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Rivera-Díaz R, Pozo T, Alfageme F, Díaz Ley B, Osorio GF, Chico R, Vilarrasa E, Silvente C, Ciudad Blanco C, Romaní J, Martorell A, Fernández P, Romero Ferreiro C, Molina Leyva A. The Effectiveness of Guselkumab in Patients With Hidradenitis Suppurativa Under Clinical Practice Conditions: A Spanish Multicentre Retrospective Study. Actas Dermosifiliogr 2023; 114:T755-T762. [PMID: 37479135 DOI: 10.1016/j.ad.2023.06.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 06/12/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND Hidradenitis suppurativa (HS) is a chronic skin condition causing lesions in which high levels of interleukin (IL)-23 and T-helper17 cells are found. Adalimumab remains the only approved treatment. Guselkumab, an antibody targeting the p19 protein subunit of extracellular IL-23, is approved for the treatment of moderate-severe psoriasis, but evidence on its efficacy in treating HS is limited. OBJECTIVES To assess the effectiveness and safety of guselkumab in treating moderate-severe HS under clinical practice conditions. METHODS A multicentre retrospective observational study was carried out in 13 Spanish hospitals including adult HS patients treated with guselkumab within a compassionate use programme (March 2020-March 2022). Data referred to patient demographic and clinical characteristics at treatment initiation (baseline), patient-reported outcomes (Numerical Pain Rating Scale [NPRS] and Dermatology Life Quality Index [DLQI]), physician scores (International Hidradenitis Suppurativa Severity Score System [IHS4], HS Physical Global Score [HS-PGA] and Hidradenitis Suppurativa Clinical Response [HiSCR]) were recorded at baseline and at 16, 24, and 48weeks of treatment. RESULTS A total of 69 patients were included. Most (84.10%) had severe HS (HurleyIII) and had been diagnosed for over ten years (58.80%). The patients had been subjected to multiple non-biological (mean: 3.56) or biological (mean: 1.78) therapies, and almost 90% of those treated with biologics had received adalimumab. A significant decrease in IHS4, HS-PGA, NPRS, and DLQI scores was observed from baseline to 48weeks of guselkumab treatment (all P<.01). HiSCR was achieved in 58.33% and 56.52% of the patients at 16 and 24weeks, respectively. Overall, 16 patients discontinued treatment, mostly due to inefficacy (n=7) or loss of efficacy (n=3). No serious adverse events were observed. CONCLUSIONS Our results indicate that guselkumab may be a safe and effective therapeutic alternative for patients with severe HS that fail to respond to other biologics.
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Affiliation(s)
- R Rivera-Díaz
- Departamento de Dermatología, Hospital Universitario 12 de Octubre, Universidad Complutense, Madrid, España.
| | - T Pozo
- Departamento de Dermatología, Hospital Rio Hortega, Valladolid, España
| | - F Alfageme
- Departamento de Dermatología, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Madrid, España
| | - B Díaz Ley
- Departamento de Dermatología, Hospital Universitario del Sureste, Arganda del Rey, Madrid, España
| | - G F Osorio
- Departamento de Dermatología, Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, España
| | - R Chico
- Departamento de Dermatología, Hospital Infanta Sofía, Alcobendas, Madrid, España
| | - E Vilarrasa
- Departamento de Dermatología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, España
| | - C Silvente
- Departamento de Dermatología, Hospital Universitario Infanta Leonor, Madrid, España
| | - C Ciudad Blanco
- Departamento de Dermatología, Hospital Universitario Gregorio Marañón, Universidad Complutense, Madrid, España
| | - J Romaní
- Departamento de Dermatología, Hospital General de Granollers, Granollers, Barcelona, España
| | - A Martorell
- Departamento de Dermatología, Hospital de Manises, Manises, Valencia, España
| | - P Fernández
- Departamento de Dermatología, Hospital Universitario Ramón y Cajal, Madrid, España
| | - C Romero Ferreiro
- Scientific Support Unit, Instituto de Investigación Sanitaria Hospital Universitario, 12 de Octubre (imas12), Madrid, España; Facultad de Ciencias de la Salud, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, España
