RESUMEN
Scabies infestation is a growing public health issue due to its world wide increase of incidence. The objective of this study was to proof treatment resistance towards treatment, which was applied according to international guidelines. This is a controversial issue since treatment failures were believed to be due to false application oft he treatment. Here, we proof fort he first time this treatment resistance by videomicroscopic evaluation. Additionally an escalation therapy is described, which led to an effective treatment.
RESUMEN
A 31-year-old woman used a "mole removal pen" purchased from the internet for cosmetic reasons to remove numerous pigmentary moles. After self-application there was multiple scarring. Sequential videodermatoscopic documentation was performed. The purchase of medical-cosmetic products, their use, and the possible risks are discussed.
Asunto(s)
Nevo , Neoplasias Cutáneas , Femenino , Humanos , Adulto , Cicatriz , Comportamiento del Consumidor , DocumentaciónRESUMEN
O objetivo deste trabalho foi avaliar as características bromatológicas e agronômicas dos genótipos de milho para a produção de silagem dos cultivares do Ensaio Centro Superprecoce da Rede Nacional de Genótipos de Milho, bem como avaliar se a base genética (híbridos simples, duplos, tripos, intervarietais e variedades cultivadas) ou a dureza dos grãos (duro, semiduro e dentado mole) alteram a indicação de cultivares de milho para silagem. O experimento foi realizado na área experimental da Universidade Tecnológica Federal do Paraná (campus Dois Vizinhos). Os trinta e dois genótipos avaliados foram colhidos quando os grãos encontravam-se no estádio pastoso a farináceo, ensilados em microssilos de PVC e desensilados após 53 dias. Avaliou-se a relação entre as bases genéticas, a dureza do grão e as características individuais dos genótipos quanto à aptidão para a produção de silagem. Não se verificaram diferenças significativas entre os contrastes formados entre as bases genéticas, bem como a dureza dos grãos, para os caracteres estudados. Porém, foi possível identificar genótipos superiores para a produção de silagem pela produção de matéria seca pelos genótipos AS 1555 YG, AS 1572 YG, 30A37, 30A77, 20A78, Dx 908, Dx 603, 2A550, 2B433, AL2007A, Embrapa 1F640, PRE 22T10, PREXT0109, PRE 22D11, DKB330 YG (Test).
The aim of this study was to evaluate the nutritive value and agronomic characteristics of maize genotypes for the silage production cultivars test center network of Super Early National Corn Genotypes; and to assess whether the genetic background (hybrids simple, doubles, triples, intervarieties and cultivated varieties) or the hardness of the grains (hard, soft flint and dent) may change the indication of maize cultivars for silage. The experiment was conducted at the experimental Federal Technological University of Paraná (Campus Dois Vizinhos). Thirty-two genotypes were harvested when the grains were in the dough soft dough stage, micro-ensiled in PVC silos, silage cutters and after 53 days after silage cutters. We evaluated the characteristics and chemical plant parameters of each genotype. We evaluated the relationship between genetic bases, hardness of the grain and individual characteristics of genotypes related to the production of corn silage. There was no significant difference between the contrast formed between the genetic and hardness of the grains for the characteristics studied. However, it was possible to identify superior genotypes for the production of silage whit bases in dry matter production by genotype YG AS 1555, AS 1572 YG, 30A37, 30A77, 20A78, DX 908, DX 603, 2A550, 2B433, AL2007A, EMBRAPA 1F640, PRE 22T10, PREXT0109, PRE 22D11, DKB330 YG (Test).
Asunto(s)
Animales , Agricultura , Genotipo , Ensilaje/análisis , Zea mays , Análisis de los Alimentos/métodosRESUMEN
For cosmetic reasons, a 24-year-old man performed subcutaneous autoinjections with a preparation having alpha-MSH-like effects (melanotan II) purchased via the internet. The changes of patient's nevi were documented by sequential videodermoscopy before and during treatment. The observed dermoscopic changes made it difficult to differentiate a nevus from a melanoma.
