Actas dermo-sifiliograficas最新文献

{"title":"ICTIOSIS: Actualización clínica y molecular. Parte 1: introducción e ictiosis no sindrómicas","authors":"C. Gutiérrez-Cerrajero ,&nbsp;R. González-Sarmiento ,&nbsp;Á. Hernández-Martín","doi":"10.1016/j.ad.2024.09.025","DOIUrl":"10.1016/j.ad.2024.09.025","url":null,"abstract":"<div><div>Ichthyoses are a heterogeneous group of diseases sharing symptoms and a common etiopathogenic mechanism. Clinically, these diseases are characterized by the presence of erythema and variable degrees of skin thickening and desquamation. Although the affected area, severity, and molecular substrate are very variable, they are all signs of a disruption of the barrier formed during epidermal differentiation. Ichthyoses follow patterns of Mendelian inheritance and present symptoms since birth or shortly thereafter. Clinically, they can be categorized into non-syndromic (when symptoms are caused exclusively by the epidermal barrier dysfunction) and syndromic ichthyoses (when the causal gene has extracutaneous functions impacting other organs).</div><div>Knowledge of molecular mechanisms has improved dramatically over the past few years, and we currently know not only most causal genes, but also the functions of the encoded proteins and their impact on skin barrier formation. In the first part of this review, we’ll be introducing ichthyosis physiopathology, along with a clinical and genetic update of non-syndromic entities (those included in the consensus classification and those clinically and/or molecularly characterized since then).</div></div>","PeriodicalId":7173,"journal":{"name":"Actas dermo-sifiliograficas","volume":"116 5","pages":"Pages 481-496"},"PeriodicalIF":3.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Translated article] ICHTHYOSIS: Clinical and Molecular Update. Part 2: Syndromic Ichthyosis. Diagnostic and Therapeutic Approach of Ichthyosis","authors":"C. Gutiérrez-Cerrajero ,&nbsp;R. González-Sarmiento ,&nbsp;Á. Hernández-Martín","doi":"10.1016/j.ad.2025.03.013","DOIUrl":"10.1016/j.ad.2025.03.013","url":null,"abstract":"<div><div>Syndromic ichthyoses are a group of disorders whose genetic alterations impact both epidermal and non-epidermal tissues. Therefore, patients present symptoms in other organs. Most are extraordinary and, in some, ichthyosiform desquamation has been poorly described. Their patterns of inheritance are diverse; their extracutaneous clinical signs, heterogeneous; and the skin symptoms, highly variable, which hinders a proper clinical classification.</div><div>Ichthyosis diagnosis starts with proper anamnesis, detailed physical examination, and detection of associated analytic and/or histologic findings. Genetic testing is indispensable, not only for diagnostic certainty, but also because understanding the molecular substrate for each patient is the first step towards finding an individualized therapeutic regimen. While it will almost invariably involve facilitating desquamation and maintaining skin hydration using topical exfoliants and emollients, recently, replacement therapies aiming at substituting the proteins and lipids specifically altered in each patient are being developed and gene therapy approaches with the ultimate goal of curing the disease are being assessed. In part 2 of this review, we will be updating the clinical and genetic findings of syndromic entities, ichthyosis diagnosis and treatment.</div></div>","PeriodicalId":7173,"journal":{"name":"Actas dermo-sifiliograficas","volume":"116 5","pages":"Pages T497-T510"},"PeriodicalIF":3.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Artículo traducido] Alteraciones analíticas durante el tratamiento con dupilumab para la dermatitis atópica","authors":"D. Flor ,&nbsp;C. Montero-Vilchez ,&nbsp;T. Montero-Vilchez ,&nbsp;S. Arias-Santiago ,&nbsp;M. Gonçalo","doi":"10.1016/j.ad.2025.02.020","DOIUrl":"10.1016/j.ad.2025.02.020","url":null,"abstract":"<div><h3>Introduction</h3><div>Dupilumab is an IL-4/IL-13 inhibitor monoclonal antibody approved for the treatment of moderate-to-severe atopic dermatitis (AD) with remarkable safety and efficacy profiles. However, former studies have reported an increase in serum eosinophils during treatment, with undetermined clinical significance.