| | - A Molina Leyva
- Departamento de Dermatología, Hospital Universitario Virgen de las Nieves, Granada, España; European Hidradenitis Suppurativa Foundation (EHSF), Dessau-Roßlau, Alemania
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Rivera-Díaz R, Pozo T, Alfageme F, Díaz Ley B, Osorio GF, Chico R, Vilarrasa E, Silvente C, Ciudad Blanco C, Romaní J, Martorell A, Fernández P, Romero Ferreiro C, Molina Leyva A. The Effectiveness of Guselkumab in Patients With Hidradenitis Suppurativa Under Clinical Practice Conditions: A Spanish Multicentre Retrospective Study. Actas Dermosifiliogr 2023; 114:755-762. [PMID: 37331620 DOI: 10.1016/j.ad.2023.06.013] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 05/26/2023] [Accepted: 06/12/2023] [Indexed: 06/20/2023] Open
Abstract
BACKGROUND Hidradenitis suppurativa (HS) is a chronic skin condition causing lesions in which high levels of interleukin (IL)-23 and T-helper 17 cells are found. Adalimumab remains the only approved treatment. Guselkumab, an antibody targeting the p19 protein subunit of extracellular IL-23, is approved for the treatment of moderate-severe psoriasis, but evidence on its efficacy in treating HS is limited. OBJECTIVES To assess the effectiveness and safety of guselkumab in treating moderate-severe HS under clinical practice conditions. METHODS A multicentre retrospective observational study was carried out in 13 Spanish Hospitals including adult HS patients treated with guselkumab within a compassionate use programme (March 2020-March 2022). Data referred to patient demographic and clinical characteristics at treatment initiation (baseline), patient-reported outcomes (Numerical Pain Rating Scale [NPRS] and Dermatology Life Quality Index [DLQI]), physician scores (International Hidradenitis Suppurativa Severity Score System [IHS4], HS Physical Global Score [HS-PGA] and Hidradenitis Suppurativa Clinical Response [HiSCR]) were recorded at baseline and at 16, 24, and 48 weeks of treatment. RESULTS A total of 69 patients were included. Most (84.10%) had severe HS (Hurley III) and had been diagnosed for over ten years (58.80%). The patients had been subjected to multiple non-biological (mean 3.56) or biological (mean 1.78) therapies, and almost 90% of those treated with biologics had received adalimumab. A significant decrease in IHS4, HS-PGA, NPRS, and DLQI scores was observed from baseline to 48 weeks of guselkumab treatment (all p<0.01). HiSCR was achieved in 58.33% and 56.52% of the patients at 16 and 24 weeks, respectively. Overall, 16 patients discontinued treatment, mostly due to inefficacy (n=7) or loss of efficacy (n=3). No serious adverse events were observed. CONCLUSIONS Our results indicate that guselkumab may be a safe and effective therapeutic alternative for patients with severe HS that fail to respond to other biologics.
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Affiliation(s)
- R Rivera-Díaz
- Department of Dermatology, Hospital Universitario 12 de Octubre, Universidad Complutense, Madrid, Spain.
| | - T Pozo
- Department of Dermatology, Hospital Rio Hortega, Valladolid, Spain
| | - F Alfageme
- Department of Dermatology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - B Díaz Ley
- Department of Dermatology, Hospital Universitario del Sureste, Arganda, Madrid, Spain
| | - G F Osorio
- Department of Dermatology, Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, Spain
| | - R Chico
- Department of Dermatology, Hospital Infanta Sofía, Alcobendas, Madrid, Spain
| | - E Vilarrasa
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - C Silvente
- Department of Dermatology, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - C Ciudad Blanco
- Department of Dermatology, Hospital Universitario Gregorio Marañón, Universidad Complutense Madrid, Madrid, Spain
| | - J Romaní
- Department of Dermatology, Hospital General de Granollers, Barcelona, Spain
| | - A Martorell
- Department of Dermatology, Hospital de Manises, Valencia, Spain
| | - P Fernández
- Department of Dermatology, Hospital Universitario Ramon y Cajal, Madrid, Spain
| | - C Romero Ferreiro
- Scientific Support Unit, Instituto de Investigación Sanitaria Hospital Universitario, 12 de Octubre (imas12), 28041 Madrid, Spain; Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223 Madrid, Spain
