.)
- Instituto de Investigación Biosanitaria Granada, 18012 Granada, Spain
- Dermatology Department, Faculty of Medicine, University of Granada, 18016 Granada, Spain
- Correspondence: ; Tel.: +34-958-023-422
| | - Ana Leyva-García
- Nursing Department, Faculty of Nursing, University of Granada, 18012 Granada, Spain; (A.V.-A.); (A.L.-G.)
| | - Alejandro Molina-Leyva
- Dermatology, Hidradenitis Suppurativa Clinic, Hospital Universitario Virgen de las Nieves, 18012 Granada, Spain; (T.M.-V.); (C.C.-B.); (A.M.-L.)
- Instituto de Investigación Biosanitaria Granada, 18012 Granada, Spain
- Nursing Department, Faculty of Nursing, University of Granada, 18012 Granada, Spain; (A.V.-A.); (A.L.-G.)
- European Hidradenitis Suppurativa Foundation (EHSF), 06847 Dessau-Roßlau, Germany
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17
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Cuenca-Barrales C, Ruiz-Villaverde R, Molina-Leyva A. Familial Frontal Fibrosing Alopecia: Report of a case and systematic review of the literature. Sultan Qaboos Univ Med J 2021; 21:e320-e323. [PMID: 34221484 PMCID: PMC8219322 DOI: 10.18295/squmj.2021.21.02.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 07/19/2020] [Accepted: 08/13/2020] [Indexed: 12/03/2022] Open
Abstract
Frontal fibrosing alopecia (FFA) is an emerging disease in Western countries. We present the cases of three sisters who were referred simultaneously to the Department of Dermatology, Hospital Universitario San Cecilio, Granada, Spain, in 2018. All patients suffered from at least partial frontotemporal hairline recession and eyebrow loss. Following trichoscopic examination, the three sisters were diagnosed with FFA. Only one of the sisters agreed to be treated; she was prescribed with topical clobetasol propionate solution and minoxidil and achieved disease control at the three-month follow-up. These patients represent a new case of familial FFA wherein three sisters as well as their mother were affected by FFA. A systematic review found a total of 24 cases of familial FFA, of which this report is the 25th. In the majority of families, only females were affected (88%) while in the remainder both males and females (8%) were affected; there was only one family where only males were affected (4%). The relationship between the affected individuals was predominately between sisters (56%) followed by mother and daughter (32%). The median age was 61 years old (range: 14–88 years) and the duration of the disease ranged between 3–360 months. Family groups of FFA are an infrequently described phenomenon with unknown prevalence.
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18
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Montero-Vilchez T, Cuenca-Barrales C, Martinez-Lopez A, Molina-Leyva A, Arias-Santiago S. Skin adverse events related to personal protective equipment: a systematic review and meta-analysis. J Eur Acad Dermatol Venereol 2021; 35:1994-2006. [PMID: 34077565 DOI: 10.1111/jdv.17436] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 05/21/2021] [Indexed: 01/03/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a global pandemic that has spread all over the word. To avoid the virus transmission, healthcare workers must wear adequate personal protective equipment (PPE). PPE is associated with several side events, including skin reactions. The objective of this study was to summarize the prevalence, type and risk factors for cutaneous adverse events related to PPE and prevention measures to avoid them. A systematic review and meta-analysis was conducted using MEDLINE, Scopus and EMBASE databases from conception to 21 January 2021. All types of epidemiological studies regarding skin adverse events related to PPE were included. The literature search identified 1007 references, 35 of them met the eligible criteria and were included for analysis, representing 31 453 participants. The media of skin side events related to PPE was 75.13%. The rate of cutaneous adverse events related to mask was 57.71%, and those associated with gloves and hand hygiene products was 49.16%. Most common skin adverse events were contact dermatitis, acne and itching. The most damaged anatomical regions were the nasal bridge, the cheeks and the hands. The duration of PPE wearing was the most common risk factor. Frequent handwashing, gloves and masks were the agents most frequently related to skin reactions. N95 respirators were the most harmful mask type for the skin. Hydrocolloid use prevented from developing skin adverse events related to masks. In conclusion, the rate of cutaneous adverse events related to PPE use is high. A longer duration of PPE wearing was the most common risk factor. Using hydrocolloid could prevent from skin injuries related to mask use.
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Affiliation(s)
- T Montero-Vilchez
- Department of Dermatology, Virgen de las Nieves University Hospital, Granada, Spain.,Biosanitary Institute of Granada (ibs.GRANADA), Granada, Spain
| | - C Cuenca-Barrales
- Department of Dermatology, Virgen de las Nieves University Hospital, Granada, Spain.,Biosanitary Institute of Granada (ibs.GRANADA), Granada, Spain
| | - A Martinez-Lopez
- Department of Dermatology, Virgen de las Nieves University Hospital, Granada, Spain.,Biosanitary Institute of Granada (ibs.GRANADA), Granada, Spain
| | - A Molina-Leyva
- Department of Dermatology, Virgen de las Nieves University Hospital, Granada, Spain.,Biosanitary Institute of Granada (ibs.GRANADA), Granada, Spain
| | - S Arias-Santiago
- Department of Dermatology, Virgen de las Nieves University Hospital, Granada, Spain.,Biosanitary Institute of Granada (ibs.GRANADA), Granada, Spain.,Cell Production and Tissue Engineering Unit, Virgen de las Nieves University Hospital, Andalusian Network of Design and Translation of Advanced Therapies, Granada, Spain.,Department of Dermatology, Faculty of Medicine, University of Granada, Granada, Spain
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19
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Cuenca-Barrales C, Baselga-Torres E, Del Boz-González J, Vicente A, Palencia-Pérez SI, Campos-Domínguez M, Valdivieso-Ramos M, Martín-Santiago A, Montserrat-García MT, Azón-Masoliver A, Feito-Rodríguez M, Domínguez-Cruz JJ, Roé-Crespo E, Salas-Márquez C, Giacaman A, Lorente-Lavirgen AI, Quintana-Castanedo L, de Vega-Martínez M, García-Doval I, Bernabéu-Wittel J. Baseline description of the Spanish Academy of Dermatology infantile haemangioma nationwide prospective cohort. Comparison of patients treated with propranolol in routine clinical practice with previous pivotal clinical trial data. Actas Dermosifiliogr (Engl Ed) 2021; 112:S0001-7310(21)00198-8. [PMID: 34052200 DOI: 10.1016/j.ad.2021.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/12/2021] [Accepted: 05/17/2021] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND There are several therapeutic options for infantile haemangiomas (IH). Propranolol is used according to a pivotal trial. We aimed to describe the characteristics of IH in clinical practice, including the therapies used, and to compare the characteristics of patients treated with propranolol with those of the trial to assess its external validity. METHODS Consecutive patients attending 12 Spanish hospitals from June 2016 to October 2019 were included (n=601). RESULTS The mean age was 3.9 (SD:1.9) months, with a 2:1 female-to-male ratio. Most IHs were localized (82%, 495), superficial (64%, 383) and located in the face (25%, 157) and trunk (31%, 188). Median size was 17 (IR: 10-30) x 12 (IR: 7-20) mm. Complications were found in 16 (3%) patients. Treatment was initiated for 52% (311). Most patients received timolol (76%, 237); propranolol was reserved for complications or high-risk IHs. Aesthetic impairment was the main reason for starting therapy (64%, 199). Several characteristics of the patients and IHs treated with propranolol are similar to those of the pivotal clinical trial, but 1/3 of IHs did not reach the minimum diameter to meet the inclusion criteria, and important prognostic information was not reported. CONCLUSIONS As most patients receive treatment for aesthetic impairment, there is a need to better understand the aesthetic results of therapies and to increase evidence on the use of timolol, which is currently the most common therapy. Propranolol is being used in a population generally similar to that of the trial; however, this statement cannot be definitely confirmed.
