Publications by authors named "Antonio Martínez-López"

44 Publications

Skin adverse events related to personal protective equipment: a systematic review and metanalysis.

J Eur Acad Dermatol Venereol 2021 Jun 2. Epub 2021 Jun 2.

Department of Dermatology, Virgen de las Nieves University Hospital, Granada, Spain.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a global pandemic that has spread all over the word. To avoid the virus transmission, healthcare workers (HCWs) must wear adequate personal protective equipment (PPE). PPE is associated with several side events, including skin reactions. The objective of this study is to summarize the prevalence, type and risk factors for cutaneous adverse events related to PPE and prevention measures to avoid them. A systematic review and metanalysis was conducted using Medline, Scopus and Embase databases from conception to 21 January 2021. All types of epidemiological studies regarding skin adverse events related to PPE were included. The literature search identified 1,007 references, 35 of them met the eligible criteria and were included for analysis, representing 31,453 participants. The media of skin side events related to PPE was 75.13%. The rate of cutaneous adverse events related to mask was 57.71% and those associated with gloves and hand hygiene products was 49.16%. Most common skin adverse events were contact dermatitis, acne and itching. The most damaged anatomical regions were the nasal bridge, the cheeks and the hands. The duration of PPE wearing was the most common risk factor. Frequent hand washing, gloves and masks were the agents most frequently related to skin reactions. N95 respirators were the most harmful mask type for the skin. Hydrocolloid use prevented from developing skin adverse events related to masks. In conclusion, the rate of cutaneous adverse events related to PPE use is high. A longer duration of PPE wearing was the most common risk factor. Using hydrocolloid could prevent from skin injuries related to mask use.
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http://dx.doi.org/10.1111/jdv.17436DOI Listing
June 2021

Cutaneous homeostasis and epidermal barrier function in a young healthy Caucasian population.

Eur J Dermatol 2021 Apr;31(2):176-182

Dermatology Department. Faculty of Medicine, University of Granada, Granada, Spaina.

Background: Transepidermal water loss (TEWL), stratum corneum hydration (SCH), and skin surface pH are indicators of skin barrier integrity. There is scant evidence on normative data for cutaneous homeostasis parameters in healthy individuals.

Objectives: To develop normative data for skin erythema, melanin, pH, SCH, and TEWL; identify differences in these variables among different anatomical locations; and explore factors that may modify these values.

Material & Methods: A cross-sectional study was conducted in 87 healthy volunteers (34 males) aged 20 to 40 years. TEWL, SCH, pH, erythema, and melanin were measured on the cheeks, volar forearms, and palms.

Results: The lowest TEWL value corresponded to volar forearms (9.69 ± 2.94 g m·h) and the highest to palms (49.32 ± 14.55 g m·h). Erythema was more evident on cheeks than palms or volar forearms (413.51 arbitruary units [AU] vs. 259.98 AU vs. 252.02 AU). The lowest melanin index was documented for palms (92.72 ± 41.70 AU). pH levels were similar among the different locations. The erythema index was significantly higher in males versus females for all locations. Linear regression analysis adjusted for age and SCH revealed an increase in 0.45 ± 0.18 g m·h for TEWL on the cheek and 0.32 ± 0.10 g m·h for TEWL on the forearm for each one-year increase in age.

Conclusion: We provide normative data for individuals aged 20-40 years, across three anatomical locations, and propose a predictive model for TEWL on the cheek and forearm as a function of age and SCH.
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http://dx.doi.org/10.1684/ejd.2021.4021DOI Listing
April 2021

The role of biologic treatment in special scenarios in hidradenitis suppurativa: Facial and nape phenotype, dissecting cellulitis of the scalp, and lymphedema.

Dermatol Ther 2021 03 15;34(2):e14829. Epub 2021 Feb 15.

Hidradenitis Suppurativa Clinic, Department of Dermatology, Hospital Universitario Virgen de las Nieves, Granada, Spain.

