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Martinez-Lopez A, Salvador-Rodriguez L, Montero-Vilchez T, Molina-Leyva A, Tercedor-Sanchez J, Arias-Santiago S. Vascular malformations syndromes: an update. Curr Opin Pediatr 2019; 31:747-753. [PMID: 31693582 DOI: 10.1097/mop.0000000000000812] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE OF REVIEW To provide an update of vascular malformation syndromes by reviewing the most recent articles on the topic and following the new International Society for the Study of Vascular Anomalies (ISSVA) 2018 classification. RECENT FINDINGS This review discusses the main features and diagnostic approaches of the vascular malformation syndromes, the new genetic findings and the new therapeutic strategies developed in recent months. SUMMARY Some vascular malformations can be associated with other anomalies, such as tissue overgrowth. PIK3CA-related overgrowth spectrum (PROS) is a group of rare genetic disorders with asymmetric overgrowth caused by somatic mosaic mutations in PI3K-AKT-mTOR pathway that encompass a heterogeneous group of rare disorder that are associated with the appearance of overgrowth. CLOVES syndrome and Klippel-Trénaunay syndrome are PROS disease. Proteus syndrome is an overgrowth syndrome caused by a somatic activating mutation in AKT1. CLOVES, Klippel-Trénaunay and Proteus syndromes are associated with high risk of thrombosis and pulmonary embolism. Hereditary hemorrhagic telangiectasia is an autosomic dominant disorder characterized by the presence of arteriovenous malformations. New therapeutic strategies with bevacizumab and thalidomide have been employed with promising results.
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Porriño-Bustamante ML, Fernández-Pugnaire MA, Arias-Santiago S. A Cross-sectional Study of Rosacea and Risk Factors in Women with Frontal Fibrosing Alopecia. Acta Derm Venereol 2019; 99:1099-1104. [PMID: 31408181 DOI: 10.2340/00015555-3286] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Frontal fibrosing alopecia has been related to some autoimmune diseases, but the association with rosacea is not clear. The objective of this study was to analyse the prevalence of rosacea in a group of patients with frontal fibrosing alopecia. A cross-sectional study, including 99 women with frontal fibrosing alopecia and 40 controls, was performed, in which clinical, dermoscopic and hormonal data were analysed. Women with frontal fibrosing alopecia presented a higher prevalence of rosacea than the controls did (61.6% vs. 30%, p = 0.001), especially those with severe grades of alopecia (77.8% in grade V vs. 33.3% in grade I, p = 0.02). Binary logistic multivariate analysis showed that perifollicular erythema (odds ratio (OR) 8.5; 95% confidence interval (95% CI) 1.73-42.30), higher body mass index (OR 1.16; 95% CI 1.01-1.34) and lower progesterone levels (OR 0.15; 95% CI 0.028-0.89) were associated with a higher risk of rosacea in patients with frontal fibrosing alopecia. In conclusion, patients with frontal fibrosing alopecia presented a higher prevalence of rosacea than did controls. Perifollicular erythema, higher body mass index and lower progesterone levels were associated with a higher risk of rosacea in the group with frontal fibrosing alopecia.
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Egea-Guerrero JJ, Carmona G, Correa E, Mata R, Arias-Santiago S, Alaminos M, Gacto P, Cuende N. Transplant of Tissue-Engineered Artificial Autologous Human Skin in Andalusia: An Example of Coordination and Institutional Collaboration. Transplant Proc 2019; 51:3047-3050. [PMID: 31627920 DOI: 10.1016/j.transproceed.2019.08.014] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
A new model of tissue-engineered artificial autologous human skin developed in Andalusia is currently being transplanted into patients suffering from large burns within the Andalusian Public Healthcare System. This product is considered an advanced therapy medicinal product (ATMP) in Europe, and its clinical use implies meeting transplant and medicinal product legal requirements, being the Guidelines of Good Manufacturing Practice for ATMPs of particular importance. The preclinical research and clinical translation of the product have represented a technical, regulatory, and organizational challenge, which has taken 10 years since the first preclinical experiments were designed. Twelve patients with large burns, including 3 pediatric patients, have hitherto received artificial autologous skin grafts with an overall survival rate of 75% and positive clinical, homeostatic, and histologic results. Achieving such a milestone within our Healthcare System was possible through a multidisciplinary approach and the joint efforts of multiple publicly funded institutions and units under the coordination of the Andalusian Initiative for Advanced Therapies. In this article, we present the organizational model set up to facilitate collaboration and logistics among the professionals involved, totaling more than 80 people. The similarities between the tissue-engineered artificial autologous human skin transplant and other organ and tissue transplants, in terms of logistic requirements, reveal how regional and hospital transplant coordination have played a crucial role.