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Affiliation(s)
- C Cuenca-Barrales
- Unidad de investigación, Fundación Piel Sana Academia Española de Dermatología y Venereología, Madrid, España; Departamento de Dermatología, Hospital Universitario Virgen de las Nieves, Granada, España; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, España.
| | - E Baselga-Torres
- Departamento de Dermatología, Hospital Sant Joan de Déu, Barcelona, España; Clínica Dermik, Barcelona, España
| | - J Del Boz-González
- Departamento de Dermatología, Hospital Costa del Sol, Marbella, Málaga, España
| | - A Vicente
- Departamento de Dermatología, Hospital Sant Joan de Déu, Barcelona, España
| | | | | | | | - A Martín-Santiago
- Departamento de Dermatología, Hospital Son Espases, Palma de Mallorca, España
| | - M T Montserrat-García
- Departamento de Dermatología, Hospital Virgen del Rocío, Sevilla, España; Departamento de Dermatología, Hospital Viamed Santa Ángela de la Cruz, Sevilla, España
| | - A Azón-Masoliver
- Departamento de Dermatología, Hospital Sant Joan de Reus, Tarragona, España
| | | | - J J Domínguez-Cruz
- Departamento de Dermatología, Hospital Virgen del Rocío, Sevilla, España; Departamento de Dermatología, Hospital Viamed Santa Ángela de la Cruz, Sevilla, España
| | - E Roé-Crespo
- Departamento de Dermatología, Hospital Santa Creu i Sant Pau, Barcelona, España
| | - C Salas-Márquez
- Departamento de Dermatología, Hospital Costa del Sol, Marbella, Málaga, España
| | - A Giacaman
- Departamento de Dermatología, Hospital Son Espases, Palma de Mallorca, España
| | - A I Lorente-Lavirgen
- Departamento de Dermatología, Hospital Viamed Santa Ángela de la Cruz, Sevilla, España
| | | | - M de Vega-Martínez
- Unidad de investigación, Fundación Piel Sana Academia Española de Dermatología y Venereología, Madrid, España
| | - I García-Doval
- Unidad de investigación, Fundación Piel Sana Academia Española de Dermatología y Venereología, Madrid, España; Departamento de Dermatología, Complexo Hospitalario Universitario de Vigo, España
| | - J Bernabéu-Wittel
- Departamento de Dermatología, Hospital Virgen del Rocío, Sevilla, España; Departamento de Dermatología, Hospital Viamed Santa Ángela de la Cruz, Sevilla, España
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20
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Cuenca-Barrales C, de Vega-Martínez M, Descalzo-Gallego MÁ, García-Doval I. Stationäre Dermatologie: Wohin geht die Reise? Eine landesweite bevölkerungsbasierte Studie in Spanien von 2006 bis 2016. J Dtsch Dermatol Ges 2021; 19:707-719. [PMID: 33979051 DOI: 10.1111/ddg.14336_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 11/04/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Carlos Cuenca-Barrales
- Research Unit, Fundación Piel Sana Academia Española de Dermatología y Venereología, Madrid, Spain
| | - Marina de Vega-Martínez
- Research Unit, Fundación Piel Sana Academia Española de Dermatología y Venereología, Madrid, Spain
| | | | - Ignacio García-Doval
- Research Unit, Fundación Piel Sana Academia Española de Dermatología y Venereología, Madrid, Spain.,Dermatology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
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21
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Cuenca-Barrales C, Monserrat-García MT, Domínguez-Cruz JJ, Suñol-Capella M, Zulueta-Dorado T, Fernández R, Mascaró JM, Vicente A, Bernabéu-Wittel J. Ektodermale Dysplasie‐Hautfragilität‐Syndrom: zwei neue Fälle mit einer neuartigen Missense‐Mutation. J Dtsch Dermatol Ges 2021; 19:595-597. [PMID: 33861009 DOI: 10.1111/ddg.14315_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | | | | | | | | | - Raquel Fernández
- Department of Genetics, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | | | - Asunción Vicente
- Department of Dermatology, Hospital Sant Joan de Déu, Barcelona, Spain
| | - José Bernabéu-Wittel
- Pediatric Dermatology Unit, Hospital Universitario Virgen del Rocío, Sevilla, Spain
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22
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Cuenca-Barrales C, de Vega-Martínez M, Descalzo-Gallego MÁ, García-Doval I. Inpatient dermatology: Where are we headed? A nationwide population-based study of Spain from 2006 to 2016. J Dtsch Dermatol Ges 2021; 19:707-717. [PMID: 33617112 DOI: 10.1111/ddg.14336] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 11/04/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND AND OBJECTIVES Information about hospital admissions for skin diseases is restricted to studies describing admissions to single centers, to specific wards, or only for a few diagnoses, and there is no information about the outcomes between different wards. The aim of this research is to describe hospital admissions due to dermatological diseases. PATIENTS AND METHODS Cross-sectional study of hospital discharges at Spanish hospitals. Discharges were assumed to be the same as admissions. RESULTS 519,440 discharges (1.1 % of total discharges) were identified. Most admissions (60.1 %) were done from emergency departments. Only 7 % of cases were admitted to dermatology wards. The most prevalent group was cellulitis and acute lymphangitis. Median age was 57 years, and men were more common. The median length of hospital stay was four days; 40,823 (7.9 %) cases required readmission. There were 13,558 (2.6 %) hospital deaths. After adjusted analysis (by age, sex and group of diagnosis), the OR of readmission was 1.49 (95 % CI: 1.42-1.57) times higher and length of stay was 0.22 (95 % CI: 0.15-0.29) days longer in non-dermatology wards (P < 0.0001). From 2006-2016, admissions to dermatology wards decreased 38 %, while in non-dermatology wards they increased 8 %. CONCLUSIONS A non-negligible number of patients require dermatological inpatient management. This is mainly provided by non-dermatologists. Some of our findings may indicate an improved overall care by dermatologists.
