RESUMEN
BACKGROUND: Chronic actinic dermatitis is usually controlled under systemic immunosuppressive drugs. We report herein two patients successfully treated with topical tacrolimus. CASE REPORTS: Two men aged 60 and 70 years were treated for chronic actinic dermatitis for two years using systemic immunosuppressive drugs. Due to drug intolerance and treatment resistance, systemic treatment was substituted by topical tacrolimus. Cutaneous lesions improved dramatically within two months but withdrawal of daily application was immediately followed by recurrence of the lesions. DISCUSSION: Our cases, together with the 10 others reported in the literature, confirm the efficacy of topical tacrolimus in the treatment of chronic actinic dermatitis. Since tacrolimus chiefly targets activated T lymphocytes, it has been successfully deployed in various inflammatory dermatoses and its use is logical in the treatment of chronic actinic dermatitis. While dramatic improvement is achieved within a few weeks in this indication with twice-daily applications of tacrolimus ointment 0.1%, symptoms recur rapidly on dosage reduction, and extremely long-term, or even lifelong, treatment is thus probably needed. Topical tacrolimus application has been shown to be safe for periods of three years. However, the peculiar mechanism of chronic actinic dermatitis with a pronounced imbalance in T-cell subsets raises the question of theoretical risk of carcinogenicity of tacrolimus applications, and this, together with the prolonged duration of treatment, calls for long-term follow-up of chronic actinic dermatitis patients.
Asunto(s)
Inmunosupresores/administración & dosificación , Trastornos por Fotosensibilidad/tratamiento farmacológico , Tacrolimus/administración & dosificación , Administración Cutánea , Anciano , Brazo , Cara , Antebrazo , Humanos , Masculino , Persona de Mediana Edad , Pomadas , Trastornos por Fotosensibilidad/diagnóstico , Resultado del TratamientoRESUMEN
Cutaneous Fluorescence Diagnosis (FD) is a new promising dermatological procedure which is based on the combination of a local application of a photosensitizer such as 5-aminolevulinic acid (ALA) or its methyl ester (MAL) and the use of a light source (red light) adapted to the absorption spectrum of these molecules. The targeted photosensitization of skin cancers, particularily superficial and extensive lesions including superficial basal cell carcinoma and Bowen's disease, by ALA or MAL induced porphyrins leads to a selective red fluorescence which can be demonstrated by Wood's lamp. This technique may be useful either to define better the choice of margins or to detect earlier and or multifocal recurrences.
Asunto(s)
Carcinoma Basocelular/diagnóstico , Carcinoma Basocelular/terapia , Fluorescencia , Neoplasias Cutáneas/diagnóstico , Neoplasias Cutáneas/terapia , Adulto , Anciano , Ácido Aminolevulínico/análogos & derivados , Ácido Aminolevulínico/uso terapéutico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Fotoquimioterapia , Fármacos Fotosensibilizantes/uso terapéutico , PorfirinasRESUMEN
The ectodermal dysplasias form a heterogeneous group of rare and complex genetic diseases with different ectodermal derivates abnormalities. The aim of this paper is to present briefly the anhidrotic form or Christ-Siemens-Touraines's syndrome and the hidrotic form or Clouston's syndrome.