Hidradenitis suppurativa (HS) is a chronic inflammatory disorder affecting the hair follicle which typically affects the axilla, inguinal, submammary, and perianal areas. Atypical HS, such as facial HS, dissecting cellulitis of the scalp (DCS), nape HS, and HS lymphedema has also been described. There is scarce evidence about the treatment of atypical HS. To describe the efficacy of biologic drugs and adjuvant therapeutic interventions used in patients with atypical HS who had an inadequate response to systemic antibiotics. Prospective case series study of patients with atypical HS (facial HS, DCS, nape HS, and HS lymphedema) treated with biologic drugs in a HS Clinic setting. Disease activity indexes, sociodemographic, clinical, and safety variables were collected. Two patients met criteria for Facial HS, three met criteria for DCS/nape HS and three patients met criteria for HS lymphedema. Patients with facial HS achieved rapid improvement without requiring other therapies. Patients with DCS, nape HS, and HS lymphedema showed variable response, with decrease of activity indexes, and requiring adjuvant treatments. Biologic drugs are useful in the management of special HS locations. In the case of facial HS, biologic therapy seems to be quite effective as monotherapy. In the cases of DCS, HS lymphedema and nape HS, treatment combination or intensification may be needed.
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http://dx.doi.org/10.1111/dth.14829DOI Listing
March 2021

Skin Barrier Function in Psoriasis and Atopic Dermatitis: Transepidermal Water Loss and Temperature as Useful Tools to Assess Disease Severity.

J Clin Med 2021 Jan 19;10(2). Epub 2021 Jan 19.

Dermatology Department, Hospital Universitario Virgen de las Nieves, Avenida de Madrid, 15, 18012 Granada, Spain.

Multiple diagnostic tools are used to evaluate psoriasis and atopic dermatitis (AD) severity, but most of them are based on subjective components. Transepidermal water loss (TEWL) and temperature are skin barrier function parameters that can be objectively measured and could help clinicians to evaluate disease severity accurately. Thus, the aims of this study are: (1) to compare skin barrier function between healthy skin, psoriatic skin and AD skin; and (2) to assess if skin barrier function parameters could predict disease severity. A cross-sectional study was designed, and epidermal barrier function parameters were measured. The study included 314 participants: 157 healthy individuals, 92 psoriatic patients, and 65 atopic dermatitis patients. TEWL was significantly higher, while stratum corneum hydration (SCH) (8.71 vs. 38.43 vs. 44.39 Arbitrary Units (AU)) was lower at psoriatic plaques than at uninvolved psoriatic skin and healthy controls. Patients with both TEWL > 13.85 g·mh and temperature > 30.85 °C presented a moderate/severe psoriasis (psoriasis area severity index (PASI) ≥ 7), with a specificity of 76.3%. TEWL (28.68 vs. 13.15 vs. 11.60 g·m h) and temperature were significantly higher, while SCH (25.20 vs. 40.95 vs. 50.73 AU) was lower at AD eczematous lesions than uninvolved AD skin and healthy controls. Patients with a temperature > 31.75 °C presented a moderate/severe AD (SCORing Atopic Dermatitis (SCORAD) ≥ 37) with a sensitivity of 81.8%. In conclusion, temperature and TEWL values may help clinicians to determine disease severity and select patients who need intensive treatment.
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http://dx.doi.org/10.3390/jcm10020359DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7833436PMC
January 2021

Impact of Gloves and Mask Use on Epidermal Barrier Function in Health Care Workers.

Dermatitis 2021 Jan-Feb 01;32(1):57-62

Instituto de Investigación Biosanitaria IBS.

Background: Coronavirus disease 2019 has rapidly spread all over the world. Personal protective equipment (PPE) including masks and gloves is needed to avoid transmission. Adverse skin reactions associated with PPE have been described, but there is no information regarding objective measures to assess skin impairment related to PPE.

Objective: The aim of the study was to evaluate the impact of using facial mask and nitrile gloves on epidermal barrier function and skin homeostasis.

Methods: A cross-sectional study was designed. Thirty-four health care workers wearing nitrile gloves and a mask for 2 hours were included. Transepidermal water loss, stratum corneum hydration, erythema, and temperature were measured.

Results: Transepidermal water loss (31.11 vs 14.24 g·m-2·h-1), temperature (33.29°C vs 32.57°C), and erythema were significantly greater at the area covered by gloves compared with the noncovered area. Transepidermal water loss (22.82 vs 13.69 g·m-2·h-1), temperature, and erythema (411.43 vs 335.52 arbitrary units) were significantly increased at the area covered by mask, whereas stratum corneum hydration was lower. Transepidermal water loss was greater at the area covered by a surgical mask than at a filtering respirator mask coded filtering facepiece 2 (27.09 vs 18.02 g·m-2·h-1, P = 0.034).