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González-Cruz C, Descalzo M, Arias-Santiago S, Molina-Leyva A, Gilaberte Y, Fernández-Crehuet P, Husein-ElAhmed H, Viera-Ramírez A, Fernández-Peñas P, Taberner R, Buendía-Eisman A, García-Doval I, García-Patos V. Análisis de la proporción de derivaciones potencialmente evitables desde Atención Primaria a Dermatología por lesiones quísticas o tumorales benignas en España. Datos del estudio DIADERM. ACTAS DERMO-SIFILIOGRAFICAS 2019; 110:659-665. [DOI: 10.1016/j.ad.2019.02.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 02/03/2019] [Accepted: 02/07/2019] [Indexed: 11/25/2022] Open
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González-Cruz C, Descalzo M, Arias-Santiago S, Molina-Leyva A, Gilaberte Y, Fernández-Crehuet P, Husein-ElAhmed H, Viera-Ramírez A, Fernández-Peñas P, Taberner R, Buendía-Eisman A, García-Doval I, García-Patos V. Proportion of Potentially Avoidable Referrals From Primary Care to Dermatologists for Cystic Lesions or Benign Neoplasms in Spain: Analysis of Data From the DIADERM Study. ACTAS DERMO-SIFILIOGRAFICAS 2019. [DOI: 10.1016/j.adengl.2019.02.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Martinez-Lopez A, Blasco-Morente G, Giron-Prieto MS, Arrabal-Polo MA, Luque-Valenzuela M, Luna-Del Castillo JDD, Tercedor-Sanchez J, Arias-Santiago S. Linking of psoriasis with osteopenia and osteoporosis: A cross-sectional study. Indian J Dermatol Venereol Leprol 2019; 85:153-159. [PMID: 30226478 DOI: 10.4103/ijdvl.ijdvl_831_17] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background/Purpose Psoriasis is a multisystem disease which has been related to vitamin-D deficiency through chronic inflammation. This psoriasis-related inflammatory state and vitamin-D deficiency may induce bone mineral density loss. The purpose of this study is to assess the relationship of psoriasis with bone mineral density, by comparing psoriatic patients with healthy controls and patients with osteopenia/osteoporosis. Methods A total of 185 subjects were studied; 58 psoriatic patients who had not been under systemic or biological treatment were included. Age, gender, body mass index, phosphocalcic metabolic parameters and hip and lumbar (L4) bone mineral density data were collected. These variables were compared with those collected in 61 healthy controls and 67 patients with osteopenia/osteoporosis. Results Psoriatic patients showed worse hip and lumbar spine bone mineral density levels than healthy controls (P = 0.001) and better levels than osteoporotic patients (P < 0.001). Multivariate analysis demonstrated a negative association of age and a positive association of body mass index in hip bone mineral density in psoriatic patients. Limitations The main limitations are those of cross-sectional studies, such as a lack of follow up period, and a male predominance in the psoriatic group, which is corrected employing a multivariate analysis with an adjusted model for confounding factors. Conclusions Bone mineral density levels in psoriatic patients are situated halfway between healthy controls and patients with osteopenia/osteoporosis. In addition, the higher body mass index in patients with psoriasis appears to confer a protective effect against further development of lower bone mineral density.
