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Garbayo-Salmons P, Vilarrasa E, Bassas-Vila J, Mora-Fernández V, Fuertes I, Luque-Luna M, Fornons-Servent R, Martin-Ezquerra G, Aguayo-Ortiz RS, Ceravalls J, Mollet J, Gómez Tomás Á, Masferrer E, Corral-Magaña O, Matas-Nadal C, Del Estal J, Fuertes Bailón D, Calvet J, Romaní J. Real-world adalimumab survival and discontinuation factors in hidradenitis suppurativa. J Eur Acad Dermatol Venereol 2024. [PMID: 38687278 DOI: 10.1111/jdv.20044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 03/11/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND AND OBJECTIVES Survival analyses can provide valuable insights into effectiveness and safety as perceived by prescribers. Here, we aimed to evaluate adalimumab (ADA) survival and the interruption risk factors in a multicentre cohort of patients with hidradenitis suppurativa (HS). Moreover, we performed a subanalysis considering the periods before and after the onset of the COVID-19 pandemic. METHODS We conducted a retrospective study including 539 adult patients with HS who received ADA from 1 May 2015 to 31 December 2022. Overall drug survival was analysed using Kaplan-Meier survival curves and compared between the subgroups via stratified log-rank test. Possible predictors for overall drug survival and reasons for discontinuation were assessed using univariate and multivariate Cox regression. RESULTS Overall, 50.1% were females with a mean age of 43.5 ± 1 years and a mean BMI of 29.5 ± 6.7. At the start of ADA, 95.29% were biologic-naïve and 24.63% had undergone surgical treatment. During follow-up, 9.46% of patients required dose escalation, while 39.92% interrupted ADA. Concomitant therapy was used in 64.89% of cases. A subanalyses comparing pre- and post-pandemic periods revealed a tendency to initiate ADA treatment at a younger age, among patient with higher BMI and at a lower HS stage after COVID-19 pandemic. Interestingly, ADA demonstrated extended survival compared to previous studies, with a median overall drug survival of 56.2 months (95% CI 51.2 to 80.3). The primary causes for discontinuation were inefficacy (51.69%), followed by adverse effects (21.35%). Female sex, longer delay in HS diagnosis, higher baseline IHS4 score and concomitant spondyloarthritis were associated with poorer ADA survival or increased risk of discontinuation. CONCLUSIONS ADA demonstrated prolonged survival (median 56.2 months). While addition of antibiotics did not have a positive effect on survival rate, basal IHS4 proved useful in predicting ADA survival.
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Affiliation(s)
- Patricia Garbayo-Salmons
- Dermatology Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Sabadell, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Eva Vilarrasa
- Dermatology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Julio Bassas-Vila
- Dermatology Department, Hospital Germans Trias i Pujol, Barcelona, Spain
| | | | - Irene Fuertes
- Dermatology Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Mar Luque-Luna
- Dermatology Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | | | | | | | - Joan Ceravalls
- Dermatology Department, Hospital Universitari Sagrat Cor, Grupo Quirónsalud, Barcelona, Spain
| | - Jordi Mollet
- Dermatology Department, Hospital Vall d'Hebrón, Barcelona, Spain
| | | | - Emili Masferrer
- Dermatology Department, Hospital Universitari Mútua Terrassa, Terrassa, Spain
| | - Oriol Corral-Magaña
- Dermatology Department, Hospital Universitari Mútua Terrassa, Terrassa, Spain
| | - Clara Matas-Nadal
- Dermatology Department, Hospital de Santa Caterina de Girona, Girona, Spain
| | - Jorge Del Estal
- Pharmacy Department, Parc Taulí Hospital Universitari, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Diana Fuertes Bailón
- Research Support Unit, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Joan Calvet
- Departament de Medicina, Universitat Autònoma de Barcelona, Sabadell, Spain
- Rheumatology Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Sabadell, Spain
| | - Jorge Romaní
- Dermatology Department, Hospital General de Granollers, Granollers, Spain
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2
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Jacques-Aviñó C, Alarcón Guitiérrez M, Barbera MJ, Fuertes I, Martin-Ezquerra G, Lopez-Contreras J, Vives Á, Rodriguez R, Ros M, Rius C, de Olalla PG. Epidemiological Characteristics and Factors Associated with Repeat Sexually Transmitted Infections in Barcelona, Spain Over a Decade. Arch Sex Behav 2024; 53:735-744. [PMID: 37875628 PMCID: PMC10844332 DOI: 10.1007/s10508-023-02711-6] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 09/12/2023] [Accepted: 09/15/2023] [Indexed: 10/26/2023]
Abstract
In the last few years, the frequency of sexually transmitted infections (STI) has increased, as has the number of people with multiple infections. The aim of our study was to describe the epidemiological characteristics of persons with repeated bacterial STI and to determine the risk factors for these episodes in persons living in Barcelona during the period 2007-2018. We studied all cases of bacterial STI included in the STI registry of Barcelona. Repeated STI were defined as a diagnosis of gonorrhea, syphilis, or lymphogranuloma venereum (LGV) after a first episode of one of these infections. Analysis was stratified by sex and place of birth. The factors associated with time to reinfection were determined by Kaplan-Meier estimates, while the factors associated with risk of infection were determined by a Cox proportional hazards model. Of 9927 persons with a diagnosis of bacterial STI, 1690 (17.0%) had at least two episodes of STI during the study period. On multivariate analysis, repeat STI were independently associated with male sex assigned at birth (HR: 3.45; 95%CI 2.22-5.36), age less than 34 years (HR: 1.22; 95%CI 1.10-1.35); gay, bisexual, and other men who have sex with men, and transgender o transsexual woman (GBSMS/Trans) (HR: 4.03; 95%CI 3.24-5.03), having gonorrhea as first diagnosis (HR:1.49, 95%CI 1.34-1.66) or LGV (HR:1.75; 95%CI 1.47-2.08) and coinfection with HIV (HR:1.98; 95%CI 1.78-2.21). Sexual health programs should be strengthened to prevent STI and reinfection in key populations.
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Affiliation(s)
- Constanza Jacques-Aviñó
- Servei d'Epidemiologia, Agència de Salut Pública de Barcelona, Barcelona, Spain.
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Gran Via Corts Catalanes, 587, àtic, 08007, Barcelona, Spain.