Conclusions: Skin homeostasis and epidermal barrier function may be impaired by gloves and mask use. High-quality PPE should be provided, and adequate skin prevention measures should be implemented to reduce epidermal barrier damage.
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http://dx.doi.org/10.1097/DER.0000000000000682DOI Listing
January 2021

Epidermal barrier changes in patients with psoriasis: The role of phototherapy.

Photodermatol Photoimmunol Photomed 2020 Dec 30. Epub 2020 Dec 30.

Dermatology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain.

Background: Some skin diseases may modify epidermal barrier function. Psoriasis is a chronic multi-systemic inflammatory disease that affects the epidermal barrier. Phototherapy is an option for treating psoriasis, but little is known about how epidermal barrier function is modified by phototherapy in psoriatic patients.

Objectives: (a) To compare skin homeostasis between involved and uninvolved skin in psoriatic patients with healthy controls (b) To evaluate changes in the epidermal barrier function in psoriatic patients treated with phototherapy.

Methods: Sixty patients with plaque-type psoriasis and sixty gender and age-matched healthy controls were enrolled. Temperature, transepidermal water loss (TEWL), stratum corneum hydration (SCH), pH, elasticity, erythema and melanin index were measured using non-invasive tools in the healthy control and involved and uninvolved psoriatic skin before and after phototherapy.

Results: Healthy controls had lower TEWL and erythema index and higher SCH than psoriatic patients, both at uninvolved psoriatic skin and psoriasis plaques. TEWL was higher at psoriasis plaques than at uninvolved skin (19.20 vs 11.57 g/h/m ; P < .001). Following phototherapy, a decreasing trend was observed for TEWL, of 1.03 (SD 0.75) and 0.97 (SD 0.81) g/h/m for uninvolved and involved skin respectively. SCH was significantly lower at psoriatic plaques than at uninvolved skin (7.32 vs 36.62Arbitrary Units [AU]; P < .001). SCH increased by 1.15AU (SD 0.26) on psoriatic plaques after the phototherapy session (P < .001).

Conclusion: Psoriatic plaques showed epidermal barrier dysfunction compared to uninvolved skin and healthy controls. Phototherapy may improve epidermal barrier function in psoriatic patients. SCH increased after a phototherapy session on the psoriatic plaques.
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http://dx.doi.org/10.1111/phpp.12650DOI Listing
December 2020

Advanced Medical Therapies in the Management of Non-Scarring Alopecia: Areata and Androgenic Alopecia.

Int J Mol Sci 2020 Nov 9;21(21). Epub 2020 Nov 9.

Dermatology Unit, Virgen de las Nieves University Hospital, Av de Madrid, 15, 18012 Granada, Spain.

Alopecia is a challenging condition for both physicians and patients. Several topical, intralesional, oral, and surgical treatments have been developed in recent decades, but some of those therapies only provide partial improvement. Advanced medical therapies are medical products based on genes, cells, and/or tissue engineering products that have properties in regenerating, repairing, or replacing human tissue. In recent years, numerous applications have been described for advanced medical therapies. With this background, those therapies may have a role in the treatment of various types of alopecia such as alopecia areata and androgenic alopecia. The aim of this review is to provide dermatologists an overview of the different advanced medical therapies that have been applied in the treatment of alopecia, by reviewing clinical and basic research studies as well as ongoing clinical trials.
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http://dx.doi.org/10.3390/ijms21218390DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7664905PMC
November 2020

Clinical selection criteria in new clinical trials of hidradenitis suppurativa: External validity and implications on the daily clinical practice.

Dermatol Ther 2020 11 15;33(6):e14254. Epub 2020 Sep 15.

Department of Dermatology, Hidradenitis Suppurativa Clinic, Hospital Universitario Virgen de las Nieves, Granada, Spain.

Introduction: There are an increasing number of biologic drugs in the pipeline for treating hidradenitis suppurativa (HS). Clinical trials for these drugs usually share the same clinical selection criteria.