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Affiliation(s)
- Carlos Cuenca-Barrales
- Research Unit, Fundación Piel Sana Academia Española de Dermatología y Venereología, Madrid, Spain
| | - Marina de Vega-Martínez
- Research Unit, Fundación Piel Sana Academia Española de Dermatología y Venereología, Madrid, Spain
| | | | - Ignacio García-Doval
- Research Unit, Fundación Piel Sana Academia Española de Dermatología y Venereología, Madrid, Spain.,Dermatology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
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23
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Montero-Vilchez T, Martinez-Lopez A, Cuenca-Barrales C, Rodriguez-Tejero A, Molina-Leyva A, Arias-Santiago S. Impact of Gloves and Mask Use on Epidermal Barrier Function in Health Care Workers. Dermatitis 2021; 32:57-62. [PMID: 33449481 DOI: 10.1097/der.0000000000000682] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Coronavirus disease 2019 has rapidly spread all over the world. Personal protective equipment (PPE) including masks and gloves is needed to avoid transmission. Adverse skin reactions associated with PPE have been described, but there is no information regarding objective measures to assess skin impairment related to PPE. OBJECTIVE The aim of the study was to evaluate the impact of using facial mask and nitrile gloves on epidermal barrier function and skin homeostasis. METHODS A cross-sectional study was designed. Thirty-four health care workers wearing nitrile gloves and a mask for 2 hours were included. Transepidermal water loss, stratum corneum hydration, erythema, and temperature were measured. RESULTS Transepidermal water loss (31.11 vs 14.24 g·m-2·h-1), temperature (33.29°C vs 32.57°C), and erythema were significantly greater at the area covered by gloves compared with the noncovered area. Transepidermal water loss (22.82 vs 13.69 g·m-2·h-1), temperature, and erythema (411.43 vs 335.52 arbitrary units) were significantly increased at the area covered by mask, whereas stratum corneum hydration was lower. Transepidermal water loss was greater at the area covered by a surgical mask than at a filtering respirator mask coded filtering facepiece 2 (27.09 vs 18.02 g·m-2·h-1, P = 0.034). CONCLUSIONS Skin homeostasis and epidermal barrier function may be impaired by gloves and mask use. High-quality PPE should be provided, and adequate skin prevention measures should be implemented to reduce epidermal barrier damage.
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24
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Cuenca-Barrales C, Montero-Vilchez T, Salvador-Rodríguez L, Sánchez-Díaz M, Arias-Santiago S, Molina-Leyva A. Implications of Hidradenitis Suppurativa Phenotypes in Cardiovascular Risk and Treatment Decisions: A Retrospective Cohort Study. Dermatology 2021; 237:727-732. [PMID: 33477150 DOI: 10.1159/000513044] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 11/11/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND New integrative hidradenitis suppurativa (HS) lesion pattern phenotypes have been proposed, an inflammatory phenotype (IP) and a follicular phenotype (FP). They are characterized by different lesion patterns, symptoms, and risks of disease progression. OBJECTIVES To evaluate whether lesion pattern phenotypes (1) have a different cardiovascular risk factor profile, and (2) are associated with a different therapeutic approach in the setting of an HS clinic. METHODS A retrospective cohort study was conducted on 233 patients with HS. They were classified according to lesion pattern phenotype criteria. Data regarding cardiovascular risk factors and treatment decisions were gathered. RESULTS One hundred and seventeen HS patients (50.21%) were classified as FP and 112 (48.07%) as IP. IP was associated with more severe disease and greater impairment of quality of life. Regardless of disease severity, patients with IP may have a higher cardiovascular risk, assessed according to higher C-reactive protein (CRP) levels (12.75 vs. 5.89, p = 0.059). The lesion pattern phenotype also influenced treatment decisions regardless of disease severity. Patients with IP were more likely to be treated with systemic corticosteroids and adalimumab, showing that lesion pattern phenotypes are associated with different therapeutic approaches. CONCLUSIONS IP is associated with higher CRP values, suggesting a greater cardiovascular risk in these patients and also a different therapeutic approach. This information could help guide dermatologists in the management of HS patients and help to determine future treatment recommendations.
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Affiliation(s)
- Carlos Cuenca-Barrales
- Hidradenitis Suppurativa Clinic, Department of Dermatology, Hospital Universitario Virgen de las Nieves, Granada, Spain.,Instituto de Investigación Biosanitaria Granada, Granada, Spain
| | - Trinidad Montero-Vilchez
- Hidradenitis Suppurativa Clinic, Department of Dermatology, Hospital Universitario Virgen de las Nieves, Granada, Spain.,Instituto de Investigación Biosanitaria Granada, Granada, Spain
| | - Luis Salvador-Rodríguez
- Hidradenitis Suppurativa Clinic, Department of Dermatology, Hospital Universitario Virgen de las Nieves, Granada, Spain.,Instituto de Investigación Biosanitaria Granada, Granada, Spain
| | - Manuel Sánchez-Díaz
- Hidradenitis Suppurativa Clinic, Department of Dermatology, Hospital Universitario Virgen de las Nieves, Granada, Spain.,Instituto de Investigación Biosanitaria Granada, Granada, Spain
| | - Salvador Arias-Santiago
- Hidradenitis Suppurativa Clinic, Department of Dermatology, Hospital Universitario Virgen de las Nieves, Granada, Spain, .,Instituto de Investigación Biosanitaria Granada, Granada, Spain,
| | - Alejandro Molina-Leyva
- Hidradenitis Suppurativa Clinic, Department of Dermatology, Hospital Universitario Virgen de las Nieves, Granada, Spain.,Instituto de Investigación Biosanitaria Granada, Granada, Spain.,European Hidradenitis Suppurativa Foundation (EHSF), Dessau-Roßlau, Germany
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25
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van Straalen KR, Tzellos T, Guillem P, Benhadou F, Cuenca-Barrales C, Daxhelet M, Daoud M, Efthymiou O, Giamarellos-Bourboulis EJ, Jemec GBE, Katoulis AC, Koenig A, Lazaridou E, Marzano AV, Matusiak Ł, Molina-Leyva A, Moltrasio C, Pinter A, Potenza C, Romaní J, Saunte DM, Skroza N, Stergianou D, Szepietowski J, Trigoni A, Vilarrasa E, van der Zee HH. The efficacy and tolerability of tetracyclines and clindamycin plus rifampicin for the treatment of hidradenitis suppurativa: Results of a prospective European cohort study. J Am Acad Dermatol 2021; 85:369-378. [PMID: 33484766 DOI: 10.1016/j.jaad.2020.12.089] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 12/19/2020] [Accepted: 12/29/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Tetracyclines and clindamycin plus rifampicin combination therapy are both considered first-line therapy in current hidradenitis suppurativa guidelines. However, evidence for their efficacy is drawn from small studies, often without validated outcomes. OBJECTIVE To assess the 12-week efficacy of oral tetracyclines and a combination of clindamycin and rifampicin. METHODS A prospective, international cohort study performed between October 2018 and August 2019. RESULTS In total, 63.6% of the included 283 patients received oral tetracyclines, and 36.4% were treated with clindamycin and rifampicin. Both groups showed a significant decrease in International Hidradenitis Suppurativa Severity Score System from baseline (both P < .001). The Hidradenitis Suppurativa Clinical Response (HiSCR) was achieved in 40.1% and 48.2% of patients, respectively (P = .26). Patient characteristics or disease severity were not associated with the attainment of HiSCR or the minimal clinically important differences for the Dermatology Life Quality Index and pain. LIMITATIONS Cohort study. Respectively, 23.9% and 19.4% of patients had to be excluded from the HiSCR analysis for the tetracycline and combination therapy group because of a low abscess and nodule count at baseline. CONCLUSION This study shows significant efficacy of both tetracycline treatment and clindamycin and rifampicin combination therapy after 12 weeks in patients with hidradenitis suppurativa. No significant differences in efficacy were observed between the 2 treatments, regardless of disease severity.
