Background: Quality of life (QoL) is a term used to evaluate general well-being, and it is defined as ‘the degree to which an individual enjoys his or her life. Within the realm of medicine, the evaluation of QoL fre...Background: Quality of life (QoL) is a term used to evaluate general well-being, and it is defined as ‘the degree to which an individual enjoys his or her life. Within the realm of medicine, the evaluation of QoL frequently involves examining how disease exerts a detrimental impact, diminishing the enjoyment and fulfilment experienced by the individual. Dermatological diseases have been found to exert a substantial negative influence on the QoL of dogs and their owners due to nuisance and stress related to the disease but also due to the caregiver burden. In the management of bacterial skin infections, topical therapy is commonly administered alongside systemic antibiotics. Nonetheless, the protracted duration of treatment and difficulties in ensuring owner compliance can introduce a significant caregiver burden, potentially exacerbating the challenges associated with these conditions. Purpose: This study aimed to evaluate the impact on the quality of life (QoL) of dogs with dermatologic diseases after fluorescent light energy (FLE) treatment. Methods: The study was an open, prospective, multicentric clinical trial that included dogs with various dermatological conditions. The dogs received FLE treatment once weekly until the clinical resolution was achieved. Owners completed a validated questionnaire to assess the QoL of their dogs before and after therapy. Results: Thirty-five dogs with deep pyoderma, interdigital furunculosis, pyotraumatic dermatitis, wounds and perianal fistulas were included. All dogs received two sessions of fluorescent light energy once a week. Median treatment duration was 9 weeks for perianal fistula, 7 weeks for interdigital furunculosis, 5 weeks for deep pyoderma, 3 weeks for wounds and 1.5 weeks for pyotraumatic dermatitis. Complete remission was noted in 86% of dogs, and 14% showed an improvement but partial remission. The majority of owners reported a positive impact on their dogs’ QoL after therapy, and 74% of the dogs showed at least a 50% reduction in QoL scores. Conclusion: Fluorescent light energy has been shown to exert beneficial effects on the healing of dermatological diseases and the quality of life (QoL) in dogs and their owners, whether used as a standalone treatment or in combination with standard care therapies. Additionally, it was well-tolerated by the dogs. This study emphasizes the significance of considering both the owner’s and dog’s QoL when evaluating the therapeutic efficacy of dermatological treatments.展开更多
Background: A group of vitamin D derivatives has revealed to be an efficient treatment for psoriasis. Different types of studies have been designed to confirm the efficacy of its use without relevant side-effects. Obj...Background: A group of vitamin D derivatives has revealed to be an efficient treatment for psoriasis. Different types of studies have been designed to confirm the efficacy of its use without relevant side-effects. Objective: Evaluation of tolerability and efficacy of tacalcitol ointment in moderate psoriasis. Design: A 2-month multicentre prospective open-label observational study in patients with psoriasis treated with tacalcitol ointment. Methods: A cohort of patients with psoriasis vulgaris seeking medical advice and being treated with tacalcitol based on the decision of their dermatologists was selected. A 2-month follow- up was performed to assess efficacy and tolerability of tacalcitol in an ointmen t formulation (4 μg/g) once daily. A psoriatic lesion was selected in each pati ent in order to assess clinical symptoms (erythema, desquamation and thickness) by means of five-point scale: 0 (none) to 4 (maximal severity). Percentages of involved skin, adverse effects, physicians’global assessments of efficacy and t olerability, and patients’global satisfaction scores were also evaluated after 15-30 days (first visit) and 2 months (second visit) of treatment. Results: A t otal of 556 patients were included. Mean psoriasis duration was 10.1 years (rang e, 0-61 years). Follow-up data were available for 493 patients in first follow -up visit and 449 in second (final) visit. Adverse events were uncommon (1.0%a nd 0.6%of patients in first and second follow-up visits, respectively). At fir st follow-up visit, mean decrease in selected lesions surface area (from a base line value of 185.8 cm2 per lesion) was 11.1 cm2 (95%CI, 1.6-20.6; P=0.0213). After 2 months of treatment, mean scores for erythema, desquamation and thicknes s changed from 2.2 ±0.8 to 1.1 ±0.8 (19%of patients with no erythema at final visit); from 2.4 ±0.8 to 0.6 ±0.7 (55%of patients with no desquamation); and from 2.2 ±0.9 to 0.8 ±0.6 (51%of patients with less thickness), respectively. Mean percentage of total body skin involvement was 14%(7.5%and 6.9%of anterior and posterior body surf ace,respectively). After 2months of treatment, a 3.2%(95%CI, 2.7-3.8;P=0.0001 ) and 3.0%(95%CI, 2.4-3.6; P=0.0001) decrease was observed in the percentage of involved anterior and posterior skin surface area, respectively. Efficacy and tolerability evaluation by investigators was very good or good in 94%and 74%o f patients, respectively; 78%of patients evaluated study treatment as satisfact ory/ very satisfactory. More than 80%, 50-80% and less than 50%of prescribed doses were used by 88%, 9.3%and 2.3%of pati ents, respectively. Conclusions: Tacalcitol was highly effective in the symptoma tic treatment of moderate psoriasis. Compliance was very high, probably due to t he easy and convenient application. Physicians’global assessments of tacalcitol were excellent, both for tolerability and efficacy. Excellent tolerability was confirmed by the low rate of adverse events. Our results in an everyday clinical setting show that tacalcitol is a useful therapy in patients with moderate psor iasis.展开更多