| | - A Molina Leyva
- Department of Dermatology, Hospital Universitario Virgen de las Nieves, Granada, Spain; European Hidradenitis Suppurativa Foundation (EHSF), Dessau-Roßlau, Germany
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Luna-Bastante L, Sigüenza M, Nájero L, Alfageme F. [Translated article] Ultrasound Image of a Stair-Like Border in Circumscribed Palmar Hypokeratosis. Actas Dermo-Sifiliográficas 2022. [DOI: 10.1016/j.ad.2020.11.040] [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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Martorell A, Martin-Gorgojo A, Ríos-Viñuela E, Rueda-Carnero J, Alfageme F, Taberner R. [Translated article] Artificial intelligence in dermatology: A threat or an opportunity? Actas Dermo-Sifiliográficas 2022. [DOI: 10.1016/j.ad.2021.07.014] [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: 12/09/2022] Open
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Martorell A, Martin-Gorgojo A, Ríos-Viñuela E, Rueda-Carnero J, Alfageme F, Taberner R. Inteligencia artificial en dermatología: ¿amenaza u oportunidad? Actas Dermo-Sifiliográficas 2022; 113:30-46. [DOI: 10.1016/j.ad.2021.07.003] [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: 06/10/2021] [Accepted: 07/18/2021] [Indexed: 11/25/2022] Open
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6
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Martorell A, Martin-Gorgojo A, Ríos-Viñuela E, Rueda-Carnero J, Alfageme F, Taberner R. Artificial intelligence in dermatology: A threat or an opportunity? Actas Dermo-Sifiliográficas (English Edition) 2021. [DOI: 10.1016/j.adengl.2021.11.007] [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: 11/30/2022] Open
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7
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Luna-Bastante L, Sigüenza M, Nájero L, Alfageme F. Ultrasound Image of a Stair-Like Border in Circumscribed Palmar Hypokeratosis. Actas Dermosifiliogr (Engl Ed) 2021; 113:732-733. [PMID: 33992623 DOI: 10.1016/j.ad.2020.11.023] [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: 08/24/2020] [Accepted: 11/24/2020] [Indexed: 11/17/2022] Open
Affiliation(s)
- L Luna-Bastante
- Servicio de Dermatología del Complejo Hospitalario de Toledo. Hospital Virgen del Valle, Carretera de Cobisa s/n, 45071, Toledo, España.
| | - M Sigüenza
- Hospital Universitario Puerta de Hierro. Calle Manuel de Falla 1, 28222, Majadahonda, Madrid, España
| | - L Nájero
- Hospital Universitario Puerta de Hierro. Calle Manuel de Falla 1, 28222, Majadahonda, Madrid, España
| | - F Alfageme
- Hospital Universitario Puerta de Hierro. Calle Manuel de Falla 1, 28222, Majadahonda, Madrid, España; Universidad Autónoma de Madrid. Ciudad Universitaria de Cantoblanco, 28049 Madrid, España
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Martinez-Mera C, Moreno-Torres V, González-Vioque E, Mellor S, Alfageme F. Atrophic violaceus pretibial plaques: when the clue is the oral mucosa. Clin Exp Dermatol 2020; 46:227-230. [PMID: 32940912 DOI: 10.1111/ced.14440] [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: 06/24/2020] [Revised: 07/02/2020] [Accepted: 07/31/2020] [Indexed: 11/30/2022]
Affiliation(s)
- C Martinez-Mera
- Department of Dermatology, Hospital Universitario Puerta de Hierro, Majadahonda, Spain
| | - V Moreno-Torres
- Department of Internal Medicine, Hospital Universitario Puerta de Hierro, Majadahonda, Spain
| | - E González-Vioque
- Deparment of Clinical Chemistry, Hospital Universitario Puerta de Hierro, Majadahonda, Spain
| | - S Mellor
- Department of Internal Medicine, Hospital Universitario Puerta de Hierro, Majadahonda, Spain
| | - F Alfageme
- Department of Dermatology, Hospital Universitario Puerta de Hierro, Majadahonda, Spain
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9
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Gómez Zubiaur A, Alfageme F, López-Negrete E, Roustan G. Protuberancia occipital externa tipo 3 (en espina o espolón): diagnóstico ecográfico de una causa infrecuente de pseudotumor subcutáneo del cuero cabelludo en adolescentes. Actas Dermo-Sifiliográficas 2019; 110:774-775. [DOI: 10.1016/j.ad.2018.04.015] [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: 12/27/2017] [Revised: 04/09/2018] [Accepted: 04/11/2018] [Indexed: 10/26/2022] Open
