J F Silvestre

Hospital General Universitario de Alicante, Alicante, Valencia, Spain

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Publications (78)127.48 Total impact

  • M. Leiva-Salinas, L. Francés, J.F. Silvestre
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    ABSTRACT: The combination of methylchloroisothiazolinone (MCI) and methylisothiazolinone (MI) is widely used as a preservative in cosmetics, household, and industrial products. Furthermore, MI at a concentration of 100 ppm has been permitted in cosmetic products since 2005. Recently, a considerable increase in cases of contact dermatitis to both MCI and MI have been noted, and this warrants closer monitoring by relevant authorities and, probably, stricter legislation. In fact, MI at a test concentration of 2000 ppm was recently included in the European baseline patch test series. The clinical manifestations of allergy to MCI/MI and MI are highly variable and diagnosis is often missed. In the standard patch test series of the Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC), MCI/MI is tested at 100 ppm, but at this concentration, up to 50% of cases might go undetected. Furthermore, our data indicate that MCI/MI at 200 ppm would make it possible to diagnose more cases of contact allergy to MI. To improve the diagnosis of contact allergy to MCI/MI and MI, we believe that the test concentration of MCI/MI should be increased to 200 ppm in the GEIDAC standard series and that MI should be added in the GEIDAC standard series.
    Actas Dermo-Sifiliográficas 11/2014; DOI:10.1016/j.ad.2013.12.010
  • M Leiva-Salinas, L Francés, J F Silvestre
    [Show abstract] [Hide abstract]
    ABSTRACT: The combination of methylchloroisothiazolinone (MCI) and methylisothiazolinone (MI) is widely used as a preservative in cosmetics, household, and industrial products. Furthermore, MI at a concentration of 100ppm has been permitted in cosmetic products since 2005. Recently, a considerable increase in cases of contact dermatitis to both MCI and MI have been noted, and this warrants closer monitoring by relevant authorities and, probably, stricter legislation. In fact, MI at a test concentration of 2000ppm was recently included in the European baseline patch test series. The clinical manifestations of allergy to MCI/MI and MI are highly variable and diagnosis is often missed. In the standard patch test series of the Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC), MCI/MI is tested at 100ppm, but at this concentration, up to 50% of cases might go undetected. Furthermore, our data indicate that MCI/MI at 200ppm would make it possible to diagnose more cases of contact allergy to MI. To improve the diagnosis of contact allergy to MCI/MI and MI, we believe that the test concentration of MCI/MI should be increased to 200ppm in the GEIDAC standard series and that MI should be added in the GEIDAC standard series.
    Actas Dermo-Sifiliográficas 03/2014;
  • Journal of the European Academy of Dermatology and Venereology 03/2014; 29(5). DOI:10.1111/jdv.12450 · 3.11 Impact Factor
  • Journal of the European Academy of Dermatology and Venereology 03/2014; 29(6). DOI:10.1111/jdv.12469 · 3.11 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Chronic spontaneous urticaria, also known as chronic idiopathic urticaria or simply chronic urticaria, is a common disorder that has a prevalence in the general population that ranges between 0.5% and 1%. This condition negatively affects the patient's quality of life and has considerable impact on direct and indirect health-related costs. Chronic urticaria is difficult to manage. Nonsedating H1 antihistamines are the first line of therapy, but fewer than 50% of patients experience relief at recommended dosages. Although guidelines call for increasing the dosage when response is inadequate, some patients still do not achieve adequate control of symptoms. New treatment alternatives, with proven efficacy under the standards of evidence-based medical practice, must therefore be developed.
    Actas Dermo-Sifiliográficas 01/2014; 105(5):469–482.
  • L. Francés, M. Leiva-Salinas, J.F. Silvestre
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    ABSTRACT: Omalizumab is a monoclonal anti-immunoglobulin E antibody currently only approved for use in severe, refractory asthma. In recent years, many authors have reported satisfactory results with omalizumab in patients with difficult-to-treat chronic urticaria. As a result, clinical trials were undertaken to broaden the indication of omalizumab to include chronic urticaria, and the drug was recently cited as a third-line treatment after selective antihistamines at high doses in a consensus document on the treatment of chronic urticaria. In this article our aim is to provide a comprehensive update on the use of omalizumab in the treatment of chronic urticaria. The structure of this biologic agent and its possible mechanisms of actions in this setting will be presented. Treatment strategies and the different dosage regimens used in the series of cases published to date will also be reviewed. Finally, we will discuss the adverse effects that may arise with treatment and the recommended strategies for minimizing the most feared effect, anaphylaxis. Based on the experience of many researchers, omalizumab is emerging as a novel treatment for certain types of spontaneous refractory chronic urticaria and has shown promising results in this setting. The drug has a good safety profile and the main limitation is its high cost.
    Actas Dermo-Sifiliográficas 01/2014; 105(1):45–52. DOI:10.1016/j.ad.2013.06.002
  • Source
