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Menéndez-Sánchez M, Pérez-Fernández E, López-Estebaranz JL, Gómez-de la Fuente E. [Translated article] Use of Antihistamines During Omalizumab Therapy in Chronic Urticaria in the Routine Clinical Practice. A 48-Patient Observational Trial. Actas Dermosifiliogr 2024:S0001-7310(24)00352-1. [PMID: 38648933 DOI: 10.1016/j.ad.2024.04.012] [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: 06/27/2023] [Accepted: 08/08/2023] [Indexed: 04/25/2024] Open
Affiliation(s)
- M Menéndez-Sánchez
- Servicio de Dermatología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain.
| | - E Pérez-Fernández
- Unidad de Investigación, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - J L López-Estebaranz
- Servicio de Dermatología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - E Gómez-de la Fuente
- Servicio de Dermatología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
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2
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Menéndez-Sánchez M, Pérez-Fernández E, López-Estebaranz JL, Gómez-de la Fuente E. Use of Antihistamines During Omalizumab Therapy in Chronic Urticaria in the Routine Clinical Practice. A 48-Patient Observational Trial. Actas Dermosifiliogr 2024:S0001-7310(24)00145-5. [PMID: 38382744 DOI: 10.1016/j.ad.2023.08.015] [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: 06/27/2023] [Revised: 07/20/2023] [Accepted: 08/08/2023] [Indexed: 02/23/2024] Open
Affiliation(s)
- M Menéndez-Sánchez
- Servicio de Dermatología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España.
| | - E Pérez-Fernández
- Unidad de Investigación, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - J L López-Estebaranz
- Servicio de Dermatología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - E Gómez-de la Fuente
- Servicio de Dermatología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
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3
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Sahuquillo-Torralba A, Hospital-Gil M, Vilarrasa-Rull E, Llamas-Velasco M, Rivera R, Carrascosa JM, de la Cueva-Dovao P, Armesto-Santos S, Ruíz-Villaverde R, Velasco-Pastor M, Magdaleno-Tapial J, Yanguas-Bayona JI, Ribera-Pibernat M, Salgado-Boquete L, Herranz-Pinto P, Romero-Mate A, Martínez-Lorenzo E, López-Estebaranz JL, Ballescá-López F, Botella-Estrada R. Effectiveness and safety of brodalumab in the treatment of plaque, scalp and palmoplantar psoriasis: A multicentre retrospective study in a Spanish population. Australas J Dermatol 2023; 64:e317-e326. [PMID: 37435962 DOI: 10.1111/ajd.14130] [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: 11/07/2022] [Revised: 03/26/2023] [Accepted: 06/26/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND AND OBJECTIVE The data in clinical practice regarding the effectiveness and safety of brodalumab in psoriasis are scarce, especially at scalp and palmoplantar locations. The main objective was the percentage of patients achieving absolute PASI ≤3/ ≤1/ =0 for plaque psoriasis and the percentage of patients achieving an IGA 0-1/IGA 0 for the special locations at Week 52 of treatment. PATIENTS AND METHODS Observational retrospective multicentre study in 28 Spanish Hospitals that included adult patients with plaque psoriasis treated with brodalumab, from September 2018 until March 2021. RESULTS A total of 200 patients were included. The mean baseline PASI was 10.97 (±6.28) with a mean basal scalp (n = 58) and palmoplantar (n = 40) IGA of 2.10 (±0.97) and 2.15 (±1.26), respectively. At Week 52, 93.98%/75.90%/68.67% of patients reached an absolute PASI ≤3/ ≤1/ =0 in plaque psoriasis (n = 83), with a percentage of patients achieving scalp (n = 27) and palmoplantar (n = 19) IGA 0-1/IGA 0 of 96.3%/88.9% and 100%/88.9%, respectively. Fifteen per cent of patients reported any adverse events with candidiasis being the most reported (6%), but only 6% of the adverse events required the withdrawal. CONCLUSIONS Brodalumab demonstrated high PASI and IGA responses and was well tolerated in clinical practice in plaque, scalp and palmoplantar psoriasis.
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Affiliation(s)
- A Sahuquillo-Torralba
- Department of Dermatology, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - M Hospital-Gil
- Department of Dermatology, Hospital Universitario Puerta del Hierro, Madrid, Spain
| | - E Vilarrasa-Rull
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - M Llamas-Velasco
- Department of Dermatology, Hospital Universitario de la Princesa, Instituto de Investigación Sanitaria La Princesa (IIS-IP), Madrid, Spain
| | - R Rivera
- Department of Dermatology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - J M Carrascosa
- Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Badalona, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - P de la Cueva-Dovao
- Department of Dermatology, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - S Armesto-Santos
- Department of Dermatology, Hospital Universitario Marques De Valdecilla, Santander, Spain
| | - R Ruíz-Villaverde
- Department of Dermatology, Hospital Universitario San Cecilio, Granada, Spain
| | - M Velasco-Pastor
- Department of Dermatology, Hospital Arnau de Vilanova, Valencia, Spain
| | - J Magdaleno-Tapial
- Department of Dermatology, Consorcio Hospital General Universitario de Valencia, Spain
| | | | - M Ribera-Pibernat
- Department of Dermatology, Hospital Universitari Parc Tauli de Sabadell, Barcelona, Spain
| | - L Salgado-Boquete
- Deparment of Dermatology, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, Spain
| | - P Herranz-Pinto
- Department of Dermatology, Hospital Universitario La Paz, Madrid, Spain
| | - A Romero-Mate
- Department of Dermatology, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - E Martínez-Lorenzo
- Department of Dermatology, Hospital Universitario Virgen de la Salud, Toledo, Spain
| | | | | | - R Botella-Estrada
- Department of Dermatology, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Facultad de Medicina, Universidad de Valencia, Valencia, Spain
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4
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Oro-Ayude M, González-Sixto B, Sanmartin-Jiménez O, Garcés JR, Rodríguez-Prieto MA, Ruiz-Salas V, de Eusebio-Murillo E, Miñano-Medrano R, Escutia-Muñoz B, Feal Cortizas C, Artola-Igarza JL, Alfaro-Rubio A, Redondo P, Delgado-Jiménez Y, Sánchez-Schmidt JM, Allende-Markixana I, Alonso-Pacheco ML, García-Bracamonte B, de la Cueva-Dobao P, Navarro-Tejedor R, Ciudad-Blanco C, Carnero-González L, Vázquez-Veiga H, Cano-Martínez N, Vilarrasa-Rull E, Sánchez-Sambucety P, López-Estebaranz JL, Botella-Estrada R, Martorell-Calatayud A, Gil P, Morales-Gordillo V, Toll-Abelló A, Ocerin-Guerra I, Mayor-Arenal M, Suárez-Fernández R, Sainz-Gaspar L, Descalzo MA, Garcia-Doval I, Flórez Á. Mohs surgery: a long-term, nationwide prospective cohort to describe recurrence rate and risk factors (REGESMOHS, Spanish Registry of Mohs Surgery). J Eur Acad Dermatol Venereol 2021; 36:e35-e37. [PMID: 34374137 DOI: 10.1111/jdv.17597] [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: 03/13/2021] [Revised: 07/21/2021] [Accepted: 07/29/2021] [Indexed: 11/29/2022]
Affiliation(s)
- M Oro-Ayude
- Complexo Universitario Hospitalario Pontevedra, Pontevedra, Spain
| | - B González-Sixto
- Complexo Universitario Hospitalario Pontevedra, Pontevedra, Spain
| | | | - J R Garcés
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Centro Médico Teknon, Barcelona, Spain
| | | | - V Ruiz-Salas
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Centro Médico Teknon, Barcelona, Spain
| | | | | | | | - C Feal Cortizas
- Complexo Universitario Hospitalario Pontevedra, Pontevedra, Spain
| | | | | | - P Redondo
- Clínica Universidad de Navarra, Pamplona, Spain
| | - Y Delgado-Jiménez
- Hospital Universitario Quirón Salud, Madrid, Spain.,Hospital Universitario de la Princesa, Madrid, Spain
| | | | | | | | | | | | | | - C Ciudad-Blanco
- Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Hospital La Zarzuela, Madrid, Spain
| | | | - H Vázquez-Veiga
- Complexo Hospitalario Universitario de Santiago, Santiago Compostela, Spain
| | - N Cano-Martínez
- Hospital Infanta Leonor, Madrid, Spain.,Hospital La Zarzuela, Madrid, Spain
| | - E Vilarrasa-Rull
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Centro Médico Teknon, Barcelona, Spain
| | | | | | | | | | - P Gil
- Clínica Universidad de Navarra, Pamplona, Spain
| | | | | | | | | | | | - L Sainz-Gaspar
- Complexo Hospitalario Universitario de Santiago, Santiago Compostela, Spain
| | - M A Descalzo
- Fundación Piel Sana Academia Española de Dermatología, Madrid, Spain
| | - I Garcia-Doval
- Fundación Piel Sana Academia Española de Dermatología, Madrid, Spain
| | - Á Flórez
- Complexo Universitario Hospitalario Pontevedra, Pontevedra, Spain
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Munera-Campos M, Vilar-Alejo J, Rivera R, Carrascosa JM, Daudén E, Herrera-Acosta E, Sahuquillo-Torralba A, Gómez-García FJ, Baniandrés-Rodríguez O, de la Cueva P, López-Estebaranz JL, Belinchón I, Ferran M, Riera-Monroig J, Rodriguez L, Carretero G, García-Donoso C, Ballescá F, Llamas-Velasco M, Herrera-Ceballos E, Pujol-Marco C, Nieto-Benito LM, Ruiz-Genao DP, Alsina M, Descalzo MA, García-Doval I. The risk of hepatic adverse events of systemic medications for psoriasis: a prospective cohort study using the BIOBADADERM registry. J DERMATOL TREAT 2021; 33:2110-2117. [PMID: 33913796 DOI: 10.1080/09546634.2021.1922572] [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] [Indexed: 10/21/2022]
Abstract
BACKGROUND Limited information is available regarding the risk of incident liver disease in patients with psoriasis receiving systemic therapies. OBJECTIVES To describe the liver safety findings of conventional and modern systemic therapies for moderate-to-severe psoriasis, and to compare the relative incidence rates of hepatic adverse events (AEs) for each drug. METHODS All the patients on the BIOBADADERM registry were included. Crude and adjusted incidence rate ratios (cIRR and aIRR, respectively) of hepatic AEs, using anti-TNF drugs as reference, were determined. Outcomes of interest were hypertransaminasemia, nonalcoholic fatty liver disease (NADFLD) and a group of other, less represented, hepatic AEs. RESULTS Our study included 3,171 patients exposed to systemic drugs (6279 treatment cycles). Incident hypertransaminasemia was the most frequent hepatic AE (incidence rate of 21 per 1000 patients-years [CI 95% CI 18-23]), followed by NAFLD (8 cases per 1000 patients-years [95% CI 6-10]). Methotrexate (aIRR 3.06 [2.31-4.4]; p = 0.000) and cyclosporine (aIRR 2.37 [1.05-5.35]; p = 0.0378) were associated with an increased risk for hypertransaminasemia when compared to anti-TNF-α agents. No differences were observed between different groups of biologics. Conventional therapies were not associated with new incident NAFLD. CONCLUSIONS Comparative information of the incidence of hepatic AEs could facilitate drug selection in moderate-to-severe psoriasis.