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès (Barcelona), Bellaterra, Spain.
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain.
| | - Miguel Alarcón Guitiérrez
- Servei d'Epidemiologia, Agència de Salut Pública de Barcelona, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès (Barcelona), Bellaterra, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain
| | - María Jesús Barbera
- Department of Infectious Diseases, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Irene Fuertes
- Dermatology Department, Hospital Clinic, Barcelona, Spain
| | - Gemma Martin-Ezquerra
- Dermatology Department, Institut Hospital del Mar d'Investigacions Mèdiques, Hospital del Mar, Barcelona, Spain
| | - Joaquín Lopez-Contreras
- Infectious Diseases Unit-Internal Medicine Department, Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain
| | | | - Raquel Rodriguez
- Servei d'Epidemiologia, Agència de Salut Pública de Barcelona, Barcelona, Spain
| | - Miriam Ros
- Servei d'Epidemiologia, Agència de Salut Pública de Barcelona, Barcelona, Spain
| | - Cristina Rius
- Servei d'Epidemiologia, Agència de Salut Pública de Barcelona, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain
- Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Patricia Garcia de Olalla
- Servei d'Epidemiologia, Agència de Salut Pública de Barcelona, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain
- Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
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3
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Rivera M, López-Trujillo E, Ciudad A, Martin-Ezquerra G, Pujol RM. Relapsing annular lesions: a diagnostic challenge. Clin Exp Dermatol 2023; 48:1402-1404. [PMID: 37539692 DOI: 10.1093/ced/llad256] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 07/03/2023] [Accepted: 07/24/2023] [Indexed: 08/05/2023]
Abstract
We present a case of a 60-year-old patient who had several flares of nonscaling, erythematous, urticarial annular skin lesions on her abdomen, buttocks and proximal extremities, possibly related to COVID-19 vaccination. Skin biopsy and histopathological examination revealed a dense perivascular and interstitial inflammatory infiltrate involving the upper and mid dermis composed of lymphocytes and abundant eosinophils. Degranulation of eosinophils with occasional flame figures was also observed.
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Affiliation(s)
- María Rivera
- Dermatology Department, Hospital del Mar, Barcelona, Spain
| | | | - Andrea Ciudad
- Dermatology Department, Hospital del Mar, Barcelona, Spain
| | | | - Ramon M Pujol
- Dermatology Department, Hospital del Mar, Barcelona, Spain
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4
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Tormo-Mainar S, Marcantonio OY, Deza G, Martin-Ezquerra G. Correspondence on 'Lymphogranuloma venereum mimicking squamous cell carcinoma' by 'Sara Tormo-Mainar et al'. Sex Transm Infect 2023; 99:146. [PMID: 36601746 DOI: 10.1136/sextrans-2022-055555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- Sara Tormo-Mainar
- Department of Dermatology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Gustavo Deza
- Department of Dermatology, Universitat Autònoma de Barcelona, Barcelona, Spain
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5
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Marcantonio-Santa Cruz OY, Vidal-Navarro A, Pesqué D, Giménez-Arnau AM, Pujol RM, Martin-Ezquerra G. Pityriasis rosea developing after COVID-19 vaccination. J Eur Acad Dermatol Venereol 2021; 35:e721-e722. [PMID: 34237178 PMCID: PMC8447432 DOI: 10.1111/jdv.17498] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/08/2021] [Accepted: 06/25/2021] [Indexed: 01/02/2023]
Affiliation(s)
- O Y Marcantonio-Santa Cruz
- Dermatology Department, Hospital del Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Vidal-Navarro
- Dermatology Department, Hospital del Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - D Pesqué
- Dermatology Department, Hospital del Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A M Giménez-Arnau
- Dermatology Department, Hospital del Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - R M Pujol
- Dermatology Department, Hospital del Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - G Martin-Ezquerra
- Dermatology Department, Hospital del Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona, Barcelona, Spain
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6
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Martin-Ezquerra G, Monreal P, Mercuriali L, Cañas-Ruano E, Pujol RM, Duran X, Masferrer Niubò M, Domingo P, Villar-Garcia J, Lopez-Contreras J, Gonzalez-Cordón A, Garcia-Olalla P, Barberá MJ. Evolution of notified sexually transmitted infections in Barcelona during the first wave of the COVID-19 pandemic. J Eur Acad Dermatol Venereol 2021; 35:e642-e645. [PMID: 34146425 PMCID: PMC8447417 DOI: 10.1111/jdv.17460] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- G Martin-Ezquerra
- Dermatology Department, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Hospital del Mar, Barcelona, Spain
| | - P Monreal
- Dermatology Department, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Hospital del Mar, Barcelona, Spain
| | - L Mercuriali
- Epidemiology Service, Public Health Agency of Barcelona (ASPB), Barcelona, Spain
| | - E Cañas-Ruano
- Department of Infectious Diseases, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Vall d'Hebron Institut de Recerca, Barcelona, Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain
| | - R M Pujol
- Dermatology Department, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Hospital del Mar, Barcelona, Spain
| | - X Duran
- Scientifics, Statistics and Technical Department, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Hospital del Mar, Barcelona, Spain
| | - M Masferrer Niubò
- Facultat de Ciències, Seu de Barcelona, Universidad Nacional de Educación a Distancia (UNED), Barcelona, Spain
| | - P Domingo
- Infectious Diseases Unit-Internal Medicine Department, Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - J Villar-Garcia
- Department of Infectious Diseases, Hospital del Mar, Barcelona, Spain
| | - J Lopez-Contreras
- Infectious Diseases Unit-Internal Medicine Department, Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain
| | | | - P Garcia-Olalla
- Epidemiology Service, Public Health Agency of Barcelona (ASPB), Barcelona, Spain.,Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - M-J Barberá
- Department of Infectious Diseases, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Vall d'Hebron Institut de Recerca, Barcelona, Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain
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7