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Porriño-Bustamante ML, García-Lora E, Buendía-Eisman A, Arias-Santiago S. Familial frontal fibrosing alopecia in two male families. Int J Dermatol 2019; 58:e178-e180. [PMID: 31166008 DOI: 10.1111/ijd.14499] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 03/27/2019] [Accepted: 04/29/2019] [Indexed: 12/19/2022]
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Navarro-Triviño F, Arias-Santiago S, Gilaberte-Calzada Y. Vitamin D and the Skin: A Review for Dermatologists. ACTAS DERMO-SIFILIOGRAFICAS 2019. [DOI: 10.1016/j.adengl.2019.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Navarro-Triviño FJ, Arias-Santiago S, Gilaberte-Calzada Y. Vitamin D and the Skin: A Review for Dermatologists. ACTAS DERMO-SIFILIOGRAFICAS 2019; 110:262-272. [PMID: 30857638 DOI: 10.1016/j.ad.2018.08.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 07/28/2018] [Accepted: 08/02/2018] [Indexed: 02/07/2023] Open
Abstract
In recent years, the growing interest in the role played by vitamin D in skin disease has given rise to the publication of many studies of the relationship between this vitamin and certain skin conditions. As dermatologists, we need to understand, among other aspects, how vitamin D is synthesized and the main sources in humans, as well as plasma levels and the factors that can modify them. Of particular interest are the latest discoveries about the role of vitamin D in skin diseases such as lupus erythematosus, ichthyosis, atopic dermatitis, hidradenitis suppurativa, acne, alopecia areata, androgenetic alopecia, melanoma, and nonmelanoma skin cancer. Also of interest is the importance of vitamin D as adjuvant therapy in patients on long-term treatment with corticosteroids. In this review, we provide an overview of the most important and most recent information regarding the relationship between vitamin D and skin disease and discuss the importance of assessing individual vitamin D status and correcting deficiencies.
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González-López G, Descalzo-Gallego M, Arias-Santiago S, Molina-Leyva A, Gilaberte Y, Fernández-Crehuet P, Husein-El Ahmed H, Viera-Ramírez A, Fernández-Peñas P, Taberner R, García-Doval I, Buendía-Eisman A, Buendía A, Fernández-Crehuet P, Husein-ElAhmed H, Vega J, Viera A, Manuel Carrascosa J, Ferrán M, Gómez E, Ascanio L, García Doval I, Arias S, Gilaberte Y, Sánchez JA, Serrano A, Castillo R, Fernandez R, Armario J, Lluc Cantalejo C, Albarrán C, Cruz Martín M, Martín JA, Barabash R, Pérez L, Salamanca M, Hernández C, Millán JF, Ruiz I, Armesto S, González M, Beteta V, Cuadrado de Valles C, Cristóbal P, Roth MM, Garcias J, Fernandez de Misa R, García E, Rivero MDP, Suárez J, Farthmann B, Álvarez A, García I, Morales CE, Zemba MC, Repiso T, Sastre C, Ubals M, Fernández A, González U, Grimalt R, Gómez S, López I, Gemigniani FA, Izquierdo MJ, Alfageme F, Barrientos N, Pericet LM, Vidal S, Camarero C, Lázaro P, García C, de Pablo MP, Herranz P, del Olmo N, Castellanos M, Jiménez N, Aboín S, Aldanondo I, Juanes A, Arranz DM, González O, Casas L, Vázquez JJ, Peña C, Cubero JL, Feal C, Mayo ME, Iglesias N, Rojo R, Aniz E, Kindem S, Barrado N, Tirado M, Quecedo E, Hernández I, Sahuquillo A, Bella R, García R, Calle A, Messeguer F, Alfaro A, Casanova L, Aspe L, Moreno MP, Trébol I, Serrano G, Alcalde VM, García P, Coscojuela C. Referral of Patients to Dermatology and Teledermatology Consultations in Spain. DIADERM Study. ACTAS DERMO-SIFILIOGRAFICAS 2019. [DOI: 10.1016/j.adengl.2019.