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Affiliation(s)
- M Munera-Campos
- Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Badalona, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - J Vilar-Alejo
- Department of Dermatology, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - R Rivera
- Department of Dermatology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - J M Carrascosa
- Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Badalona, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - E Daudén
- Department of Dermatology. Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria de La Princesa (IIS-IP), Madrid, Spain
| | - E Herrera-Acosta
- Department of Dermatology, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - A Sahuquillo-Torralba
- Department of Dermatology, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - F J Gómez-García
- Department of Dermatology, Hospital Universitario Reina Sofía, Cordoba, Spain
| | - O Baniandrés-Rodríguez
- Department of Dermatology, CEIMI Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - P de la Cueva
- Department of Dermatology, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - J L López-Estebaranz
- Department of Dermatology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - I Belinchón
- Department of Dermatology, Hospital General Universitario de Alicante-ISABIAL, Alicante, Spain
| | - M Ferran
- Department of Dermatology, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
| | - J Riera-Monroig
- Department of Dermatology, Hospital Clínic de Barcelona, UB, Barcelona, Spain
| | - L Rodriguez
- Department of Dermatology, Hospital Virgen del Rocío, Sevilla, Spain
| | - G Carretero
- Department of Dermatology, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - C García-Donoso
- Department of Dermatology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - F Ballescá
- Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Badalona, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - M Llamas-Velasco
- Department of Dermatology. Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria de La Princesa (IIS-IP), Madrid, Spain
| | - E Herrera-Ceballos
- Department of Dermatology, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - C Pujol-Marco
- Department of Dermatology, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - L M Nieto-Benito
- Department of Dermatology, CEIMI Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - D P Ruiz-Genao
- Department of Dermatology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - M Alsina
- Department of Dermatology, Hospital Clínic de Barcelona, UB, Barcelona, Spain
| | - M A Descalzo
- Research Unit. Fundación Piel Sana AEDV, Madrid, Spain
| | - I García-Doval
- Research Unit. Fundación Piel Sana AEDV, Madrid, Spain.,Department of Dermatology, Complexo Hospitalario Universitario de Vigo, Vigo, Spain
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6
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Pampín-Franco A, Gamo-Villegas R, Floristán-Muruzábal U, Pinedo-Moraleda FJ, Pérez-Fernández E, López-Estebaranz JL. Melanocytic lesions with peripheral globules: results of an observational prospective study in 154 high-risk melanoma patients under digital dermoscopy follow-up evaluated with reflectance confocal microscopy. J Eur Acad Dermatol Venereol 2021; 35:1133-1142. [PMID: 33428272 DOI: 10.1111/jdv.17105] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 12/11/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND The management of melanocytic lesions with peripheral globules (MLPGs) is usually age-dependent and can be challenging in high-risk melanoma patients. OBJECTIVES To evaluate clinical, dermoscopic and reflectance confocal microscopy (RCM) features of MLPG in patients under digital dermoscopic surveillance. To know whether dermoscopic or RCM findings correlate with histologic diagnosis and the accuracy of the dermoscopy-RCM compared with histopathology. METHODS During 24 months, we prospectively enrolled MLPG in patients under digital dermoscopy follow-up. All were evaluated by dermoscopy and RCM and excised for histologic examination. RESULTS We enrolled 154 patients, mean age 42.45 years (18.78-73.19). Three melanomas and 19 dysplastic naevi (DNs) were diagnosed. There were no significant differences in the age of the patients (P = 0.662). MLPGs with diameter of 6 mm or more and asymmetry in two axes were associated with melanoma (P = 0.01, P = 0.003). Patients with more than one MLPG were less likely to have melanoma. Blue-grey and red colours were more frequent in melanoma (P = 0.013 and P = 0.000). Different sizes and shapes of PG were associated with DN and melanoma (P = 0.000 and P = 0.001). In a new lesion, PG in <25% of the circumference was related to malignancy (P = 0.010). RCM signs of malignancy were related to melanoma: pagetoid cells (P = 0.000), non-edged papillae (P = 0.001), atypical junctional thickenings (P = 0.000) and atypical cells at the dermal-epidermal junction (P = 0.000). Dense irregular nests were associated to melanoma (P = 0.019). Dermoscopy and confocal evaluation were able to diagnose 100% of melanomas and 84.21% of DNs. The kappa coefficient between dermoscopy-RCM vs. histology was 0.76. CONCLUSIONS We recommend to excise a MLPG when it presents asymmetry in two axes, 6 or more mm, new lesion with PG in less than the 25% of the circumference, irregular size and shape PGs and irregular dense nests on RCM, regardless of the patient's age.
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Affiliation(s)
- A Pampín-Franco
- Dermatology Unit, University Hospital Fundación Alcorcón, Madrid, Spain
| | - R Gamo-Villegas
- Dermatology Unit, University Hospital Fundación Alcorcón, Madrid, Spain
| | | | | | - E Pérez-Fernández
- Research Unit, University Hospital Fundación Alcorcón, Madrid, Spain
| | - J L López-Estebaranz
- Dermatology Unit, University Hospital Fundación Alcorcón, Madrid, Spain.,Medicine and Surgery Department, Rey Juan Carlos University, Madrid, Spain
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García-Zamora E, Vela Ganuza M, Martín-Alcalde J, Miñano Medrano R, Pinedo Moraleda F, López-Estebaranz JL. Merkel Cell Carcinoma: A Description of 11 Cases. Actas Dermosifiliogr (Engl Ed) 2020; 112:63-68. [PMID: 32888930 DOI: 10.1016/j.ad.2019.04.014] [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: 02/20/2019] [Revised: 04/17/2019] [Accepted: 04/22/2019] [Indexed: 12/01/2022] Open
Abstract
Merkel cell carcinoma (MCC) is a malignant neuroendocrine tumor. Metastasis or lymph node spread is often detected at diagnosis. We performed a descriptive, retrospective study of patients diagnosed with MMC at Hospital Universitario Fundación Alcorcón in the Community of Madrid, Spain between January 1998 and December 2018. Eleven patients (7 men [63%] and 4 women [36%]; mean age, 77.6 years) were diagnosed with MCC during this 21-year period; 45% of patients had stage IIIB disease (pTNM) at diagnosis. All patients but one underwent local surgery, and lymphovascular invasion was detected in 7 cases. Eight patients received adjuvant therapy after surgery (radiation therapy in 5 cases and chemotherapy in 3). Six patients (54%) died of MCC (mean survival, 14.5 months). MCC is an uncommon malignant tumor with an annual incidence of around 0.18 to 0.41 cases per 100 000 inhabitants; this is similar to the rate of 0.29 to 0.32 cases per 100 000 inhabitants a year detected in our series. Results with avelumab, a drug recently approved for the treatment of metastatic MCC; have been promising.