</div><div>The objective of this study is to evaluate changes in blood eosinophils and other laboratory parameters while on dupilumab.</div></div><div><h3>Methods</h3><div>We conducted a multicenter, prospective, observational study from 2018 to 2022 with adolescent and adult patients with moderate-to-severe atopic dermatitis treated with dupilumab from <em>Hospital Universitario Virgen de las Nieves</em>, Spain, and Coimbra University Hospital, Portugal. Clinical scoring of the dermatitis, complete blood count, total serum IgE and LDH levels were collected at baseline and on weeks 8, 16, 24 and 48.</div></div><div><h3>Results</h3><div>We included a total of 81 patients (41 women/40 men; mean age of 30.86<!--> <!-->±<!--> <!-->12.26 years). Clinical and demographic characteristics were similar across centres. AD severity scales (EASI, SCORAD, BSAM, ItchVAS and SleepVAS) showed sustained improvement from week 8 of treatment onwards. Eosinophil levels were significantly higher on week 16 (0.69<!--> <!-->×<!--> <!-->10³/μL) vs baseline (0.41<!--> <!-->×<!--> <!-->10³/μL) (<em>p</em> <!-->=<!--> <!-->0.018) and returned to baseline levels on week 48 (0.59<!--> <!-->×<!--> <!-->10³/μL, <em>p</em> <!-->&gt;<!--> <!-->0.05). LDH and IgE levels decreased during the study.</div></div><div><h3>Conclusion</h3><div>Our study showed a significant clinical improvement of AD but a mild and self-limited increase in eosinophil levels on week 16, not associated with any clinical signs. Therefore, elevated serum eosinophil levels in AD patients on dupilumab does not seem clinically relevant and should not condition treatment withdrawal.</div></div>","PeriodicalId":7173,"journal":{"name":"Actas dermo-sifiliograficas","volume":"116 5","pages":"Pages T474-T480"},"PeriodicalIF":3.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143481943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laboratory Changes During Dupilumab Treatment for Atopic Dermatitis","authors":"D. Flor ,&nbsp;C. Montero-Vilchez ,&nbsp;T. Montero-Vilchez ,&nbsp;S. Arias-Santiago ,&nbsp;M. Gonçalo","doi":"10.1016/j.ad.2024.10.059","DOIUrl":"10.1016/j.ad.2024.10.059","url":null,"abstract":"<div><h3>Introduction</h3><div>Dupilumab is an IL-4/IL-13 inhibitor monoclonal antibody approved for the treatment of moderate-to-severe atopic dermatitis (AD) with remarkable safety and efficacy profiles. However, former studies have reported an increase in serum eosinophils during treatment, with undetermined clinical significance.</div><div>The objective of this study is to evaluate changes in blood eosinophils and other laboratory parameters while on dupilumab.</div></div><div><h3>Methods</h3><div>We conducted a multicenter, prospective, observational study from 2018 to 2022 with adolescent and adult patients with moderate-to-severe atopic dermatitis treated with dupilumab from <em>Hospital Universitario Virgen de las Nieves</em>, Spain, and Coimbra University Hospital, Portugal. Clinical scoring of the dermatitis, complete blood count, total serum IgE and LDH levels were collected at baseline and on weeks 8, 16, 24 and 48.</div></div><div><h3>Results</h3><div>We included a total of 81 patients (41 women/40 men; mean age of 30.86<!--> <!-->±<!--> <!-->12.26 years). Clinical and demographic characteristics were similar across centres. AD severity scales (EASI, SCORAD, ItchVAS and SleepVAS) showed sustained improvement from week 8 of treatment onwards. Eosinophil levels were significantly higher on week 16 (0.69<!--> <!-->×<!--> <!-->10³/μL) vs baseline (0.41<!--> <!-->×<!--> <!-->10³/μL) (<em>p</em> <!-->=<!--> <!-->0.018) and returned to baseline levels on week 48 (0.59<!--> <!-->×<!--> <!-->10³/μL, <em>p</em> <!-->&gt;<!--> <!-->0.05). LDH and IgE levels decreased during the study.</div></div><div><h3>Conclusion</h3><div>Our study showed a significant clinical improvement of AD but a mild and self-limited increase in eosinophil levels on week 16, not associated with any clinical signs. Therefore, elevated serum eosinophil levels in AD patients on dupilumab does not seem clinically relevant and should not condition treatment withdrawal.