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Gonzalez-Cantero A, Gonzalez-Cantero J, Sanchez-Moya AI, Perez-Hortet C, Arias-Santiago S, Schoendorff-Ortega C, Gonzalez-Calvin JL. Subclinical atherosclerosis in psoriasis. Usefulness of femoral artery ultrasound for the diagnosis, and analysis of its relationship with insulin resistance. PLoS One 2019; 14:e0211808. [PMID: 30735527 PMCID: PMC6368294 DOI: 10.1371/journal.pone.0211808] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Accepted: 01/20/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Psoriasis is associated with an increased risk of cardiovascular disease (CVD) at younger ages that is not identifiable by traditional risk factors. Screening for subclinical atherosclerosis with ultrasound has only been investigated in carotid arteries. Femoral artery ultrasound has never been considered for this purpose. The link between psoriasis and accelerated atherosclerosis has not yet been established. OBJECTIVE To study the usefulness of femoral artery ultrasound for the detection of subclinical atherosclerosis in psoriasis. We also investigated its possible relationship with changes in insulin resistance. METHODS We conducted a cross-sectional study in 140 participants, 70 patients with moderate-to-severe psoriasis and 70 healthy controls, matched 1:1 for age, sex, and BMI. Femoral and carotid atherosclerotic plaques were evaluated by ultrasonography. Insulin resistance was assessed by the homeostasis model assessment method (HOMA-IR). RESULTS Femoral atherosclerotic plaque prevalence was significantly higher in patients with psoriasis (44.64%) than in controls (19.07%) (p<0.005), but no significant difference was found in carotid plaque prevalence (p<0.3). Femoral plaques were significantly more prevalent than carotid plaques (21.42%) among patients with psoriasis (p<0.001). In the regression analysis, insulin resistance was the most influential determinant of atherosclerosis in psoriasis and C-reactive protein the most significant predictor of insulin resistance. CONCLUSIONS Ultrasound screening for femoral atherosclerotic plaques improves the detection of subclinical atherosclerosis in patients with psoriasis, whereas the study of carotid arteries is not sufficiently accurate. Insulin resistance appears to play a greater role in the development of atherosclerosis in these patients in comparison to other classical CVD risk factors.
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Porriño-Bustamante ML, López-Nevot MÁ, Aneiros-Fernández J, Casado-Ruiz J, García-Linares S, Pedrinacci-Rodríguez S, García-Lora E, Martín-Casares MA, Fernández-Pugnaire MA, Arias-Santiago S. Study of Human Leukocyte Antigen (HLA) in 13 cases of familial frontal fibrosing alopecia: CYP21A2 gene p.V281L mutation from congenital adrenal hyperplasia linked to HLA class I haplotype HLA-A*33:01; B*14:02; C*08:02 as a genetic marker. Australas J Dermatol 2019; 60:e195-e200. [PMID: 30656636 DOI: 10.1111/ajd.12985] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 11/28/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND/OBJECTIVES The aetiology of frontal fibrosing alopecia is unknown, and its genetic aspect remains uncharacterised. The aim of this report is to elucidate if major histocompatibility complex is associated with familial frontal fibrosing alopecia. METHODS A case-control study was performed of 13 patients with frontal fibrosing alopecia belonging to six families. Their human leukocyte antigen profiles were compared to the data of 636 healthy controls without frontal fibrosing alopecia. Patients underwent high-resolution genomic typing for human leukocyte antigen class I and II loci by PCR-SSO for Luminex. In addition, CYP21A2 gene (major histocompatibility complex class III) mutations were detected by PCR-SSO on strips. RESULTS 61.5% of patients shared CYP21A2 gene p.V281L linked to the F16A human leukocyte antigen class I haplotype (HLA-A*33:01; B*14:02; C*08:02; Pc < 0.000001). The patients F16A-negative shared other human leukocyte antigen class I haplotypes: Y16A (3/13) and S26 (2/13). CONCLUSION CYP21A2 gene p.V281L mutation can be used as a genetic marker for susceptibility to familial frontal fibrosing alopecia. Both the linkage of the mutation to F16A and the fact that F16A-negative patients share other human leukocyte antigen class I haplotype, point to an antigen-driven mechanism in susceptible patients with these haplotypes.