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Marcantonio O, López-Castillo D, Pujol RM, Martin-Ezquerra G. Syphilitic paronychia: a diagnostic challenge. Sex Transm Infect 2021; 98:232. [PMID: 33952679 DOI: 10.1136/sextrans-2020-054937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 03/15/2021] [Accepted: 03/24/2021] [Indexed: 11/04/2022] Open
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8
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Lopez-Trujillo E, Rodriguez Mercader S, Güerri-Fernández R, Arrieta Aldea I, Pujol RM, Martin-Ezquerra G. Varicella complicated with pneumonia in a patient infected by COVID-19: the need to rule out other viral coinfections in SARS-CoV-2 patients with vesicular eruptions. Int J Dermatol 2021; 60:886-888. [PMID: 33686647 PMCID: PMC8250854 DOI: 10.1111/ijd.15515] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 01/09/2021] [Accepted: 02/17/2021] [Indexed: 11/29/2022]
Affiliation(s)
| | | | | | - Itziar Arrieta Aldea
- Department of Infectious Diseases, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
| | - Ramon M Pujol
- Department of Dermatology, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
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9
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Lopez-Trujillo E, Gonzàlez-Farré M, Pujol RM, Bellosillo B, Fisa R, Riera C, Alcover M, Barranco C, Martin-Ezquerra G. Diagnostic usefulness of immunohistochemical evaluation of CD1a antigen and polyclonal anti-leishmania antibodies in cutaneous leishmaniasis. Histol Histopathol 2021; 36:567-576. [PMID: 33665791 DOI: 10.14670/hh-18-324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Different immunohistochemical markers to detect amastigotes in cutaneous leishmaniasis have been proposed with variable diagnostic usefulness. OBJECTIVES To evaluate the diagnostic usefulness of immunohistochemical amastigotes identification by specific polyclonal anti-Leishmania antibodies and CD1a expression (clone EP3622) in a series of PCR confirmed cutaneous leishmaniasis. MATERIALS AND METHODS Thirty-three skin samples corresponding to PCR confirmed cutaneous leishmaniasis were included in the study. All samples were stained with Hematoxylin-eosin and Giemsa. Moreover, immunohistochemical studies with anti-CD1a and anti-Leishmania antibodies were performed. The patients clinical features and the observed histopathological features were also recorded. RESULTS From the selected 33 biopsies, Leishmania spp. amastigotes were detected in 48.4% of cases with conventional Hematoxylin-eosin stain and in 57.5% of cases by Giemsa staining. In 31/33 cases, anti-CD1a allowed us to identify parasitic structures, and in 33/33 cases amastigotes were detected with anti-Leishmania antibodies. Concordance between both techniques, anti-CD1a and anti-Leishmania, was 94% [CI 95%: (79,8%-99,3%)] ; p value <0.05. The sensitivity of anti-CD1a in comparison with the PCR was 94%, with a positive predictive value of 100%. Two cases of low parasitic index were negative for CD1a immunostaining. In cases with high parasitic index, anti-CD1a stained amastigotes in superficial and deep dermis. Only a few cases were originally diagnosed with the available histological techniques, needing PCR for Leishmania spp. CONCLUSIONS Anti-CD1a antibody seems to be a useful technique to identify amastigotes when PCR and anti-Leishmania antibodies are not available. The sensitivity to detect amastigotes is increased when the CD1a immunostaining is added to the classical Haematoxylin - eosin and Giemsa staining.
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Affiliation(s)
| | | | - Ramon M Pujol
- Department of Dermatology, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
| | - Beatriz Bellosillo
- Department of Pathology, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
| | - Roser Fisa
- Department of Biology, Healthcare and the Environment, Faculty of Pharmacy and Food Science, Universitat de Barcelona, Barcelona, Spain
| | - Cristina Riera
- Department of Biology, Healthcare and the Environment, Faculty of Pharmacy and Food Science, Universitat de Barcelona, Barcelona, Spain
| | - Magdalena Alcover
- Department of Biology, Healthcare and the Environment, Faculty of Pharmacy and Food Science, Universitat de Barcelona, Barcelona, Spain
| | - Carlos Barranco
- Department of Pathology, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
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10
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Sentís A, Martin-Sanchez M, Arando M, Vall M, Barbera MJ, Ocaña I, González Cordón A, Alsina M, Martin-Ezquerra G, Knobel H, Gurguí M, Vives A, Coll J, Caylà JA, Garcia de Olalla P. Sexually transmitted infections in young people and factors associated with HIV coinfection: an observational study in a large city. BMJ Open 2019; 9:e027245. [PMID: 31061051 PMCID: PMC6502227 DOI: 10.1136/bmjopen-2018-027245] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES Young people are a critical target group for sexually transmitted infections (STI) surveillance due to their particular behavioural and social related vulnerability. The aim of this study was to describe the epidemiological characteristics and trends in the incidence of gonorrhoea, syphilis, HIV and venereal lymphogranuloma (LGV) among 15-24-year-olds in Barcelona, and to determine factors associated with HIV coinfection. DESIGN We performed a population-based incidence study covering the 2007-2015 period. PARTICIPANTS All new cases of STI-HIV, gonorrhoea, infectious syphilis and LGV-notified to the epidemiological surveillance system in Barcelona between 2007 and 2015. 1218 cases were studied: 84.6% were men, 19.3% were 15-19 years old and 50.6% were born in Spain. Among men, 73.7% were men who have sex with men (MSM); among women, 85.6% were women that have sex with men. PRIMARY AND SECONDARY OUTCOMES Incidence of HIV, gonorrhoea, infectious syphilis and LGV. HIV coinfection. RESULTS There was an increase in the incidence of gonorrhoea, from 1.9 cases per 10 000 people in 2007 to 7.6/10 000 in 2015 (p<0.01), in MSM from 27.1 to 228.8/10 000 (p<0.01). The incidence of syphilis increased from 0.4/10 000 in 2007 to 3.1/10 000 in 2015 (significant in men only, p<0.01), in MSM from 18.1 to 116.9/10 000 (p<0.01). The incidence of HIV showed a non-significant increase in men (p=0.27), and that of LGV remained stable (p=0.59). Factors associated with increased risk of HIV coinfection included being MSM (adjusted OR[ORa]=14.14, 95% CI 3.34 to 59.91) and having >10 sexual partners (ORa=4.11, 95% CI 1.53 to 11.01) or STI diagnosis during the previous 12 months (ORa=2.06; 95% CI 1.13 to 3.77). CONCLUSIONS The incidence of gonorrhoea and syphilis among 15-24-year-olds increased, while HIV infection remained stable but with a high incidence among MSM. Being MSM, having sex with multiple partners and having a diagnosis of an STI in the previous 12 months were factors associated with HIV coinfection.