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    ABSTRACT: Chronic urticaria (CU) is very prevalent in the general population and, despite its low mortality, can have devastating effects on the quality of life (QoL) of those who experience it.Therefore, consensus documents on its classification, diagnosis, and treatment have become a necessity. The intensity of urticaria is currently evaluated using indices such as the Urticaria Activity Score and visual analog scales to assess itch or the degree of itch associated with the use of antihistamines. QoL is evaluated using various generic questionnaires and specific tools for skin disease and for CU. In recent years, attempts have been made to combine these evaluations to create a specific tool that would enable us to simultaneously evaluate the severity of the condition and the impact of symptoms on QoL. One such tool is the Urticaria Severity Score, which also allows us to compare global changes brought about by different treatments.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Chronic spontaneous urticaria, also known as chronic idiopathic urticaria or simply chronic urticaria, is a common disorder that has a prevalence in the general population that ranges between 0.5% and 1%. This condition negatively affects the patient's quality of life and has considerable impact on direct and indirect health-related costs. Chronic urticaria is difficult to manage. Nonsedating H1 antihistamines are the first line of therapy, but fewer than 50% of patients experience relief at recommended dosages. Although guidelines call for increasing the dosage when response is inadequate, some patients still do not achieve adequate control of symptoms. New treatment alternatives, with proven efficacy under the standards of evidence-based medical practice, must therefore be developed.
    Actas Dermo-Sifiliográficas 05/2013; DOI:10.1016/j.ad.2012.12.019
  • Actas Dermo-Sifiliográficas 05/2013; 104(4):351–352. DOI:10.1016/j.ad.2012.04.017
  • M.P. Arribas, P. Soro, J.F. Silvestre
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    ABSTRACT: Allergic contact dermatitis due to fragrances usually manifests as subacute or chronic dermatitis because fragrances are found in a wide range of products to which patients are repeatedly exposed. The typical patient is a middle-aged woman with dermatitis on her hands and face, although other sites may be affected depending on the allergen and the product in which it is found. The standard patch test series of the Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC) contains 4 fragrance markers: balsam of Peru, fragrance mix i, fragrance mix ii, and lyral. Testing with a specific fragrance series is recommended in patients with a positive result to any of these 4 markers. The use of a specific fragrance series and new legislation obliging manufacturers to specify the fragrances used in their products, will help to improve the management of allergic contact dermatitis due to fragrances.
    Actas Dermo-Sifiliográficas 01/2013; 104(1):29–37. DOI:10.1016/j.ad.2012.03.005
  • M.P. Arribas, P. Soro, J.F. Silvestre
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    ABSTRACT: Fragrances are a large group of substances and the second most common cause of allergic contact dermatitis in Spain.These potential allergens are extremely common and the general population is subject to continuous exposure on a daily basis.While the fragrance markers included in the current Spanish standard patch test series are good, there is room for improvement. New markers that have emerged in recent years have proven to be of value in standard series used in other countries. Diagnosing fragrance allergy has taken on even greater importance since the European Union added 26 fragrances to its list of mandatory ingredients to be specified on product labels. The aim of this review is to provide an update on allergic contact dermatitis to fragrances. We examine the main sources of exposure and clinical manifestations of this condition and propose a diagnostic and treatment protocol
    Actas Dermo-Sifiliográficas 12/2012; 103(10):874–879. DOI:10.1016/j.ad.2012.01.015
  • Actas Dermo-Sifiliográficas 09/2012; 104(4). DOI:10.1016/j.adengl.2012.04.022
  • Source
    M P Arribas, P Soro, J F Silvestre
    [Show abstract] [Hide abstract]
    ABSTRACT: Fragrances are a large group of substances and the second most common cause of allergic contact dermatitis in Spain. These potential allergens are extremely common and the general population is subject to continuous exposure on a daily basis. While the fragrance markers included in the current Spanish standard patch test series are good, there is room for improvement. New markers that have emerged in recent years have proven to be of value in standard series used in other countries. Diagnosing fragrance allergy has taken on even greater importance since the European Union added 26 fragrances to its list of mandatory ingredients to be specified on product labels. The aim of this review is to provide an update on allergic contact dermatitis to fragrances. We examine the main sources of exposure and clinical manifestations of this condition and propose a diagnostic and treatment protocol.
    Actas Dermo-Sifiliográficas 07/2012; 103(10). DOI:10.1016/j.adengl.2012.01.022
  • Source