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Affiliation(s)
- Kelsey R van Straalen
- Erasmus MC, University Medical Center Rotterdam, Department of Dermatology, Rotterdam, the Netherlands
| | | | - Phillipe Guillem
- Department of Surgery, Clinique du Val d'Ouest, Lyon, France; ResoVerneuil, Paris, France; Groupe de Recherche en Proctologie de la Société Nationale Française de ColoProctologie, Paris, France
| | - Farida Benhadou
- Department of Dermatology, Université Libre de Bruxelles, Erasme Hospital, Brussels, Belgium
| | - Carlos Cuenca-Barrales
- Department of Dermatology, Hospital Universitario Virgen de las Nieves, Granada, Spain; TECe19-Clinical and Translational Dermatology Investigation Group Instituto de Investigación Biosanitaria, Granada, Spain
| | - Mathilde Daxhelet
- Department of Dermatology, Université Libre de Bruxelles, Erasme Hospital, Brussels, Belgium
| | - Mathieu Daoud
- Department of Dermatology, Université Libre de Bruxelles, Erasme Hospital, Brussels, Belgium
| | - Ourania Efthymiou
- Second Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, "Attikon" General University Hospital, Athens, Greece
| | | | - Gregor B E Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde and Health Sciences Faculty, University of Copenhagen, Denmark
| | - Alexandros C Katoulis
- Second Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, "Attikon" General University Hospital, Athens, Greece
| | - Anke Koenig
- Department of Dermatology, Venereology and Allergology, University Hospital Frankfurt am Main, Germany
| | - Elizabeth Lazaridou
- Second Department of Dermatology and Venereology, Aristotle University of Thessaloniki, General Hospital Papageorgiou, Thessaloniki, Greece
| | - Angelo V Marzano
- Dermatology Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Łucas Matusiak
- Department of Dermatology, Venereology and Allergology, Medical University, Wroclaw, Poland
| | - Alejandro Molina-Leyva
- Department of Dermatology, Hospital Universitario Virgen de las Nieves, Granada, Spain; TECe19-Clinical and Translational Dermatology Investigation Group Instituto de Investigación Biosanitaria, Granada, Spain
| | - Chiara Moltrasio
- Dermatology Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Medical Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Andreas Pinter
- Department of Dermatology, Venereology and Allergology, University Hospital Frankfurt am Main, Germany
| | - Concetta Potenza
- Dermatology Unit 'Daniele Innocenzi,' Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino-Latina, Italy
| | - Jorge Romaní
- Department of Dermatology, Corporació Sanitaria Parc Taulí, Sabadell, Spain
| | - Ditte M Saunte
- Department of Dermatology, Zealand University Hospital, Roskilde and Health Sciences Faculty, University of Copenhagen, Denmark
| | - Nevena Skroza
- Dermatology Unit 'Daniele Innocenzi,' Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino-Latina, Italy
| | - Dimitra Stergianou
- Fourth Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Jacek Szepietowski
- Department of Dermatology, Venereology and Allergology, Medical University, Wroclaw, Poland
| | - Anastasia Trigoni
- Second Department of Dermatology and Venereology, Aristotle University of Thessaloniki, General Hospital Papageorgiou, Thessaloniki, Greece
| | - Eva Vilarrasa
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Hessel H van der Zee
- Erasmus MC, University Medical Center Rotterdam, Department of Dermatology, Rotterdam, the Netherlands.
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26
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Cuenca-Barrales C, Aneiros-Fernández J, Pérez-López I, Rodríguez-Pérez J, Ruiz-Villaverde R, Espelt-Otero JL. Histological Changes Related to Symptomatic Improvement of Spontaneous Keloids Treated with a Low-Dosage Regimen of UVA-1 Phototherapy. Dermatopathology (Basel) 2020; 7:53-56. [PMID: 33287371 PMCID: PMC7768383 DOI: 10.3390/dermatopathology7030009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 11/27/2020] [Accepted: 12/01/2020] [Indexed: 11/16/2022] Open
Abstract
Keloids are a difficult-to-treat disease characterized by an imbalance in mechanisms of tissue reparation. We present the case of a middle-aged woman with spontaneous keloids which histologically and clinically improved after UVA-1 phototherapy treatment. There are few reported cases of keloids treated with high doses of UVA-1 phototherapy. We used a low-dosage regimen with a good response in only one cycle, which could diminish the risk of skin cancer development.
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Affiliation(s)
- Carlos Cuenca-Barrales
- Dermatology Department, Hospital Universitario San Cecilio, 18016 Granada, Spain; (I.P.-L.); (R.R.-V.); (J.L.E.-O.)