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Affiliation(s)
- Alexis Sentís
- Epidemiology Service, Public Health Agency of Barcelona (ASPB), Barcelona, Spain
| | - Mario Martin-Sanchez
- Epidemiology Service, Public Health Agency of Barcelona (ASPB), Barcelona, Spain
- Preventive Medicine and Public Health Training Unit PSMar-UPF-ASPB (Parc de Salut Mar - Pompeu Fabra University - Agència de Salut Pública de Barcelona), Barcelona, Spain
| | - Maider Arando
- Hospital de la Vall d’Hebron, Universitat Autònoma de Barcelona, Spain
| | - Martí Vall
- Hospital de la Vall d’Hebron, Universitat Autònoma de Barcelona, Spain
| | | | - Inma Ocaña
- Hospital de la Vall d’Hebron, Universitat Autònoma de Barcelona, Spain
| | | | - Mercè Alsina
- Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | | | - Hernando Knobel
- Hospital del Mar, Universitat Autonòma de Barcelona, Barcelona, Spain
| | - Mercè Gurguí
- Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Alvaro Vives
- Hospital Puigvert, Universitat Autònoma de Barcelona, Spain
| | - Josep Coll
- Hospital Tries i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain
| | - Joan Artur Caylà
- Epidemiology Service, Public Health Agency of Barcelona (ASPB), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Foundation of Tuberculosis Research Unit of Barcelona, Spain
| | - Patricia Garcia de Olalla
- Epidemiology Service, Public Health Agency of Barcelona (ASPB), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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11
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Leyva-Moral JM, Feijoo-Cid M, Moriña D, Caylà JA, Arando M, Vall M, Barbera MJ, Armengol P, Vives A, Martin-Ezquerra G, Alsina M, García Olalla P. Gay Circuit Parties in Barcelona and Their Impact on Gonorrhea Incidence. Arch Sex Behav 2018; 47:2027-2034. [PMID: 30014338 DOI: 10.1007/s10508-018-1220-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 04/10/2018] [Accepted: 04/17/2018] [Indexed: 06/08/2023]
Abstract
This study explored the role of circuit parties on the incidence of gonorrhea among men who have sex with men (MSM) in Barcelona (Spain). Specifically, it aimed to detect cyclic peaks in the number of reported diagnoses of gonorrhea after gay circuit parties. We analyzed monthly cases of gonorrhea reported from January 2007 through December 2016 after the main annual gay circuit parties in Barcelona. We used the integer autoregressive model for time series with discrete values. The performance of the model was tested in heterosexual men and women, in whom the circuit parties could be expected to have no impact. A sensitivity analysis was conducted, changing post-event diagnosis windows to 1 week later/1 week before. In the study period, a total of 4182 of gonorrhea cases were detected, of which 74.8% (n = 2181) occurred in men who identified themselves as MSM. The average annual increase in gonorrhea cases reported among MSM was 32.57%. In an independent analysis of each gay circuit party, cases increased significantly in two of them. The results were also similar for same-sex practices among men only. On controlling for the increasing trend over the study period and the seasonal effect, an average of 1.16 gonorrhea cases in MSM (95% CI: 0.68, 1.64) were attributable to the celebration of one of the gay circuit parties considered. During the expected outbreak, an average of 13 gonorrhea cases were detected and between 5 and 13% were attributable to one of the circuit parties. In view of these findings, participants should consider seeking advice from their healthcare provider and practice safer sex using condoms to prevent sexually transmitted infections. Local public health services should be reinforced to ensure care for participants during and after gay circuit parties. More research is needed to design and implement preventive programs.
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Affiliation(s)
- Juan M Leyva-Moral
- Department of Nursing, Faculty of Medicine, Universitat Autònoma de Barcelona, Barcelona, 08193, Spain
| | - Maria Feijoo-Cid
- Department of Nursing, Faculty of Medicine, Universitat Autònoma de Barcelona, Barcelona, 08193, Spain.
| | - David Moriña
- Unit of Infections and Cancer - Information and Interventions (UNIC-I&I), Catalan Institute of Oncology (ICO)-IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Joan A Caylà
- Epidemiology Service, Public Health Agency of Barcelona, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Maider Arando
- Sexually Transmitted Infection Unit-Vall Hebron, Hospital de la Vall d'Hebron, Barcelona, Spain
| | - Martí Vall
- Sexually Transmitted Infection Unit-Vall Hebron, Hospital de la Vall d'Hebron, Barcelona, Spain
| | - María Jesús Barbera
- Sexually Transmitted Infection Unit-Vall Hebron, Hospital de la Vall d'Hebron, Barcelona, Spain
| | - Pere Armengol
- Sexually Transmitted Infection Unit-Vall Hebron, Hospital de la Vall d'Hebron, Barcelona, Spain
| | - Alvaro Vives
- Sexually Transmitted Infection Unit, Fundació Puigvert, Barcelona, Spain
| | | | - Mercè Alsina
- Department of Dermatology, Hospital Clínic, Barcelona, Spain
| | - Patricia García Olalla
- Epidemiology Service, Public Health Agency of Barcelona, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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12
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Artal E, Martin-Ezquerra G. Malodorous feet. J Paediatr Child Health 2018; 54:587-588. [PMID: 29756378 DOI: 10.1111/jpc.1_13888] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 02/17/2018] [Accepted: 02/21/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Elena Artal
- Department of Medicine, General Practice Encants, Barcelona, Spain
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13
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Abstract
Pilosebaceous unit occlusion and secondary inflammatory perifollicular lympho-histiocytic infiltration seem to be the underlying etiopathogenic mechanisms giving rise to hidradenitis suppurativa (HS). Increased levels of tumor necrosis factor (TNF)-alpha and other cytokines such as interleukins 12 and 23 (IL12/23) and interleukins 10 and 17 have been observed in HS lesional skin. Biological drugs have been reported to be effective for HS, but the level and duration of the response are quite variable. Among anti-TNF drugs, adalimumab and infliximab seem to obtain better results in HS. Adalimumab is the only registered systemic agent for HS and results from multicenter clinical trials demonstrate that 58.9% of patients may achieve clinical response without significant adverse events. Continuous treatment seems to maintain the therapeutic response, but discontinuation of the treatment usually results in a rapid relapse of the disease. Infliximab may also obtain a good response profile with 50% improvement of HS lesions. Treatment with ustekinumab for HS resulted in variable results showing a moderate-to-marked improvement in 82% of patients. Anakinra, a recombinant IL-1 receptor antagonist, has been also been postulated as a potential systemic treatment for HS. A reduction in the disease activity in 67% of patients has been reported. Biological drugs seem to represent an effective therapeutic option for HS, but complete and persistent resolution of the disease is rarely achieved. Flares of the disease usually develop regardless the prescribed treatment. Combined treatments including antibiotics and retinoids seem to be a potential additional therapeutic approach. In chronic and severe cases, a surgical approach is mandatory in order to remove persistent scarring tissue. New drugs are currently being evaluated as new insights in the pathogenesis of the disease are elucidated. Several clinical trials with apremilast, anti-IL17 drugs and anti-interleukin-1 alpha are currently ongoing.
