J F Silvestre

Hospital General Universitario de Alicante, Alicante, Valencia, Spain

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Publications (104)175.31 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) and methylisothiazolinone (MI) contact allergies are rising dramatically. Moreover, 100 ppm of MCI/MI patch test might not detect an important number of MCI/MI and MI allergies. This study aimed to present the prevalence of contact allergy to both preservatives in an area of Spain and to investigate if 100 ppm of MCI/MI is an adequate concentration for a proper diagnosis. A prospective study was conducted from October 2011 to September 2013. All patients were patch tested with the Spanish baseline series (containing 100 ppm of MCI/MI) and with 200 ppm of MCI/MI and 2000 ppm of MI. A total of 490 patients were patch tested. The MCI/MI prevalence was 10% and increased from 7.8% in last term of 2011 to 14.3% in the first 9 months of 2013. The MI prevalence was 4.5% and increased from 1% to 7.7% in the same period. One hundred parts per million of MCI/MI could not diagnose 24.5% of MCI/MI allergies. All MI allergies were detected by 200 ppm of MCI/MI, whereas only 68.2% were positive to 100-ppm concentration. For a correct diagnosis of MCI/MI and MI contact allergies, we advocate increasing the MCI/MI patch test concentration to 200 ppm along with a temporal inclusion of MI in the North American Contact Dermatitis Group baseline series.
    Dermatitis 05/2014; · 0.93 Impact Factor
  • European journal of dermatology : EJD. 04/2014;
  • 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;
  • Irene Ballester, Jaime Guijarro, Juan Francisco Silvestre, María Niveiro
    International journal of dermatology 03/2014; · 1.18 Impact Factor
  • Journal of the European Academy of Dermatology and Venereology 03/2014; · 2.69 Impact Factor
  • Journal of the European Academy of Dermatology and Venereology 03/2014; · 2.69 Impact Factor
  • L. Francés, M. Leiva-Salinas, J.F. Silvestre
    [Show abstract] [Hide abstract]
    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.
  • 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 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 01/2014;
  • Source
    [Show abstract] [Hide abstract]
    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.
    Journal of investigational allergology & clinical immunology. 01/2014; 24(2):80-6.
  • [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
    [Show abstract] [Hide abstract]
    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 08/2013;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective: To collect data on the efficacy and safety of omalizumab in 110 patients from 9 Spanish hospitals suffering from chronic spontaneous urticaria (CSU) refractory to conventional treatment. Methods: A retrospective, descriptive analysis was performed, showing the data of 110 patients suffering from refractory CSU who received omalizumab as an off-label treatment in 9 Spanish hospitals from October 2009 to September 2012. Results: Ninety (81.8%) patients exhibited a complete or significant response, 12 (10.9%) had partial response, and 8 (7.2%) showed no response. Sixty-six (60%) patients were able to stop all concomitant medications, remaining asymptomatic treated with omalizumab alone. No serious adverse events were reported. Conclusions: Omalizumab shows excellent efficacy and safety profile in a large series of CSU patients in real-life practice. This drug will contribute to settle the debt with CSU patients contributing to restore their quality of life.
    Expert opinion on biological therapy 07/2013; · 3.22 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 05/2013;
  • Actas Dermo-Sifiliográficas 05/2013; 104(4):351–352.
  • 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 12/2012; 103(10):874–879.
  • Actas Dermo-Sifiliográficas 09/2012;
  • 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;
  • [Show abstract] [Hide abstract]
    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. · 1.96 Impact Factor
  • Fernando Toledo, Juan Francisco Silvestre, Laura Cuesta, José Bañuls
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    ABSTRACT:   Ammonium bifluoride is one of the most corrosive acids that may produce severe chemical burns when in contact with skin. This hazardous chemical is widely used in household products. We report two pediatric cases of irritant contact dermatitis after exposure to a rust remover, which contained ammonium bifluoride.
    Pediatric Dermatology 12/2011; · 1.04 Impact Factor
  • F Toledo, J F Silvestre, C Muñoz
    Journal of the European Academy of Dermatology and Venereology 11/2011; 26(10):1325-7. · 2.69 Impact Factor

Publication Stats

408 Citations
175.31 Total Impact Points

Institutions

  • 1995–2014
    • Hospital General Universitario de Alicante
      • Departamento de Dermatología
      Alicante, Valencia, Spain
  • 2013
    • Parc de Salut Mar
      Barcino, Catalonia, Spain
  • 2012
    • University of Alicante
      • Departamento de Ecología
      Alicante, Valencia, Spain
  • 2011
    • Complejo Hospitalario Universitario de Badajoz
      Ara Pacis Augustalis, Extremadura, Spain
    • Complejo Hospitalario Universitario de Santiago
      Santiago, Galicia, Spain
  • 1996–1999
    • Consorcio Hospital General Universitario de Valencia
      • Departamento de Dermatología
      Valenza, Valencia, Spain
  • 1997
    • Port of Spain General Hospital
      City of Port-of-Spain, City of Port of Spain, Trinidad and Tobago