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Affiliation(s)
- E García-Zamora
- Dermatología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España.
| | - M Vela Ganuza
- Dermatología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - J Martín-Alcalde
- Dermatología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - R Miñano Medrano
- Dermatología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - F Pinedo Moraleda
- Anatomía Patológica, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - J L López-Estebaranz
- Dermatología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
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8
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García-Zamora E, Naz-Villalba E, Pampín-Franco A, García-Iñigo FJ, López-Estebaranz JL. Congenital dyserythropoietic anaemia type I with nails and bone abnormalities. Clin Exp Dermatol 2020; 45:515-517. [PMID: 31900952 DOI: 10.1111/ced.14154] [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] [Accepted: 11/28/2019] [Indexed: 11/30/2022]
Affiliation(s)
- E García-Zamora
- Dermatology Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - E Naz-Villalba
- Dermatology Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - A Pampín-Franco
- Dermatology Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - F J García-Iñigo
- Clinical and Genetic Laboratory Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - J L López-Estebaranz
- Dermatology Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain
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9
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García-Zamora E, Gómez de la Fuente E, Miñano-Medrano R, López-Estebaranz JL. Use of Etanercept for Psoriasis in a Renal Transplant Recipient. Actas Dermosifiliogr (Engl Ed) 2019; 111:169-171. [PMID: 31627849 DOI: 10.1016/j.ad.2018.07.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 07/09/2018] [Accepted: 07/11/2018] [Indexed: 11/17/2022] Open
Affiliation(s)
- E García-Zamora
- Servicio de Dermatología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España.
| | - E Gómez de la Fuente
- Servicio de Dermatología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - R Miñano-Medrano
- Servicio de Dermatología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - J L López-Estebaranz
- Servicio de Dermatología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
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10
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Guerra-Tapia A, Serra-Baldrich E, Prieto Cabezas L, González-Guerra E, López-Estebaranz JL. Diagnosis and Treatment of Sensitive Skin Syndrome: An Algorithm for Clinical Practice. Actas Dermosifiliogr (Engl Ed) 2019; 110:800-808. [PMID: 31146882 DOI: 10.1016/j.ad.2018.10.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 07/23/2018] [Revised: 10/09/2018] [Accepted: 10/13/2018] [Indexed: 10/26/2022] Open
Abstract
Sensitive skin has traditionally been viewed as a cosmetic problem or as a purely psychosomatic alteration with a major subjective component. Different studies of its pathophysiologic etiology, however, have shown it to be a complex entity that several authors now consider to be a neurodermatological syndrome. Because of this complexity, skin sensitivity can be difficult to diagnose and treat, particularly considering that it may present with another disease. Simple tools applicable to clinical practice are thus necessary to identify and manage this disease as an independent entity. In this study, we perform a practical review of the most recent scientific advances in the area of sensitive skin that justify it being considered an individual entity, and provide tools for its identification and treatment. We propose diagnostic and treatment algorithms based on evidence from the literature and our experience and expertise.
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Affiliation(s)
- A Guerra-Tapia
- Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España; Sección de Dermatología, Hospital Universitario 12 de Octubre, Madrid, España.
| | - E Serra-Baldrich
- Servicio Dermatología, Hospital Sant Pau, Universidad Autónoma de Barcelona, España
| | | | - E González-Guerra
- Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España; Servicio de Dermatología, Hospital Clínico San Carlos, Madrid, España
| | - J L López-Estebaranz
- Servicio de Dermatología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España; Universidad Rey Juan Carlos, Madrid, España
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11
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Podlipnik S, Carrera C, Boada A, Richarz NA, López-Estebaranz JL, Pinedo-Moraleda F, Elosua-González M, Martín-González MM, Carrillo-Gijón R, Redondo P, Moreno E, Malvehy J, Puig S. Early outcome of a 31-gene expression profile test in 86 AJCC stage IB-II melanoma patients. A prospective multicentre cohort study. J Eur Acad Dermatol Venereol 2019; 33:857-862. [PMID: 30702163 PMCID: PMC6483866 DOI: 10.1111/jdv.15454] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Accepted: 01/04/2019] [Indexed: 12/23/2022]
Abstract
Background The clinical and pathological features of primary melanoma are not sufficiently sensitive to accurately predict which patients are at a greater risk of relapse. Recently, a 31‐gene expression profile (DecisionDx‐Melanoma) test has shown promising results. Objectives To evaluate the early prognostic performance of a genetic signature in a multicentre prospectively evaluated cohort. Methods Inclusion of patients with AJCC stages IB and II conducted between April 2015 and December 2016. All patients were followed up prospectively to assess their risk of relapse. Prognostic performance of this test was evaluated individually and later combined with the AJCC staging system. Prognostic accuracy of disease‐free survival was determined using Kaplan–Meier curves and Cox regression analysis. Results of the gene expression profile test were designated as Class 1 (low risk) and Class 2 (high risk). Results Median follow‐up time was 26 months (IQR 22–30). The gene expression profile test was performed with 86 patients; seven had developed metastasis (8.1%) and all of them were in the Class 2 group, representing 21.2% of this group. Gene expression profile was an independent prognostic factor for relapse as indicated by multivariate Cox regression analysis, adjusted for AJCC stages and age. Conclusions This prospective multicentre cohort study, performed in a Spanish Caucasian cohort, shows that this 31‐gene expression profile test could correctly identify patients at early AJCC stages who are at greater risk of relapse. We believe that gene expression profile in combination with the AJCC staging system could well improve the detection of patients who need intensive surveillance and optimize follow‐up strategies.
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Affiliation(s)
- S Podlipnik
- Department of Dermatology, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - C Carrera
- Department of Dermatology, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - A Boada
- Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - N A Richarz
- Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - J L López-Estebaranz
- Department of Dermatology, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - F Pinedo-Moraleda
- Department of Dermatology, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - M Elosua-González
- Department of Dermatology, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - M M Martín-González
- Department of Dermatology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - R Carrillo-Gijón
- Department of Dermatology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - P Redondo
- Department of Dermatology, University Clinic of Navarra, Pamplona, Spain
| | - E Moreno
- Department of Dermatology, University Clinic of Navarra, Pamplona, Spain
| | - J Malvehy
- Department of Dermatology, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - S Puig
- Department of Dermatology, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
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12
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Aterido A, Cañete JD, Tornero J, Ferrándiz C, Pinto JA, Gratacós J, Queiró R, Montilla C, Torre-Alonso JC, Pérez-Venegas JJ, Fernández Nebro A, Muñoz-Fernández S, González CM, Roig D, Zarco P, Erra A, Rodríguez J, Castañeda S, Rubio E, Salvador G, Díaz-Torné C, Blanco R, Willisch Domínguez A, Mosquera JA, Vela P, Sánchez-Fernández SA, Corominas H, Ramírez J, de la Cueva P, Fonseca E, Fernández E, Puig L, Dauden E, Sánchez-Carazo JL, López-Estebaranz JL, Moreno D, Vanaclocha F, Herrera E, Blanco F, Fernández-Gutiérrez B, González A, Pérez-García C, Alperi-López M, Olivé Marques A, Martínez-Taboada V, González-Álvaro I, Sanmartí R, Tomás Roura C, García-Montero AC, Bonàs-Guarch S, Mercader JM, Torrents D, Codó L, Gelpí JL, López-Corbeto M, Pluma A, López-Lasanta M, Tortosa R, Palau N, Absher D, Myers R, Marsal S, Julià A. Genetic variation at the glycosaminoglycan metabolism pathway contributes to the risk of psoriatic arthritis but not psoriasis. Ann Rheum Dis 2018; 78:annrheumdis-2018-214158. [PMID: 30552173 DOI: 10.1136/annrheumdis-2018-214158] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [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: 07/24/2018] [Revised: 11/16/2018] [Accepted: 11/16/2018] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Psoriatic arthritis (PsA) is a chronic inflammatory arthritis affecting up to 30% of patients with psoriasis (Ps). To date, most of the known risk loci for PsA are shared with Ps, and identifying disease-specific variation has proven very challenging. The objective of the present study was to identify genetic variation specific for PsA. METHODS We performed a genome-wide association study in a cohort of 835 patients with PsA and 1558 controls from Spain. Genetic association was tested at the single marker level and at the pathway level. Meta-analysis was performed with a case-control cohort of 2847 individuals from North America. To confirm the specificity of the genetic associations with PsA, we tested the associated variation using a purely cutaneous psoriasis cohort (PsC, n=614) and a rheumatoid arthritis cohort (RA, n=1191). Using network and drug-repurposing analyses, we further investigated the potential of the PsA-specific associations to guide the development of new drugs in PsA. RESULTS We identified a new PsA risk single-nucleotide polymorphism at B3GNT2 locus (p=1.10e-08). At the pathway level, we found 14 genetic pathways significantly associated with PsA (pFDR<0.05). From these, the glycosaminoglycan (GAG) metabolism pathway was confirmed to be disease-specific after comparing the PsA cohort with the cohorts of patients with PsC and RA. Finally, we identified candidate drug targets in the GAG metabolism pathway as well as new PsA indications for approved drugs. CONCLUSION These findings provide insights into the biological mechanisms that are specific for PsA and could contribute to develop more effective therapies.