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Affiliation(s)
| | - Emili Masferrer
- Dermatology Department, Hospital Universitari Mútua de Terrassa, Barcelona, Spain
| | - Ramon M Pujol
- Dermatology Department, Hospital del Mar, Barcelona, Spain
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14
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García-Colmenero L, Martin-Ezquerra G, Monfort J, Pujol RM. Persistent cutaneous ulcers after Yttrium-90 synovectomy, an unusual complication: two case reports and a review of the literature. Int Wound J 2016; 14:508-511. [PMID: 27444802 DOI: 10.1111/iwj.12636] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 06/13/2016] [Accepted: 06/17/2016] [Indexed: 11/30/2022] Open
Abstract
Development of persistent deep cutaneous ulceration is a rare and serious complication of radiosynovectomy, an extended procedure used in the treatment of chronic synovitis. Cutaneous radiation necrosis is a rare complication of synovectomy, probably as a result of radiocolloid para-articular injection. This rare phenomenon should be suspected when an ulcer adjacent to an articulation appears several days or even months after a radiation synovectomy. It can turn into a challenging diagnosis for rheumatologists, orthopaedists and dermatologists, especially in those cases with a late development of the skin lesions. Recognition of this potential side effect is important in order to establish a proper therapeutic strategy and avoid unnecessary treatments. Surgical excision appears to be the treatment of choice. We report two patients with knee osteoarthritis treated with intra-articular injection of Yttrium-90 who developed persistent cutaneous ulcers secondary to radiation necrosis.
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Affiliation(s)
| | | | - Jordi Monfort
- Department of Rheumatology, Hospital del Mar, Barcelona, Spain
| | - Ramon M Pujol
- Department of Dermatology, Hospital del Mar, Barcelona, Spain
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15
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García-Colmenero L, Martin-Ezquerra G, Gómez-Martín I, Mellado Joan M, Barranco C, Albero-González R, Villar-García J, Pujol RM. Persistent cutaneous abdominal ulcerations secondary to diffuse dermal angiomatosis: an underestimated sign for severe atherosclerosis: A case report. Medicine (Baltimore) 2016; 95:e4212. [PMID: 27442644 PMCID: PMC5265761 DOI: 10.1097/md.0000000000004212] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Diffuse dermal angiomatosis (DDA) is a rare, acquired, reactive vascular proliferation, clinically characterized by livedoid erythematous-violaceous plaques, which frequently evolve to ulceration and necrosis. Histopathologically, it is manifested by a diffuse proliferation of endothelial cells within the full thickness of the dermis. DDA has been mainly associated with severe peripheral atherosclerosis. METHODS We report a 63-year-old woman who presented with multiple erythematous-violaceous plaques with central deep skin ulcers on thighs, lower abdomen, and perianal area, associated with intermittent claudication, low-grade fever, and weight loss. Initially, the clinical picture along with positive cultures for Klebsiella pneumoniae suggested a multifocal ecthyma gangrenosum; nevertheless, a skin biopsy showed a diffuse dermal proliferation of endothelial cells interstitially arranged between collagen bundles. A computed tomography scan revealed severe aortic atheromatosis with complete luminal occlusion of the infrarenal aorta and common iliac arteries. RESULTS The diagnosis of DDA secondary to severe atherosclerosis was established. The patient underwent a left axillofemoral bypass surgery with a rapidly healing of the ulcers in the next weeks. CONCLUSIONS DDA should be considered in the differential diagnosis of livedoid ischemic lesions. Recognition of DDA as a cutaneous sign of severe peripheral vascular disease is important for both dermatologists and internists. Recognition of risk factors and their management with an early intervention to correct tissue ischemia can be curative.
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Affiliation(s)
- Lidia García-Colmenero
- Department of Dermatology
- Correspondence: Lidia García-Colmenero, Department of Dermatology, Hospital del Mar, Parc de Salut Mar, Passeig Marítim 25–29, Barcelona, Spain (e-mail: )
| | | | | | | | | | | | - Judith Villar-García
- Department of Infectious Diseases, Hospital del Mar, Parc de Salut Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
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16
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Deza G, Martin-Ezquerra G, Gómez J, Villar-García J, Supervia A, Pujol RM. Isolation of Haemophilus influenzae and Haemophilus parainfluenzae in urethral exudates from men with acute urethritis: a descriptive study of 52 cases. Sex Transm Infect 2016; 92:29-31. [PMID: 26139207 DOI: 10.1136/sextrans-2015-052135] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 06/18/2015] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To describe the clinical characteristics and therapeutic outcomes from male patients diagnosed of Haemophilus spp urethritis. METHODS A chart review of patients who presented to our hospital from January 2013 to December 2014 with symptoms of acute urethritis in which Haemophilus spp was isolated in their urethral samples was performed. RESULTS Haemophilus spp was isolated in 52 out of 413 urethral samples (12.6%) received in our laboratory from patients with symptoms of acute urethritis during the study period. Seven cases corresponded to Haemophilus influenzae and 45 cases to Haemophilus parainfluenzae. The most common clinical presentation was mucopurulent urethral discharge (71%). Eight per cent were HIV-infected patients, and 60% were men who have sex with men. Haemophilus spp was isolated as a single pathogen in 6.8% (28 of 413) of cases. Seventeen per cent of Haemophilus spp were β-lactamase producers. All patients reported having practiced unprotected insertive oral sex the month before consultation, and five of them denied having had another sexual contact apart from this exposure. In all cases in which follow-up was available, empirical treatment achieved a complete clinical resolution. CONCLUSIONS Haemophilus spp was considered a pathogen in at least 6.8% of the patients from the evaluated area. It affected men regardless their sexual orientation or HIV status. Unprotected oral sex could play a role in its transmission. The limitations of the study (small sample size and lack of a representative control group) do not allow to prove the true pathogenic role of Haemophilus spp in acute urethritis.