Objectives: (a) To describe the clinical profile of HS patients receiving first-line biologic treatment in an HS clinic setting, (b) to assess how this population would meet clinical criteria to participate in a clinical trial, and (c) to assess treatment effectiveness at week 16 in eligible vs non-eligible patients.

Methods: Prospective observational study. Patients were grouped according to their eligibility for clinical trials. The effectiveness of adalimumab was assessed by HiSCR, IHS4-category-change and a-50%-reduction on IHS4 at week 16.

Results: Thirty-eight patients were included in the study: eight (21.05%) were eligible for clinical trials and 30 (78.95%) were not. The main reason for non-eligibility was not having an AN count ≥5. Both groups presented similar number of draining tunnels. Effectiveness at week 16 was lower in non-eligible than eligible patients when evaluated by HiSCR-response but similar if evaluated by the IHS4-category-change or the 50%-reduction in IHS4.

Conclusion: In our population, the external validity of current eligibility criteria for clinical trials is low. Most patients receiving adalimumab in real-life setting would not be eligible for clinical trials.
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http://dx.doi.org/10.1111/dth.14254DOI Listing
November 2020

Review of adverse cutaneous reactions of pharmacologic interventions for COVID-19: A guide for the dermatologist.

J Am Acad Dermatol 2020 Dec 7;83(6):1738-1748. Epub 2020 Aug 7.

Dermatology Unit, Virgen de las Nieves University Hospital, Granada, Spain; TECe19-Clinical and Translational Dermatology Investigation Group, Instituto Biosanitario, Granada, Spain; Dermatology Department, University of Granada, Granada, Spain.

The new coronavirus, severe acute respiratory syndrome coronavirus 2, is associated with a wide variety of cutaneous manifestations. Although new skin manifestations caused by COVID-19 are continuously being described, other cutaneous entities should also be considered in the differential diagnosis, including adverse cutaneous reactions to drugs used in the treatment of COVID-19 infections. The aim of this review is to provide dermatologists with an overview of the cutaneous adverse effects associated with the most frequently prescribed drugs in patients with COVID-19. The skin reactions of antimalarials (chloroquine and hydroxychloroquine), antivirals (lopinavir/ritonavir, ribavirin with or without interferon, oseltamivir, remdesivir, favipiravir, and darunavir), and treatments for complications (imatinib, tocilizumab, anakinra, immunoglobulins, corticosteroids, colchicine and low molecular weight heparins) are analyzed. Information regarding possible skin reactions, their frequency, management, and key points for differential diagnosis are presented.
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http://dx.doi.org/10.1016/j.jaad.2020.08.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7413159PMC
December 2020

Research in dermatology in the COVID-19 era.

Dermatol Ther 2020 11 27;33(6):e13971. Epub 2020 Jul 27.

Dermatology Unit, Virgen de las Nieves University Hospital, Granada, Spain.

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http://dx.doi.org/10.1111/dth.13971DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7361061PMC
November 2020

Management of patients with hidradenitis suppurativa during the COVID-19 pandemic.

Dermatol Ther 2020 11 7;33(6):e13875. Epub 2020 Jul 7.

Department of Dermatology, Hospital Universitario Virgen de las Nieves, Granada, Spain.

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http://dx.doi.org/10.1111/dth.13875DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7323050PMC
November 2020

Cutaneous Manifestations of Granulomatosis with Polyangiitis: A Case Series Study.

Acta Derm Venereol 2020 May 28;100(10):adv00150. Epub 2020 May 28.

Department of Dermatology, Virgen de las Nieves University Hospital, ES-18014 Granada, Spain.

The aim of this study was to determine the prevalence and type of cutaneous manifestations which occur in patients with granulomatosis with polyangiitis and to explore the potential association between cutaneous and systemic involvement in these patients. A retrospective case series study was designed, including all granulomatosis with polyangiitis cases diagnosed between 2010 and 2018 at the Hospital Universitario Virgen de las Nieves. Thirty-nine patients with granulomatosis with polyangiitis were identified, of which 53.85% presented cutaneous manifestations. In decreasing order of frequency, the types of cutaneous problems observed included: palpable purpura, mucocutaneous ulcers, subcutaneous nodules, pyoderma gangrenosum-like ulcers, digital necrosis, papulonecrotic lesions and livedo reticularis. Patients with palpable purpura presented a higher frequency of renal involvement (p = 0.008). Cutaneous manifestations of granulomatosis with polyangiitis may facilitate early disease diagnosis. Likewise, a manifestation such as palpable purpura may be a predictor of kidney damage.
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http://dx.doi.org/10.2340/00015555-3506DOI Listing
May 2020

The use of guselkumab 100 mg every 4 weeks on patients with hidradenitis suppurativa and a literature review.