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Affiliation(s)
- Adrià Aterido
- Rheumatology Research Group, Vall d'Hebron Research Institute, Barcelona, Spain.,Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Juan D Cañete
- Rheumatology Department, Hospital Clínic de Barcelona and IDIBAPS, Barcelona, Spain
| | - Jesús Tornero
- Rheumatology Department, Hospital Universitario Guadalajara, Guadalajara, Spain
| | - Carlos Ferrándiz
- Dermatology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - José Antonio Pinto
- Rheumatology Department, Complejo Hospitalario Juan Canalejo, A Coruña, Spain
| | - Jordi Gratacós
- Rheumatology Department, Hospital Parc Taulí, Sabadell, Spain
| | - Rubén Queiró
- Rheumatology Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Carlos Montilla
- Rheumatology Department, Hospital Virgen de la Vega, Salamanca, Spain
| | | | | | - Antonio Fernández Nebro
- Rheumatology Department, Instituto de Investigación Biomédica de Málaga, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Santiago Muñoz-Fernández
- Rheumatology Department, Hospital Universitario Infanta Sofía, Universidad Europea, Madrid, Spain
| | - Carlos M González
- Rheumatology Department, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - Daniel Roig
- Rheumatology Department, Hospital Moisès Broggi, Barcelona, Spain
| | - Pedro Zarco
- Rheumatology Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Alba Erra
- Rheumatology Department, Hospital Sant Rafael, Barcelona, Spain
| | - Jesús Rodríguez
- Rheumatology Department, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Santos Castañeda
- Rheumatology Department, Hospital Universitario La Princesa, IIS La Princesa, Madrid, Spain
| | - Esteban Rubio
- Rheumatology Department, Centro de Salud Virgen de los Reyes, Sevilla, Spain
| | - Georgina Salvador
- Rheumatology Department, Hospital Universitario Mútua de Terrassa, Terrassa, Spain
| | - Cesar Díaz-Torné
- Rheumatology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Ricardo Blanco
- Rheumatology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | | | - José Antonio Mosquera
- Rheumatology Department, Complejo Hospitalario Hospital Provincial de Pontevedra, Pontevedra, Spain
| | - Paloma Vela
- Rheumatology Department, Hospital General Universitario de Alicante, Alicante, Spain
| | | | - Héctor Corominas
- Rheumatology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Rheumatology Department, Hospital Dos de Maig, Barcelona, Spain
| | - Julio Ramírez
- Rheumatology Department, Hospital Clínic de Barcelona and IDIBAPS, Barcelona, Spain
| | - Pablo de la Cueva
- Dermatology Department, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - Eduardo Fonseca
- Dermatology Department, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | - Emilia Fernández
- Dermatology Department, Hospital Universitario de Salamanca, Salamanca, Spain
| | - Lluis Puig
- Dermatology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Esteban Dauden
- Dermatology Department, Hospital Universitario La Princesa, IIS La Princesa, Madrid, Spain
| | | | | | - David Moreno
- Dermatology Department, Hospital Virgen Macarena, Sevilla, Spain
| | | | - Enrique Herrera
- Dermatology Department, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - Francisco Blanco
- Rheumatology Department, INIBIC-Hospital Universitario A Coruña, A Coruña, Spain
| | | | - Antonio González
- Instituto de Investigación Sanitaria Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain
| | | | | | | | | | | | - Raimon Sanmartí
- Rheumatology Department, Hospital Clínic de Barcelona and IDIBAPS, Barcelona, Spain
| | | | | | - Sílvia Bonàs-Guarch
- Barcelona Supercomputing Centre (BSC), Joint BSC-CRG-IRB Research Program in Computational Biology, Barcelona, Spain
| | - Josep Maria Mercader
- Barcelona Supercomputing Centre (BSC), Joint BSC-CRG-IRB Research Program in Computational Biology, Barcelona, Spain
| | - David Torrents
- Barcelona Supercomputing Centre (BSC), Joint BSC-CRG-IRB Research Program in Computational Biology, Barcelona, Spain.,Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - Laia Codó
- Life Sciences Department, Barcelona Supercomputing Centre, Barcelona, Spain
| | - Josep Lluís Gelpí
- Life Sciences Department, Barcelona Supercomputing Centre, Barcelona, Spain
| | | | - Andrea Pluma
- Rheumatology Research Group, Vall d'Hebron Research Institute, Barcelona, Spain
| | - Maria López-Lasanta
- Rheumatology Research Group, Vall d'Hebron Research Institute, Barcelona, Spain
| | - Raül Tortosa
- Rheumatology Research Group, Vall d'Hebron Research Institute, Barcelona, Spain
| | - Nuria Palau
- Rheumatology Research Group, Vall d'Hebron Research Institute, Barcelona, Spain
| | - Devin Absher
- HudsonAlpha Institute for Biotechnology, Huntsville, Alabama, USA
| | - Richard Myers
- HudsonAlpha Institute for Biotechnology, Huntsville, Alabama, USA
| | - Sara Marsal
- Rheumatology Research Group, Vall d'Hebron Research Institute, Barcelona, Spain
| | - Antonio Julià
- Rheumatology Research Group, Vall d'Hebron Research Institute, Barcelona, Spain
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Burillo-Martínez S, Gamo R, Pinedo F, López-Estebaranz JL. Usefulness of Reflectance Confocal Microscopy For in Vivo Diagnosis of Sebomatricomas. Actas Dermosifiliogr (Engl Ed) 2018; 110:176-179. [PMID: 29970223 DOI: 10.1016/j.ad.2017.12.014] [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: 08/22/2017] [Revised: 10/29/2017] [Accepted: 12/26/2017] [Indexed: 11/16/2022] Open
Affiliation(s)
- S Burillo-Martínez
- Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, España.
| | - R Gamo
- Servicio de Dermatología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - F Pinedo
- Servicio de Anatomía Patológica, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - J L López-Estebaranz
- Servicio de Dermatología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
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14
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Elosua-González M, Gamo-Villegas R, Floristán-Muruzábal U, Pinedo-Moraleda F, López-Estebaranz JL. Reflectance Confocal Microscopy: A Promising Tool to Identify Malignancy in Melanocytic Lesions Exhibiting a Dermoscopic Island. Actas Dermosifiliogr (Engl Ed) 2017; 109:e37-e41. [PMID: 29173995 DOI: 10.1016/j.ad.2017.06.018] [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: 03/24/2017] [Revised: 05/16/2017] [Accepted: 06/25/2017] [Indexed: 10/18/2022] Open
Abstract
The dermoscopic island is described as a well-defined area in a melanocytic lesion, with a different dermoscopic pattern from the rest of the lesion. It is predictive of melanoma, particularly when the pattern of the island is atypical. We present the reflectance confocal microscopy (RCM) findings in 3 lesions with dermoscopic islands: nevus-associated melanoma, melanocytic nevus, and in situ melanoma. The nevus-associated melanoma and in situ melanoma presented cellular atypia (atypical cells in isolation or forming nests) and architectural distortion on RCM. The nevus presented a dermoscopic island with a typical globular pattern with dense nests and no atypia on RCM. Dermoscopic island is mainly associated with in situ and nevus-associated melanomas. RCM offers good cellular resolution to the depth of the reticular dermis and is useful for diagnosing of melanomas presenting a dermoscopic island.
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Affiliation(s)
- M Elosua-González
- Servicio de Dermatología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España.
| | - R Gamo-Villegas
- Servicio de Dermatología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - U Floristán-Muruzábal
- Servicio de Dermatología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - F Pinedo-Moraleda
- Servicio de Anatomía Patológica, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - J L López-Estebaranz
- Servicio de Dermatología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
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15
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López-Estebaranz JL, Herranz-Pinto P, Dréno B. Consensus-Based Acne Classification System and Treatment Algorithm for Spain. Actas Dermosifiliogr 2016; 108:120-131. [PMID: 27816123 DOI: 10.1016/j.ad.2016.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 06/15/2016] [Revised: 09/14/2016] [Accepted: 10/02/2016] [Indexed: 01/24/2023] Open
Abstract
Acne is a chronic inflammatory disease whose psychosocial effects can greatly impair quality of life. Various scales are used to classify the severity of acne, and several treatment algorithms are currently applied: no consensus on a common scale or treatment guidelines has been reached. A group of Spanish experts therefore met to identify a scale the majority could accept as the most appropriate for classifying severity and treating accordingly. The group chose the following classifications: comedonal acne, mild or moderate papulopustular acne, severe papulopustular acne, moderate nodular acne, and nodular-cystic acne (or acne tending to leave scars). Consensus was reached on first- and second-choice treatments for each type and on maintenance treatment. The experts also issued specific recommendations on antibiotic use (starting with mild or moderate papulopustular acne), always in combination with retinoids and/or benzoyl peroxide. The use of isotretinoin (starting at severe papulopustular or moderate nodular acne) was also covered.