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Molina-Leyva A, Salvador-Rodriguez L, Martinez-Lopez A, Ruiz-Carrascosa JC, Arias-Santiago S. Association Between Psoriasis and Sexual and Erectile Dysfunction in Epidemiologic Studies. JAMA Dermatol 2019; 155:98-106. [DOI: 10.1001/jamadermatol.2018.3442] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Porriño-Bustamante ML, López-Nevot MÁ, Aneiros-Fernández J, García-Lora E, Fernández-Pugnaire MA, Arias-Santiago S. Familial frontal fibrosing alopecia: A cross-sectional study of 20 cases from nine families. Australas J Dermatol 2018; 60:e113-e118. [PMID: 30430555 DOI: 10.1111/ajd.12951] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 10/17/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND/OBJECTIVES Frontal fibrosing alopecia (FFA) is a scarring alopecia whose prevalence is increasing. The pathogenesis of this disease is not well known. Genetic, environmental, hormonal and autoimmunity related factors have been considered; however, only a few cases of familial frontal fibrosing alopecia have been reported. MATERIAL AND METHODS A cross-sectional study was performed at University Hospital in Granada (Spain). Twenty patients with frontal fibrosing alopecia belonging to nine different families were included, and clinical and dermoscopic features were analysed. RESULTS Overall, 90% of the patients studied were women (mean age 61.4 years). About 50% of the patients had grade II frontal fibrosing alopecia at the time of diagnosis, whilst 35% had grades III or V. Mean recession was 2.83 cm in the frontal area and 1.99 cm in the temporo-parietal area. Daughters presented a shorter recession area and earlier debut of the disease than mothers. Androgenetic alopecia was found in only two patients (10%). The dermoscopic signs most commonly found were perifollicular erythema (85%), hyperkeratosis (85%), and absence of vellus hair in the hairline (78.9%). CONCLUSION This study adds to the growing evidence that there is a genetic component to frontal fibrosing alopecia. The clinical pattern of frontal fibrosing alopecia was not different from that found in non-familial cases, but the debut of the disease in daughters of mothers with frontal fibrosing alopecia may be earlier.
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Sierra-Sánchez Á, Ordóñez-Luque A, Espinosa-Ibáñez O, Ruiz-García A, Arias-Santiago S. Epithelial In vitro Differentiation of Mesenchymal Stem Cells. Curr Stem Cell Res Ther 2018; 13:409-422. [PMID: 29714147 DOI: 10.2174/1574888x13666180501120416] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 04/20/2018] [Accepted: 04/27/2018] [Indexed: 11/22/2022]
Abstract
Mesenchymal stem cells or mesenchymal stromal cells (MSCs) are non-hematopoietic stromal cells that reside in many human organs and have been isolated from a variety of adult or fetal tissues such as adipose tissue, bone marrow and umbilical cord Wharton's jelly, among others. Because they are a heterogeneous population, International Society for Cellular Therapy has established 3 minimum criteria to characterize MSCs in vitro: i) adherence to plastic, ii) differentiation potential (osteogenic, chondrogenic and adipogenic lineages) and iii) expression of specific surface antigens (CD73+, CD90+, CD105+, CD34-, CD45-, CD11b-, CD14-, CD19-, CD79a-, HLA-DR-). Because of these characteristics, MSCs are useful for different applications and studies, most of them related with regenerative biomedicine. Epithelial in vitro differentiation of MSCs, for clinical use, is one of the main objectives in this field, due to, on the one hand, the difficulties to establish epithelial cell cultures and, on the other hand, the immunomodulatory capacity of MSCs that could increase the success of transplantation. According to this and the information compiled from bibliography, production of epithelial cells differentiated in vitro from MSCs is a complex procedure and a lot of techniques and culture media are necessary to explore. The objective of this review is to show the different methods of epithelial in vitro differentiation and remark the need to further study for being capable of establishing specific cell lines of epithelial cells differentiated from autogenic or allogenic MSCs.
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Miguel-Gómez L, Rodrigues-Barata AR, Molina-Ruiz A, Martorell-Calatayud A, Fernández-Crehuet P, Grimalt R, Barco D, Arias-Santiago S, Serrano-Falcón C, Camacho FM, Saceda-Corralo D, Jaén-Olasolo P, Vañó-Galván S. Folliculitis decalvans: Effectiveness of therapies and prognostic factors in a multicenter series of 60 patients with long-term follow-up. J Am Acad Dermatol 2018; 79:878-883. [PMID: 29864465 DOI: 10.1016/j.jaad.2018.05.1240] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Revised: 05/21/2018] [Accepted: 05/28/2018] [Indexed: 10/14/2022]
Abstract
BACKGROUND Folliculitis decalvans (FD) is a rare neutrophilic cicatricial alopecia that poses a therapeutic challenge. OBJECTIVES To describe the therapeutic response in a large number of cases of FD with long-term follow-up and analyze potential prognostic factors associated with severity of form and with a better therapeutic response. METHODS This multicenter prospective study included patients with FD who had a minimum of 5 years of follow-up. Severity was assessed by the maximum diameter of the cicatricial area. Therapeutic response was evaluated according to stabilization of the size of the cicatricial areas and the improvement in clinical symptoms. RESULTS A total of 60 patients (37 men [61.7%] and 23 women [38.3%]) with a mean age of 40 years were included. Earlier age of onset (P = .01) was statistically associated with severity of form. Treatment with rifampicin and clindamycin, tetracyclines, and intralesional steroids was the most effective. No statistically significant prognostic factors predicting a better therapeutic response were found. LIMITATIONS Because FD is a rare disease, the main limitation was the sample size. CONCLUSIONS An earlier age of onset was associated with the severe form of the disease. The proposed specific therapeutic protocol can be a very useful tool in clinical dermatologic practice.