Asunto(s)
Cosméticos/administración & dosificación , Dermoscopía , Melanoma/patología , Nevo Pigmentado/tratamiento farmacológico , Nevo Pigmentado/patología , Neoplasias Cutáneas/patología , Diagnóstico Diferencial , Reacciones Falso Positivas , Humanos , Inyecciones Subcutáneas , Masculino , Adulto JovenRESUMEN
For more than 10 years, ecologists have been discussing the concept of ecosystem engineering (i.e., nontrophic interactions of an organism that alters the physical state of its environment and affects other species). In conservation biology, the functional role of species is of interest because persistence of some species may be necessary for maintaining an entire assemblage with many threatened species. The great capricorn (Cerambyx cerdo), an endangered beetle listed in the European Union's Habitats Directive, has suffered a dramatic decline in the number of populations and in population sizes in Central Europe over the last century. The damage caused by C. cerdo larvae on sound oak trees has considerable effects on the physiological characteristics of these trees. We investigated the impacts of these effects on the species richness and heterogeneity of the saproxylic beetle assemblage on oaks. We compared the catches made with flight interception traps on 10 oaks colonized and 10 oaks uncolonized by C. cerdo in a study area in Lower Saxony (Germany). Our results revealed a significantly more species-rich assemblage on the trees colonized by C. cerdo. Colonized trees also harbored more red-listed beetle species. Our results suggest that an endangered beetle species can alter its own habitat to create favorable habitat conditions for other threatened beetle species. Efforts to preserve C. cerdo therefore have a positive effect on an entire assemblage of insects, including other highly endangered species. On the basis of the impact C. cerdo seems to have on the saproxylic beetle assemblage, reintroductions might be considered in regions where the species has become extinct.
Asunto(s)
Escarabajos/fisiología , Conservación de los Recursos Naturales/métodos , Ecosistema , Quercus , Animales , Alemania , Dinámica Poblacional , Especificidad de la EspecieAsunto(s)
Inmunosupresores/uso terapéutico , Enfermedades de la Boca/tratamiento farmacológico , Penfigoide Benigno de la Membrana Mucosa/tratamiento farmacológico , Tacrolimus/uso terapéutico , Administración Tópica , Anciano , Femenino , Enfermedades de las Encías/tratamiento farmacológico , Humanos , MasculinoRESUMEN
Patients with systemic sclerosis (SSc) develop often acral ulcers which are resistant to therapy and may result in gangrene and amputation. We investigated the effects of iloprost infusion on the acral ulcers and necrosis in patients with five patients with SSc and one with mixed connective tissue disease who had been previously treated with various modalities without improvement. All patients had Raynaud phenomenon, acral ulcers and necrosis. Iloprost 25 microg per day was administered intravenously daily over six hours for ten consecutive days. Eight weeks later all patients were treated with a second iloprost therapy cycle for five days. Two patients with severe ulceration received a third cycle until remission occurred. In all cases acral ulcers healed completely and no patient relapsed during an observation period of 6 months.
Asunto(s)
Dedos/patología , Iloprost/administración & dosificación , Esclerodermia Sistémica/tratamiento farmacológico , Esclerodermia Sistémica/prevención & control , Úlcera Cutánea/tratamiento farmacológico , Úlcera Cutánea/prevención & control , Adulto , Anciano , Esquema de Medicación , Resistencia a Medicamentos , Femenino , Humanos , Infusiones Intravenosas , Persona de Mediana Edad , Necrosis , Esclerodermia Sistémica/complicaciones , Prevención Secundaria , Úlcera Cutánea/patología , Resultado del TratamientoRESUMEN
Oral cicatricial pemphigoid is a chronic autoimmune blistering disease which affects predominantly the gingiva and the buccal mucosa. The pathogenesis of this disease is still incompletely understood; however, there is compelling evidence that cicatricial pemphigoid might be mediated by T lymphocytes. Therefore, we performed immunomodulatory therapy with topical tacrolimus in patients with long-standing, therapy-resistant oral cicatricial pemphigoid. Following 3 months of treatment, complete healing and ongoing remission could be achieved.
