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Tamayo Buendía M, Chaparro-Reyes D, Charry Anzola LP, Garzón J. Hallazgos en piel en pacientes con infección por VIH en Bogotá. Rev Salud Publica (Bogota) 2021. [DOI: 10.15446/rsap.v23n6.87995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objetivo Describir los hallazgos en piel y las características sociodemográficas de pacientes VIH positivos atendidos en un centro de remisión en Bogotá.
Métodos Se realizó un estudio observacional descriptivo, incluyendo adultos con infección por VIH atendidos en el Hospital Universitario San Ignacio de Bogotá, entre abril de 2019 y febrero de 2020. A partir de un interrogatorio, un examen físico y la revisión de historias clínicas, se registraron hallazgos en piel, datos de terapia antirre- troviral recibida, conteo de linfocitos CD4+ y carga viral para VIH, así como pruebasmicológicas e histopatológicas (cuando fueron necesarias).
Resultados Se evaluó un total de 168 pacientes que, en su mayoría, eran hombres (88,7%), en la cuarta década de la vida, de orientación HSH (77,4%), con fototipos del II al IV (97%) y manejados con terapia antirretroviral (94,6%). Se encontraron hallazgos en piel en el 97,6% de los pacientes, siendo más frecuentes las infecciones (43,8%), específicamente los condilomas anogenitales, principalmente en pacientes con <200 linfocitos CD4+/mm3, seguidas por las condiciones inflamatorias (35,4%), principalmente dermatitis seborreica y acné. Este último, más frecuente en pacientes con >200 linfocitos CD4+/mm3.
Conclusiones Los hallazgos más frecuentes en piel fueron: dermatitis seborreica, condilomas anogenitales, verrugas virales, moluscos contagiosos y micosis superficiales, que se asemeja a lo reportado en poblaciones con buen control inmunovirológico de la enfermedad. La alta prevalencia de condilomas anogenitales nos invita a imple- mentar estrategias de tamización para VPH, así como de educación en infecciones de transmisión sexual.
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Pottegård A, Pedersen SA, Schmidt SAJ, Lee CN, Hsu CK, Liao TC, Shao SC, Lai ECC. Use of hydrochlorothiazide and risk of skin cancer: a nationwide Taiwanese case-control study. Br J Cancer 2019; 121:973-978. [PMID: 31673105 PMCID: PMC6889460 DOI: 10.1038/s41416-019-0613-4] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 10/08/2019] [Indexed: 11/30/2022] Open
Abstract
Background The antihypertensive agent hydrochlorothiazide has been associated with increased risks of non-melanoma skin cancer (NMSC) and possibly some melanoma subtypes. Previous studies were, however, conducted in predominantly Caucasian populations. We therefore examined the association between hydrochlorothiazide and skin cancer risk in an Asian population. Methods By using Taiwan’s National Health Insurance Research Database (NHIRD), we conducted three separate case–control studies of lip cancer, non-lip non-melanoma skin cancer and melanoma. Cases (n = 29,082) with a first-ever skin cancer diagnoses (2008–2015) were matched 1:10 to population controls. We estimated odds ratios (ORs) associating hydrochlorothiazide use with skin cancer risk by using conditional logistic regression. Results Hydrochlorothiazide use showed no overall association with any of the three outcomes: ORs for high cumulative use of HCTZ (≥50,000 mg) were 0.86 (95% CI 0.09–7.81) for lip cancer, 1.16 (95% CI 0.98–1.37) for non-lip NMSC and 1.07 (95% CI 0.65–1.76) for melanoma. There was some evidence of a dose–response pattern for non-lip NMSC, with an OR of 1.66 (95% CI 0.82–3.33) for 100,000–149,999 mg of HCTZ. The null findings were robust across subgroup and sensitivity analyses. Conclusion Use of HCTZ appears safe in terms of skin cancer risk in an Asian population.
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Affiliation(s)
- Anton Pottegård
- Clinical Pharmacology and Pharmacy, Department of Public health, University of Southern Denmark, Odense, Denmark
| | - Sidsel Arnspang Pedersen
- Clinical Pharmacology and Pharmacy, Department of Public health, University of Southern Denmark, Odense, Denmark.,Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark
| | - Sigrun Alba Johannesdottir Schmidt
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.,Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | - Chaw-Ning Lee
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chao-Kai Hsu
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Tzu-Chi Liao
- School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Shih-Chieh Shao
- School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Pharmacy, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Edward Chia-Cheng Lai
- School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan. .,Department of Pharmacy, National Cheng Kung University Hospital, Tainan, Taiwan.