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Affiliation(s)
- Gustavo Deza
- Department of Dermatology, Hospital del Mar-Parc de Salut Mar, Barcelona, Spain
| | | | - Julià Gómez
- Laboratori de Referència de Catalunya, Barcelona, Spain
| | - Judit Villar-García
- Department of Infectious Diseases, Hospital del Mar-Parc de Salut Mar, Barcelona, Spain
| | - August Supervia
- Department of Emergency, Hospital del Mar-Parc de Salut Mar, Barcelona, Spain
| | - Ramon M Pujol
- Department of Dermatology, Hospital del Mar-Parc de Salut Mar, Barcelona, Spain
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17
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Deza G, Martin-Ezquerra G, Curto-Barredo L, Villar García J, Pujol RM. Successful treatment of hypertrophic herpes simplex genitalis in HIV-infected patient with topical imiquimod. J Dermatol 2015; 42:1176-8. [PMID: 26074211 DOI: 10.1111/1346-8138.12969] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [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: 03/31/2015] [Accepted: 04/26/2015] [Indexed: 11/28/2022]
Abstract
Hypertrophic herpes simplex genitalis is an atypical presentation of genital herpes described in the context of immunosuppression, particularly HIV-positive patients. This situation can become a diagnostic and therapeutic challenge. For this reason, alternative therapies are currently being discussed in the literature. We report a case of hypertrophic genital herpes in a HIV-positive patient who was successfully treated with topical 5% imiquimod after treatment failures with oral and i.v. antivirals.
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Affiliation(s)
- Gustavo Deza
- Department of Dermatology, Hospital del Mar, Barcelona, Spain
| | | | | | | | - Ramon M Pujol
- Department of Dermatology, Hospital del Mar, Barcelona, Spain
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18
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Man MQ, Lin TK, Santiago JL, Celli A, Zhong L, Huang ZM, Roelandt T, Hupe M, Sundberg JP, Silva KA, Crumrine D, Martin-Ezquerra G, Trullas C, Sun R, Wakefield JS, Wei ML, Feingold KR, Mauro TM, Elias PM. Basis for enhanced barrier function of pigmented skin. J Invest Dermatol 2014; 134:2399-2407. [PMID: 24732399 PMCID: PMC4134407 DOI: 10.1038/jid.2014.187] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Revised: 02/25/2014] [Accepted: 03/06/2014] [Indexed: 12/29/2022]
Abstract
Humans with darkly pigmented skin display superior permeability barrier function in comparison with humans with lightly pigmented skin. The reduced pH of the stratum corneum (SC) of darkly pigmented skin could account for enhanced function, because acidifying lightly pigmented human SC resets barrier function to darkly pigmented levels. In SKH1 (nonpigmented) versus SKH2/J (pigmented) hairless mice, we evaluated how a pigment-dependent reduction in pH could influence epidermal barrier function. Permeability barrier homeostasis is enhanced in SKH2/J versus SKH1 mice, correlating with a reduced pH in the lower SC that colocalizes with the extrusion of melanin granules. Darkly pigmented human epidermis also shows substantial melanin extrusion in the outer epidermis. Both acute barrier disruption and topical basic pH challenges accelerate reacidification of SKH2/J (but not SKH1) SC, while inducing melanin extrusion. SKH2/J mice also display enhanced expression of the SC acidifying enzyme, secretory phospholipase A2f (sPLA2f). Enhanced barrier function of SKH2/J mice could be attributed to enhanced activity of two acidic pH-dependent, ceramide-generating enzymes, β-glucocerebrosidase and acidic sphingomyelinase, leading to accelerated maturation of SC lamellar bilayers. Finally, organotypic cultures of darkly pigmented human keratinocytes display enhanced barrier function in comparison with lightly pigmented cultures. Together, these results suggest that the superior barrier function of pigmented epidermis can be largely attributed to the pH-lowering impact of melanin persistence/extrusion and enhanced sPLA2f expression.
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Affiliation(s)
- Mao-Qiang Man
- Dermatology Service, Department of Veterans Affairs Medical Center, San Francisco, California, USA; Department of Dermatology, University of California, San Francisco, San Francisco, California, USA
| | - Tzu-Kai Lin
- Dermatology Service, Department of Veterans Affairs Medical Center, San Francisco, California, USA; Department of Dermatology, University of California, San Francisco, San Francisco, California, USA; Graduate Institute of Clinical Medicine, National Cheng Kung University Medical College, Tainan, Taiwan; Department of Dermatology, National Cheng Kung University Medical College and Hospital, Tainan, Taiwan
| | - Juan L Santiago
- Dermatology Service, Department of Veterans Affairs Medical Center, San Francisco, California, USA; Department of Dermatology, University of California, San Francisco, San Francisco, California, USA
| | - Anna Celli
- Dermatology Service, Department of Veterans Affairs Medical Center, San Francisco, California, USA; Department of Dermatology, University of California, San Francisco, San Francisco, California, USA
| | - Lily Zhong
- Dermatology Service, Department of Veterans Affairs Medical Center, San Francisco, California, USA; Department of Dermatology, University of California, San Francisco, San Francisco, California, USA
| | - Zhi-Ming Huang
- Dermatology Service, Department of Veterans Affairs Medical Center, San Francisco, California, USA; Department of Dermatology, University of California, San Francisco, San Francisco, California, USA
| | - Truus Roelandt
- Department of Dermatology, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Melanie Hupe
- Dermatology Service, Department of Veterans Affairs Medical Center, San Francisco, California, USA; Department of Dermatology, University of California, San Francisco, San Francisco, California, USA
| | - John P Sundberg
- Department of Research and Development, The Jackson Laboratory, Bar Harbor, Maine, USA
| | - Kathleen A Silva
- Department of Research and Development, The Jackson Laboratory, Bar Harbor, Maine, USA
| | - Debra Crumrine
- Dermatology Service, Department of Veterans Affairs Medical Center, San Francisco, California, USA; Department of Dermatology, University of California, San Francisco, San Francisco, California, USA
| | - Gemma Martin-Ezquerra
- Dermatology Service, Department of Veterans Affairs Medical Center, San Francisco, California, USA; Department of Dermatology, University of California, San Francisco, San Francisco, California, USA; Department of Dermatology, Hospital del Mar-IMIM, Universitat Autonoma de Barcelona, Barcelona, Spain
| | | | - Richard Sun
- Dermatology Service, Department of Veterans Affairs Medical Center, San Francisco, California, USA; Department of Dermatology, University of California, San Francisco, San Francisco, California, USA
| | - Joan S Wakefield
- Dermatology Service, Department of Veterans Affairs Medical Center, San Francisco, California, USA; Department of Dermatology, University of California, San Francisco, San Francisco, California, USA
| | - Maria L Wei
- Dermatology Service, Department of Veterans Affairs Medical Center, San Francisco, California, USA; Department of Dermatology, University of California, San Francisco, San Francisco, California, USA
| | - Kenneth R Feingold
- Medical Service, Department of Veterans Affairs Medical Center, and Department of Metabolism, University of California, San Francisco, San Francisco, California, USA
| | - Theodora M Mauro
- Dermatology Service, Department of Veterans Affairs Medical Center, San Francisco, California, USA; Department of Dermatology, University of California, San Francisco, San Francisco, California, USA
| | - Peter M Elias
- Dermatology Service, Department of Veterans Affairs Medical Center, San Francisco, California, USA; Department of Dermatology, University of California, San Francisco, San Francisco, California, USA.