- Correspondence: ; Tel.: +34-958-02-30
| | | | - Israel Pérez-López
- Dermatology Department, Hospital Universitario San Cecilio, 18016 Granada, Spain; (I.P.-L.); (R.R.-V.); (J.L.E.-O.)
| | | | - Ricardo Ruiz-Villaverde
- Dermatology Department, Hospital Universitario San Cecilio, 18016 Granada, Spain; (I.P.-L.); (R.R.-V.); (J.L.E.-O.)
| | - Jorge Luis Espelt-Otero
- Dermatology Department, Hospital Universitario San Cecilio, 18016 Granada, Spain; (I.P.-L.); (R.R.-V.); (J.L.E.-O.)
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27
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Martinez-Lopez A, Cuenca-Barrales C, Montero-Vilchez T, Molina-Leyva A, Arias-Santiago S. Review of adverse cutaneous reactions of pharmacologic interventions for COVID-19: A guide for the dermatologist. J Am Acad Dermatol 2020; 83:1738-1748. [PMID: 32777318 PMCID: PMC7413159 DOI: 10.1016/j.jaad.2020.08.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 07/27/2020] [Accepted: 08/01/2020] [Indexed: 12/15/2022]
Abstract
The new coronavirus, severe acute respiratory syndrome coronavirus 2, is associated with a wide variety of cutaneous manifestations. Although new skin manifestations caused by COVID-19 are continuously being described, other cutaneous entities should also be considered in the differential diagnosis, including adverse cutaneous reactions to drugs used in the treatment of COVID-19 infections. The aim of this review is to provide dermatologists with an overview of the cutaneous adverse effects associated with the most frequently prescribed drugs in patients with COVID-19. The skin reactions of antimalarials (chloroquine and hydroxychloroquine), antivirals (lopinavir/ritonavir, ribavirin with or without interferon, oseltamivir, remdesivir, favipiravir, and darunavir), and treatments for complications (imatinib, tocilizumab, anakinra, immunoglobulins, corticosteroids, colchicine and low molecular weight heparins) are analyzed. Information regarding possible skin reactions, their frequency, management, and key points for differential diagnosis are presented.
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Affiliation(s)
- Antonio Martinez-Lopez
- Dermatology Unit, Virgen de las Nieves University Hospital, Granada, Spain,TECe19–Clinical and Translational Dermatology Investigation Group, Instituto Biosanitario, Granada, Spain
| | - Carlos Cuenca-Barrales
- TECe19–Clinical and Translational Dermatology Investigation Group, Instituto Biosanitario, Granada, Spain
| | | | - Alejandro Molina-Leyva
- Dermatology Unit, Virgen de las Nieves University Hospital, Granada, Spain; TECe19-Clinical and Translational Dermatology Investigation Group, Instituto Biosanitario, Granada, Spain.
| | - Salvador Arias-Santiago
- Dermatology Unit, Virgen de las Nieves University Hospital, Granada, Spain,TECe19–Clinical and Translational Dermatology Investigation Group, Instituto Biosanitario, Granada, Spain,Dermatology Department, University of Granada, Granada, Spain
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28
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Cuenca-Barrales C, Molina-Leyva A, Arias-Santiago S. Potential role of human allogeneic mesenchymal cells in the treatment of refractory fistulas in patients with hidradenitis suppurativa. Dermatol Ther 2020; 34:e14548. [PMID: 33191614 DOI: 10.1111/dth.14548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 10/02/2020] [Accepted: 11/11/2020] [Indexed: 02/06/2023]
Affiliation(s)
- Carlos Cuenca-Barrales
- TECe19-Clinical and Translational Dermatology Investigation Group, Instituto de Investigación Biosanitaria, Granada, Spain
| | - Alejandro Molina-Leyva
- TECe19-Clinical and Translational Dermatology Investigation Group, Instituto de Investigación Biosanitaria, Granada, Spain.,Hidradenitis Suppurativa Clinic, Dermatology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain.,European Hidradenitis Suppurativa Foundation (EHSF), Dessau-Roßlau, Germany
| | - Salvador Arias-Santiago
- TECe19-Clinical and Translational Dermatology Investigation Group, Instituto de Investigación Biosanitaria, Granada, Spain.,Hidradenitis Suppurativa Clinic, Dermatology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain.,Dermatology Department, University of Granada, Granada, Spain
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29
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Cuenca-Barrales C, Monserrat-García MT, Domínguez-Cruz JJ, Suñol-Capella M, Zulueta-Dorado T, Fernández R, Mascaró JM, Vicente A, Bernabéu-Wittel J. Ectodermal dysplasia-skin fragility syndrome: two new cases with a novel missense mutation. J Dtsch Dermatol Ges 2020; 19:595-597. [PMID: 33125806 DOI: 10.1111/ddg.14315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | | | | | | | | | - Raquel Fernández
- Department of Genetics, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | | | - Asunción Vicente
- Department of Dermatology, Hospital Sant Joan de Déu, Barcelona, Spain
| | - José Bernabéu-Wittel
- Pediatric Dermatology Unit, Hospital Universitario Virgen del Rocío, Sevilla, Spain
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30
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Montero-Vilchez T, Salvador-Rodriguez L, Sanchez-Diaz M, Cuenca-Barrales C, Martinez-Lopez A, Arias-Santiago S, Molina-Leyva A. Clinical selection criteria in new clinical trials of hidradenitis suppurativa: External validity and implications on the daily clinical practice. Dermatol Ther 2020; 33:e14254. [PMID: 32860480 DOI: 10.1111/dth.14254] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/18/2020] [Accepted: 08/21/2020] [Indexed: 12/17/2022]
Abstract
INTRODUCTION There are an increasing number of biologic drugs in the pipeline for treating hidradenitis suppurativa (HS). Clinical trials for these drugs usually share the same clinical selection criteria. OBJECTIVES (a) To describe the clinical profile of HS patients receiving first-line biologic treatment in an HS clinic setting, (b) to assess how this population would meet clinical criteria to participate in a clinical trial, and (c) to assess treatment effectiveness at week 16 in eligible vs non-eligible patients. METHODS Prospective observational study. Patients were grouped according to their eligibility for clinical trials. The effectiveness of adalimumab was assessed by HiSCR, IHS4-category-change and a-50%-reduction on IHS4 at week 16. RESULTS Thirty-eight patients were included in the study: eight (21.05%) were eligible for clinical trials and 30 (78.95%) were not. The main reason for non-eligibility was not having an AN count ≥5. Both groups presented similar number of draining tunnels. Effectiveness at week 16 was lower in non-eligible than eligible patients when evaluated by HiSCR-response but similar if evaluated by the IHS4-category-change or the 50%-reduction in IHS4. CONCLUSION In our population, the external validity of current eligibility criteria for clinical trials is low. Most patients receiving adalimumab in real-life setting would not be eligible for clinical trials.
