J M Hernanz

Hospital Universitario Infanta Leonor, Madrid, Madrid, Spain

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Publications (39)31.43 Total impact

  • Clinical and Experimental Dermatology 04/2014; 39(3):406-7. DOI:10.1111/ced.12291 · 1.23 Impact Factor
  • D Velázquez · I Casado · P de la Cueva · J M Hernanz
    Clinical and Experimental Dermatology 07/2013; 38(5):562-3. DOI:10.1111/j.1365-2230.2012.04429.x · 1.23 Impact Factor
  • M. Valdivielso-Ramos · J.M. Hernanz
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    ABSTRACT: Dermatofibrosarcoma protuberans (DFSP) is a fibrohistiocytic tumor of intermediate malignancy that is very rare in childhood. Only 6% of these tumors present in children. Clinical diagnosis is very difficult in the early stages of disease, but to ensure appropriate treatment it is important to identify DFSP as early as possible and rule out benign conditions that are more common at this age.The clinical presentation and histopathologic and molecular characteristics of DFSP are similar in children and adults. Clinical diagnosis is, however, more difficult in children and requires a high degree of suspicion. The absence of characteristic features and the rarity of this tumor explain why diagnosis is often delayed. Complete surgical excision of the tumor is very important to reduce the risk of recurrence.This article presents a review of current knowledge about the management of DFSP in children and examines the latest treatment options.ResumenEl dermatofibrosarcoma protuberans es un tumor fibrohistiocitario de grado intermedio de malignidad, muy infrecuente en la infancia, con tan solo un 6% de estos tumores diagnosticados en la edad pediátrica. El diagnóstico clínico en los estadios iniciales es muy difícil, pero es necesario realizarlo lo más precozmente posible, así como excluir otros procesos benignos que son más frecuentes en la infancia para asegurar un tratamiento correcto.Tanto la presentación clínica como la histopatología y las anomalías moleculares en los niños son similares a las que encontramos en los adultos. Sin embargo, el diagnóstico inicial es más difícil y requiere un alto índice de sospecha por parte del dermatólogo. La ausencia de rasgos característicos, junto a la rareza de este cuadro, conducen en muchas ocasiones a un retraso en el diagnóstico. Es muy importante realizar una extirpación quirúrgica completa del tumor para reducir el riesgo de recidiva.Este artículo proporciona una revisión de los actuales conocimientos y opciones terapéuticas más novedosas en el manejo del dermatofibrosarcoma protuberans infantil.
    Actas Dermo-Sifiliográficas 12/2012; 103(10):863–873. DOI:10.1016/j.adengl.2011.12.002
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    ABSTRACT: Background Evaluation of disease severity is considered essential in the optimal management of psoriasis.Objectives To describe the clinical characteristics and therapeutic profile of patients with moderate to severe psoriasis in Spain and to assess the impact of the disease on the patients’ quality of life.Materials and methodsThis was an observational, cross-sectional study carried out in 90 dermatology units in Spain in 2009. We included 442 patients diagnosed with moderate to severe psoriasis who had started treatment with systemic agents, phototherapy, and/or topical treatments between 2004 and 2006.ResultsMore severe psoriasis was significantly associated with the following: longer disease duration; higher prevalence of concomitant disease; greater involvement of the nails, scalp, flexures, palms, and soles; and poorer quality of life. In the 5 years before the start of the study, 68% of the patients had received conventional systemic treatments, 39.1% biologic agents, and 22.3% phototherapy. At present, 57.5% of the patients are being treated with biologic agents, 32.6% with conventional systemic treatments, and 11% with phototherapy.Conclusions Severity of psoriasis was associated with a marked impact on quality of life. Regardless of disease severity, psychiatric comorbidity was the strongest predictor of poor quality of life. On average, patients had received other treatments, such as conventional systemic treatments or phototherapy, for more than 2 years before switching to biologic agents for the first time.
    Actas Dermo-Sifiliográficas 12/2012; 103(10):897–904. DOI:10.1016/j.ad.2012.04.005
  • M. Valdivielso-Ramos · J.M. Hernanz
    [Show abstract] [Hide abstract]
    ABSTRACT: Dermatofibrosarcoma protuberans (DFSP) is a fibrohistiocytic tumor of intermediate malignancy that is very rare in childhood. Only 6% of these tumors present in children. Clinical diagnosis is very difficult in the early stages of disease, but to ensure appropriate treatment it is important to identify DFSP as early as possible and rule out benign conditions that are more common at this age.The clinical presentation and histopathologic and molecular characteristics of DFSP are similar in children and adults. Clinical diagnosis is, however, more difficult in children and requires a high degree of suspicion. The absence of characteristic features and the rarity of this tumor explain why diagnosis is often delayed. Complete surgical excision of the tumor is very important to reduce the risk of recurrence.This article presents a review of current knowledge about the management of DFSP in children and examines the latest treatment options.