Dermatol Ther 2020 05 3;33(3):e13456. Epub 2020 May 3.

Hidradenitis Suppurativa Clinic, Dermatology, Hospital Universitario Virgen de las Nieves, Granada, Spain.

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http://dx.doi.org/10.1111/dth.13456DOI Listing
May 2020

Nodular lichen myxoedematous: a new adverse event associated with ustekinumab.

Australas J Dermatol 2020 Aug 14;61(3):e344-e345. Epub 2020 Apr 14.

Department of Dermatology at Hospital, Universitario Virgen de las Nieves, Granada, Spain.

Nodular lichen myxoedematosus is a localised form of lichen myxoedematosus, a chronic idiopathic cutaneous mucinosis of known aetiology. Ustekinumab is a human interleukin-12/23 monoclonal antibody that could directly or indirectly increase mucin production. Herein, we report for the first time a case of nodular lichen myxoedematosus associated with ustekinumab.
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http://dx.doi.org/10.1111/ajd.13291DOI Listing
August 2020

Vascular malformations syndromes: an update.

Curr Opin Pediatr 2019 12;31(6):747-753

Dermatology Unit, Hospital Universitario Virgen de las Nieves.

Purpose Of Review: To provide an update of vascular malformation syndromes by reviewing the most recent articles on the topic and following the new International Society for the Study of Vascular Anomalies (ISSVA) 2018 classification.

Recent Findings: This review discusses the main features and diagnostic approaches of the vascular malformation syndromes, the new genetic findings and the new therapeutic strategies developed in recent months.

Summary: Some vascular malformations can be associated with other anomalies, such as tissue overgrowth. PIK3CA-related overgrowth spectrum (PROS) is a group of rare genetic disorders with asymmetric overgrowth caused by somatic mosaic mutations in PI3K-AKT-mTOR pathway that encompass a heterogeneous group of rare disorder that are associated with the appearance of overgrowth. CLOVES syndrome and Klippel-Trénaunay syndrome are PROS disease. Proteus syndrome is an overgrowth syndrome caused by a somatic activating mutation in AKT1. CLOVES, Klippel-Trénaunay and Proteus syndromes are associated with high risk of thrombosis and pulmonary embolism. Hereditary hemorrhagic telangiectasia is an autosomic dominant disorder characterized by the presence of arteriovenous malformations. New therapeutic strategies with bevacizumab and thalidomide have been employed with promising results.
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http://dx.doi.org/10.1097/MOP.0000000000000812DOI Listing
December 2019

Bullous pemphigoid in a patient treated with nivolumab.

Dermatol Ther 2019 09 1;32(5):e13030. Epub 2019 Aug 1.

Dermatology Department, Hospital Universitario San Cecilio, Granada, Spain.

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http://dx.doi.org/10.1111/dth.13030DOI Listing
September 2019

Performance of different methanogenic species for the microbial electrosynthesis of methane from carbon dioxide.

Bioresour Technol 2019 Oct 27;289:121706. Epub 2019 Jun 27.

DECHEMA-Forschungsinstitut, Industrielle Biotechnologie, Frankfurt am Main, Germany. Electronic address:

Microbial electrosynthesis (MES) is a promising technology to convert CO and electricity into the biofuel methane using methanogens. Until now, most investigations on electro-methanogenesis are "proof-of-principle" studies. In this paper, different strains were quantitatively compared in regard to final methane concentration, yields based on CO-conversion, productivities as well as Coulombic efficiencies in order to identify suitable organisms for MES. Methanococcus vannielii, Methanococcus maripaludis, Methanolacinia petrolearia, Methanobacterium congolense, and Methanoculleus submarinus were able to produce methane via MES at -700 mV vs. standard hydrogen electrode (SHE). Beside methane also biological H production was detected during MES, which might be due to the involvement of hydrogenases. A direct electron transfer pathway is most likely. Obviously, M. maripaludis is the most resource efficient methane producer in microbial electrosynthesis regarding the methane productivity (8.81 ± 0.51 mmol m d) and the Coulombic efficiency (58.9 ± 0.8%).
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http://dx.doi.org/10.1016/j.biortech.2019.121706DOI Listing
October 2019

Association Between Psoriasis and Sexual and Erectile Dysfunction in Epidemiologic Studies: A Systematic Review.