Cutaneous plasmacytosis is a rare disorder characterized by a benign proliferation of mature plasma cells that appears as multiple dark-brown to purplish skin lesions, often associated with polyclonal hypergammaglobul...Cutaneous plasmacytosis is a rare disorder characterized by a benign proliferation of mature plasma cells that appears as multiple dark-brown to purplish skin lesions, often associated with polyclonal hypergammaglobulinaemia. We present the case of a 55-year-old Caucasian man who suffered from a cutaneous plasmacytosis associated with two different carcinomas. Cutaneous plasmacytosis seems to be a reactive process because most cases reported are not associated with any apparent underlying disease. Nevertheless, because few reported cases were associated with malignancies, screening of additional neoplasms would be justified.展开更多
Objective: To study 26 cases of lupus erythematosus tumidus (LET), a subset of chronic cutaneous lupus erythematosus (CCLE), referred to in the literature as a rare entity. Patients and Methods: A retrospective study ...Objective: To study 26 cases of lupus erythematosus tumidus (LET), a subset of chronic cutaneous lupus erythematosus (CCLE), referred to in the literature as a rare entity. Patients and Methods: A retrospective study was conducted of 26 patients diagnosed with LET between 1996 and 2002. The clinical characteristics, histopathologic and laboratory findings, response to treatment, association with other subsets of lupus, course, and diagnostic criteria were analyzed. Results: The incidence by sex was similar. The mean age of presentation was 49.19 years. The clinical presentation usually involved erythematous, edematous plaques located on the face, chest, back, or extremities, related to sun exposure. A dermal lymphocytic infiltrate with a perivascular disposition and differing degrees of mucin deposition was observed in all cases. Minimal epidermal changes were present in 18 cases, and 11 of these also showed minimal dermal-epidermal changes. Only one case showed dermal-epidermal changes without any epidermal alteration. Direct immunofluorescence test was performed in 15 patients, and 11 were negative. All cases showed a benign course without systemic manifestations. The response to topical steroids or antimalarial treatment was excellent, but a seasonal recurrence was usually observed. Discussion: No defined criteria for LET are universally accepted. The main controversies are the acceptance of LET as a separate subset of CCLE, and the histopathologic diagnostic features, mainly the presence or absence of epidermal and dermal-epidermal changes in these lesions. Conclusions: No inflexible histologic criteria should be employed for the diagnosis of LET. This subset of lupus erythematosus is characterized by intense photosensitivity, definite clinical lesions, a benign course, the absence of systemic disease, good response to antimalarial treatment,and a tendency to recur. More studies should be performed in order to establish the true incidence of LET because this subset of CCLE is probably underestimated.展开更多
Psoriasis is a chronic inflammatory skin disease with a strong genetic background and is triggered by environmental factors.Available evidence supports CD6,a lymphocyte surface receptor mostly expressed by T cells,as ...Psoriasis is a chronic inflammatory skin disease with a strong genetic background and is triggered by environmental factors.Available evidence supports CD6,a lymphocyte surface receptor mostly expressed by T cells,as a putative target in autoimmunity.Accordingly,a humanized anti-CD6 antibody has been assayed for the treatment of certain autoimmune disorders,including psoriasis.Here,we present novel evidence in mice and humans for a direct involvement of CD6 in psoriasis pathophysiology.First,an attenuated form of imiquimod-induced psoriasis-like skin inflammation was demonstrated in CD6-deficient mice,as deduced from lower epidermal thickness and local reduced production of pro-inflammatory cytokines,namely,interleukin-17A.Thus,isolated CD4+CD62L+T cells from CD6-deficient mice displayed decreased in vitro T-helper type 17 polarization.Second,a statistically significant association between CD6 single-nucleotide polymorphisms(rs17824933,rs11230563 and rs12360861)and more severe forms of psoriasis was demonstrated in a cohort of 304 patients at three public hospitals from the metropolitan area of Barcelona.Taken together,these results provide new supportive evidence of the contribution of the CD6 lymphocyte receptor in psoriasis at both experimental and clinical levels.展开更多