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Martin-Ezquerra G, Masferrer E, Masferrer-Niubò M, Ferran M, Sánchez-Regaña M, Collgros H, Bordas X, Notario J, Alsina M, Gil I, Izquierdo N, Aparicio G, Mollet J, Garcia-Patos V, Pujol R. Use of biological treatments in patients with hidradenitis suppurativa. J Eur Acad Dermatol Venereol 2014; 29:56-60. [DOI: 10.1111/jdv.12438] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Accepted: 01/31/2014] [Indexed: 01/28/2023]
Affiliation(s)
| | - E. Masferrer
- Dermatology Department; Hospital del Mar; Barcelona Spain
| | - M. Masferrer-Niubò
- Mathematic Department; Universidad Nacional de Educación a Distancia UNED; Barcelona Spain
| | - M. Ferran
- Dermatology Department; Hospital del Mar; Barcelona Spain
| | | | - H. Collgros
- Dermatology Department; Hospital Sagrat Cor; Barcelona Spain
| | - X. Bordas
- Dermatology Department; Hospital de Bellvitge; Barcelona Spain
| | - J. Notario
- Dermatology Department; Hospital de Bellvitge; Barcelona Spain
| | - M. Alsina
- Dermatology Department; Hospital Clínic; Barcelona Spain
| | - I. Gil
- Dermatology Department; Hospital Sant Joan de Reus; Reus Spain
| | - N. Izquierdo
- Dermatology Department; Hospital Son Espases; Palma de Mallorca Spain
| | - G. Aparicio
- Dermatology Department; Hospital de la Vall d ‘Hebron; Barcelona Spain
| | - J. Mollet
- Dermatology Department; Hospital de la Vall d ‘Hebron; Barcelona Spain
| | - V. Garcia-Patos
- Dermatology Department; Hospital de la Vall d ‘Hebron; Barcelona Spain
| | - R.M. Pujol
- Dermatology Department; Hospital del Mar; Barcelona Spain
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20
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Man W, Man M, Hupe M, Martin-Ezquerra G, Feingold KR, Elias PM, Man MQ. Topical herbal extract (Huangdang mixture) exhibits both preventive and therapeutic effects in murine acute irritant contact dermatitis. Int J Dermatol 2012; 50:1421-1427. [PMID: 22004502 DOI: 10.1111/j.1365-4632.2011.04970.x] [Citation(s) in RCA: 4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Contact dermatitises, including allergic contact dermatitis and irritant contact dermatitis, are among the most common skin disorders in humans. Chinese herbal medicines (CHM) have been used in treating contact dermatitises for centuries. Systemic administration of CHM, including ingredients in huangdang mixture containing Chinese angelica, radix Paeonlae rubra, cat nut, and phelloden dron, rhizoma alismatis, rhizoma smilacis glabrae, and rhizome of swordlike, improves allergic contact dermatitis induced by l-fluoro-2,4-dinitrobenzene. Whether topical applications of these herbal extracts display preventive and/or therapeutic effects on contact dermatitis, thereby avoiding the potential side effects of systemic CHM, remains largely unknown. AIMS To determine whether this topical CHM extract exerts preventive and/or therapeutic effects, we assessed its efficacy in both allergic contact dermatitis and irritant contact dermatitis murine models. MATERIALS AND METHODS Allergic contact dermatitis and irritant contact dermatitis murine models were established by topical oxazolone and a phorbol ester (12-O-tetradecanoylphorbol-13-acetate; TPA), respectively. Ear thickness was assessed in both dermatitis models. RESULTS Our results demonstrate that this topical CHM extract exhibits both therapeutic and preventive effects in acute irritant contact dermatitis but no demonstrable efficacy in murine allergic contact dermatitis. CONCLUSION These results suggest that this topical CHM extract could provide an alternative regimen for the prevention and treatment of irritant contact dermatitis.
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Affiliation(s)
- Wenyan Man
- Dermatology Service, Veterans Affairs Medical Center, and Department of Dermatology, University of California, San Francisco, CA 94121, USA
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21
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Sagristà M, Martin-Ezquerra G, Gallardo F, Membrilla E, Salazar AJ, Salvadó M, Gómez J, Pujol RM. Inguinal syndrome secondary to Prevotella bivia after accidental bite in orogenital sex. Sex Transm Infect 2012; 88:250-1. [PMID: 22375046 DOI: 10.1136/sextrans-2011-050348] [Citation(s) in RCA: 4] [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] [Indexed: 11/04/2022] Open
Abstract
The authors report a case of an inguinal bubo in a young man caused by an anaerobe, Prevotella bivia, which was acquired during oral sexual intercourse. As far as the authors know, this is the first reported case of a sexually transmitted infection by Prevotella. Prevotella spp. inhabit the oral cavity and are highly prevalent in bacterial vaginosis, a polymicrobial syndrome resulting from replacement of the normal vaginal Lactobacillus spp. flora by high concentrations of anaerobic microorganisms such as Prevotella spp., Mobiluncus spp., Gardnerella vaginalis and other uncultivated anaerobes.
