[Show abstract][Hide abstract] ABSTRACT: Pruritus results from the activation of small nerve endings in the skin by noxious mediators. Gastrin-releasing peptide (GRP) and substance P and glutamate have a key role in histamine-dependent itch transmission. GRP is present in primary afferent nerve fibers and found to be increased in mice with chronic dermatitis and pruritus.(1) Therefore; GRP-expressing nerves have an important role in mediating itch in animal models. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.
British Journal of Dermatology 12/2014; · 3.76 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: BACKGROUND: The efficacy of topical retinoids is well known according to several clinical studies conducted predominantly among Caucasian patients. This study aimed to evaluate the efficacy and safety profile of adapalene and tretinoin among Mexican patients. AIMS: To compare adapalene 0.1 and 0.3% and tretinoin 0.05% in Mexican subjects with acne vulgaris. METHODS: We enrolled 171 patients in this single-center, randomized, double-blinded, placebo-controlled clinical trial. The patients applied on the face either adapalene 0.1%, adapalene 0.3%, tretinoin 0.05%, or placebo for 90 days and were evaluated for the reduction in total lesion counts and for the level of irritation. RESULTS: Tretinoin 0.05% and adapalene 0.3% were more effective than adapalene 0.1% and placebo in the reduction of both inflammatory and noninflammatory lesions. Most of adverse events to adapalene and many on tretinoin group were related to skin irritation, dry skin, scaling, pruritus, burning, and postinflammatory hyperpigmentation. CONCLUSION: Adapalene 0.3% and tretinoin 0.05% are comparable in efficacy, and adapalene 0.1% offers a better safety profile in Mexican patients.
Journal of Cosmetic Dermatology 06/2013; 12(2):103-107. · 1.00 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: AIM: Diaper dermatitis (DD) is an inflammatory irritating condition that is common in infants. Most cases are associated with the yeast colonization of Candida or diaper dermatitis candidiasis (DDC), and therefore, the signs and symptoms improve with antimycotic treatment. Sertaconazole is a broad-spectrum third-generation imidazole derivative that is effective and safe for the treatment for superficial mycoses, such as tineas, candidiasis, and pityriasis versicolor. Our goal was to assess the efficacy and safety of sertaconazole cream (2 %) in DDC. MATERIALS AND METHODS: Twenty-seven patients with clinical and mycological diagnosis of DDC were enrolled and treated with 2 daily applications for 14 days and were followed-up for 2 further weeks. RESULTS: Three etiologic agents were isolated: Candida albicans in 88.8 %, Candida parapsilosis in 7.3 %, and Candida glabrata in 3.2 %. There was an average symptom reduction from 7.1 to 3.2 in the middle of treatment and to 1.2 and 0.4 units at the end of treatment and follow-up, respectively. The treatment evaluation at the end of the follow-up period showed a total clinical and mycological cure in 88.8 %, improvement in 3.7 %, and failure in 7.4 %. There was side effect (3.7 %) of skin irritation, but the drug was not discontinued. CONCLUSIONS: Based on its safety and effectiveness, sertaconazole cream may be considered a new alternative for DDC treatment.
[Show abstract][Hide abstract] ABSTRACT: Systemic corticosteroids represent an effective treatment for pemphigus vulgaris (PV). However, this treatment is related to many adverse side effects. Herein, we report a case of PV treated with ustekinumab.
[Show abstract][Hide abstract] ABSTRACT: Calcipotriene ointment is widely used in the topical treatment of psoriasis, with tacrolimus ointment as an effective alternative in controlling stable plaque psoriasis. The efficacy of the combination of both products on stable plaque psoriasis has not been assessed in the literature consulted. We evaluated the efficacy of calcipotriene ointment 0.005% applied twice daily, tacrolimus ointment 0.1% applied twice daily, or a morning application of calcipotriene and an evening application of tacrolimus in 27 participants with stable plaque psoriasis over an 8-week treatment period. The mean reduction in the sum of the scores between baseline and week 8 was significant (P = .001) for calcipotriene alone (39.5%), tacrolimus alone (38.2%), and the combination of calcipotriene and tacrolimus (60.7%). Combination therapy was statistically more effective than tacrolimus alone (P = .043) but not statistically superior to calcipotriene alone (P=.056). Most adverse events (AEs) were related to skin irritation and pruritus; however, no AEs were evident in participants given the combination therapy.
Cutis; cutaneous medicine for the practitioner 09/2012; 90(3):140-4. · 0.59 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Cutaneous zygomycosis is a fungal infection caused by zygomycetes that affects the skin. It occurs in uncontrolled diabetic patients and immunosuppressed individuals. It has 2 clinical forms: primary cutaneous zygomycosis and secondary cutaneous zygomycosis. The first is characterized by necrotic lesions and the fungus is usually inoculated by trauma. If diagnosed early, it generally has a good prognosis. Secondary zygomycosis is usually a complication and extension of the rhinocerebral variety that starts as a palpebral fistula and progresses to a necrotic lesion with a poor prognosis. The diagnosis is made by identification of the fungus by direct KOH examination, culture, and biopsy. Treatment for the primary disease is surgical debridement plus amphotericin B. The secondary type is treated with amphotericin B and/or posaconazole.