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Affiliation(s)
- Trinidad Montero-Vilchez
- Department of Dermatology, Hidradenitis Suppurativa Clinic, Hospital Universitario Virgen de las Nieves, Granada, Spain.,Instituto de Investigación Biosanitaria Granada, Granada, Spain
| | - Luis Salvador-Rodriguez
- Department of Dermatology, Hidradenitis Suppurativa Clinic, Hospital Universitario Virgen de las Nieves, Granada, Spain.,Instituto de Investigación Biosanitaria Granada, Granada, Spain
| | - Manuel Sanchez-Diaz
- Department of Dermatology, Hidradenitis Suppurativa Clinic, Hospital Universitario Virgen de las Nieves, Granada, Spain.,Instituto de Investigación Biosanitaria Granada, Granada, Spain
| | - Carlos Cuenca-Barrales
- Department of Dermatology, Hidradenitis Suppurativa Clinic, Hospital Universitario Virgen de las Nieves, Granada, Spain.,Instituto de Investigación Biosanitaria Granada, Granada, Spain
| | - Antonio Martinez-Lopez
- Department of Dermatology, Hidradenitis Suppurativa Clinic, Hospital Universitario Virgen de las Nieves, Granada, Spain.,Instituto de Investigación Biosanitaria Granada, Granada, Spain
| | - Salvador Arias-Santiago
- Department of Dermatology, Hidradenitis Suppurativa Clinic, Hospital Universitario Virgen de las Nieves, Granada, Spain.,Instituto de Investigación Biosanitaria Granada, Granada, Spain.,Department of Medicine, Granada School of Medicine, Granada University, Granada, Spain
| | - Alejandro Molina-Leyva
- Department of Dermatology, Hidradenitis Suppurativa Clinic, Hospital Universitario Virgen de las Nieves, Granada, Spain.,Instituto de Investigación Biosanitaria Granada, Granada, Spain.,European Hidradenitis Suppurativa Foundation, Dessau-Roßlau, Germany
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Salvador-Rodriguez L, Cuenca-Barrales C, Arias-Santiago S, Molina-Leyva A. Neoadjuvant Biologic Therapy in the Surgical Management of Patients with Hidradenitis Suppurativa: A Cohort Study. Acta Derm Venereol 2020; 100:adv00257. [PMID: 32830282 PMCID: PMC9234998 DOI: 10.2340/00015555-3616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Luis Salvador-Rodriguez
- Hidradenitis Suppurativa Clinic, Dermatology, Hospital Universitario Virgen de las Nieves, ES-18012 Granada, Spain
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Montero-Vilchez T, Martinez-Lopez A, Cuenca-Barrales C, Martin-Castro A, Molina-Leyva A, Arias-Santiago S. Nodular lichen myxoedematous: a new adverse event associated with ustekinumab. Australas J Dermatol 2020; 61:e344-e345. [PMID: 32285931 DOI: 10.1111/ajd.13291] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 03/06/2020] [Accepted: 03/14/2020] [Indexed: 11/28/2022]
Abstract
Nodular lichen myxoedematosus is a localised form of lichen myxoedematosus, a chronic idiopathic cutaneous mucinosis of known aetiology. Ustekinumab is a human interleukin-12/23 monoclonal antibody that could directly or indirectly increase mucin production. Herein, we report for the first time a case of nodular lichen myxoedematosus associated with ustekinumab.
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Affiliation(s)
| | - Antonio Martinez-Lopez
- Department of Dermatology at Hospital, Universitario Virgen de las Nieves, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | | | - Aurelio Martin-Castro
- Department of Pathology at Hospital, Universitario Virgen de las Nieves, Granada, Spain
| | - Alejandro Molina-Leyva
- Department of Dermatology at Hospital, Universitario Virgen de las Nieves, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Salvador Arias-Santiago
- Department of Dermatology at Hospital, Universitario Virgen de las Nieves, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
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Cuenca-Barrales C, Espadafor-Lopez B, Ruiz-Villaverde R. Majocchís granuloma on the genital area. J OBSTET GYNAECOL 2020; 40:438-439. [DOI: 10.1080/01443615.2019.1601169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- C. Cuenca-Barrales
- Department of Dermatology, Hospital Universitario San Cecilio, Granada, Spain
| | - B. Espadafor-Lopez
- Department of Dermatology, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - R. Ruiz-Villaverde
- Department of Dermatology, Hospital Universitario San Cecilio, Granada, Spain
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Cuenca-Barrales C, Navarro-Triviño F, Espadafor-López B, Arias-Santiago S, Ruiz-Vilaverde R. Zosteriform Metastases From Eccrine Porocarcinoma. Actas Dermo-Sifiliográficas (English Edition) 2020. [DOI: 10.1016/j.adengl.2018.10.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Espadafor-López B, Cuenca-Barrales C, Salvador-Rodriguez L, Ruiz-Villaverde R. Sarcoma de Kaposi iatrogénico tratado con éxito con timolol tópico. Actas Dermo-Sifiliográficas 2020; 111:176-178. [DOI: 10.1016/j.ad.2018.06.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 06/02/2018] [Accepted: 06/04/2018] [Indexed: 11/30/2022] Open
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36
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Cuenca-Barrales C, Navarro-Triviño FJ, Vega-Castillo JJ, Rodríguez-Pérez J, Ruiz-Villaverde R, Espelt-Otero JL. Cutaneous hardening in a patient with systemic sclerosis successfully treated with UVA-1 phototherapy. Dermatol Ther 2019; 32:e13133. [PMID: 31631448 DOI: 10.1111/dth.13133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 10/13/2019] [Accepted: 10/16/2019] [Indexed: 11/30/2022]
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Molina-Leyva A, Cuenca-Barrales C. Pruritus and Malodour in Patients with Hidradenitis Suppurativa: Impact on Quality of Life and Clinical Features Associated with Symptom Severity. Dermatology 2019; 236:59-65. [DOI: 10.1159/000502139] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 07/16/2019] [Indexed: 11/19/2022] Open
Abstract
Background: Patients with hidradenitis suppurativa (HS) suffer from symptoms such as pruritus and malodour which can significantly impair their quality of life. Objectives: (1) To analyse the impact of pruritus and malodour on the quality of life of patients with HS and (2) to explore the potential association between clinical features and the severity of these symptoms. Patients and Methods: This is a cross-sectional study. The Numeric Rating Scale (NRS) was used to assess pruritus and malodour. Quality of life was assessed by means of the Dermatology Life Quality Index (DLQI). Results: Two hundred and thirty-three patients were included in the study. Both pruritus and malodour positively correlated with worse quality of life (p < 0.05). Pruritus intensity was associated with the number of regions affected by HS, female sex, the intensity of suppuration, and the presence of comorbid Crohn’s disease. Statin use was associated with lower levels of pruritus. Malodour intensity was associated with higher body mass index, disease duration, the number of regions affected, Hurley stage, and intensity of suppuration. Conclusions: The results of our study show that pruritus and malodour are key symptoms in patients with HS which have a great impact on their quality of life. We have identified clinical features potentially associated with the intensity of these symptoms which could be useful to identify higher-risk patients and may influence treatment decisions.