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Affiliation(s)
| | | | - B Dréno
- Hospital Universitario de Nantes, Nantes, Francia
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16
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Prieto-Pérez R, Solano-López G, Cabaleiro T, Román M, Ochoa D, Talegón M, Baniandrés O, López-Estebaranz JL, de la Cueva P, Daudén E, Abad-Santos F. New polymorphisms associated with response to anti-TNF drugs in patients with moderate-to-severe plaque psoriasis. Pharmacogenomics J 2016; 18:70-75. [DOI: 10.1038/tpj.2016.64] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 12/15/2015] [Accepted: 05/02/2016] [Indexed: 12/29/2022]
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17
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Galiano Mejías S, Carretero G, Ferrandiz C, Vanaclocha F, Daudén E, Gómez-García FJ, Herrera-Ceballos E, Belinchón-Romero I, Sánchez-Carazo JL, López-Estebaranz JL, Alsina M, Ferrán M, Torrado R, Carrascosa JM, Rivera R, Llamas-Velasco M, Jiménez-Puya R, Mendiola MV, Ruiz-Genao D, Descalzo MA, de la Cueva Dobao P. Management of Biologic Therapy in Moderate to Severe Psoriasis in Surgical Patients: Data From the Spanish Biobadaderm Registry. Actas Dermosifiliogr 2016; 108:52-58. [PMID: 27658689 DOI: 10.1016/j.ad.2016.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 03/19/2016] [Revised: 07/02/2016] [Accepted: 08/04/2016] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND AND OBJECTIVE We now have considerable experience in the use of biologic agents to treat psoriasis, but doubts about management arise in certain clinical settings. Surgery is one of them. Although treatment guidelines advise that biologics be suspended before major surgery, data about actual clinical practices and associated complications are lacking. We aimed to analyze current practice in the clinical management of these cases. METHODS Retrospective study of cases in the Biobadaderm database. We analyzed the management of biologic therapy in patients with psoriasis who underwent surgical procedures. RESULTS Forty-eight of the 2113 patients registered in Biobadaderm underwent surgery. The largest percentage of procedures (31%) involved skin lesions. Biologic treatment was interrupted in 42% of the cases. No postsurgical complications were significantly related to treatment interruption. Likewise we detected no associations between treatment interruption and other variables, such as sex, age, or duration or severity of psoriasis. CONCLUSION Continuity of biologic treatment and the risk of postsurgical complications were not associated in this study, although conclusions are limited by the small sample size.
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Affiliation(s)
- S Galiano Mejías
- Servicio de Dermatología, Hospital Infanta Leonor, Madrid, España.
| | - G Carretero
- Servicio de Dermatología, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, España
| | - C Ferrandiz
- Servicio de Dermatología, Hospital Universitario Germans Trias i Pujol, Badalona, Universitat Autónoma de Barcelona, Barcelona, España
| | - F Vanaclocha
- Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, España
| | - E Daudén
- Servicio de Dermatología, Hospital Universitario La Princesa, Madrid, España
| | - F J Gómez-García
- Servicio de Dermatología, Hospital Universitario Reina Sofía, Córdoba, España
| | - E Herrera-Ceballos
- Servicio de Dermatología, Hospital Universitario Virgen de la Victoria, Málaga, España
| | - I Belinchón-Romero
- Servicio de Dermatología, Hospital General Universitario de Alicante, Alicante, España
| | - J L Sánchez-Carazo
- Servicio de Dermatología, Hospital General Universitario de Valencia, Valencia, España
| | - J L López-Estebaranz
- Servicio de Dermatología, Hospital Universitario Fundación Alcorcón, Madrid, España
| | - M Alsina
- Servicio de Dermatología, Hospital Universitario Clinic de Barcelona, Barcelona, España
| | - M Ferrán
- Servicio de Dermatología, Hospital del Mar, Parc de Salut Mar, Barcelona, España
| | - R Torrado
- Servicio de Dermatología, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, España
| | - J M Carrascosa
- Servicio de Dermatología, Hospital Universitario Germans Trias i Pujol, Badalona, Universitat Autónoma de Barcelona, Barcelona, España
| | - R Rivera
- Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, España
| | - M Llamas-Velasco
- Servicio de Dermatología, Hospital Universitario La Princesa, Madrid, España
| | - R Jiménez-Puya
- Servicio de Dermatología, Hospital Universitario Reina Sofía, Córdoba, España
| | - Mª V Mendiola
- Servicio de Dermatología, Hospital Universitario Virgen de la Victoria, Málaga, España
| | - D Ruiz-Genao
- Servicio de Dermatología, Hospital Universitario Fundación Alcorcón, Madrid, España
| | - M A Descalzo
- Unidad de Investigación, Fundación Academia Española de Dermatología y Venereología, Madrid, España
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18
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Gollnick HP, Bettoli V, Lambert J, Araviiskaia E, Binic I, Dessinioti C, Galadari I, Ganceviciene R, Ilter N, Kaegi M, Kemeny L, López-Estebaranz JL, Massa A, Oprica C, Sinclair W, Szepietowski JC, Dréno B. A consensus-based practical and daily guide for the treatment of acne patients. J Eur Acad Dermatol Venereol 2016; 30:1480-90. [PMID: 27177989 DOI: 10.1111/jdv.13675] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 02/11/2016] [Indexed: 01/01/2023]
Abstract
BACKGROUND Many current guidelines provide detailed evidence-based recommendations for acne treatment. OBJECTIVE To create consensus-based, simple, easy-to-use algorithms for clinical acne treatment in daily office-based practice and to provide checklists to assist in determining why a patient may not have responded to treatment and what action to take. METHODS Existing treatment guidelines and consensus papers were reviewed. The information in them was extracted and simplified according to daily clinical practice needs using a consensus-based approach and based on the authors' clinical expertise. RESULTS As outcomes, separate simple algorithms are presented for the treatment of predominant comedonal, predominant papulopustular and nodular/conglobate acne. Patients with predominant comedonal acne should initially be treated with a topical retinoid, azelaic acid or salicylic acid. Fixed combination topicals are recommended for patients with predominant papulopustular acne with treatment tailored according to the severity of disease. Treatment recommendations for nodular/conglobate acne include oral isotretinoin or fixed combinations plus oral antibiotics in men, and these options may be supplemented with oral anti-androgenic hormonal therapy in women. Further decisions regarding treatment responses should be evaluated 8 weeks after treatment initiation in patients with predominant comedonal or papulopustular acne and 12 weeks after in those with nodular/conglobate acne. Maintenance therapy with a topical retinoid or azelaic acid should be commenced once a patient is clear or almost clear of their acne to prevent the disease from recurring. The principal explanations for lack of treatment response fall into 5 main categories: disease progression, non-drug-related reasons, drug-related reasons, poor adherence, and adverse events. CONCLUSION This practical guide provides dermatologists with treatment algorithms adapted to different clinical features of acne which are simple and easy to use in daily clinical practice. The checklists to establish the causes for a lack of treatment response and subsequent action to take will facilitate successful acne management.
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Affiliation(s)
- H P Gollnick
- Department of Dermatology & Venereology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - V Bettoli
- Department of Clinical and Experimental Medicine, O.U. of Dermatology, Azienda Ospedaliero-Universitaria, University of Ferrara, Ferrara, Italy
| | - J Lambert
- Department of Dermatology, University Hospital of Antwerp, University of Antwerp, Edegem, Belgium
| | - E Araviiskaia
- Department of Dermatology and Venereal Diseases, First I. P. Pavlov State Medical University of St. Petersburg, St. Petersburg, Russia
| | - I Binic
- Department of Dermatovenerology, Faculty of Medicine, University of Nis, Nis, Serbia
| | - C Dessinioti
- Department of Dermatology, A. Syggros Hospital, University of Athens, Athens, Greece
| | - I Galadari
- School of Medicine, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - R Ganceviciene
- Clinic of Infectious, Chest Diseases, Dermatovenereology and Allergology, Vilnius University, Vilnius, Lithuania
| | - N Ilter
- Department of Dermatology, Gazi University Medical School, Ankara, Turkey
| | - M Kaegi
- Hautzentrum Zürich, Zürich, Switzerland
| | - L Kemeny
- Department of Dermatology and Allergology University of Szeged, Szeged, Hungary
| | | | - A Massa
- Clínica Dermatológica Dr António Massa, Porto, Portugal
| | - C Oprica
- Department of Laboratory Medicine, Karolinska Institutet Karolinska University Hospital Huddinge, Stockholm, Sweden.,Diagnostiskt Centrum Hud, Stockholm, Sweden
| | - W Sinclair
- Department of Dermatology, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - J C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - B Dréno
- Department of Dermato-Cancerology, University of Nantes, Nantes, France
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Ruiz-Salas V, Garcés JR, Miñano Medrano R, Alonso-Alonso T, Rodríguez-Prieto MÁ, López-Estebaranz JL, Sanmartín-Jiménez O, Guillén Barona C, Delgado Jiménez Y, Toll-Abelló A, Vargas Diez E, Ciudad Blanco C, Alfaro Rubio A, Allende Markixana I, de Eusebio Murillo E, Manubens-Mercadé E, Vázquez-Veiga H, Barchino Ortiz L, García-Doval I, Redondo Bellón P. Description of Patients Undergoing Mohs Surgery in Spain: Initial Report on Data From the Spanish Registry of Mohs Surgery (REGESMOHS). Actas Dermosifiliogr 2015; 106:562-8. [PMID: 26028578 DOI: 10.1016/j.ad.2015.04.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [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: 12/02/2014] [Revised: 04/02/2015] [Accepted: 04/07/2015] [Indexed: 10/23/2022] Open
Abstract
INTRODUCTION The Spanish registry of Mohs micrographic surgery started collecting data in July 2013. The aim of the registry is to report on the use of this technique in Spain and the outcomes achieved. In the present article, we describe the characteristics of patients and the tumors treated. MATERIAL AND METHODS This is a prospective cohort study of patients treated with Mohs micrographic surgery. The participating centers are hospitals where at least one intervention of this type is performed each week. All patients considered for Mohs micrographic surgery in participating centers are included in the registry except those who have been declared legally incompetent. RESULTS Between July 2013 and October 2014, data from 655 patients were included in the registry. The most common tumor involved was basal cell carcinoma, and the most common histological subtype was infiltrative basal cell carcinoma. Most of the tumors treated were located on the face or scalp, and the most common site was the nose. Almost 40% of the tumors treated were recurrent or persistent, and preoperative tumor size was similar to that reported in other European studies and in Australia. In total, 45.5% of patients had received previous surgical treatment. CONCLUSION The findings are similar to those reported in other studies, and the data collected are useful for assessing whether the results of studies carried out elsewhere are applicable in Spain.