Clinics in dermatology 07/2012; 30(4):413-9. · 3.11 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Serum lactate is a useful prognostic marker in severe sepsis; high levels of serum lactate in critically ill patients are related to high mortality risk; assessing serum lactate levels in patients with pemphigus vulgaris is justified. The objective was to determine the role of serum lactate as a predictor of shock and its outcome in patients with pemphigus vulgaris and severe sepsis without acute organ dysfunction.
Thirty-seven patients with pemphigus vulgaris, 22 with severe sepsis and 15 without sepsis. Blood lactate levels were analyzed. The outcome was recorded as survival or non-survival.
High serum lactate levels, compared with intermediate and low levels, were significantly associated with increased 28-day mortality in patients with severe sepsis. The 28-day mortality for the cohort was 27.3%.
Initial serum lactate was associated with mortality in pemphigus vulgaris with severe sepsis. Patients with severe sepsis and with high serum lactate levels (≥ 4 mmol/L) constitute a potential risk group that may benefit from more aggressive treatment.
Acta dermatovenerologica Alpina, Panonica, et Adriatica 03/2012; 21(1):7-9.
[Show abstract][Hide abstract] ABSTRACT: Several studies have tried to determine the relationship between autoantibodies against the acetylcholine receptor and the development of pemphigus vulgaris. In this study, we observed that antibody levels against the acetylcholine receptor are mildly elevated in pemphigus vulgaris (PV), and significantly correlate with disease severity on the initial diagnosis and during follow up. However, it is not clear if these antibodies are just an epiphenomenon or a potential trigger of the known pathogenic process in PV.
[Show abstract][Hide abstract] ABSTRACT: Bullous pemphigoid is a chronic, blistering and autoimmune disease, common in old age. The treatment usually includes systemic steroids, however, these cause high morbidity rates, and then different products that function as adjuvants have been tried. At present, there are no studies to determine which adjuvant offers a better efficacy and safety profile.
We performed a retrospective study which included the records of patients with bullous pemphigoid, treated either with azathioprine or dapsone. We evaluated the time to achieve complete remission, the time to inhibit disease progression, and the control of pruritus.
Fifteen records of patients were selected, eight (53%) treated with azathioprine and seven (47%) with dapsone. Complete remission was achieved at week six in both groups. We found no difference in the inhibition of disease progression (p=0.083). Pruritus was controlled at four weeks of treatment in both treatments.
Both products are effective as adjuvant in the treatment of bullous pemphigoid, with an acceptable safety profile.
Allergologia et Immunopathologia 04/2011; 40(3):152-5. · 1.23 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Background. Actinic keratoses (AK) are dysplastic keratinocytic lesions confined to the epidermis. Currently, the standard screening method for detecting AK is performed by a health professional. Objectives. We seek to determine if were differences in diagnosis of AK by dermatologists (DL) and primary care physicians (PCP) in Mexico. Material and Methods. The clinical diagnoses of PCP and DL were correlated with histopathologic diagnoses. In total, 285 cases were analyzed. Results. DL diagnosed 90% (256/285) of the cases compared with 36% (102/285) of PCP (P= .001). Primary care physicians were the group with the lowest diagnostic accuracy rate. Conclusion: Primary care physician needs to acquire sufficient knowledge of basic dermatology as well as dermatopathology. The overall accuracy of the clinical diagnosis, mainly in hyperplastic AK, depends on the clinicopathologic correlation.
[Show abstract][Hide abstract] ABSTRACT: Melasma is a common disorder of pigmentation characterized by relatively symmetric, brown or gray-brown patches on sun-exposed facial areas. Hydroquinone, the most effective agent in melasma, is known to irritate the skin, and so new alternatives in the treatment of melasma are required. We sought to assess the clinical response of a new depigmenting agent in melasma.
Ninety-six Mexican female patients with melasma were enrolled in this open, comparative, 12-week study. The patients received 1% dioic acid cream (twice daily) or 2% hydroquinone cream (twice daily).
There was a significant difference in the Melasma Area Severity Index (MASI) scores from baseline to the end of the study using treatment with dioic acid (baseline, 14.52 3.4; after 12 weeks of treatment, 6.05 +/- 1.2; P = 0.001) and hydroquinone (baseline, 15.22 +/- 2.4; after 12 weeks of treatment, 6.34 +/- 1.3; P = 0.001); however, there were no significant differences between treatments (baseline, P = 0.311; after 12 weeks of treatment, P = 0.287). The side-effects were similar with both medications; however, pruritus was more common in patients using hydroquinone.
Dioic acid is an effective and highly tolerated skin product, although further controlled, blind, multicenter studies are required to support these results.
International journal of dermatology 09/2009; 48(8):893-5. · 1.23 Impact Factor