JAMA Dermatol 2019 01;155(1):98-106

Dermatología, Hospital Universitario Virgen de las Nieves, Granada, Spain.

Importance: Sexual health is a major aspect of life. Increasing scientific evidence shows a potential association between psoriasis and sexual dysfunction (SD) and erectile dysfunction (ED).

Objective: To evaluate the available scientific evidence regarding epidemiologic associations and treatment outcomes between psoriasis and SD and ED.

Evidence Review: Information sources were MEDLINE and Embase databases, using the Scopus search engine. The search was performed on August 25, 2017. Search terms were psoriasis and sexual or sexual dysfunction, and the search was limited to epidemiologic studies published in English answering any of the 4 research questions. Quality was assessed according to the Centre for Evidence-Based Medicine.

Findings: Twenty-eight studies representing 52 520 cases of psoriasis and 1 806 022 controls were included for review. Of the 28 studies, 19 were cross-sectional, 3 were clinical trials, 3 were quasi-experimental, 2 were population-based cohort, and 1 was population-based case-control. Prevalence of SD and ED ranged from 40.0% to 55.6% and 34.2% to 81.1%, respectively. Two of 2 studies observed an association between psoriasis and SD after adjusting for physical and psychological comorbidities. Five of 8 studies observed an independent association between ED and psoriasis. Among patients with psoriasis, the features that showed the strongest association with SD were anxiety and depression (5 of 5 studies), psoriatic arthritis (3 of 4 studies), and genital psoriasis (5 of 7 studies). Regarding ED, anxiety and depression (2 of 2 studies) and increasing age (3 of 3 studies) showed the strongest association. All 3 clinical trials using biologic drugs showed an improvement in SD compared with placebo.

Conclusions And Relevance: Patients with psoriasis have physical and psychological comorbidities that have been associated with a higher risk of SD. In addition, psoriasis may play a role in its development. The presence of anxiety, depression, psoriatic arthritis, genital lesions, and increasing age should raise the awareness of SD. Biologic drugs have demonstrated the improvement of SD in patients with psoriasis.
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http://dx.doi.org/10.1001/jamadermatol.2018.3442DOI Listing
January 2019

Linking of psoriasis with osteopenia and osteoporosis: A cross-sectional study.

Indian J Dermatol Venereol Leprol 2019 Mar-Apr;85(2):153-159

General Dermatology Department, Dermatology Unit, Virgin de las Nieves University Hospital; Dermatology Department, Medicine School of the University of Granada, Granada, Spain.

Background/purpose: Psoriasis is a multisystem disease which has been related to vitamin-D deficiency through chronic inflammation. This psoriasis-related inflammatory state and vitamin-D deficiency may induce bone mineral density loss. The purpose of this study is to assess the relationship of psoriasis with bone mineral density, by comparing psoriatic patients with healthy controls and patients with osteopenia/osteoporosis.

Methods: A total of 185 subjects were studied; 58 psoriatic patients who had not been under systemic or biological treatment were included. Age, gender, body mass index, phosphocalcic metabolic parameters and hip and lumbar (L4) bone mineral density data were collected. These variables were compared with those collected in 61 healthy controls and 67 patients with osteopenia/osteoporosis.

Results: Psoriatic patients showed worse hip and lumbar spine bone mineral density levels than healthy controls (P = 0.001) and better levels than osteoporotic patients (P < 0.001). Multivariate analysis demonstrated a negative association of age and a positive association of body mass index in hip bone mineral density in psoriatic patients.

Limitations: The main limitations are those of cross-sectional studies, such as a lack of follow up period, and a male predominance in the psoriatic group, which is corrected employing a multivariate analysis with an adjusted model for confounding factors.