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Affiliation(s)
- Marc Sagristà
- Department of Dermatology, Sexually Transmitted Infections Unit, Hospital del Mar, Parc de Salut Mar, Passeig Marítim 25-29 Barcelona 08003, Spain.
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22
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Vargas-Leguas H, Garcia de Olalla P, Arando M, Armengol P, Barbera M, Vall M, Vives A, Martin-Ezquerra G, Alsina M, Blanco J, Munoz C, Caballero E, Andreu A, Ros M, Gorrindo P, Dominguez A, Cayla J. Lymphogranuloma venereum: a hidden emerging problem, Barcelona, 2011. Euro Surveill 2012; 17:20057. [PMID: 22264862] [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: 05/31/2023] Open
Abstract
From the beginning of 2007 until the end of 2011, 146 cases of lymphogranuloma venereum (LGV) were notified to the Barcelona Public Health Agency. Some 49% of them were diagnosed and reported in 2011, mainly in men who have sex with men. Almost half of them, 32 cases, were reported between July and September. This cluster represents the largest since 2004. This article presents the ongoing outbreak of LGV in Barcelona.
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Affiliation(s)
- H Vargas-Leguas
- Epidemiology Service, Public Health Agency of Barcelona, Barcelona, Spain
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23
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Man M, Hupe M, Mackenzie D, Kim H, Oda Y, Crumrine D, Lee SH, Martin-Ezquerra G, Trullas C, Mauro TM, Feingold KR, Elias PM, Man MQ. A topical Chinese herbal mixture improves epidermal permeability barrier function in normal murine skin. Exp Dermatol 2011; 20:285-8. [PMID: 21323748 DOI: 10.1111/j.1600-0625.2010.01205.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Chinese herbal medicine (CHM) has been shown to have beneficial effects for both skin disorders with barrier abnormality and as skin care ingredients. Yet, how CHM exerts their benefits is unclear. As most, if not all, inflammatory dermatoses are accompanied by abnormal permeability barrier function, we assessed the effects of topical CHM extracts on epidermal permeability barrier function and their potential mechanisms. Topical CHM accelerated barrier recovery following acute barrier disruption. Epidermal lipid content and mRNA expression of fatty acid and ceramide synthetic enzymes increased following topical CHM treatment in addition to mRNA levels for the epidermal glucosylceramide transport protein, ATP-binding cassette A12. Likewise, CHM extract increased mRNA expression of antimicrobial peptides both in vivo and in vitro. These results demonstrate that the topical CHM extract enhances epidermal permeability barrier function, suggesting that topical CHM could provide an alternative regimen for the prevention/treatment of inflammatory dermatoses accompanied by barrier abnormalities.
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Juanpere-Rodero N, Martin-Ezquerra G, Fernandez-Casado A, Magan-Perea L, Garcia-Alguacil MA, Barranco-Sanz C, Serrano-Figueras S, Pujol-Vallverdu RM, Lloreta-Trull J. Cell and Tissue Interactions ofTreponema pallidumin Primary and Secondary Syphilitic Skin Lesions: An Ultrastructural Study of Serial Sections. Ultrastruct Pathol 2011; 37:36-42. [DOI: 10.3109/01913123.2011.584498] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Masferrer E, Martin-Ezquerra G, Martínez-Escala E, Pujol RM, Giménez-Arnau A. Eosinophilic panniculitis triggered by intramuscular penicillin and occupational setting. Allergy 2011; 66:436-7. [PMID: 21284653 DOI: 10.1111/j.1398-9995.2010.02490.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- E Masferrer
- Department of Dermatology, Hospital del Mar Passeig, Barcelona, Spain.
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Fernández-Casado A, Martin-Ezquerra G, Yébenes M, Plana F, Elvira-Betanzos JJ, Herrero-González JE, Mariñoso ML, Pujol RM. Progressive supravenous granulomatous nodular eruption in a human immunodeficiency virus-positive intravenous drug user treated with highly active antiretroviral therapy. Br J Dermatol 2007; 158:145-9. [PMID: 17941945 DOI: 10.1111/j.1365-2133.2007.08238.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We describe a 41-year-old human immunodeficiency virus-infected woman with a previous history of intravenous drug abuse, who developed multiple linear nodules following the superficial veins on both arms. Histopathological examination disclosed a dermal histiocytic inflammatory reaction with sarcoid-like granuloma formation occasionally showing an intracytoplasmic refractile material in the histiocytic cells. Nodular lesions developed progressively after starting on highly active antiretroviral therapy (HAART) which increased her CD4 cell count and suppressed her viral load. The appearance of latent inflammatory or autoimmune disease following HAART is a well-recognized phenomenon. We consider that this peculiar 'progressive supravenous granulomatous nodular eruption' should be included within the spectrum of the so-called immune reconstitution inflammatory syndrome.
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Affiliation(s)
- A Fernández-Casado
- Department of Dermatology, Hospital del Mar-IMAS, Passeig Marítim 25-29, 08003 Barcelona, Spain
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Ferran M, Martin-Ezquerra G, Vicente A, Noguera A, Alsina L, Gonzalez-Enseñat MA. Picture of the month. Acquired secondary syphilis. ACTA ACUST UNITED AC 2007; 161:199-200. [PMID: 17283307 DOI: 10.1001/archpedi.161.2.199] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Marta Ferran
- Department of Dermatology, Hospital Sant Joan de Déu, Barcelona, Spain
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Martin-Ezquerra G, Sanchez-Regaña M, Massana-Gil J, Umbert-Millet P. Papular mucinosis associated with subclinical hypothyroidism: improvement with thyroxine therapy. J Eur Acad Dermatol Venereol 2006; 20:1340-1. [PMID: 17062063 DOI: 10.1111/j.1468-3083.2006.01685.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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