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Martinez-Lopez A, Almazan-Fernandez FM, Perez-Lopez I, Aguayo-Carreras P, Salvador-Rodriguez L, Cuenca-Barrales C, Arias-Santiago S. Successful treatment of cutaneous metastatic melanoma with high-dose intralesional interleukin-2 treatment combined with cryosurgery. Dermatol Ther 2018; 31:e12612. [PMID: 29766618 DOI: 10.1111/dth.12612] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 03/18/2018] [Indexed: 01/08/2023]
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Martinez-Lopez A, Blasco-Morente G, Perez-Lopez I, Tercedor-Sanchez J, Arias-Santiago S. Studying the effect of systemic and biological drugs on intima-media thickness in patients suffering from moderate and severe psoriasis. J Eur Acad Dermatol Venereol 2018; 32:1492-1498. [PMID: 29405437 DOI: 10.1111/jdv.14841] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 01/23/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Psoriasis has been related to a large number of cardiovascular risk factors such as hypertension, diabetes mellitus and arteriosclerosis. The increased carotid intima-media thickness (IMT) could be considered to be a marker of generalized arteriosclerosis. OBJECTIVE To assess the effect of systemic and biological drugs on psoriatic patients' carotid IMT. METHODS A prospective study was performed. We studied 53 patients with moderate and severe psoriasis from our psoriasis dermatological unit, analysing lipid and glucose metabolism and performing a carotid IMT sonography before introduction of systemic and biological drugs. After that, we performed an 8-month closely analytic and sonographic follow-up. RESULTS The IMT of the patients with psoriasis treated with biological drugs tended to decrease, although this occurrence was not statistically significant (P = 0.086). The subgroup analysis revealed that patients treated with methotrexate (P = 0.045) and anti-IL-12/23 (P = 0.010) presented a decrease in their IMT levels. This analysis also showed a decrease in glycaemia and insulin levels in patients treated with TNF-alpha inhibitors and ustekinumab. CONCLUSIONS Our study suggests that the carotid IMT may benefit from treatment with biological drugs, particularly anti-IL-12/23 and methotrexate in patients suffering from moderate and severe psoriasis. However, larger longitudinal studies should be performed to fully confirm these results.
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Vidal D, Alfageme F, Ruiz-Villaverde R, Arias-Santiago S, Martorell A. Caracterización ecográfica de la psoriasis ungueal: estudio de casos y controles. ACTAS DERMO-SIFILIOGRAFICAS 2017; 108:968-969. [DOI: 10.1016/j.ad.2017.04.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 03/17/2017] [Accepted: 04/10/2017] [Indexed: 11/25/2022] Open
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Vidal D, Alfageme F, Ruiz-Villaverde R, Arias-Santiago S, Martorell A. Ultrasound Characterization of Psoriasis of the Nails: A Case-Control Study. ACTAS DERMO-SIFILIOGRAFICAS 2017. [DOI: 10.1016/j.adengl.2017.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Pérez-López I, Martínez-López A, Retamero JA, Gallo F, Arias-Santiago S. Paquidermodactilia, engrosamiento digital proximal. Pachydermodactyly, digital proximal thickening. Dermatol Online J 2017; 23:13030/qt2np957pj. [PMID: 29469789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 11/09/2017] [Indexed: 06/08/2023] Open
Abstract
We report a case of pachydermodactyly (PDD). PDD is a benign, asymptomatic soft tissue swelling affecting the skin of the lateral aspects of the proximal interphalangeal joints of the fingers, mostly in young adolescent males. It has often been interpreted as a consequence of tic-like behavior as part of an obsessive-compulsive disorder. Although the diagnosis is essentially clinical, skin biopsy shows compact orthokeratotic hyperkeratosis, increased numbers of collagen fibers and fibroblasts, and no inflammatory changes. A rapid clinical recognition of PDD should avoid many unproductive and expensive diagnostic tests.