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Cuenca-Barrales C, Molina-Leyva A. Risk Factors of Sexual Dysfunction in Patients with Hidradenitis Suppurativa: A Cross-Sectional Study. Dermatology 2019; 236:37-45. [PMID: 31434072 DOI: 10.1159/000501905] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 06/26/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Hidradenitis suppurativa (HS) has a high impact on quality of life. However, sexual health has scarcely been investigated. OBJECTIVE To describe the frequency of sexual dysfunction (SD) in women and erectile dysfunction (ED) in men with HS and to explore potential risk factors. PATIENTS AND METHODS We conducted a cross-sectional study using a crowd-sourced online questionnaire spread by the Spanish hidradenitis suppurativa patients' association (ASENDHI). RESULTS In total, 393 participants answered the questionnaire. SD was found in 51% (95% CI 45-57%) of women and ED in 60% (95% CI 49-70%) of men. Factors related to SD were education status, patient's global assessment for disease activity, numeric rating scale for pain and unpleasant odour and the absence of a stable relationship. Factors related to ED were increasing age, the presence of active lesions in the genital area and the number of areas affected by active lesions. CONCLUSIONS There is a high prevalence of SD and ED in HS patients. Being in a stable relationship has been a protective factor of SD in women. The results suggest that sexual impairment in HS patients is due, at least in part, to disease activity, symptoms and active lesions.
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Affiliation(s)
| | - Alejandro Molina-Leyva
- Hidradenitis Suppurativa Clinic, Dermatology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain, .,European Hidradenitis Suppurativa Foundation (EHSF), Dessau-Roßlau, Germany, .,Instituto de Investigación Biosanitaria Granada, Granada, Spain,
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Cuenca-Barrales C, Espadafor-López B, Martínez-López A, Cancela-Díez B, Ruiz-Villaverde R. Bullous pemphigoid in a patient treated with nivolumab. Dermatol Ther 2019; 32:e13030. [PMID: 31339202 DOI: 10.1111/dth.13030] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 07/09/2019] [Accepted: 07/17/2019] [Indexed: 11/30/2022]
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40
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Cuenca-Barrales C, Aguayo-Carreras P, Bueno-Rodriguez A, Ruiz-Villaverde R. Ultrasound in the Evaluation of Cutaneous Metastases of Internal Tumors. Actas Dermo-Sifiliográficas (English Edition) 2019. [DOI: 10.1016/j.adengl.2019.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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41
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Cuenca-Barrales C, Aguayo-Carreras P, Bueno-Rodriguez A, Ruiz-Villaverde R. Estudio ecográfico de metástasis cutáneas de origen visceral. Actas Dermo-Sifiliográficas 2019; 110:506-509. [DOI: 10.1016/j.ad.2017.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Revised: 11/22/2017] [Accepted: 12/06/2017] [Indexed: 10/28/2022] Open
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42
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Cuenca-Barrales C, Ruiz-Villaverde R, Molina-Leyva A. Sexual Distress in Patients with Hidradenitis Suppurativa: A Cross-Sectional Study. J Clin Med 2019; 8:jcm8040532. [PMID: 31003427 PMCID: PMC6518250 DOI: 10.3390/jcm8040532] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Revised: 04/14/2019] [Accepted: 04/16/2019] [Indexed: 12/22/2022] Open
Abstract
Hidradenitis suppurativa (HS) is a chronic auto-inflammatory skin disease with a great impact in quality of life. However, there is little research about the impact of HS on sex life. The aims of this study are to describe the frequency of sexual distress (SD) in patients with HS and to explore potentially associated epidemiological and clinical factors. We conducted a cross-sectional study by means of a crowd-sourced online questionnaire hosted by the Spanish hidradenitis suppurativa patients’ association (ASENDHI). Sexual distress (SD) was evaluated with a Numeric Rating Scale (NRS) for HS impact on sex life. A total of 393 participants answered the questionnaire. The mean NRS for HS impact on sex life was 7.24 (2.77) in women and 6.39 (3.44) in men (p < 0.05). Variables significantly associated (p < 0.05) with SD in the multiple linear regression model were sex, with a higher risk in females, the presence of active lesions in the groin and genitals and NRS for pain and unpleasant odor; being in a stable relationship was an important protector factor. Regarding these results, it seems that SD in HS patients is due, at least in part, to disease symptoms and active lesions in specific locations, emphasizing the importance of disease control with a proper treatment according to management guidelines. Women and single patients are more likely to suffer from sexual distress.
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Affiliation(s)
- Carlos Cuenca-Barrales
- Dermatology, Hospital Universitario San Cecilio, Avenida de la Investigación s/n, 18016 Granada, Spain.
| | - Ricardo Ruiz-Villaverde
- Dermatology, Hospital Universitario San Cecilio, Avenida de la Investigación s/n, 18016 Granada, Spain.
| | - Alejandro Molina-Leyva
- Dermatology, Hidradenitis Suppurativa Clinic, Hospital Universitario Virgen de las Nieves, Avenida de las Fuerzas Armadas 2, 18014 Granada, Spain.
- European Hidradenitis Suppurativa Foundation (EHSF), 06847 Dessau-Roßlau, Germany.
- Instituto de Investigación Biosanitaria Granada, 18016 Granada, Spain.
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Navarro-Triviño FJ, Cuenca-Barrales C, Vega-Castillo JJ, Ruiz-Villaverde R. Chronic hand eczema and hepatogenic pruritus with good response to apremilast. Dermatol Ther 2019; 32:e12879. [PMID: 30912252 DOI: 10.1111/dth.12879] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 03/07/2019] [Accepted: 03/19/2019] [Indexed: 11/27/2022]
Abstract
Hand eczema (HE) presents a high prevalence and severe impact on the quality of life of the patients. HE is a worldwide problem recognized for his high socio-occupational involvement. Treatment is mainly based on adequate recommendations for hand care together with topical anti-inflammatory treatments. Frequently, patients require systemic treatments such alitretinoin, among others. The comorbidities of the patients and the side effects of the treatments sometimes require prescribing other treatments off label on the technical data. This role in immunomodulation has led to the development of new studies that investigate what role does apremilast have in eczematous diseases, such as atopic dermatitis. We present this case for the quick and complete response of HE with apremilast, and the effective control of hepatogenic pruritus. These finding open a new possibility and alternative treatment of this complex and difficult of control with the treatments already described in the literature.