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Affiliation(s)
- V Ruiz-Salas
- Hospital de la Santa Creu i Sant Pau, Barcelona, España.
| | - J R Garcés
- Hospital de la Santa Creu i Sant Pau, Barcelona, España; Hospital Quirón Teknon, Barcelona, España
| | - R Miñano Medrano
- Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | | | | | | | | | | | - Y Delgado Jiménez
- Clínica Quirón, Madrid, España; Hospital de La Princesa, Madrid, España
| | | | | | - C Ciudad Blanco
- Hospital La Zarzuela, Madrid, España; Hospital Gregorio Marañón, Madrid, España
| | | | | | | | | | - H Vázquez-Veiga
- Complexo Hospitalario Universitario de Santiago, Santiago de Compostela, A Coruña, España
| | - L Barchino Ortiz
- Hospital La Zarzuela, Madrid, España; Hospital Gregorio Marañón, Madrid, España
| | - I García-Doval
- Unidad de Investigación, Fundación Academia Española de Dermatología, Madrid, España
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Carretero G, Ferrandiz C, Dauden E, Vanaclocha Sebastián F, Gómez-García FJ, Herrera-Ceballos E, De la Cueva-Dobao P, Belinchón I, Sánchez-Carazo JL, Alsina-Gibert M, López-Estebaranz JL, Ferrán M, Torrado R, Carrascosa JM, Carazo C, Rivera R, Jiménez-Puya R, García-Doval I. Risk of adverse events in psoriasis patients receiving classic systemic drugs and biologics in a 5-year observational study of clinical practice: 2008-2013 results of the Biobadaderm registry. J Eur Acad Dermatol Venereol 2014; 29:156-63. [PMID: 24684267 DOI: 10.1111/jdv.12492] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Accepted: 03/03/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Biobadaderm is the Spanish registry of psoriasis patients receiving systemic treatment in clinical practice. OBJECTIVE To compare the safety of biologics and classic systemic treatment. METHODS Prospective cohort of patients receiving biologics and classic systemic therapies between 2008 and 2013 in 12 hospitals are included. We registered demographic data, diagnoses, comorbidities, treatments and adverse events (AE). We obtained raw relative risks (RR) for specific AE. Multivariate analysis consisted of Cox models adjusting for age, gender, chronic hepatic disease and previous cancer. RESULTS A total of 1030 patients received biologics (2061 AE in 3681 person-years), 926 patients classic systemic drugs (1015 AE in 1517 person-years). Ninety-three per cent of AE in both groups were non-serious, 6% serious and 0.003% fatal. The age- and gender-adjusted hazard ratio of AE was lower in the biologics group [hazard ratio 0.6 (95% CI: 0.5-0.7)].We found no differences in rates of serious and mortal AE. Some system organ class AE rates differed between both groups. As limitations: Prescription bias might affect the incidence of AE in both groups. Association of drug and AE was based on timing: associations might not be causal. CONCLUSION Patients receiving biologics had lower risk of AE. We did not find differences in the risk of serious or fatal AE.
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Affiliation(s)
- G Carretero
- Hospital Universitario de Gran Canaria Dr Negrín, Las Palmas de Gran Canaria, Spain
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21
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Pampín A, Gómez-de la Fuente E, Feltes RA, Pinedo F, Rodríguez-Peralto JL, López-Estebaranz JL. Cutaneous diffuse large B-cell lymphoma, leg type, secondary to testicular diffuse large B-cell lymphoma. Clin Exp Dermatol 2013; 39:230-2. [PMID: 24354909 DOI: 10.1111/ced.12255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2013] [Indexed: 11/26/2022]
Affiliation(s)
- A Pampín
- Department of Dermatology, Hospital Universitario Fundacion Alcorcon, Alcorcón, Spain.
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22
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Julià A, Tortosa R, Hernanz JM, Cañete JD, Fonseca E, Ferrándiz C, Unamuno P, Puig L, Fernández-Sueiro JL, Sanmartí R, Rodríguez J, Gratacós J, Dauden E, Sánchez-Carazo JL, López-Estebaranz JL, Moreno-Ramírez D, Queiró R, Montilla C, Torre-Alonso JC, Pérez-Venegas JJ, Vanaclocha F, Herrera E, Muñoz-Fernández S, González C, Roig D, Erra A, Acosta I, Fernández-Nebro A, Zarco P, Alonso A, López-Lasanta M, García-Montero A, Gelpí JL, Absher D, Marsal S. Risk variants for psoriasis vulgaris in a large case-control collection and association with clinical subphenotypes. Hum Mol Genet 2012; 21:4549-57. [PMID: 22814393 DOI: 10.1093/hmg/dds295] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Recent genome-wide association studies (GWASs) have identified >20 new loci associated with the susceptibility to psoriasis vulgaris (PsV) risk. We investigated the association of PsV and its main clinical subphenotypes with 32 loci having previous genome-wide evidence of association with PsV (P < 5e-8) or strong GWAS evidence (P < 5e-5 in discovery and P < 0.05 in replication sample) in a large cohort of PsV patients (n = 2005) and controls (n = 1497). We provide the first independent replication for COG6 (P = 0.00079) and SERPINB8 (P = 0.048) loci with PsV. In those patients having developed psoriatic arthritis (n = 955), we found, for the first time, a strong association with IFIH1 (P = 0.013). Analyses of clinically relevant PsV subtypes yielded a significant association of severity of cutaneous disease with variation at LCE3D locus (P = 0.0005) in PsV and nail involvement with IL1RN in purely cutaneous psoriasis (PsC, P = 0.007). In an exploratory analysis of epistasis, we replicated the previously described HLA-C-ERAP1 interaction with PsC. Our findings show that common genetic variants associated with a complex phenotype like PsV influence different subphenotypes of high clinical relevance.
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Affiliation(s)
- Antonio Julià
- Rheumatology Research Group, Vall d’Hebron Research Institute, Barcelona 08035, Spain
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23
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Nast A, Dréno B, Bettoli V, Degitz K, Erdmann R, Finlay AY, Ganceviciene R, Haedersdal M, Layton A, López-Estebaranz JL, Ochsendorf F, Oprica C, Rosumeck S, Rzany B, Sammain A, Simonart T, Veien NK, Zivković MV, Zouboulis CC, Gollnick H. European evidence-based (S3) guidelines for the treatment of acne. J Eur Acad Dermatol Venereol 2012; 26 Suppl 1:1-29. [PMID: 22356611 DOI: 10.1111/j.1468-3083.2011.04374.x] [Citation(s) in RCA: 224] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- A Nast
- Division of Evidence-Based Medicine, Klinik für Dermatologie, Charité-Universitätsmedizin Berlin, Berlin, Germany.
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24
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Gutiérrez-Pascual M, Vicente-Martín FJ, López-Estebaranz JL. Lichen sclerosus and squamous cell carcinoma. Actas Dermosifiliogr 2012; 103:21-8. [PMID: 22445563 DOI: 10.1016/j.adengl.2011.05.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2011] [Accepted: 05/26/2011] [Indexed: 02/08/2023] Open
Abstract
Lichen sclerosus is a chronic inflammatory disease that can progress to malignancy. The literature indicates an association with anogenital squamous cell carcinoma and verrucous carcinoma. Two pathogenic pathways, differentiated vulvar and penile intraepithelial neoplasias, which have recently been described in relation to squamous cell carcinoma, are both highly associated with genital lichen sclerosus independently of human papilloma virus (HPV) infection. Furthermore, tumor-promoting molecular changes unrelated to HPV infection have been demonstrated and may explain the malignant potential of lichen sclerosus. The possible relationship between HPV and genital lichen sclerosus currently remains open to discussion, and the prognostic importance of the overlapping of these 2 diseases is still unclear. This review considers the relationship between lichen sclerosus and squamous cell and verrucous carcinomas, the possible oncogenic mechanisms involved, and their possible association with HPV infection.
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Affiliation(s)
- M Gutiérrez-Pascual
- Servicio de Dermatología, Hospital Universitario Fundación Alcorcón, Madrid, Spain.
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25
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Gutiérrez-Pascual M, Vicente-Martín FJ, López-Estebaranz JL. [Lichen sclerosus and squamous cell carcinoma]. Actas Dermosifiliogr 2011; 103:21-8. [PMID: 22078768 DOI: 10.1016/j.ad.2011.05.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2011] [Revised: 04/27/2011] [Accepted: 05/26/2011] [Indexed: 12/14/2022] Open
Abstract
Lichen sclerosus is a chronic inflammatory disease that can progress to malignancy. The literature indicates an association with anogenital squamous cell carcinoma and verrucous carcinoma. Two pathogenic pathways, differentiated vulvar and penile intraepithelial neoplasias, which have recently been described in relation to squamous cell carcinoma, are both highly associated with genital lichen sclerosus independently of human papilloma virus (HPV) infection. Furthermore, tumor-promoting molecular changes unrelated to HPV infection have been demonstrated and may explain the malignant potential of lichen sclerosus. The possible relationship between HPV and genital lichen sclerosus currently remains open to discussion, and the prognostic importance of the overlapping of these 2 diseases is still unclear. This review considers the relationship between lichen sclerosus and squamous cell and verrucous carcinomas, the possible oncogenic mechanisms involved, and their possible association with HPV infection.