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    ABSTRACT: The pattern of contact sensitization to the supposedly most important allergens assembled in the baseline series differs between countries, presumably at least partly because of exposure differences. Objectives. To describe the prevalence of contact sensitization to allergens tested in consecutive patients in the years 2007 and 2008, and to discuss possible differences. Data from the 39 departments in 11 European countries comprising the European Surveillance System on Contact Allergy network (www.essca-dc.org) in this period have been pooled and analysed according to common standards. Patch test results with the European baseline series, and country-specific or department-specific additions to it, obtained in 25 181 patients, showed marked international variation. Metals and fragrances are still the most frequent allergens across Europe. Some allergens tested nationally may be useful future additions to the European baseline series, for example methylisothiazolinone, whereas a few long-term components of the European baseline series, namely primin and clioquinol, no longer warrant routine testing. The present analysis points to 'excess' prevalences of specific contact sensitization in some countries, although interpretation must be cautious if only few, and possibly specialized, centres are representing one country. A comparison as presented may help to target in-depth research into possible causes of 'excess' exposure, and/or consideration of methodological issues, including modifications to the baseline series.
    Contact Dermatitis 04/2012; 67(1):9-19. DOI:10.1111/j.1600-0536.2012.02070.x · 3.62 Impact Factor
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    ABSTRACT: Extramammary Paget's disease is an uncommon intraepithelial adenocarcinoma which occurs in areas rich in apocrine glands. Although surgery is the treatment of choice, numerous noninvasive treatments have been tried. There are studies that have demonstrated the efficacy of imiquimod to treat Extramammary Paget's disease, but we found no mention in the literature of its use as neoadjuvant therapy previous to surgery excision. We present a case of a large plaque of extramammary Paget's disease successfully treated with imiquimod and minor surgery of the residual disease.
    Dermatologic Therapy 01/2012; 25(1):82-5. DOI:10.1111/j.1529-8019.2012.01428.x · 1.48 Impact Factor
  • F Toledo, J F Silvestre, C Muñoz
    Journal of the European Academy of Dermatology and Venereology 11/2011; 26(10):1325-7. DOI:10.1111/j.1468-3083.2011.04326.x · 3.11 Impact Factor
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    ABSTRACT: Hand eczema is not uncommon in children but it is rarely studied using skin-prick tests. Few reports have addressed their usefulness in children and none has specifically analyzed their use in children with hand eczema. We performed a retrospective study of all children up to 16 years of age with hand eczema who were assessed in the Department of Dermatology at Hospital General Universitario in Alicante, Spain with the standard GEIDAC panel over a 5-year period. We compared the epidemiologic data and results of skin-prick tests in this group with those obtained in children with eczema at any site and in adults with hand eczema. The study included a total of 1695 patients: 141 (8.3%) children and 1533 (91.7%) adults. Hand eczema was diagnosed in 496 (31.9%) adults and 32 (22.7%) children. Positive results were obtained in skin-prick tests in 50% of children with hand eczema compared with 37.6% of children with eczema at any site and 50.6% of adults with hand eczema. The current relevance of the positive allergens found in children with hand eczema (76.2%) was greater than that observed in children with eczema at any site (61%) or in adults with hand eczema (43%). The most common allergens in children with hand eczema were kathon CG and fragrance mix I, whereas in the other 2 groups metals were the most common. The most common final diagnosis in children with hand eczema was allergic contact dermatitis (34.3%), which proved to be more common than atopic dermatitis. We recommend the use of skin-prick tests in all children with chronic hand eczema.
    Actas Dermo-Sifiliográficas 09/2011; 102(6):429-38. DOI:10.1016/j.adengl.2011.01.001
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background Hand eczema is not uncommon in children but it is rarely studied using skin-prick tests. Few reports have addressed their usefulness in children and none has specifically analyzed their use in children with hand eczema.
    Actas Dermo-Sifiliográficas 07/2011; 102(6):429-438. DOI:10.1016/j.ad.2011.01.004
  • Contact Dermatitis 05/2011; 64(5):289-91. DOI:10.1111/j.1600-0536.2010.01865.x · 3.62 Impact Factor
  • N. Latorre, J. F. Silvestre, A. F. Monteagudo
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    ABSTRACT: Formaldehyde is a colorless gas with a pungent odor that is widely used as a preservative in toiletries and cosmetics and in products for household and industrial use. Both formaldehyde itself and substances that can release it are a common cause of allergic contact dermatitis. This condition often becomes chronic, given that these allergens are found nearly everywhere and it is difficult for patients to avoid them completely. This article reviews the sources of exposure to formaldehyde and formaldehyde releasers and the clinical manifestations of allergen exposure. We also review current debates and recent developments and propose guidelines for the diagnosis and treatment of patients with formaldehyde contact dermatitis.
    Actas Dermo-Sifiliográficas 03/2011; 102(2):86-97. DOI:10.1016/j.ad.2010.09.004

Publication Stats

455 Citations
127.48 Total Impact Points

Institutions

  • 1998–2013
    • Hospital General Universitario de Alicante
      • Departamento de Dermatología
      Alicante, Valencia, Spain
  • 2011
    • Complejo Hospitalario Universitario de Santiago
      Santiago, Galicia, Spain
  • 1996–1997
    • Consorcio Hospital General Universitario de Valencia
      • Departamento de Dermatología
      Valenza, Valencia, Spain