RESUMO
Pigmented purpuric dermatoses are chronic vascular inflammatory conditions characterized by the presence of pigmented macules. Among its different presentations, lichen aureus is distinguished by the lichenoid conformation of its plaques and the predilection for lower limb involvement. Its segmented form is rare and difficult to control, especially in cases of symptomatic lesions. We report a rare case of segmental lichen aureus with six years of evolution associated with light itching. We also discuss the main therapeutic approaches to control the disease.
Assuntos
Erupções Liquenoides/patologia , Betametasona/uso terapêutico , Feminino , Glucocorticoides/uso terapêutico , Humanos , Erupções Liquenoides/terapia , Metoxaleno/uso terapêutico , Pessoa de Meia-Idade , Fármacos Fotossensibilizantes/uso terapêutico , Luz SolarRESUMO
Abstract: Pigmented purpuric dermatoses are chronic vascular inflammatory conditions characterized by the presence of pigmented macules. Among its different presentations, lichen aureus is distinguished by the lichenoid conformation of its plaques and the predilection for lower limb involvement. Its segmented form is rare and difficult to control, especially in cases of symptomatic lesions. We report a rare case of segmental lichen aureus with six years of evolution associated with light itching. We also discuss the main therapeutic approaches to control the disease.
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Erupções Liquenoides/patologia , Luz Solar , Betametasona/uso terapêutico , Fármacos Fotossensibilizantes/uso terapêutico , Erupções Liquenoides/terapia , Glucocorticoides/uso terapêutico , Metoxaleno/uso terapêuticoRESUMO
Catecóis são derivados do benzeno, podendo apresentar citotoxicidade, que pode constituir um modelo experimental útil para o desenvolvimento de novos fármacos. No bioma brasileiro inúmeras plantas produzem metabólitos com atividades diversas, como antioxidantes, ou inibidores do crescimento celular. No Brasil, as neoplasias são a segunda causa de óbito, especialmente aquelas derivadas do sistema nervoso, aumentando o interesse por novos antineoplásicos e agentes neuroprotetores. Este trabalho caracteriza efeitos citotóxicos do 1,2-dihidroxibenzeno (CAT) e discretamina (DSC) em células do sistema nervoso in vitro. Determinou-se a EC50 de CAT e DSC usando brometo de 3-(4,5-dimetiltiazol-2-il)-2,5-difeniltetrazolium (MTT), investigou-se sua auto-oxidação por espectrofotometria, avaliou-se mudanças morfológicas e condensação/fragmentação nuclear por microscopia. Avaliou-se a proteção de DSC e 8-metoxipsoraleno (8-MOP) contra a citotoxicidade do CAT. O padrão de morte celular foi analisado por citometria de fluxo. A espoliação de glutation reduzido (GSH) foi analisada usando monoclorobimano. A toxicidade do CAT para células SH-SY5Y e C6 depende da dose e associa-se à formação de quinonas. Houve mudanças morfológicas, condensação/fragmentação da cromatina e morte apoptótica, não relacionada à espoliação de GSH. DSC não foi tóxica para células SH-SY5Y, porém protegeu contra os efeitos do CAT em baixas concentrações. DSC mostrou-se citotóxica para células de glioma (GL-15 e C6) e potencializou o CAT. Pré-tratamento por 30 minutos com DSC protegeu contra a ação do CAT após 72 horas. 8-MOP potencializou os efeitos do CAT, não revertendo seus efeitos na viabilidade celular, morfologia celular, condensação/fragmentação nuclear, e espoliação de GSH. Esses resultados caracterizam um modelo de citotoxicidade que pode ser aplicado no desenvolvimento de novos agentes farmacológicos. Estudos complementares são necessários para elucidar a proteção da DSC.
Catechols are benzene derivatives, which may exhibit cytotoxic activity that can be employed to develop new drugs. Plants are important sources of metabolites with pharmacological activities such as antioxidants, or cell growth inhibitors. In Brazil, cancer is the second leading cause of death, especially those derived from the nervous system, which increase the interest for new antineoplastic and neuroprotective drugs. The cytotoxic effects promoted by 1,2-dihydroxybenzene (CAT) and discretamine (DSC) in nervous system cells were characterized in vitro. The protective effects of DSC and 8-methoxypsoralen (8-MOP) against CAT-induced cytotoxicity were also evaluated. CAT and DSC EC50 was determined by using 3-(4,5-dimethylthiazol-2-yl) 2,5-diphenyltetrazolium bromide (MTT). CAT auto-oxidation was investigated by spectrophotometry. Morphological changes and nuclear condensation/ fragmentation were evaluated by microscopy. The pattern of cell death was obtained by flow cytometry. Reduced glutathione (GSH) depletion was analyzed by using monochlorobimane. CAT induced a dose-dependent toxicity to SH-SY5Y and C6 cells, associated with reactive quinones formation. It also induced morphological changes, nuclear condensation/fragmentation, and apoptotic death not caused by GSH depletion. DSC was not toxic to SH-SY5Y cells, but protected against CAT effects at low concentrations. DSC was be cytotoxic to glioma cells (GL-15 and C6) and potentiated CAT effects. However, pretreatment for 30 minutes with DSC protected them against CAT after 72 hours. 8-MOP also potentiated CAT effects instead to protect cells. These results characterize an experimental model useful for studies searching new pharmacological agents. However, further studies are needed to elucidate the DSC protective effects.