Asunto(s)
Enfermedades Autoinmunes/tratamiento farmacológico , Dermatosis Facial/tratamiento farmacológico , Inmunosupresores/administración & dosificación , Enfermedades de la Boca/tratamiento farmacológico , Penfigoide Ampolloso/tratamiento farmacológico , Tacrolimus/administración & dosificación , Anciano , Enfermedades Autoinmunes/diagnóstico , Enfermedades Autoinmunes/inmunología , Dermatosis Facial/diagnóstico , Dermatosis Facial/inmunología , Femenino , Humanos , Masculino , Enfermedades de la Boca/diagnóstico , Enfermedades de la Boca/inmunología , Pomadas , Penfigoide Ampolloso/diagnóstico , Penfigoide Ampolloso/inmunología , Factores de Tiempo , Resultado del TratamientoAsunto(s)
Antibacterianos/administración & dosificación , Antiinflamatorios/administración & dosificación , Doxiciclina/administración & dosificación , Glucocorticoides/administración & dosificación , Metilprednisolona/administración & dosificación , Pénfigo/tratamiento farmacológico , Quimioterapia Combinada , Femenino , Técnica del Anticuerpo Fluorescente Directa , Técnica del Anticuerpo Fluorescente Indirecta , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Pénfigo/diagnóstico , Pénfigo/patología , Piel/patología , Factores de TiempoAsunto(s)
Flebitis , Adulto , Analgésicos no Narcóticos/administración & dosificación , Analgésicos no Narcóticos/uso terapéutico , Antiinflamatorios no Esteroideos/administración & dosificación , Antiinflamatorios no Esteroideos/uso terapéutico , Diagnóstico Diferencial , Femenino , Estudios de Seguimiento , Humanos , Ibuprofeno/administración & dosificación , Ibuprofeno/uso terapéutico , Masculino , Flebitis/diagnóstico , Flebitis/diagnóstico por imagen , Flebitis/tratamiento farmacológico , Flebitis/etiología , Embarazo , Factores de Riesgo , Síndrome , Factores de Tiempo , Ultrasonografía Doppler DúplexRESUMEN
Hot bitumen burns, although rare, usually occur in workers in the paving or roofing industries. When bitumen is heated to high temperatures it can cause deep burns, and its incorrect removal often causes further skin damage. Application of butter has been proven to be very effective to remove bitumen from the skin. Further clinical and legal safety guidelines for occupational injuries are described.
Asunto(s)
Accidentes de Trabajo , Quemaduras/etiología , Hidrocarburos/efectos adversos , Piel/lesiones , Adulto , Antibacterianos/administración & dosificación , Antibacterianos/uso terapéutico , Quemaduras/diagnóstico , Quemaduras/terapia , Desbridamiento , Ácido Fusídico/administración & dosificación , Ácido Fusídico/uso terapéutico , Gentamicinas/administración & dosificación , Gentamicinas/uso terapéutico , Humanos , Masculino , Pomadas , Oxacilina/administración & dosificación , Oxacilina/uso terapéutico , Penicilinas/administración & dosificación , Penicilinas/uso terapéutico , Factores de TiempoRESUMEN
Chronic inflammatory skin disorders, such as atopic eczema, can cause considerable impairment of life quality. Their treatment is mainly driven by systemic or topical glucocorticosteroids which have the risk of many side effects. Recently, immunosuppressive macrolides which act via the inhibition of cytokine expression in T-lymphocytes have been shown to exert good therapeutic potency in inflammatory skin disorders. Cyclosporin, widely used in transplantation medicine, is also effective in psoriasis and atopic eczema but is not suitable for topical treatment. Tacrolimus (FK506) has been found to be 10-100 times more potent than cyclosporin and to penetrate skin much better due to a lower molecular weight. Initial clinical investigations have shown efficacy of topical tacrolimus in patients with atopic eczema. Large multi-centre studies have proven that long-term therapy with 0.03% and 0.1% tacrolimus ointment reveals effectiveness and safety both in adults and in children with severe atopic eczema. A burning sensation at the site of application is the most frequently observed local side effect. Relevant systemic adverse events were not detected. In Japan and the US, the drug is already licensed for the treatment of atopic eczema. The European admission for the pharmaceutical market is expected in the year 2002. Tacrolimus represents a milestone in topical therapy of inflammatory skin disorders which has so far been dominated by corticosteroid formulations and gives hope for the development of further topical immunosuppressive agents of its class in the future.