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González-Cantero Á, Honorato-Guerra S, Sánchez-Moya AI, Arias-Santiago S, Moreno-Torres B, Martinez-Lorenzo E, Mollejo M, Schoendorff-Ortega C. Comment on: "A Unique Clinicopathological Manifestation of Fungal Infection: A Case Series of Deep Dermatophytosis in Immunosuppressed Patients". Am J Clin Dermatol 2017; 18:709-711. [PMID: 28653140 DOI: 10.1007/s40257-017-0309-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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González-Andrades M, Mata R, González-Gallardo MDC, Medialdea S, Arias-Santiago S, Martínez-Atienza J, Ruiz-García A, Pérez-Fajardo L, Lizana-Moreno A, Garzón I, Campos A, Alaminos M, Carmona G, Cuende N. A study protocol for a multicentre randomised clinical trial evaluating the safety and feasibility of a bioengineered human allogeneic nanostructured anterior cornea in patients with advanced corneal trophic ulcers refractory to conventional treatment. BMJ Open 2017; 7:e016487. [PMID: 28947445 PMCID: PMC5623476 DOI: 10.1136/bmjopen-2017-016487] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
INTRODUCTION There is a need to find alternatives to the use of human donor corneas in transplants because of the limited availability of donor organs, the incidence of graft complications, as well as the inability to successfully perform corneal transplant in patients presenting limbal deficiency, neo-vascularized or thin corneas, etc. We have designed a clinical trial to test a nanostructured fibrin-agarose corneal substitute combining allogeneic cells that mimics the anterior human native cornea in terms of optical, mechanical and biological behaviour. METHODS AND ANALYSIS This is a phase I-II, randomised, controlled, open-label clinical trial, currently ongoing in ten Spanish hospitals, to evaluate the safety and feasibility, as well as clinical efficacy evidence, of this bioengineered human corneal substitute in adults with severe trophic corneal ulcers refractory to conventional treatment, or with sequelae of previous ulcers. In the initial phase of the trial (n=5), patients were sequentially recruited, with a safety period of 45 days, receiving the bioengineered corneal graft. In the second phase of the trial (currently ongoing), subjects are block randomised (2:1) to receive either the corneal graft (n=10), or amniotic membrane (n=5), as the control treatment. Adverse events, implant status, infection signs and induced neovascularization are evaluated as determinants of safety and feasibility of the bioengineered graft (main outcomes). Study endpoints are measured along a follow-up period of 24 months, including 27 post-implant assessment visits according to a decreasing frequency. Intention to treat, and per protocol, and safety analysis will be performed. ETHICS AND DISSEMINATION The trial protocol received written approval by the corresponding Ethics Committee and the Spanish Regulatory Authority and is currently recruiting subjects. On completion of the trial, manuscripts with the results of phases I and II of the study will be published in a peer-reviewed journal. TRIAL REGISTRATION CT.gov identifier: NCT01765244 (Jan2013). EudraCT number: 2010-024290-40 (Dec2012).
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Fernández-Crehuet P, Vañó-Galván S, Molina-Ruiz AM, Rodrigues-Barata AR, Serrano-Falcón C, Martorell-Calatayud A, Arias-Santiago S, Barco-Nebreda D, Serrano S, Jaén P, Camacho-Martínez FM. Trichoscopic Features of Folliculitis Decalvans: Results in 58 Patients. Int J Trichology 2017; 9:140-141. [PMID: 28932072 PMCID: PMC5596655 DOI: 10.4103/ijt.ijt_85_16] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Tejera-Vaquerizo A, Pérez-Cabello G, Marínez-Leborans L, Gallego E, Oliver-Martínez V, Martín-Cuevas P, Arias-Santiago S, Aneiros-Fernández J, Herrera-Acosta E, Traves V, Herrera-Ceballos E, Nagore E. Is mitotic rate still useful in the management of patients with thin melanoma? J Eur Acad Dermatol Venereol 2017; 31:2025-2029. [DOI: 10.1111/jdv.14485] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Accepted: 07/12/2017] [Indexed: 12/30/2022]
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