</div></div>","PeriodicalId":7173,"journal":{"name":"Actas dermo-sifiliograficas","volume":"116 5","pages":"Pages 474-480"},"PeriodicalIF":3.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acral Melanoma in the Caucasian Population: A Comprehensive Cohort Study on Epidemiological, Clinicopathological, and Prognostic Features","authors":"J. Angel-Baldo ,&nbsp;S. Podlipnik ,&nbsp;A. Azón ,&nbsp;A. Boada ,&nbsp;A. Arrieta ,&nbsp;J. Marcoval ,&nbsp;C. López-Sánchez ,&nbsp;M. Sàbat ,&nbsp;S. Segura ,&nbsp;D. Bodet ,&nbsp;N. Curcó ,&nbsp;D. Lopez-Castillo ,&nbsp;J. Solà ,&nbsp;M. Quintana-Codina ,&nbsp;C. Baliu-Piqué ,&nbsp;M. Just-Sarobé ,&nbsp;S. Martín-Sala ,&nbsp;J. Malvehy ,&nbsp;S. Puig ,&nbsp;C. Carrera ,&nbsp;Nerea Mohino-Farré","doi":"10.1016/j.ad.2024.10.060","DOIUrl":"10.1016/j.ad.2024.10.060","url":null,"abstract":"<div><h3>Background</h3><div>Acral melanoma is associated with poor prognosis. Studying the characteristics and prognosis of Caucasian patients is crucial to understand the distinct features of this tumor.</div></div><div><h3>Objectives</h3><div>To analyze the epidemiological, clinicopathological, and prognostic features of acral melanoma in Caucasian patients.</div></div><div><h3>Methods</h3><div>We conducted a retrospective, multicenter, cohort study of acral melanoma from a database across 20 hospitals from South Europe from January 2000 to December 2019.</div></div><div><h3>Results</h3><div>A total of 733 acral melanomas were identified (median age, 67.5 years; 95.2%, Caucasians; 77.5% of which were located on the feet). Overall, 77.5% of cases were invasive melanomas. Foot melanomas had a higher proportion of invasive cases (80.8% vs 69.8%; <em>p</em> <!-->=<!--> <!-->0.003), stages III and IV at diagnosis (24.8% vs 11.7%; <em>p</em> <!-->&lt;<!--> <!-->0.001), thicker Breslow depth (2.8<!--> <!-->mm vs 2.0<!--> <!-->mm; <em>p</em> <!-->=<!--> <!-->0.021) and a higher rate of positive sentinel lymph node biopsy (SLNB) (30.7% vs 15.7%; <em>p</em> <!-->=<!--> <!-->0.012). Thicker Breslow depth and later age of onset were risk factors for melanoma-specific survival. Thicker Breslow depth and ulceration were independent prognostic factors of relapse-free survival. Melanoma location and histopathological subtype were not associated with worse prognosis. Recurrences were a common finding (27.7%), with distant metastases appearing earlier than locoregional recurrences (1.32 years [IQR, 1.12–1.87] vs 2.14 years [IQR, 1.68–2.70]; <em>p</em> <!-->=<!--> <!-->0.015).</div></div><div><h3>Conclusion</h3><div>This study, the largest in a predominantly Caucasian population, underscores the unfavorable outcomes of acral melanoma. Foot melanomas exhibited delayed detection, increased invasiveness, thicker Breslow depth, increased SLNB involvement, and higher AJCC stages. The high recurrence rate and early distant metastases emphasize the critical role of intensive follow-up and routine imaging modalities to detect asymptomatic relapses.</div></div>","PeriodicalId":7173,"journal":{"name":"Actas dermo-sifiliograficas","volume":"116 5","pages":"Pages 462-473"},"PeriodicalIF":3.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Translated article] Ultrasound Features of Primary Cutaneous Marginal Zone B-Cell Lymphoma","authors":"R.F. Rubio-Aguilera,&nbsp;H. Álvarez-Garrido,&nbsp;G. Baeza-Hernández,&nbsp;L. Fernández-de la Fuente,&nbsp;S.P. Herrero-Ruiz,&nbsp;B. Echeverría-García","doi":"10.1016/j.ad.2025.03.001","DOIUrl":"10.1016/j.ad.2025.03.001","url":null,"abstract":"","PeriodicalId":7173,"journal":{"name":"Actas dermo-sifiliograficas","volume":"116 5","pages":"Pages T550-T552"},"PeriodicalIF":3.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Translated article] RF – Metformin as Part of the Therapeutic Armamentarium of Hidradenitis Suppurativa","authors":"J.M. Camino Salvador,&nbsp;A. Martínez Fernández,&nbsp;C. Chiloeches Fernández","doi":"10.1016/j.ad.2025.03.005","DOIUrl":"10.1016/j.ad.2025.03.005","url":null,"abstract":"","PeriodicalId":7173,"journal":{"name":"Actas dermo-sifiliograficas","volume":"116 5","pages":"Pages T542-T544"},"PeriodicalIF":3.