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Affiliation(s)
- M Gutiérrez-Pascual
- Servicio de Dermatología, Hospital Universitario Fundación Alcorcón, Madrid, España.
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26
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Gómez-de la Fuente E, Villalón LB, Calzado-Villarreal L, Pinedo-Moraleda F, López-Estebaranz JL. [Splenic marginal zone B-cell lymphoma with epidermotropic skin involvement]. Actas Dermosifiliogr 2011; 103:427-31. [PMID: 21885023 DOI: 10.1016/j.ad.2011.06.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2011] [Revised: 06/04/2011] [Accepted: 06/26/2011] [Indexed: 10/17/2022] Open
Abstract
Marginal zone B-cell lymphoma (MZL) is subclassified into extranodal MZL of mucosa-associated lymphoid tissue (including cutaneous lymphomas), splenic MZL, and nodal MZL. We report the case of a 68-year-old man with erythematous-violaceous plaques and nodules. Skin biopsy showed an epidermotropic lymphocytic infiltration and cytology and immunohistochemistry were consistent with MZL. The workup revealed disease in the peripheral blood and bone marrow and massive splenomegaly. Splenectomy confirmed the diagnosis of splenic MZL and led to resolution of the skin lesions. Cutaneous recurrence was treated successfully with chemotherapy and rituximab but caused fatal hepatitis due to hepatitis B virus reactivation. Skin involvement by splenic MZL is uncommon; this form of the disease can present epidermotropism, a very rare finding in primary cutaneous MZL. Treatment consists of splenectomy, which may be associated with chemotherapy and/or rituximab; this treatment may lead to reactivation of latent hepatitis B infection and screening for hepatitis should therefore be performed prior to starting therapy.
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Affiliation(s)
- E Gómez-de la Fuente
- Servicios de Dermatología, Hospital Universitario Fundación Alcorcón, Madrid, Spain.
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27
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Morell L, Carrascosa JM, Ferrándiz C, García-Bustinduy M, Fonseca E, Carretero G, Daudén E, Marrón SE, López-Estebaranz JL, Ferrán M, Sánchez-Regaña M, Muñoz-Santos C, Belinchón I, Puig L. [Clinical characteristics and disease course in patients treated with efalizumab following suspension of marketing authorization by the European medicines agency: a multicenter observational study]. Actas Dermosifiliogr 2011; 102:354-64. [PMID: 21530928 DOI: 10.1016/j.ad.2010.12.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2010] [Revised: 12/16/2010] [Accepted: 12/20/2010] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The withdrawal of marketing authorization for efalizumab by the European Medicines Agency in February, 2009 provided a unique opportunity to assess the course of disease in patients who were not subject to the selection criteria and biases that were common in the pivotal trials. The aim of this study was to evaluate the course of psoriasis following forced suspension of efalizumab in a group of patients treated in normal clinical practice. As secondary objectives, we sought to assess the relationships between clinical characteristics, treatment response, and disease course during efalizumab treatment and 12 and 24 weeks after suspension. PATIENTS AND METHODS Information on the epidemiological profile and disease course during treatment and following suspension of the drug was collected from a group of patients treated with efalizumab. Statistical analyses were performed to identify predictive factors. RESULTS One hundred forty-seven patients from 12 Spanish hospitals were included in the study. During treatment, 4% of patients were diagnosed with generalized inflammatory flares. Most patients could be classified as having a good (55%) or moderate (18%) response to treatment. Rebound following withdrawal of efalizumab was observed in 30% of patients. The likelihood of rebound was independent of clinical characteristics, treatment response, or therapeutic approach used by the dermatologist following suspension. CONCLUSIONS There was a high frequency of rebound following suspension of efalizumab, exceeding the rate reported in pivotal trials. This is particularly noteworthy given the large proportion of patients with a good response to treatment and therefore believed to have a better prognosis. Other significant findings were the higher frequency of positive treatment response than observed in previous studies (possibly influenced by the mean treatment duration) and the high frequency of generalized inflammatory flares.
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Affiliation(s)
- L Morell
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España.
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28
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Gutiérrez-Pascual M, Vicente-Martín FJ, Salamanca Santamaría FJ, López-Estebaranz JL. [Facial papules and intestinal lipomatosis]. Actas Dermosifiliogr 2011; 101:547-8. [PMID: 20738974 DOI: 10.1016/s1578-2190(10)70840-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- M Gutiérrez-Pascual
- Departamento de Dermatología, Hospital Universitario Fundación de Alcorcón, Madrid, España.
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29
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Gómez-De La Fuente E, Vicente-Martín FJ, Nuño González A, López-Estebaranz JL. [Psoriasis following contact with rubber gloves in a patient sensitized to rubber additives]. Actas Dermosifiliogr 2010; 101:807-808. [PMID: 21034715] [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: 05/30/2023] Open
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30
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López-Estebaranz JL, Zarco-Montejo P, Escalas-Taberner J, García-Rodríguez M, García-Llorente JF, García-Calvo C. [Clinical management of psoriatic arthritis in Spain: the CALIPSO study]. Actas Dermosifiliogr 2010; 101:629-636. [PMID: 20858389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
OBJECTIVE To describe the clinical management of psoriatic arthritis for patients being treated by dermatologists and rheumatologists in Spain. METHODS Multicenter, retrospective, naturalistic observational study in which demographic and clinical variables were recorded for patients diagnosed with psoriatic arthritis. Data referred to the previous 12 months and were collected during a single visit with the physician. RESULTS A total of 266 patients were enrolled; 78.1% were being treated by rheumatologists and 21.9% by dermatologists. The data covered 1138 visits. The main reason for consulting a physician was to monitor psoriatic arthritis (82.7% of the visits). The most widely used examination was to determine the tender- and swollen-joint count (73.1%). The tests most frequently ordered were acute-phase reactants: erythrocyte sedimentation rate (79.8%) and C reactive protein level (74.5%). Affected body surface area and the Psoriasis Area and Severity Index were the main assessments used by dermatologists. Rheumatologists tended to examine the joints and record biochemical markers. A disease-modifying antirheumatic drug was prescribed for 71.1% of the patients; 51.8% were prescribed a biologic agent (61.5% in combination with another treatment). Treatment approach differed by specialty and was modified if response was nil or partial (the rationale for 45.1% of all changes). CONCLUSION Differences in the management of psoriatic arthritis in dermatology and rheumatology were evident in both diagnostic and treatment approaches. These 2 specialties should cooperate to establish common practice guidelines for use in Spain.
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Affiliation(s)
- J L López-Estebaranz
- Servicio de Reumatología, Hospital Universitario Fundación Alcorcón, Madrid, España.
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López-Estebaranz JL, Cuerda E. [Medical-cosmetic devices for home use: Present and future considerations]. Actas Dermosifiliogr 2010; 101:223-229. [PMID: 20398597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
Laser systems and other energy sources for home use are being developed and will have an exponential growth in the coming years. It is in the field of laser hair removal and hair regrowth where these lasers and intense pulsed light systems for home use are gaining most ground. There are few studies supporting their efficacy and safety and there are still no long term studies. Currently these systems do not require medical prescription and can be purchased in the same way as any over-the-counter product. Although they are not a substitute for professional medical systems, they will play an important role in the treatment of medical and cosmetic conditions, and dermatologists should know about them. Technological progress and commercial and market pressures will encourage the development of more sophisticated devices and broaden the cosmetic and medical indications. Appropriate use and rigorous long-term studies would be desirable to better define their safety and efficacy.
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Affiliation(s)
- J L López-Estebaranz
- Servicio de Dermatología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España.
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Sánchez-Gilo A, Gómez-De La Fuente E, Calzado L, López-Estebaranz JL. [Textile contact dermatitis in a patient sensitized to Reactive Orange 107 dye]. Actas Dermosifiliogr 2010; 101:278-279. [PMID: 20398610] [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: 05/29/2023] Open
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Gamo R, Vicente J, Calzado L, Sanz H, López-Estebaranz JL. [Deep dissecting hematoma or stage IV dermatoporosis]. Actas Dermosifiliogr 2010; 101:89-90. [PMID: 20109399 DOI: 10.1016/j.ad.2009.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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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34
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Gómez-de la Fuente E, Rosado A, Gutiérrez-Pascual M, Vicente FJ, López-Estebaranz JL. [Allergic contact dermatitis and systemic contact dermatitis in a patient with polysensitization to topical corticosteroids]. Actas Dermosifiliogr 2009; 100:817-820. [PMID: 19889306] [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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35
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Torras H, Aliaga A, López-Estebaranz JL, Hernández I, Gardeazabal J, Quintanilla E, Mascaró JM. A combination therapy of calcipotriol cream and PUVA reduces the UVA dose and improves the response of psoriasis vulgaris. J DERMATOL TREAT 2009; 15:98-103. [PMID: 15204160 DOI: 10.1080/09546630410023322] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [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: 10/26/2022]
Abstract
BACKGROUND The addition of calcipotriol ointment to PUVA therapy for psoriasis vulgaris results in a lower total UVA dose and a faster onset of response. The addition of calcipotriol cream to PUVA, however, has not been studied. OBJECTIVE To investigate whether combining calcipotriol cream with PUVA therapy has a UVA sparing effect. METHODS We performed a randomized, multicentre, vehicle-controlled, double-blind, 12-week comparative study including 120 patients with psoriasis covering 20-50% body surface area. The study consisted of a washout phase followed by a 10-week treatment phase. PUVA therapy three times weekly was added within 1 week after randomization. Efficacy was assessed by the Psoriasis Area and Severity Index (PASI). RESULTS At baseline the mean PASI scores were 17.5 and 19.2 in the calcipotriol and vehicle (placebo) groups, respectively. At the end of treatment, the mean PASI scores were 2.65 and 7.03 (p<0.01), respectively. A reduction in PASI score >90% was observed in 69% of the patients in the calcipotriol-treated group and in 36.4% of the patients in the vehicle group (p<0.01). CONCLUSION Calcipotriol cream plus PUVA clearly reduces the cumulative dose of UVA and improves the response of psoriasis vulgaris to PUVA.