Assuntos
Humanos , /administração & dosagem , /análise , /farmacologia , /uso terapêutico , Metoxaleno/análise , Metoxaleno/farmacologia , Metoxaleno/uso terapêutico , Neoplasias/patologia , Neoplasias/prevenção & controleRESUMO
Two adolescent females and a girl, all with clinically diagnosed vitiligo, were treated with 0.2% 8-methoxypsoralen cream followed by exposure to solar ultraviolet light. One year later, they developed hypopigmented and achromic spots on the areas affected by the vitiligo. Biopsy of skin tissue taken from one of these cases showed a marked reduction in melanin. Clinical and histological findings point to a diagnosis of leukoderma punctata.
Assuntos
Metoxaleno/efeitos adversos , Terapia PUVA/efeitos adversos , Fármacos Fotossensibilizantes/efeitos adversos , Transtornos da Pigmentação/etiologia , Adolescente , Criança , Feminino , Humanos , Metoxaleno/uso terapêutico , Fármacos Fotossensibilizantes/uso terapêutico , Transtornos da Pigmentação/patologia , Vitiligo/tratamento farmacológicoRESUMO
Duas adolescentes e uma menina com vitiligo clinicamente diagnosticado foram tratadas com 8-metoxipsoraleno a 0,2 por cento em creme Lanette com subsequente exposição solar. Um ano após, apresentaram máculas acrômicas na área do vitiligo. A biópsia de pele em um dos casos revelou melanócitos com escassa pigmentação melânica. Os achados clínicos e histológicos sugerem o diagnóstico de leucodermia punctata.
Two adolescent females and a girl, all with clinically diagnosed vitiligo, were treated with 0.2 percent 8-methoxypsoralen cream followed by exposure to solar ultraviolet light. One year later, they developed hypopigmented and achromic spots on the areas affected by the vitiligo. Biopsy of skin tissue taken from one of these cases showed a marked reduction in melanin. Clinical and histological findings point to a diagnosis of leukoderma punctata.
Assuntos
Adolescente , Criança , Feminino , Humanos , Metoxaleno/efeitos adversos , Terapia PUVA/efeitos adversos , Fármacos Fotossensibilizantes/efeitos adversos , Transtornos da Pigmentação/etiologia , Metoxaleno/uso terapêutico , Fármacos Fotossensibilizantes/uso terapêutico , Transtornos da Pigmentação/patologia , Vitiligo/tratamento farmacológicoRESUMO
Se presenta un caso de micosis fungoides en fase tumoral que ha respondido favorablemente al manajo con cobalto luego de 15 sesiones con dosis fraccionadas de 200 rads diarios. Posteriormente, se ha manejado con puvaterapia, obteniendo excelentes resultados hasta el momento
Assuntos
Humanos , Feminino , Adulto , Cobalto , Cobalto/uso terapêutico , Metoxaleno , Metoxaleno/uso terapêutico , Micose Fungoide/tratamento farmacológico , Micose Fungoide/patologia , Terapia PUVA/estatística & dados numéricos , Dosagem RadioterapêuticaRESUMO
El vitiligo es una hipomelanosis y amelanosis idiopática adquirida de la piel que afecta un alto porcentaje de la población. La fotoquimioterapia estimula la melanogénesis, la proliferación y la migración de melonocitos. Estudios recientes han mostrado exelente repigmentación con PUVA empleando 5-Metoxipsoralen oral. Este método tiene la ventaja de que produce muy poca fototoxicidad cutánea y náuseas. Hemos tratados 30 pacientes de vitiligo localizado con fotoquimioterapia tópica, empleando una preparación líquida nueva de 5-Metoxipsoralen que ha mostrado ser efectiva en la repigmenación de un número substancial de pacientes. (76.6%)
Assuntos
Criança , Adolescente , Adulto , Humanos , Masculino , Feminino , Terapia PUVA , Vitiligo/tratamento farmacológico , Metoxaleno/administração & dosagem , Metoxaleno/uso terapêutico , Administração Oral , Administração TópicaRESUMO
In 1974 a new therapy that employs methoxsalen and ultraviolet A irradiation (PUVA) was introduced as an outpatient treatment for severe psoriasis. To study the effect of this therapy on the cost of treatment, we documented for 1,320 patients two major components of cost--hospitalization and PUVA treatments. When the one-year period before initiation of PUVA therapy was compared with a one-year period after initiation of PUVA therapy, average hospital days per person per year declined 77% (5.1 vs 1.2). This decrease in hospitalization was most notable among patients who continued to use PUVA therapy. Largely offsetting the reduction in cost from reduced hospitalization was the cost of PUVA treatments. Our data confirm the previously known effectiveness of PUVA therapy, and they provide no support for the hypothesis that PUVA substantially increases the cost of treating patients with severe psoriasis.
Assuntos
Masculino , Feminino , Humanos , Assistência Ambulatorial , Fotoquimioterapia/economia , Hospitalização/economia , Metoxaleno/uso terapêutico , Psoríase/economia , Psoríase/tratamento farmacológico , Terapia PUVA/economiaRESUMO
Extensive psoriasis in 1,308 patients has been treated two or three times a week with oral 8-methoxypsoralen followed by high intensity, long-wave ultraviolet light (PUVA). Excluding 169 patients still under early treatment, psoriasis cleared in 88% and failed to clear in 3%. One percent dropped out due to complications of treatment, and 8% for other reasons. The twice-a-week schedule was superior for patients with lighter skin types. Once a remission was induced, there was no difference in its maintenance when patients were treated once a week, once every other week, or once every third week. Each of these schedules was superior to no maintenance treatment. Immediate side effect of the 45,000 treatments administered in the first 18 months of this study were uncommon, temporary, and generally mild. No clinically significant changes in laboratory screening or eye examinations attributable to PUVA have been uncovered.