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Secondary Intention Healing After Mohs Micrographic Surgery: An Updated Review of Classic and Novel Applications, Benefits and Complications","authors":"J. Gil-Lianes,&nbsp;I. Marti-Marti,&nbsp;D. Morgado-Carrasco","doi":"10.1016/j.ad.2024.09.024","DOIUrl":"10.1016/j.ad.2024.09.024","url":null,"abstract":"<div><div>Although secondary intention healing (SIH) is a fundamental aspect of postoperative care following Mohs micrographic ssurgery (MMS), it is currently underutilized. SIH constitutes a safe, cost-effective, and versatile method for wound closure. SIH offers multiple advantages, including enhanced cancer surveillance, reduced pain, and promosing esthetic outcomes, particularly not only on certain anatomical regions such as the medial canthus, antihelix, temple, or alar crease, but also for relatively small and superficial defects on the eyelids, ears, lips, and nose, including the alar region, and defects on the hands dorsal regions. Careful patient selection and thorough risk assessment are imperative to mitigate potential complications, including retraction, hyper/hypopigmented scars, or delayed healing. This comprehensive review aims to inform evidence-based decision-making on the role of SIH in MMS, synthesizing its indications, advantages, complications, wound care, and integration with other reconstructive methods.</div></div>","PeriodicalId":7173,"journal":{"name":"Actas dermo-sifiliograficas","volume":"116 5","pages":"Pages 511-520"},"PeriodicalIF":3.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estudio prospectivo multicéntrico de casos y controles del exposoma en melanoma","authors":"A. Navarro-Bielsa ,&nbsp;T. Gracia-Cazaña ,&nbsp;M. Almagro ,&nbsp;S. De-la-Fuente-Meira ,&nbsp;Á. Florez ,&nbsp;O. Yélamos ,&nbsp;T. Montero-Vilchez ,&nbsp;C. González-Cruz ,&nbsp;A. Diago ,&nbsp;I. Abadías-Granado ,&nbsp;V. Fuentelsaz ,&nbsp;M. Colmenero ,&nbsp;J. Bañuls ,&nbsp;S. Arias-Santiago ,&nbsp;A. Buendía-Eisman ,&nbsp;M. Almenara-Blasco ,&nbsp;P. Gil-Pallares ,&nbsp;Y. Gilaberte","doi":"10.1016/j.ad.2024.09.022","DOIUrl":"10.1016/j.ad.2024.09.022","url":null,"abstract":"<div><div>UV radiation is the main etiological agent of skin cancer. Other factors such as pollution, diet and lifestyle are also contributing factors. Our aim was to investigate the association between melanoma and exposome factors in the Spanish population with a prospective multicenter case-control study. Case group included patients with melanoma while the control group included people who attended the consultations as companions without a past medical history of skin cancer. A total of 73 melanoma patients and 126 controls were included. The former group included more outdoor workers, a history of skin cancer, drug use (acetylsalicylic acid, antidepressants and ACE inhibitors, p<!--> <!-->&lt;<!--> <!-->0.05), more sun exposure (p<!--> <!-->&lt;<!--> <!-->0.001) and more sunburns (p<!--> <!-->=<!--> <!-->0.04). Controls used shade (p<!--> <!-->=<!--> <!-->0.04) or clothing (p<!--> <!-->&lt;<!--> <!-->0.001) and the sun protection factor (SPF) used 15 years earlier was higher (p<!--> <!-->=<!--> <!-->0.04). Melanoma-related exposome factors are associated with sun exposure, drug intake and food. Prevention strategies should target specific populations, such as outdoor workers by promoting sun-safe behaviors and healthy lifestyle habits since childhood.</div></div>","PeriodicalId":7173,"journal":{"name":"Actas dermo-sifiliograficas","volume":"116 5","pages":"Pages 527-533"},"PeriodicalIF":3.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Translated article] Glossy, Pale White Plaque on the Thigh","authors":"I.R. Camardella,&nbsp;M.V. Marin,&nbsp;S. Rodríguez Saa","doi":"10.1016/j.ad.2025.03.011","DOIUrl":"10.1016/j.ad.2025.03.011","url":null,"abstract":"","PeriodicalId":7173,"journal":{"name":"Actas dermo-sifiliograficas","volume":"116 5","pages":"Pages T540-T541"},"PeriodicalIF":3.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}