    Actas Dermo-Sifiliográficas 12/2012; 103(10):863–873. DOI:10.1016/j.ad.2011.12.005
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    ABSTRACT: BACKGROUND: Evaluation of disease severity is considered essential in the optimal management of psoriasis. OBJECTIVES: To describe the clinical characteristics and therapeutic profile of patients with moderate to severe psoriasis in Spain and to assess the impact of the disease on the patients' quality of life. MATERIALS AND METHODS: This was an observational, cross-sectional study carried out in 90 dermatology units in Spain in 2009. We included 442 patients diagnosed with moderate to severe psoriasis who had started treatment with systemic agents, phototherapy, and/or topical treatments between 2004 and 2006. RESULTS: More severe psoriasis was significantly associated with the following: longer disease duration; higher prevalence of concomitant disease; greater involvement of the nails, scalp, flexures, palms, and soles; and poorer quality of life. In the 5 years before the start of the study, 68% of the patients had received conventional systemic treatments, 39.1% biologic agents, and 22.3% phototherapy. At present, 57.5% of the patients are being treated with biologic agents, 32.6% with conventional systemic treatments, and 11% with phototherapy. CONCLUSIONS: Severity of psoriasis was associated with a marked impact on quality of life. Regardless of disease severity, psychiatric comorbidity was the strongest predictor of poor quality of life. On average, patients had received other treatments, such as conventional systemic treatments or phototherapy, for more than 2 years before switching to biologic agents for the first time.
    Actas Dermo-Sifiliográficas 11/2012; 103(10). DOI:10.1016/j.adengl.2012.04.017
  • Actas Dermo-Sifiliográficas 10/2011; DOI:10.1016/j.adengl.2010.12.004
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    ABSTRACT: Bullous pemphigoid is an acquired autoimmune blistering disorder extremely uncommon in children, characterized by circulating IgG antibodies to antigens of the epidermal basement membrane zone. In general, the clinical course of this condition is good and relapses are rare. The early diagnosis and treatment are fundamental.We present a 3-month-old girl with a blistering eruption on her palms and soles, and urticarial plaques on trunk, and face, 3 weeks after vaccine at two months (hepatitis B, diphtheria, tetanus, pertussis, polio, Haemophilus influenzae B, meningococcal C, pneumococcus). The clinical course worsened with vaccinations at 4 and 6 months. The control of lesions was achieved with oral deflazacort 1mg/kg/day, with a gradual decrease until 3 months of therapy. The patient is still in remission after 8 months of follow-up.Bullous pemphigoid has been connected with some drugs and vaccinations, 1 day to 4 weeks after receiving immunization. Although the exact mechanism of induction is unclear, this case report has a visible relationship with vaccinations.
    Anales de Pediatría 09/2011; 75(3):199-202. DOI:10.1016/j.anpedi.2011.04.009 · 0.72 Impact Factor
  • Actas Dermo-Sifiliográficas 09/2011; 102(7):545-546. DOI:10.1016/j.ad.2010.12.012
  • [Show abstract] [Hide abstract]
    ABSTRACT: Bullous pemphigoid is an acquired autoimmune blistering disorder extremely uncommon in children, characterized by circulating IgG antibodies to antigens of the epidermal basement membrane zone. In general, the clinical course of this condition is good and relapses are rare. The early diagnosis and treatment are fundamental. We present a 3-month-old girl with a blistering eruption on her palms and soles, and urticarial plaques on trunk, and face, 3 weeks after vaccine at two months (hepatitis B, diphtheria, tetanus, pertussis, polio, Haemophilus influenzae B, meningococcal C, pneumococcus). The clinical course worsened with vaccinations at 4 and 6 months. The control of lesions was achieved with oral deflazacort 1 mg/kg/day, with a gradual decrease until 3 months of therapy. The patient is still in remission after 8 months of follow-up. Bullous pemphigoid has been connected with some drugs and vaccinations, 1 day to 4 weeks after receiving immunization. Although the exact mechanism of induction is unclear, this case report has a visible relationship with vaccinations.
    Anales de Pediatría 06/2011; 75(3):199-202. · 0.72 Impact Factor
  • Actas Dermo-Sifiliográficas 04/2011; 102(7):545-6.