Asunto(s)
Dermatitis/tratamiento farmacológico , Inmunosupresores/uso terapéutico , Tacrolimus/uso terapéutico , Administración Oral , Administración Tópica , Adulto , Niño , Enfermedad Crónica , Ensayos Clínicos como Asunto , Contraindicaciones , Interacciones Farmacológicas , Tolerancia a Medicamentos , Eccema/tratamiento farmacológico , Humanos , Estructura Molecular , Tacrolimus/efectos adversos , Tacrolimus/farmacologíaRESUMEN
During the last decades, systemic and topical glucocorticosteroids assumed a dominant role in immunosuppressive therapy in dermatology. However, their administration is limited because of numerous adverse effects. Consequently, there is a large need for alternative non-steroidal anti-inflammatory therapeutics with a superior risk/benefit ratio. In recent years, a new class of anti-inflammatories, the macrolide lactones, has attracted special interest. During the last decade, a member of this class, tacrolimus, proved to be a powerful suppressor of the immune system. Introduced into clinical practice to prevent allograft rejection, it is now routinely used in organ transplantation. Recently, several placebo-controlled multicenter studies showed the therapeutic efficiency of systemic and topical tacrolimus in common inflammatory skin diseases such as psoriasis and atopic eczema.Short-term tacrolimus ointment therapy disclosed significant efficacy vs. placebo and a safety profile with only few local side effects in patients with atopic eczema. Further clinical trials including greater extent of exposure (experienced by children), and comparison between tacrolimus ointment and glucocorticosteroids are being conducted and the results will show whether this drug opens a new era in the treatment of inflammatory skin disorders. The aim of this review is to summarize the current knowledge regarding the pharmacokinetic properties, adverse effects and therapeutic indications of tacrolimus in dermatology.
Asunto(s)
Enfermedades Autoinmunes/tratamiento farmacológico , Inmunosupresores/uso terapéutico , Enfermedades de la Piel/tratamiento farmacológico , Tacrolimus/uso terapéutico , Administración Tópica , Femenino , Humanos , Inmunosupresores/farmacología , Masculino , Transducción de Señal/efectos de los fármacos , Transducción de Señal/fisiología , Tacrolimus/farmacologíaRESUMEN
BACKGROUND: Tacrolimus has been shown to be a powerful suppressor of the immune system. It was introduced into clinical use to prevent allograft rejection and is now routinely used in kidney, liver, and heart transplantation. Recently, 2 double-blind multicenter studies demonstrated the therapeutic efficacy of topical and systemic tacrolimus in the inflammatory skin diseases atopic dermatitis and psoriasis. DATA SOURCE: MEDLINE was searched for relevant publications and combined with our own clinical, in vitro, and in vivo studies. STUDY SELECTION: All studies dealing with tacrolimus and dermatology were reviewed. DATA EXTRACTION: Publications with clinically relevant data were included in this review. CONCLUSIONS: Topical tacrolimus is a safe and effective therapeutic agent that may open a new era in the treatment of inflammatory skin diseases, particularly for patients with atopic dermatitis. Before its full potential in dermatology can be assessed, more clinical experience in treating children and comparison with the criterion standard of anti-inflammatory therapy, glucocorticosteroids, are needed.