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Pedersen SA, Gaist D, Schmidt SAJ, Hölmich LR, Friis S, Pottegård A. Hydrochlorothiazide use and risk of nonmelanoma skin cancer: A nationwide case-control study from Denmark. J Am Acad Dermatol 2018; 78:673-681.e9. [DOI: 10.1016/j.jaad.2017.11.042] [Citation(s) in RCA: 161] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 11/09/2017] [Accepted: 11/12/2017] [Indexed: 11/26/2022]
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Pottegård A, Hallas J, Olesen M, Svendsen MT, Habel LA, Friedman GD, Friis S. Hydrochlorothiazide use is strongly associated with risk of lip cancer. J Intern Med 2017; 282:322-331. [PMID: 28480532 DOI: 10.1111/joim.12629] [Citation(s) in RCA: 105] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND The diuretic hydrochlorothiazide is amongst the most frequently prescribed drugs in the United States and Western Europe, but there is suggestive evidence that hydrochlorothiazide use increases the risk of lip cancer. OBJECTIVES To study the association between use of hydrochlorothiazide and squamous cell carcinoma of the lip. METHODS We conducted a case-control study using Danish nationwide registry data. From the Cancer Registry (2004-2012), we identified 633 case patients with squamous cell carcinoma (SCC) of the lip and matched them to 63 067 population controls using a risk-set sampling strategy. Hydrochlorothiazide use (1995-2012) was obtained from the Prescription Registry and defined according to cumulative use. Applying conditional logistic regression, we calculated odds ratios (ORs) for SCC lip cancer associated with hydrochlorothiazide use, adjusting for predefined potential confounders obtained from demographic, prescription and patient registries. RESULTS Ever-use of hydrochlorothiazide was associated with an adjusted OR for SCC lip cancer of 2.1 (95% confidence interval (CI): 1.7-2.6), increasing to 3.9 (95%CI: 3.0-4.9) for high use (≥25 000 mg). There was a clear dose-response effect (P < 0.001), with the highest cumulative dose category of hydrochlorothiazide (≥100 000 mg) presenting an OR of 7.7 (95%CI: 5.7-10.5). No association with lip cancer was seen with use of other diuretics or nondiuretic antihypertensives. Assuming causality, we estimated that 11% of the SCC lip cancer cases could be attributed to hydrochlorothiazide use. CONCLUSIONS Hydrochlorothiazide use is strongly associated with an increased risk of lip cancer.
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Affiliation(s)
- A Pottegård
- Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - J Hallas
- Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - M Olesen
- Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - M T Svendsen
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark
| | - L A Habel
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - G D Friedman
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - S Friis
- Danish Cancer Society, Danish Cancer Society Research Center, Copenhagen, Denmark
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Abstract
Specialty-related cost differences for the treatment of nonmelanoma skin cancer (NMSC) have been previously reported but without taking into account confounding factors. Using a previously validated model for NMSC episode of care, episodes were identified in the Medicare Current Beneficiary Survey claims 2005 to 2007. A γ regression with log link model estimated the effect of physician exposure on total episode costs controlling for sociodemographics, health status and comorbidities, treatment and repair procedures, as well as tumor size and location. Treatment-related NMSC episodes (1285) were identified. In the unadjusted model, episodes managed by generalists were associated with 36% lower costs, those by otolaryngologists/plastic surgeons with 82% higher costs, and those by multiple specialists with 111% higher costs, compared to dermatologists. Cost differences were substantially reduced in the adjusted regression analysis; compared to dermatologists, episodes managed by generalists were associated with 20% lower costs (P < 0.0001), whereas otolaryngologists/plastic surgeons and multiple specialists were associated with 20% (P < 0.01) and 11% (P = 0.02) higher costs, respectively. Overall, comparison between unadjusted and adjusted estimates suggests that controlling for severity and treatment modalities explains most of the specialty cost differences. Our estimates could be subject to residual confounding due to selection bias and the limitations to using claims data to characterize an NMSC episode of care. Adjusting for the severity of the disease and other confounders, our study found much smaller specialty-related cost differences for the management of NMSC than previously reported unadjusted estimates.
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Schmidt S, Schmidt M, Mehnert F, Lemeshow S, Sørensen H. Use of antihypertensive drugs and risk of skin cancer. J Eur Acad Dermatol Venereol 2015; 29:1545-54. [DOI: 10.1111/jdv.12921] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 11/18/2014] [Indexed: 12/25/2022]
Affiliation(s)
- S.A.J. Schmidt
- Department of Clinical Epidemiology; Aarhus University Hospital; Aarhus Denmark
- Division of Biostatistics; College of Public Health; Ohio State University; Columbus OH USA
| | - M. Schmidt
- Department of Clinical Epidemiology; Aarhus University Hospital; Aarhus Denmark
- Division of Biostatistics; College of Public Health; Ohio State University; Columbus OH USA
| | - F. Mehnert
- Department of Clinical Epidemiology; Aarhus University Hospital; Aarhus Denmark
| | - S. Lemeshow
- Department of Clinical Epidemiology; Aarhus University Hospital; Aarhus Denmark
- Division of Biostatistics; College of Public Health; Ohio State University; Columbus OH USA
| | - H.T. Sørensen
- Department of Clinical Epidemiology; Aarhus University Hospital; Aarhus Denmark
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Lee TH, Do MH, Oh YL, Cho DW, Kim SH, Kim SY. Dietary fermented soybean suppresses UVB-induced skin inflammation in hairless mice via regulation of the MAPK signaling pathway. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2014; 62:8962-72. [PMID: 25144532 DOI: 10.1021/jf5018252] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Soybean may be a promising ingredient for regulating UVB-induced inflammatory damage to the skin. We investigated the anti-inflammatory effects of diets supplemented with fermented soybean on UVB-induced skin photodamage and the effectiveness of soybean (S) and fermented soybean (FS) dietary supplementation. To investigate the effects of two major isoflavones-daidzein and genistein-from FS, we used cocultures with keratinocytes and fibroblasts. Genistein treatment strongly inhibited the production of IL-6 and MAPK signaling. Forty hairless male mice divided into four groups were fed with a control diet (group N: normal, group C; +UVB) or diets with 2.5% S+UVB or 2.5% FS+UVB (group S, group FS) for 8 weeks. Macrophage infiltration to the dermis was reduced more in groups S and FS than in group C. The expression levels of iNOS and COX-2 were significantly decreased in group FS (by 7.7% ± 0.4% and 21.2% ± 0.3%, respectively [p < 0.05]).