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Gómez Zubiaur A, Alfageme F, López-Negrete E, Roustan G. Type 3 External Occipital Protuberance (Spine Type): Ultrasonographic Diagnosis of an Uncommon Cause of Subcutaneous Scalp Pseudotumor in Adolescents. Actas Dermo-Sifiliográficas (English Edition) 2019. [DOI: 10.1016/j.adengl.2019.06.001] [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: 12/01/2022] Open
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11
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Vidal D, Alfageme F. Ultrasound-Guided Fine-Needle Aspiration Cytology and Core-Needle Biopsy in Dermatology: A Step Forward. Actas Dermo-Sifiliográficas (English Edition) 2019. [DOI: 10.1016/j.adengl.2018.09.018] [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: 10/26/2022] Open
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Vidal D, Alfageme F. Ultrasound-Guided Fine-Needle Aspiration Cytology and Core-Needle Biopsy in Dermatology: A Step Forward. Actas Dermosifiliogr (Engl Ed) 2019; 110:707-709. [PMID: 30791969 DOI: 10.1016/j.ad.2018.09.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 09/24/2018] [Accepted: 09/30/2018] [Indexed: 11/15/2022] Open
Affiliation(s)
- D Vidal
- Servicio de Dermatología, Hospital Moisès Broggi de Sant Joan Despí, Sant Joan Despí, Barcelona, España.
| | - F Alfageme
- Servicio de Dermatología, Hospital Puerta de Hierro-Majadahonda, Majadahonda, Madrid, España
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Gómez-Zubiaur A, Alfageme F, Martínez-Lorenzo E, Roustán G. Diagnostic and Therapeutic Implications of Ultrasound Imaging of Perianal Fistulous Tracts in Patients with Suspected Hidradenitis Suppurativa. Actas Dermo-Sifiliográficas (English Edition) 2018. [DOI: 10.1016/j.adengl.2018.09.006] [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: 11/16/2022] Open
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14
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Romero G, de Argila D, Ferrandiz L, Sánchez M, Vañó S, Taberner R, Pasquali P, de la Torre C, Alfageme F, Malvehy J, Moreno-Ramírez D. Practice Models in Teledermatology in Spain: Longitudinal Study, 2009-2014. Actas Dermo-Sifiliográficas (English Edition) 2018. [DOI: 10.1016/j.adengl.2018.06.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Romero G, de Argila D, Ferrandiz L, Sánchez M, Vañó S, Taberner R, Pasquali P, de la Torre C, Alfageme F, Malvehy J, Moreno-Ramírez D. Modelos de práctica de la teledermatología en España. Estudio longitudinal 2009-2014. Actas Dermo-Sifiliográficas 2018; 109:624-630. [DOI: 10.1016/j.ad.2018.03.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 02/24/2018] [Accepted: 03/25/2018] [Indexed: 10/16/2022] Open
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Alfageme F. Broadening the Sonographic Spectrum of Vascular Anomalies. Actas Dermo-Sifiliográficas (English Edition) 2018. [DOI: 10.1016/j.adengl.2018.02.007] [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: 11/30/2022] Open
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Alfageme F. Ampliando el espectro ecográfico de las anomalías vasculares. Actas Dermo-Sifiliográficas 2018; 109:199. [DOI: 10.1016/j.ad.2017.06.005] [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: 06/14/2017] [Accepted: 06/14/2017] [Indexed: 11/25/2022] Open
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Vidal D, Alfageme F, Ruiz-Villaverde R, Arias-Santiago S, Martorell A. Caracterización ecográfica de la psoriasis ungueal: estudio de casos y controles. Actas Dermo-Sifiliográficas 2017; 108:968-969. [DOI: 10.1016/j.ad.2017.04.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 03/17/2017] [Accepted: 04/10/2017] [Indexed: 11/25/2022] Open
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Vidal D, Alfageme F, Ruiz-Villaverde R, Arias-Santiago S, Martorell A. Ultrasound Characterization of Psoriasis of the Nails: A Case-Control Study. Actas Dermo-Sifiliográficas (English Edition) 2017. [DOI: 10.1016/j.adengl.2017.10.015] [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: 10/18/2022] Open