Conclusions: Bone mineral density levels in psoriatic patients are situated halfway between healthy controls and patients with osteopenia/osteoporosis. In addition, the higher body mass index in patients with psoriasis appears to confer a protective effect against further development of lower bone mineral density.
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http://dx.doi.org/10.4103/ijdvl.IJDVL_831_17DOI Listing
June 2019

Paquidermodactilia, engrosamiento digital proximal. Pachydermodactyly, digital proximal thickening.

Dermatol Online J 2017 Oct 15;23(10). Epub 2017 Oct 15.

Unidad de Gestión Clínica de Dermatología Médico Quirúrgica y Venereología, Complejo Hospitalario Universitario de Granada, España.

We report a case of pachydermodactyly (PDD). PDD is a benign, asymptomatic soft tissue swelling affecting the skin of the lateral aspects of the proximal interphalangeal joints of the fingers, mostly in young adolescent males. It has often been interpreted as a consequence of tic-like behavior as part of an obsessive-compulsive disorder. Although the diagnosis is essentially clinical, skin biopsy shows compact orthokeratotic hyperkeratosis, increased numbers of collagen fibers and fibroblasts, and no inflammatory changes. A rapid clinical recognition of PDD should avoid many unproductive and expensive diagnostic tests.
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October 2017

Disappearance of All Nevi as Initial Sign of Metastatic Melanoma.

Indian J Dermatol 2017 Jul-Aug;62(4):441

Dermatology Unit, Complejo Hospitalario Universitario, Granada, Spain. E-mail:

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http://dx.doi.org/10.4103/ijd.IJD_260_16DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5527740PMC
August 2017

Desquamating collarette.

Med Clin (Barc) 2018 04 8;150(8):e23. Epub 2017 Jun 8.

Unidad de Gestión Clínica de Dermatología Médico Quirúrgica y Venereología, Complejo Hospitalario Universitario de Granada, Granada, España.

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http://dx.doi.org/10.1016/j.medcli.2017.04.030DOI Listing
April 2018

Nódulos subcutáneos faciales de 3 meses de evolución.

Dermatol Online J 2017 Feb 15;23(2). Epub 2017 Feb 15.

Dermatology Department, Dermatologist, Complejo Hospitalario de Granada, Granada, Spain.

Siliconomas are subcutaneous nodules that usuallyappear as a consequence of the migration of freesilicon implanted in other locations. They are morefrequent in women with abnormal breast implants,such as poly implant prostheses (PIP), but they may alsoappear after illegal injection of free silicone. We reporta 57-year-old woman who attended our Dermatologyclinic complaining of relapsing facial panniculitis ofunknown origin. After a thorough work-up, thesenodules were determined to be the consequence ofdermal filler made with fluid silicone, which had beeninjected 20 years prior. High frequency skin ultrasoundof one of the nodules showed a hyperechoic image,also known as "snowstorm," which was located in thesubcutaneous tissue. The disposition of silicone in thisplane obscures the view of any sonographic structurein the underlying plane. Cutaneous sonographyhas become one of the most useful non-invasivetechniques in diagnosis of filler complications andother inflammatory diseases. Combined treatmentwith prednisone and allopurinol was successful, withno recurrence after 1 year of follow-up.
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February 2017

Is it safe to use N-acetylcysteine in the treatment of bilateral ectropion on collodion baby?

Int J Dermatol 2017 04 12;56(4):e71-e72. Epub 2017 Jan 12.

Dermatology Department, Complejo Hospitalario de Granada, Granada, Spain.

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http://dx.doi.org/10.1111/ijd.13456DOI Listing
April 2017

Malleolar ulcers due to hidroxyurea treatment.

Med Clin (Barc) 2017 08 13;149(4):e23. Epub 2016 Dec 13.

Servicio de Dermatología, Complejo Hospitalario Universitario de Granada, Granada, España.

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http://dx.doi.org/10.1016/j.medcli.2016.10.006DOI Listing
August 2017

Coral-Red Fluorescence of Erythrasma Plaque.

Sultan Qaboos Univ Med J 2016 Aug 19;16(3):e381-2. Epub 2016 Aug 19.

Department of Dermatology, University Hospital Complex of Granada, Granada, Spain.

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http://dx.doi.org/10.18295/squmj.2016.16.03.023DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4996308PMC
August 2016