文摘Background: Quality of life (QoL) is a term used to evaluate general well-being, and it is defined as ‘the degree to which an individual enjoys his or her life. Within the realm of medicine, the evaluation of QoL frequently involves examining how disease exerts a detrimental impact, diminishing the enjoyment and fulfilment experienced by the individual. Dermatological diseases have been found to exert a substantial negative influence on the QoL of dogs and their owners due to nuisance and stress related to the disease but also due to the caregiver burden. In the management of bacterial skin infections, topical therapy is commonly administered alongside systemic antibiotics. Nonetheless, the protracted duration of treatment and difficulties in ensuring owner compliance can introduce a significant caregiver burden, potentially exacerbating the challenges associated with these conditions. Purpose: This study aimed to evaluate the impact on the quality of life (QoL) of dogs with dermatologic diseases after fluorescent light energy (FLE) treatment. Methods: The study was an open, prospective, multicentric clinical trial that included dogs with various dermatological conditions. The dogs received FLE treatment once weekly until the clinical resolution was achieved. Owners completed a validated questionnaire to assess the QoL of their dogs before and after therapy. Results: Thirty-five dogs with deep pyoderma, interdigital furunculosis, pyotraumatic dermatitis, wounds and perianal fistulas were included. All dogs received two sessions of fluorescent light energy once a week. Median treatment duration was 9 weeks for perianal fistula, 7 weeks for interdigital furunculosis, 5 weeks for deep pyoderma, 3 weeks for wounds and 1.5 weeks for pyotraumatic dermatitis. Complete remission was noted in 86% of dogs, and 14% showed an improvement but partial remission. The majority of owners reported a positive impact on their dogs’ QoL after therapy, and 74% of the dogs showed at least a 50% reduction in QoL scores. Conclusion: Fluorescent light energy has been shown to exert beneficial effects on the healing of dermatological diseases and the quality of life (QoL) in dogs and their owners, whether used as a standalone treatment or in combination with standard care therapies. Additionally, it was well-tolerated by the dogs. This study emphasizes the significance of considering both the owner’s and dog’s QoL when evaluating the therapeutic efficacy of dermatological treatments.
文摘Background: A group of vitamin D derivatives has revealed to be an efficient treatment for psoriasis. Different types of studies have been designed to confirm the efficacy of its use without relevant side-effects. Objective: Evaluation of tolerability and efficacy of tacalcitol ointment in moderate psoriasis. Design: A 2-month multicentre prospective open-label observational study in patients with psoriasis treated with tacalcitol ointment. Methods: A cohort of patients with psoriasis vulgaris seeking medical advice and being treated with tacalcitol based on the decision of their dermatologists was selected. A 2-month follow- up was performed to assess efficacy and tolerability of tacalcitol in an ointmen t formulation (4 μg/g) once daily. A psoriatic lesion was selected in each pati ent in order to assess clinical symptoms (erythema, desquamation and thickness) by means of five-point scale: 0 (none) to 4 (maximal severity). Percentages of involved skin, adverse effects, physicians’global assessments of efficacy and t olerability, and patients’global satisfaction scores were also evaluated after 15-30 days (first visit) and 2 months (second visit) of treatment. Results: A t otal of 556 patients were included. Mean psoriasis duration was 10.1 years (rang e, 0-61 years). Follow-up data were available for 493 patients in first follow -up visit and 449 in second (final) visit. Adverse events were uncommon (1.0%a nd 0.6%of patients in first and second follow-up visits, respectively). At fir st follow-up visit, mean decrease in selected lesions surface area (from a base line value of 185.8 cm2 per lesion) was 11.1 cm2 (95%CI, 1.6-20.6; P=0.0213). After 2 months of treatment, mean scores for erythema, desquamation and thicknes s changed from 2.2 ±0.8 to 1.1 ±0.8 (19%of patients with no erythema at final visit); from 2.4 ±0.8 to 0.6 ±0.7 (55%of patients with no desquamation); and from 2.2 ±0.9 to 0.8 ±0.6 (51%of patients with less thickness), respectively. Mean percentage of total body skin involvement was 14%(7.5%and 6.9%of anterior and posterior body surf ace,respectively). After 2months of treatment, a 3.2%(95%CI, 2.7-3.8;P=0.0001 ) and 3.0%(95%CI, 2.4-3.6; P=0.0001) decrease was observed in the percentage of involved anterior and posterior skin surface area, respectively. Efficacy and tolerability evaluation by investigators was very good or good in 94%and 74%o f patients, respectively; 78%of patients evaluated study treatment as satisfact ory/ very satisfactory. More than 80%, 50-80% and less than 50%of prescribed doses were used by 88%, 9.3%and 2.3%of pati ents, respectively. Conclusions: Tacalcitol was highly effective in the symptoma tic treatment of moderate psoriasis. Compliance was very high, probably due to t he easy and convenient application. Physicians’global assessments of tacalcitol were excellent, both for tolerability and efficacy. Excellent tolerability was confirmed by the low rate of adverse events. Our results in an everyday clinical setting show that tacalcitol is a useful therapy in patients with moderate psor iasis.