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Affiliation(s)
- H Torras
- Hospital Clínic i Provincial, Barcelona, Spain
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36
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López-Estebaranz JL, Castilla-Castellano V. [Electronic medical history: experience in a dermatology department]. Actas Dermosifiliogr 2009; 100:374-385. [PMID: 19558917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
Computerization, with a change from paper to electronic format, represents an alternative to traditional information management. This model offers advantages in legibility, uniformity, accessibility, and use of the data. However, it is not easy to apply this process to clinical practice as it requires a suitable network, continuous application development, an implementation strategy, and the cooperation of all staff involved. We have reviewed our experience in the development and introduction of electronic health records and their adaptation to a pioneer dermatology department in Spain. Since our hospital was opened 1998, the model used is that of a single, centralized electronic health record, with supplementary departmental attributes. The electronic health record is conceived as an interactive database designed around the patient, with a procedure-based structure, and that obviates the need for hardcopies (paper or films) in practically all situations; it must comply with legal requirements. The system is installed on central servers maintained by the information technology department. The potential is unlimited; particularly important possibilities include clinical guideline-directed care, remote connection for general practitioners, and online activity, stock, and quality management. With the aim of realizing this potential, a technological change was started in 2003, moving towards what was to become the chosen system in the Community of Madrid to cope with the workload arising from new hospitals.
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Affiliation(s)
- J L López-Estebaranz
- Servicio de Dermatología, Fundación Hospital Alcorcón, Alcorcón, Madrid, España.
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37
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Gutiérrez-Pascual M, Sols-Candela M, Pinedo F, López-Estebaranz JL. [Toxic dermatitis due to capecitabine: presentation of 2 cases and literature review]. Actas Dermosifiliogr 2009; 100:336-338. [PMID: 19463243] [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: 05/27/2023] Open
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Puig L, Bordas X, Carrascosa JM, Daudén E, Ferrándiz C, Hernanz JM, López-Estebaranz JL, Moreno JC, Sánchez-Carazo JL, Vanaclocha F, Vázquez-Veiga H. [Consensus document on the evaluation and treatment of moderate-to-severe psoriasis. Spanish psoriasis group of the Spanish Academy of Dermatology and Venereology]. Actas Dermosifiliogr 2009; 100:277-286. [PMID: 19463230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
The treatment of psoriasis has been revolutionized by the introduction of biologic agents; these agents achieve skin clearance and long-term improvement without the risk of toxicity that has limited use of the classic systemic treatments. The role of systemic treatment in the management of psoriasis is being reviewed on the basis of a large volume of scientific evidence on the efficacy and safety of biologic agents, and new therapeutic goals and strategies are being devised for patients with moderate-to-severe psoriasis. This has led to the need to establish severity criteria that will provide the rationale for the indication of the different systemic agents currently available for the treatment of moderate-to-severe psoriasis, as well as therapeutic goals, efficacy measures, therapeutic strategies, screening protocols, and choice of treatment based on the risk-benefit ratio of the different agents. These criteria must be established through consensus by experienced dermatologists and based on available scientific evidence. The present document reflects the consensus of the Spanish Psoriasis Group on these different issues in the management of moderate-to-severe psoriasis.
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Affiliation(s)
- L Puig
- Servicio de Dermatología, Hospital de la Santa Creu i Sant Pau. Barcelona, España.
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Gamo R, Calzado L, Pinedo F, López-Estebaranz JL. [Cutaneous follicular center B-cell lymphoma treated with intralesional rituximab]. Actas Dermosifiliogr 2008; 99:291-296. [PMID: 18394405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
Cutaneous follicular center B-cell lymphomas are indolent tumors characterized by the presence of neoplastic follicular center cells. They contain a mixture of centrocytes with a variable number of centroblasts. The tumor is usually treated by surgery or radiotherapy, although other treatments may be used such as interferon-alpha, chemotherapy, and biological agents (rituximab). Rituximab is a chimeric monoclonal anti-CD20 antibody that can be administered intravenously or intralesionally. We report the case of a 41-year-old man who consulted for violaceous nodular lesions in the left scapular region and who was diagnosed with cutaneous follicular center B-cell lymphoma after biopsy, laboratory tests, thoracic-abdominal-pelvic computed tomography, abdominal ultrasound, and bone marrow biopsy. It was decided to treat him with 30 mg of intralesional rituximab administered for 1 week (3 times) every month for 4 months. Complete response was obtained. We also review the published cases of cutaneous B-cell lymphoma treated with intralesional rituximab.
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Affiliation(s)
- R Gamo
- Servicio de Dermatología, Hospital Fundación Alcorcón, Madrid, España.
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Calzado L, Gamo R, Pinedo F, Vicente FJ, Naz E, Gómez-de la Fuente E, Alvarez-Fernández JG, Tevar E, Arranz-de la Flor E, López-Estebaranz JL. Granulomatous dermatitis due to blepharopigmentation. J Eur Acad Dermatol Venereol 2008; 22:235-6. [PMID: 18211419 DOI: 10.1111/j.1468-3083.2007.02291.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Gómez-de la Fuente E, Alvarez-Fernández JG, Pinedo F, Naz E, Gamo R, Vicente-Martín FJ, López-Estebaranz JL. [Cutaneous adverse reaction to Bio-Alcamid implant]. Actas Dermosifiliogr 2007; 98:271-5. [PMID: 17506960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023] Open
Abstract
In the last years new and numerous materials for the correction of defects and wrinkles have been developed. One of these materials is Bio-Alcamid, a non reabsorbable gel polymer constituted by meshes of poly-alkyl-imide, without known adverse effects. We report a 34-year-old woman that had Bio-Alcamid implants for acne scars and several months after presented nodular lesions together with a painful inflammatory nodule. The nodule was drained and culture of the purulent material yielded Streptococcus viridans. A cytology and a cellular block of that material showed a granulomatous inflammatory reaction together with a foreign body. The different types of reactions to implants and their pathogenic mechanism are discussed. It is important to know these possible reactions to filler materials given their increasing use and the potential medico-legal consequences.
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Borrego L, López-Estebaranz JL, Vicente J, Sols M, Pinedo F. Focal recurrent episodic hyperhidrosis on the forearm. Arch Dermatol 2001; 137:1241-6. [PMID: 11559227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Affiliation(s)
- L Borrego
- Fundación Hospital Alcorcón, Madrid, Spain
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Garau M, Sánchez-Alor G, López-Estebaranz JL, Borrego L, Galván C, Pinedo F, del Palacio A. [Exfoliative erythromatous eruption in an 8-year-old girl]. Enferm Infecc Microbiol Clin 2000; 18:357-8. [PMID: 11109727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Affiliation(s)
- M Garau
- Servicio de Microbiología, Hospital Universitario 12 de Octubre, Madrid
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López-Estebaranz JL, Rodriguez-Peralto JL, Ortiz Romero PL, Vanaclocha F, Iglesias Díez L. Cutaneous plasmacytosis: report of a case in a white man. J Am Acad Dermatol 1994; 31:897-900. [PMID: 7962744 DOI: 10.1016/s0190-9622(94)70255-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.8] [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: 01/28/2023]
Abstract
We describe a 40-year-old white man with a peculiar skin eruption in association with polyclonal hypergammaglobulinemia. No underlying disease was detected. A skin biopsy specimen showed a proliferation of mature plasma cells intermingled with some lymphocytes and histiocytes, an appearance consistent with cutaneous plasmacytosis. This disease had been previously described only in Japanese patients. In our patient the disease progressed slowly. Lymph node infiltration by mature plasma cells was later noted.
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Abstract
Febrile ulceronecrotic Mucha-Habermann disease in an 18-year-old man is reported. This disease is a severe form of pityriasis lichenoides et varioliformis acuta (PLEVA) and is characterized by the sudden onset of diffuse coalescent ulcerations associated with high fever and systemic symptoms. In the present case the disease was preceded by typical PLEVA. Histologically, a leukocytoclastic vasculitis was seen in addition to the usual features of PLEVA. Findings of laboratory studies revealed an elevated erythrocyte sedimentation rate, a high white blood cell count, and a mild increase in liver enzymes. No systemic involvement was detected. Findings of T cell receptor gene analysis in skin and peripheral blood showed no abnormality. The patient was treated with PUVA and methotrexate with a good response. We review the eight previously reported cases of febrile ulceronecrotic Mucha-Habermann disease.
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