  • Actas Dermo-Sifiliográficas 04/2011; 102(3):233-235. DOI:10.1016/j.ad.2010.07.009
  • C Mauleón · M Valdivielso · E Chavarría · J M Hernanz · I Casado
    Actas Dermo-Sifiliográficas 03/2011; 102(3):233-5. DOI:10.1016/S1578-2190(11)70796-X
  • M Valdivielso-Ramos · C Mauleón · J M Hernanz
    Journal of the European Academy of Dermatology and Venereology 03/2011; 26(2):260-2. DOI:10.1111/j.1468-3083.2011.04051.x · 3.11 Impact Factor
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    ABSTRACT: Scalp lesions are common in psoriasis and difficult to treat. Scientific evidence on the topic is scant and fragmentary, especially with respect to long-term treatment. This consensus statement is based on a critical assessment of the results of a MEDLINE search for clinical trials of the efficacy and safety of therapies used to treat scalp psoriasis. The recommendations were developed by an expert panel using the Delphi process to reach a consensus and then ratified by the members of the Psoriasis Group of the Spanish Academy of Dermatology and Venereology. The recommended induction therapy for scalp psoriasis is either a topical corticosteroid or a topical treatment combining calcipotriol and betamethasone. The choice of an appropriate vehicle is crucial in improving effectiveness and patient adherence to treatment. The only formulations that have been studied in the long-term treatment of scalp psoriasis are a combination of calcipotriol and betamethasone in gel and calcipotriol alone in solution.
    Actas Dermo-Sifiliográficas 12/2010; 101(10):827-46. DOI:10.1016/S1578-2190(10)70730-7
  • [Show abstract] [Hide abstract]
    ABSTRACT: Scalp lesions are common in psoriasis and difficult to treat. Scientific evidence on the topic is scant and fragmentary, especially with respect to long-term treatment. This consensus statement is based on a critical assessment of the results of a MEDLINE search for clinical trials of the efficacy and safety of therapies used to treat scalp psoriasis. The recommendations were developed by an expert panel using the Delphi process to reach a consensus and then ratified by the members of the Psoriasis Group of the Spanish Academy of Dermatology and Venereology. The recommended induction therapy for scalp psoriasis is either a topical corticosteroid or a topical treatment combining calcipotriol and betamethasone. The choice of an appropriate vehicle is crucial in improving effectiveness and patient adherence to treatment. The only formulations that have been studied in the long-term treatment of scalp psoriasis are a combination of calcipotriol and betamethasone in gel and calcipotriol alone in solution.
    Actas Dermo-Sifiliográficas 12/2010; 101(10):827-846. DOI:10.1016/j.ad.2010.09.001
  • Actas Dermo-Sifiliográficas 06/2010; 101(5). DOI:10.1016/j.ad.2009.12.018
  • Actas Dermo-Sifiliográficas 06/2010; 101(5):458-60. DOI:10.1016/S1578-2190(10)70674-0
  • J M Hernanz
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    ABSTRACT: The use of biological treatments in the field of Dermatology has been recent and priority focus has been given to the treatment of psoriasis. Etanercept has demonstrated its efficacy and safety in this field although it is true that it has been used in many different diseases other than psoriasis with variable results due to its action mechanism and safety profile. We present a case of Hallopeau's Acrodermatitis treated with etanercept with good results. Given the characteristics of chronicity, progressiveness and, in general, poor response to conventional treatments, the use of etanercept is of help in the therapeutic possibilities of Hallopeau's Acrodermatitis. In addition, other possible indications of etanercept in conditions other than Psoriasis are reviewed
    Actas Dermo-Sifiliográficas 05/2010; 101 Suppl 1:111-6.
  • J. M. Hernanz
    [Show abstract] [Hide abstract]
    ABSTRACT: The use of biological treatments in the field of Dermatology has been recent and priority focus has been given to the treatment of psoriasis. Etanercept has demonstrated its efficacy and safety in this field although it is true that it has been used in many different diseases other than psoriasis with variable results due to its action mechanism and safety profile. We present a case of Hallopeau's Acrodermatitis treated with etanercept with good results. Given the characteristics of chronicity, progressiveness and, in general, poor response to conventional treatments, the use of etanercept is of help in the therapeutic possibilities of Hallopeau's Acrodermatitis.In addition, other possible indications of etanercept in conditions other than Psoriasis are reviewed.
    Actas Dermo-Sifiliográficas 05/2010; 101. DOI:10.1016/S0001-7310(10)70019-3