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Affiliation(s)
| | - Carlos Cuenca-Barrales
- Unidad de Gestión Clínica de Dermatología, Hospital Universitario San Cecilio, Granada, Spain
| | - Jorge J Vega-Castillo
- Unidad de Gestión Clínica de Dermatología, Hospital Universitario San Cecilio, Granada, Spain
| | - Ricardo Ruiz-Villaverde
- Unidad de Gestión Clínica de Dermatología, Hospital Universitario San Cecilio, Granada, Spain
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Aguayo-Carreras P, Cuenca-Barrales C, Perez-López I, Ruiz-Villaverde R, Tercedor-Sanchez J. Successful response to liposomal amphotericin B in mucosal leishmaniasis in glans resistant to intralesional pentavalent. Int J Dermatol 2019; 58:e137-e138. [PMID: 30883705 DOI: 10.1111/ijd.14432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 02/12/2019] [Accepted: 02/18/2019] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - Israel Perez-López
- Department of Dermatology, Universitary Hospital San Cecilio, Granada, Spain
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Molina-Leyva A, Salvador-Rodriguez L, Martinez-Lopez A, Cuenca-Barrales C. Effectiveness, safety and tolerability of drainage and punch-trocar-assisted cryoinsufflation (cryopunch) in the treatment of inflammatory acute fluid collections in hidradenitis suppurativa patients. J Eur Acad Dermatol Venereol 2019; 33:e221-e223. [PMID: 30811686 DOI: 10.1111/jdv.15406] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- A Molina-Leyva
- Dermatology, Hidradenitis Suppurativa Clinic, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - L Salvador-Rodriguez
- Dermatology, Hidradenitis Suppurativa Clinic, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - A Martinez-Lopez
- Dermatology, Hidradenitis Suppurativa Clinic, Hospital Universitario Virgen de las Nieves, Granada, Spain
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Ruiz-Villaverde R, Cuenca-Barrales C, Linares-Gonzalez L, Ródenas-Herranz T. Alopecia universalis. Partial response to tofacitinib. Med Clin (Barc) 2019; 153:e15. [PMID: 30718001 DOI: 10.1016/j.medcli.2018.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 10/30/2018] [Accepted: 11/07/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Ricardo Ruiz-Villaverde
- Unidad de Gestión Clínica de Dermatología, Hospital Universitario San Cecilio, Granada, España.
| | - Carlos Cuenca-Barrales
- Unidad de Gestión Clínica de Dermatología, Hospital Universitario San Cecilio, Granada, España
| | - Laura Linares-Gonzalez
- Unidad de Gestión Clínica de Dermatología, Hospital Universitario San Cecilio, Granada, España
| | - Teresa Ródenas-Herranz
- Unidad de Gestión Clínica de Dermatología, Hospital Universitario San Cecilio, Granada, España
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Molina-Leyva A, Cuenca-Barrales C, Vega-Castillo JJ, Ruiz-Carrascosa JC, Ruiz-Villaverde R. Adherence to Mediterranean diet in Spanish patients with psoriasis: Cardiovascular benefits? Dermatol Ther 2019; 32:e12810. [PMID: 30632241 DOI: 10.1111/dth.12810] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 10/07/2018] [Accepted: 01/05/2019] [Indexed: 12/26/2022]
Abstract
Several studies have evaluated the role of individual nutrients on psoriasis. Only a few of them have evaluated the benefits of healthy dietary patterns and the effect of the Mediterranean diet on psoriasis with promising results. Moderate-severe psoriasis is associated with chronic systemic inflammation and increased cardiovascular risk. In this study the present authors measure the adherence to the Mediterranean diet to determine the grade of association with severity of psoriasis, a cardiovascular profile, and systemic inflammation. Our aim was to determine a cut-off point that approximates the real clinical practice by differentiating patients with systemic or biological treatment.
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Affiliation(s)
- A Molina-Leyva
- Dermatology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - C Cuenca-Barrales
- Dermatology Department, Hospital Unversitario San Cecilio, Granada, Spain
| | - J J Vega-Castillo
- Dermatology Department, Hospital Unversitario San Cecilio, Granada, Spain
| | | | - R Ruiz-Villaverde
- Dermatology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
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Cuenca-Barrales C, Ródenas-Herranz T, Linares-Gonzalez L, Ruiz-Villaverde R. Pyogenic Granuloma in an Atypical Location Following Isotretinoin Treatment. Sultan Qaboos Univ Med J 2018; 18:e409-e410. [PMID: 30607291 DOI: 10.18295/squmj.2018.18.03.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 07/20/2018] [Accepted: 08/02/2018] [Indexed: 11/16/2022] Open
Abstract
Interesting Medical Image
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Cuenca-Barrales C, Ruiz-Carrascosa J, Ruiz-Villaverde R. Fibroepithelioma of Pinkus: A Basal Cell Carcinoma With Distinctive Dermoscopic Features. Actas Dermo-Sifiliográficas (English Edition) 2018. [DOI: 10.1016/j.adengl.2018.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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50
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Molina-Leyva A, Cuenca-Barrales C. Adolescent-Onset Hidradenitis Suppurativa: Prevalence, Risk Factors and Disease Features. Dermatology 2018; 235:45-50. [DOI: 10.1159/000493465] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 09/03/2018] [Indexed: 11/19/2022] Open
Abstract
Background/Aims: Hidradenitis suppurativa (HS) is a chronic inflammatory and destructive skin disorder. Early diagnosis and treatment are critical to stop its progression. Data concerning adolescent-onset HS are scarce. The aims of this study are to describe the prevalence of adolescent-onset HS and to explore potential risk factors and the disease features of these patients. Patients and Methods: A cross-sectional study including 134 patients was performed. Results: Adolescent-onset HS occurred in 51.5% (69/134) of patients. Adolescent-onset HS was associated with female sex, positive family history, presence of pilonidal sinus, acne conglobata, longer disease duration and a worse perception of disease severity. Conclusion: Adolescent-onset HS might be more frequent than previously reported. Female sex, positive family history and the presence of elements of the follicular occlusion tetrad identify individuals with a higher risk of early onset. These patients experience a longer disease duration and perceive their disease as severer.
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