Síndrome de Osler-Weber-Rendu y su relación con la dermatología

Osler-Weber-Rendu syndrome, also known as hereditary hemorrhagic telangiectasia, is a rare autosomal dominant disorder with an estimated worldwide prevalence of 1 case per 10,000 population. Its clinical manifestations are the result of arteriovenous malformations characterized by telangiectases that can affect the skin, mucous membranes, and solid organs and cause life-threatening conditions, such as liver disease, systemic emboli, and heart failure. Timely diagnosis is thus essential in order to prevent disease-related complications and offer genetic counseling to families. We review the clinical features of Osler-Weber-Rendu syndrome with a focus on mucocutaneous manifestations and their treatment.     

Evaluación de la vida sexual y de la satisfacción matrimonial en pacientes con verruga anogenital

Anogenital wart (AGW) resulting from human papilloma virus (HPV) is one of the most common sexually transmitted diseases worldwide. Herein, we aimed to evaluate the effects of AGW on patients‘marital satisfaction and sexual function. This cross-sectional study was consisted of 74 consecutive patients including 37 patients with AGW and 37 healthy controls. ENRICH Marital Satisfaction Scale and Arizona Sexual Experience Scale were completed and analyzed for all patients. ENRICH scale items were not significantly different between the two groups. Sexual function was found to be lower in female than male patients (P < .001). According to our findings marital satisfaction was not affected by AGW. However, a history of previous treatment for HPV decreased the marital satisfaction. In addition, AGW had more adverse effects on females’ sexual function compared to males. Our findings suggest that the psychiatric treatments should be considered when managing an AGW patient.     

Leucodermia en pacientes con melanoma tratados con interferón

—The association between leucoderma or vitiligo and melanoma has often been described in the literature, and in some cases it has been related with a good prognosis. These achromic lesions may appear before or after the diagnosis of melanoma. The association between leucoderma and interferon has also been described. We present three patients diagnosed of melanoma with lymph node metastasis who developed leucoderma or leucothrichia during treatment with interferon α2b. One of the patients had a melanoma metastasis with an achromic halo before treatment with interferon. The appearance of achromic lesions in patients with melanoma could be the result of a selective immunologic response against pigmented cells. In our three patients there is a sequencial relationship between the treatment with interferon and the appearance of the achromic lesions. This fact suggests that immunotherapy could stimulate this immunological response.     

Obesidad y psoriasis: naturaleza inflamatoria de la obesidad,relación entre psoriasis y obesidad e implicaciones terapéuticas

Obesity, particularly abdominal obesity, is currently considered a chronic low-grade inflammatory condition that plays an active role in the development of the pathophysiologic phenomena responsible for metabolic syndrome and cardiovascular disease through the secretion of proinflammatory adipokines and cytokines. In recent years clear genetic, pathogenic, and epidemiologic links have been established between psoriasis and obesity, with important implications for health. The relationship between the 2 conditions is probably bidirectional, with obesity predisposing to psoriasis and psoriasis favoring obesity.Obesity also has important implications in the treatment of psoriasis, such as a greater risk of adverse effects with conventional systemic drugs and reduced efficacy and/or increased cost with biologic agents, for which dosage should be adjusted to the patient's weight.     

Morfea postradioterapia en pacientes con cáncer de mama. Posible relación con otras enfermedades autoinmunes

Postirradiation morphea is an uncommon entity that has been mostly described in women with breast cancer. The increasing use of radiotherapy to treat breast cancer and the clinical similarities between morphea and other conditions, such as radiodermatitis, postirradiation fibrosis, and tumor recurrence, highlights the need for dermatologists to be familiar with this entity. We present a series of 6 women with a mean age of 64.2 years and a mean latency of 9.5 years between radiotherapy for breast cancer and onset of morphea. Four of the patients had a history of autoimmune disease: rheumatoid arthritis, Sjögren syndrome, vitiligo, and Crohn disease. No specific risk factors for postirradiation morphea have been identified to date, although it would appear that a history of autoimmune disease could be associated with an increased risk of morphea in patients treated with radiation therapy.     