Asunto(s)
Inmunosupresores/uso terapéutico , Enfermedades de la Piel/tratamiento farmacológico , Tacrolimus/uso terapéutico , Dermatitis Atópica/tratamiento farmacológico , Humanos , Inmunosupresores/farmacología , Psoriasis/tratamiento farmacológico , Tacrolimus/farmacologíaRESUMEN
Recently, it has been shown that the immunosuppressive macrolide lactone, FK506, exerts good therapeutic efficacy in inflammatory skin diseases. The aim of this study was to analyze the influence of topical FK506 on molecular (IL-1alpha, IL-1beta, IL-2, IL-4, IL-12 p35, IL-12 p40, macrophage inflammatory protein-2 (MIP-2), granulocyte-macrophage CSF (GM-CSF), TNF-alpha, and IFN-gamma) and cellular (I-A+/CD80+, I-A+/CD54+, I-A+/CD69+, I-A+/B220+, and CD4+/CD25+) events in epidermal (EC) and local draining lymph node (LNC) cells during primary contact hypersensitivity responses. Cytokine mRNA levels for IL-1alpha, IL-1beta, GM-CSF, TNF-alpha, MIP-2, and IFN-gamma in EC and for IL-2, IL-4, IL-12 p35, IL-12 p40, and IFN-gamma in LNC were increased and resulted in significant LNC proliferation during oxazolone-induced contact hypersensitivity. Topical FK506 treatment dose-dependently suppressed oxazolone-induced LNC proliferation. This effect was correlated with decreased IL-1alpha, IL-1beta, GM-CSF, TNF-alpha, MIP-2, and IFN-gamma mRNA expression within the epidermis and decreased IL-12 p35 and p40 mRNA expression in LNC. Further analysis of the LNC cytokine pattern revealed that the production of both Thl (IFN-gamma and IL-2) and Th2 (IL-4) cytokines was dramatically impaired after topical FK506 treatment. Flow cytometric analysis showed that topical FK506 decreased the population of epidermis-infiltrating CD4+ T cells and suppressed the expression of CD54 and CD80 on I-A+ EC and LNC during hapten-induced contact hypersensitivity. Furthermore, topical FK506 profoundly impaired oxazolone-induced up-regulation of CD25 expression on CD4+ LNC and dramatically decreased hapten-induced expansion of I-A+/B220+ and I-A+/CD69+ LNC subsets. In conclusion, these results give new insights into the mechanisms of action of topical FK506 treatment.
Asunto(s)
Antígenos CD/efectos de los fármacos , Citocinas/antagonistas & inhibidores , Dermatitis por Contacto/inmunología , Epidermis/metabolismo , Inmunosupresores/administración & dosificación , Ganglios Linfáticos/metabolismo , Tacrolimus/administración & dosificación , Administración Tópica , Animales , Antígenos CD/biosíntesis , Linfocitos B/inmunología , Movimiento Celular/inmunología , Quimiocina CXCL2 , Citocinas/biosíntesis , Citocinas/genética , Dermatitis por Contacto/etiología , Células Epidérmicas , Epidermis/inmunología , Femenino , Antígenos de Histocompatibilidad Clase II/biosíntesis , Interferón gamma/biosíntesis , Interferón gamma/genética , Interleucina-1/biosíntesis , Interleucina-1/genética , Interleucina-12/biosíntesis , Interleucina-12/genética , Ganglios Linfáticos/citología , Ganglios Linfáticos/inmunología , Activación de Linfocitos/efectos de los fármacos , Ratones , Monocinas/biosíntesis , Monocinas/genética , ARN Mensajero/biosíntesis , Células TH1/metabolismo , Células Th2/metabolismo , Factores de TiempoRESUMEN
Topical glucocorticosteroids represent the mainstay of antiinflammatory therapy in the treatment of inflammatory skin diseases. Their clinical use, however, is limited by local and systemic side-effects. Thus, in dermatopharmacology there is a large demand for alternative non-steroidal antiinflammatories. Other than transplantation models, most of the frequently used in vivo test systems for assessment of drug-induced immunosuppression measure changes in inflammatory skin responses by means of skin erythema and edema after challenge of sensitized animals. The aim of this study was to develop an alternative mouse model to detect and analyse immunosuppressive effects of topically applied drugs. On the basis of a modified local lymph node assay, we analysed effects of topical hydrocortisone, dexamethasone, mometasone furoate and FK506 (tacrolimus) during the induction phase of contact hypersensitivity. On 4 consecutive days, NMRI mice were treated on the dorsal surfaces of both ears with increasing concentrations of test compound. During the last 3 days, the mice received in addition the contact sensitizer, oxazolone (1%). On day 5, draining auricular lymph nodes were removed in order to assess lymph node cell counts and perform flow cytometric analysis of lymph node cell subpopulations (CD4+/CD25+, Ia+/CD69+, Ia+/B220+). All test compounds proved to exert significant immunosuppressive effects after topical application, but showed differences in their immunomodulatory potential. In conclusion, the local lymph node assay serves as an appropriate model to characterize immunosuppressive effects of topically applied drugs by measuring immunologically relevant end-points.