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Affiliation(s)
- Taek Hwan Lee
- College of Pharmacy, Yonsei University , #162-1 Songdo-dong, Yeonsu-gu, Incheon 406-840, Republic of Korea
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Crum-Cianflone N, Hullsiek KH, Satter E, Marconi V, Weintrob A, Ganesan A, Barthel RV, Fraser S, Agan BK. Cutaneous malignancies among HIV-infected persons. ARCHIVES OF INTERNAL MEDICINE 2009; 169:1130-8. [PMID: 19546414 PMCID: PMC2761839 DOI: 10.1001/archinternmed.2009.104] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND As the life expectancy of persons infected with human immunodeficiency virus (HIV) increases, cancers have become an important cause of morbidity and mortality. Although cutaneous cancers are the most common malignant neoplasms in the general population, little data exist among HIV-positive persons, especially regarding the impact of HIV-specific factors. METHODS We evaluated the incidence rates and factors associated with the development of cutaneous malignancies among HIV-infected persons by examining data that were prospectively collected from a large HIV study that included 4490 participants (1986-2006). Poisson regression and Cox proportional hazards models were performed. RESULTS Six percent of HIV-infected persons (n = 254) developed a cutaneous malignancy during 33 760 person-years of follow-up (mean, 7.5 years). Since the advent of highly active antiretroviral therapy (HAART), the incidence rates of cutaneous non-AIDS-defining cancers (NADCs), in particular basal cell carcinoma, have exceeded the rates of cutaneous AIDS-defining cancers such as Kaposi sarcoma. Factors associated with the development of cutaneous NADCs in the multivariate models included increasing age (hazard ratio [HR], 2.1; 95% confidence interval [CI], 1.7-2.6) and race. Compared with the white/non-Hispanic race, African Americans (HR, 0.03; 95% CI, 0.01-0.14) and other races (HR, 0.14; 95% CI, 0.03-0.57) had a lower risk of cutaneous NADCs. There were no significant associations between cutaneous NADCs and time-updated CD4 lymphocyte counts, HIV RNA levels, or receipt of HAART. CONCLUSIONS At present, the most common cutaneous malignancies among HIV-infected persons are NADCs. Cutaneous NADCs do not appear to be significantly associated with immune function or HAART but rather are related to traditional factors such as aging and skin color.
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Affiliation(s)
- Nancy Crum-Cianflone
- Tri-Service AIDS Clinical Consortium, Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
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Jensen AØ, Bautz A, Olesen AB, Karagas MR, Sørensen HT, Friis S. Mortality in Danish patients with nonmelanoma skin cancer, 1978-2001. Br J Dermatol 2008; 159:419-25. [PMID: 18616784 DOI: 10.1111/j.1365-2133.2008.08698.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Nonmelanoma skin cancer (NMSC) is a growing public health problem among Caucasians, thus mortality data that may provide insight into the clinical course and foster our understanding of NMSC are important. OBJECTIVES We examined total and cause-specific mortality among patients with NMSC registered in the Danish Cancer Registry from 1978 to 2001. METHODS A total of 82 837 patients with basal cell carcinoma (BCC) and 13 453 patients with squamous cell carcinoma (SCC) were followed through the National Death Registry for specific causes of death. Standardized mortality ratios (SMRs) were computed based on mortality rates in the general population. RESULTS Among patients with BCC, we found a slightly reduced total mortality [SMR 0.97, 95% confidence interval (CI) 0.96-0.98] with decreased SMRs seen for chronic obstructive pulmonary disease (COPD), cardiovascular disease (CVD) and diabetes mellitus. The SMR for suicide was increased. Among patients with SCC, we found an increased total mortality (SMR 1.30, 95% CI 1.26-1.33) due primarily to excess deaths from cancers, COPD, CVD and infectious diseases. CONCLUSIONS We found markedly different mortality patterns among patients with BCC and those with SCC, suggesting important differences in the clinical course of these patients.
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Affiliation(s)
- A Ø Jensen
- Departments of Clinical Epidemiology and Dermatologu, Aarhus University Hospital, Denmark.
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