Actividad fotoprotectora del extracto estandarizado de Polypodium leucotomos,nicotinamida, vitamina D y cinc en la prevención y la reducción de brotes en los pacientes con erupción polimorfa lumínica

IntroductionPolymorphous light eruption (PLE) is the most common form of photodermatosis in our environment and the origin is still unknown. Persistent symptoms and evolution in outbreaks of an unpredictable nature affects the quality of life of patients. The absence of a definitive treatment indicates the need to expand the available therapeutic options.MethodologyWe present a prospective study in which 15 patients with PLE were treated with standardized extract of Polypodium leucotomos, nicotinamide, vitamin D and zinc orally for 12 weeks whose symptoms were not controlled only with topical photoprotection. Patients were evaluated for three validated scales: Urticaria Activity Score (UAS7), Dermatology Life Quality Index (DLQI) and visual analogue scale for pruritus (VAS).ResultsFor all scales, there was some degree of improvement in 13 of 15 patients. The mean reduction in the intensity of itching was 4 points on the VAS, the mean reduction for the UAS7 scale of the outbreak was 7.8 and for the DLQI scale 2.8. A third of patients did not suffer any symptoms during the summer period.ConclusionsThe use of the standardized extract of Polypodium leucotomos, nicotinamide, vitamin D and zinc orally, together with an adequate topical photoprotection, represents an effective and safe alternative to prevent and reduce the number and severity of outbreaks in these patients.     

Manifestaciones orales en pacientes con psoriasis. Prevalencia y asociación con sus características clínicas y epidemiológicas

Background and objectivePsoriasis is a multisystem disease associated with an increased prevalence of oral lesions. The aim of this study was to determine the prevalence of oral lesions in patients with psoriasis and examine associations with clinical and patient characteristics.Material and methodsWe conducted a cross-sectional study of patients with psoriasis and healthy controls seen between December 2019 and February 2020. We recorded biometric data, comorbidities associated with psoriasis, oral examination findings, and clinical characteristics of psoriasis.ResultsWe studied 100 patients with psoriasis and 100 controls. Oral lesions were more common in the psoriasis group (74% vs 46%, P < .001). The most common lesions were fissured tongue (39% vs 16%, P < .001) and periodontitis (28% vs 16%, P = .04). Geographic tongue was uncommon in both the study and the control group (4% vs 2%, P = .68). In the psoriasis group, patients with fissured tongue had a higher prevalence of cardiovascular disease (23.1% vs 4.9%), diabetes mellitus (28.2% vs 8.2%), and psoriatic arthritis (15.4% vs 1.6%) than those without this condition. Periodontitis was also associated with a higher prevalence of cardiovascular disease (28.6% vs 5.6%). Type of psoriasis, location, and time since onset were not significantly associated with oral lesions. Patients with oral lesions, however, had more severe disease (Psoriasis Area Severity Index [PASI], 3.9 vs 2.4; P = .05). Mean PASI was also higher in patients with fissured tongue (4.7 vs. 2.7, P = .03) and periodontitis (5.1 vs. 2.9, P = .04).ConclusionsThe prevalence of oral lesions, especially fissured tongue and periodontitis, is higher in patients with psoriasis than in healthy controls. Oral lesions were associated with more severe psoriasis and a higher prevalence of associated comorbidities. We recommend examining the oral cavity of patients with psoriasis, especially those with more severe disease and comorbidities, irrespective of type of psoriasis, location, or time since onset.     

Actualización en la clasificación y el tratamiento de la esclerodermia localizada

Morphea or localized scleroderma is a distinctive inflammatory disease that leads to sclerosis of the skin and subcutaneous tissues. It comprises a number of subtypes differentiated according to their clinical presentation and the structure of the skin and underlying tissues involved in the fibrotic process. However, classification is difficult because the boundaries between the different types of morphea are blurred and different entities frequently overlap. The main subtypes are plaque morphea, linear scleroderma, generalized morphea, and pansclerotic morphea. With certain exceptions, the disorder does not have serious systemic repercussions, but it can cause considerable morbidity. In the case of lesions affecting the head, neurological and ocular complications may occur. There is no really effective and universal treatment so it is important to make a correct assessment of the extent and severity of the disease before deciding on a treatment approach.