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Hernández-Aragüés I, Vázquez-Osorio I, Alfageme F, Ciudad-Blanco C, Casas-Férnandez L, Rodríguez-Blanco MI, Suárez-Fernández R. Skin ultrasound features of Merkel cell carcinoma. J Eur Acad Dermatol Venereol 2017; 31:e315-e318. [PMID: 28045198 DOI: 10.1111/jdv.14102] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
| | | | - F Alfageme
- Hospital Universitario Puerta de Hierro, Madrid, Spain
| | - C Ciudad-Blanco
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
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Alfageme F, Cerezo E, Fernandez IS, Aguilo R, Vilas-Sueiro A, Roustan G. Introduction of Basic Dermatologic Ultrasound in Undergraduate Medical Education. Ultrasound Int Open 2016; 2:E136-E139. [PMID: 27933321 DOI: 10.1055/s-0042-120273] [Citation(s) in RCA: 2] [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] [Indexed: 10/20/2022] Open
Abstract
Purpose: Teaching ultrasound procedures to undergraduates has recently been proposed to improve the quality of medical education. We address the impact of applying standardized dermatologic ultrasound teaching to our undergraduates. Materials and Methods: Medical students were offered an additional theoretical and practical seminar involving hands-on ultrasound dermatologic ultrasound during their mandatory dermatology practical training. The students' theoretical knowledge and dermatologic ultrasoud skills were tested with a multiple choice questionnaire extracted from Level 1 Spanish Society of Ultrasound Dermatologic Ultrasound accreditation exam before and after the course. After the course, the students were asked to answer a course evaluation questionnaire Results: The multiple-choice question scores after the course showed statistically significant improvement (5.82 vs. 8.71%; P<0.001). The questionnaire revealed that students were satisfied with the course, felt that it increased both their dermatologic and ultrasound knowledge, and indicated that they wanted more sonographic hands-on training in both dermatologic ultrasound and other medical fields. Conclusion: Using both objective and subjective methods, we showed that the introduction of standardized ultrasound training programs in undergraduate medical education can improve both students' understanding of the technique and the quality of medical education in dermatology.
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Affiliation(s)
- F Alfageme
- Dermatology, Hospital Puerta de Hierro, Madrid, Spain
| | - E Cerezo
- Calle Fracisco Silvela #124, lo 3, Madrid, Spain
| | - I S Fernandez
- Dermatology, Hospital Puerta de Hierro, Madrid, Spain
| | - R Aguilo
- Laboral Medicine, Asepeyo, Madrid, Spain
| | - A Vilas-Sueiro
- Dermatology, Complejo Hospitalario Universitario Ferrol, Ferrol, Spain
| | - G Roustan
- Dermatology, Hospital Puerta de Hierro, Madrid, Spain
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Carrascosa R, Alfageme F, Roustán G, Suarez MD. Skin Ultrasound in Kaposi Sarcoma. Actas Dermosifiliogr 2015; 107:e19-22. [PMID: 26706712 DOI: 10.1016/j.ad.2015.05.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [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: 03/10/2015] [Revised: 05/07/2015] [Accepted: 05/26/2015] [Indexed: 12/21/2022] Open
Abstract
The use of ultrasound imaging has recently been increasing in numerous dermatologic diseases. This noninvasive technique provides additional details on the structure and vascularization of skin lesions. Kaposi sarcoma is a vascular tumor that typically arises in the skin and mucosas. It can spread to lymph nodes and internal organs. We performed B-mode and color Doppler ultrasound studies in 3 patients with a clinical diagnosis of Kaposi sarcoma confirmed by histological examination. We found differences in the ultrasound pattern between nodular and plaque lesions, in both B-mode and color Doppler. We believe that skin ultrasound imaging could be a useful technique for studying cutaneous Kaposi sarcoma, providing additional information on the structural and vascular characteristics of the lesion.
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Affiliation(s)
- R Carrascosa
- Servicio de Dermatología, Hospital Universitario La Princesa, Madrid, España.