文摘Cutaneous plasmacytosis is a rare disorder characterized by a benign proliferation of mature plasma cells that appears as multiple dark-brown to purplish skin lesions, often associated with polyclonal hypergammaglobulinaemia. We present the case of a 55-year-old Caucasian man who suffered from a cutaneous plasmacytosis associated with two different carcinomas. Cutaneous plasmacytosis seems to be a reactive process because most cases reported are not associated with any apparent underlying disease. Nevertheless, because few reported cases were associated with malignancies, screening of additional neoplasms would be justified.
文摘Objective: To study 26 cases of lupus erythematosus tumidus (LET), a subset of chronic cutaneous lupus erythematosus (CCLE), referred to in the literature as a rare entity. Patients and Methods: A retrospective study was conducted of 26 patients diagnosed with LET between 1996 and 2002. The clinical characteristics, histopathologic and laboratory findings, response to treatment, association with other subsets of lupus, course, and diagnostic criteria were analyzed. Results: The incidence by sex was similar. The mean age of presentation was 49.19 years. The clinical presentation usually involved erythematous, edematous plaques located on the face, chest, back, or extremities, related to sun exposure. A dermal lymphocytic infiltrate with a perivascular disposition and differing degrees of mucin deposition was observed in all cases. Minimal epidermal changes were present in 18 cases, and 11 of these also showed minimal dermal-epidermal changes. Only one case showed dermal-epidermal changes without any epidermal alteration. Direct immunofluorescence test was performed in 15 patients, and 11 were negative. All cases showed a benign course without systemic manifestations. The response to topical steroids or antimalarial treatment was excellent, but a seasonal recurrence was usually observed. Discussion: No defined criteria for LET are universally accepted. The main controversies are the acceptance of LET as a separate subset of CCLE, and the histopathologic diagnostic features, mainly the presence or absence of epidermal and dermal-epidermal changes in these lesions. Conclusions: No inflexible histologic criteria should be employed for the diagnosis of LET. This subset of lupus erythematosus is characterized by intense photosensitivity, definite clinical lesions, a benign course, the absence of systemic disease, good response to antimalarial treatment,and a tendency to recur. More studies should be performed in order to establish the true incidence of LET because this subset of CCLE is probably underestimated.
基金supported by grants from the Spanish Ministerio de Economía y Competitividad(Plan Nacional I+D+i,SAF2013-46151-R and SAF2016-80535-R to FL),co-financed by the European Development Regional Fund‘A way to achieve Europe’ERDFsupported by the Sara Borrell fellowship CD15/00016 from Instituto de Salud Carlos Ⅲ.
文摘Psoriasis is a chronic inflammatory skin disease with a strong genetic background and is triggered by environmental factors.Available evidence supports CD6,a lymphocyte surface receptor mostly expressed by T cells,as a putative target in autoimmunity.Accordingly,a humanized anti-CD6 antibody has been assayed for the treatment of certain autoimmune disorders,including psoriasis.Here,we present novel evidence in mice and humans for a direct involvement of CD6 in psoriasis pathophysiology.First,an attenuated form of imiquimod-induced psoriasis-like skin inflammation was demonstrated in CD6-deficient mice,as deduced from lower epidermal thickness and local reduced production of pro-inflammatory cytokines,namely,interleukin-17A.Thus,isolated CD4+CD62L+T cells from CD6-deficient mice displayed decreased in vitro T-helper type 17 polarization.Second,a statistically significant association between CD6 single-nucleotide polymorphisms(rs17824933,rs11230563 and rs12360861)and more severe forms of psoriasis was demonstrated in a cohort of 304 patients at three public hospitals from the metropolitan area of Barcelona.Taken together,these results provide new supportive evidence of the contribution of the CD6 lymphocyte receptor in psoriasis at both experimental and clinical levels.