| | - F Alfageme
- Servicio de Dermatología, Hospital Universitario Puerta de Hierro , Majadahonda, Madrid, España
| | - G Roustán
- Servicio de Dermatología, Hospital Universitario Puerta de Hierro , Majadahonda, Madrid, España
| | - M D Suarez
- Servicio de Anatomía Patológica, Hospital Universitario Puerta de Hierro , Majadahonda, Madrid, España
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Echeverría-García B, Borbujo J, Alfageme F. Incorporación de la ecografía en Dermatología. Actas Dermo-Sifiliográficas 2014; 105:887-90. [DOI: 10.1016/j.ad.2014.03.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2014] [Revised: 03/25/2014] [Accepted: 03/29/2014] [Indexed: 01/15/2023] Open
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25
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Ciudad C, Alfageme F, Zamberk P, Zamberk P, Suárez R. [Patients with malformations of the face, mouth, and fingers: type I orofaciodigital or Papillon-Léage Psaume syndrome]. Actas Dermosifiliogr 2009; 100:732-734. [PMID: 19775559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
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Ciudad C, Alfageme F, Zamberk P, Suárez R. Patient With Malformations of the Face, Mouth, and Fingers: Type I Orofaciodigital or Papillon-Léage Psaume Syndrome. Actas Dermo-Sifiliográficas (English Edition) 2009. [DOI: 10.1016/s1578-2190(09)70163-5] [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: 11/16/2022] Open
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Abstract
Afferent projections to the mediodorsal and anterior thalamic nuclei in the cat were studied by means of stereotaxic injection of neuronal tracers (horseradish peroxidase and fluorochromes). Acetylcholinesterase reaction was studied, as well as horseradish peroxidase and NADPH-diaphorase colocation in neuronal bodies which send and receive projections to and from the mediodorsal thalamic nucleus. Based on the connectivity and histochemistry findings, the possibility that prion agents responsible for fatal familial insomnia spread from the mediodorsal and anterior thalamic nuclei through a retrograde pathway is discussed. The possible pathophysiological implication of nitrergic systems in fatal familial insomnia is also considered.
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Affiliation(s)
- J L Velayos
- Faculty of Medicine, Autonomous University of Madrid, Spain.
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Gámez P, Córdoba M, Millán I, Madrigal L, Alfageme F, Alvarez R, Núñez I, Varela A. [Improvements in lung preservation: 3 years' experience with a low-potassium dextran solution]. Arch Bronconeumol 2005; 41:16-9. [PMID: 15676131 DOI: 10.1016/s1579-2129(06)60389-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Lung preservation quality is a crucial factor in the success of a lung transplant. In October 2000 we stopped using Euro-Collins (EC) lung preservation solution and began using a low potassium dextran solution (Perfadex [PER]). The objective of the present study was to assess outcome with the 2 solutions. MATERIAL AND METHODS We analyzed the results of 68 lung transplants in which PER was used and compared the results with those of a historical control group consisting of the same number of transplants in which EC was used. RESULTS There were no significant differences in the ages and diagnoses of the recipients in the 2 groups. Waiting list time was longer in the PER group. The most frequent cause of donor death in the EC group was craniocerebral trauma (62%), whereas in the PER group it was cerebral hemorrhage (54%). In the PER group more double lung transplants were performed than in the EC group (78% and 53% respectively; P=.002). There were no differences in the use of extracorporal circulation or ischemia time between the 2 groups. Early graft function, based on the patient's oxygenation index (ratio of PaO2 to inspired oxygen fraction [FiO2]) on arrival at the intensive care unit, was similar in the 2 groups. The incidence of severe graft failure (PaO2/FiO2<150 mm Hg) was significantly lower in the PER group than in the EC group (16% and 37% respectively; P=.01). No significant differences in hours of mechanical ventilation or postoperative mortality between the 2 patient series were found. CONCLUSIONS Use of the newer lung preservation solution --PER-- led to a 50% lower incidence of severe ischemia-reperfusion graft injury during the early recovery from lung transplantation.
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Affiliation(s)
- P Gámez
- Servicio de Cirugía Torácica y Cardiovascular, Hospital Universitario Puerta de Hierro, Madrid, Spain.
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Gámez P, Córdoba M, Millán I, Madrigal L, Alfageme F, Álvarez R, Núñez I, Varela A. Mejoras en la preservación pulmonar. Tres años de experiencia con una solución de dextrano bajo en potasio. Arch Bronconeumol 2005. [DOI: 10.1157/13070279] [Citation(s) in RCA: 10] [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] [Indexed: 11/21/2022]
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Varela A, Nuñez J, Gamez A, Rio F, Cordoba M, Calatayud J, Ussetti P, Carreño M, Alfageme F, Gomez D. Are out hospital non heart beating donors (NHBD) better than brain death lung donors? J Heart Lung Transplant 2004. [DOI: 10.1016/j.healun.2003.11.136] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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