Publications by authors named "Esther Roe"

27 Publications

  • Page 1 of 1

Autochthonous and imported tegumentary leishmaniasis in Catalonia (Spain): Aetiological evolution in the last four decades and usefulness of different typing approaches based on biochemical, molecular and proteomic markers.

Transbound Emerg Dis 2021 Apr 17. Epub 2021 Apr 17.

Secció de Parasitologia, Departament de Biologia, Sanitat i Medi Ambient, Facultat de Farmàcia i Ciències de l'Alimentació, Universitat de Barcelona, Barcelona, Spain.

Leishmaniasis is a transmissible disease caused by Leishmania protozoa. Spain is endemic for both visceral and cutaneous leishmaniasis, the autochthonous aetiological agent being Leishmania infantum. Around the world, the L. donovani complex is associated with visceral symptoms, while any species of the Leishmania or Viannia subgenera affecting human can produce tegumentary forms. In a context of growing numbers of imported cases, associated with globalisation, the aim of this study was to analyse the aetiological evolution of human tegumentary leishmaniasis in a region of Spain (Catalonia). Fifty-six Leishmania strains, isolated from 1981 to 2018, were analysed using MLEE, gene sequencing (hsp70, rpoIILS, fh and ITS2) and MALDI-TOF. The utility of these different analytical methods was compared. The results showed an increase in leishmaniasis over the two last decades, particularly imported cases, which represented 39% of all cases studied. Leishmania infantum, L. major, L. tropica, L. braziliensis, L. guyanensis and L. panamensis were identified. The combination of molecular and enzymatic methods allowed the identification of 29 different strain types (A to AC). Strain diversity was higher in L. (Viannia), whilst the different L. major types were relatable with geo-temporal data. Among the autochthonous cases, type C prevailed throughout the studied period (39%). Minor types generally appeared within a short time interval. While all the techniques provided identical identification at the species complex level, MALDI-TOF and rpoIILS or fh sequencing would be the most suitable identification tools for clinical practice, and the tandem hsp70-ITS2 could substitute MLEE in the epidemiological field.
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http://dx.doi.org/10.1111/tbed.14107DOI Listing
April 2021

Net-like superficial lymphatic malformation.

Pediatr Dermatol 2021 Mar 24;38(2):516-517. Epub 2021 Jan 24.

Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.

The net-like superficial lymphatic malformation (LM) is a newly described entity with distinctive clinical, dermoscopic, and histologic characteristics. Clinical picture consists of red to purplish macules with a finely reticulated pattern of vascular structures. Dermoscopy shows arborizing telangiectatic vessels. Histology is characterized by a vascular proliferation composed of thin-walled vessels, located in the upper dermis, that stains positive with podoplanin (D2-40). We report a new case of LM with an additional clinical feature, hypopigmented areas.
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http://dx.doi.org/10.1111/pde.14526DOI Listing
March 2021

Ultrasonographic Patterns of Cutaneous Sarcoidosis.

J Ultrasound Med 2021 Jan 18. Epub 2021 Jan 18.

Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Departments of Dermatology, Faculties of Medicine, Universidad de Chile and Pontificia Universidad Católica de Chile, Santiago, Chile.

Sarcoidosis is a multiorgan disease characterized by the formation of noncaseating granulomas and possible skin involvement. Cutaneous sarcoidosis (CS) can be explored by ultrasonography when deep dermal or subcutaneous nodules are the clinical presentation. We reviewed the ultrasound characteristics of 14 patients (86% female; mean age, 55 years) with CS. Ultrasonography revealed dermal or subcutaneous hypoechoic areas with increased echogenicity and hypervascularity of the neighboring subcutaneous tissue. In 42.9% of cases a cobblestone pattern of the subcutaneous tissue suggestive of septal involvement was detected. These US features can support the detection of dermal and subcutaneous abnormalities in CS and its early diagnosis.
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http://dx.doi.org/10.1002/jum.15631DOI Listing
January 2021

Papules and vesicles on the ears of a young boy.

Int J Dermatol 2020 Dec 1. Epub 2020 Dec 1.

Department of Dermatology, Hospital Son Llàtzer, Palma de Mallorca, Spain.

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http://dx.doi.org/10.1111/ijd.15336DOI Listing
December 2020

Propranolol-resistant infantile hemangioma successfully treated with sirolimus.

Pediatr Dermatol 2020 Jul 23;37(4):684-686. Epub 2020 Apr 23.

Department of Dermatology, Hospital Sant Joan de Deu, Barcelona, Spain.

Infantile hemangiomas are the most common benign vascular tumors in childhood. Propranolol is the first-line treatment for infantile hemangiomas, but failures may occur. Sirolimus, an mTOR inhibitor, is a promising drug for the treatment of vascular malformations and vascular tumors. We present the case of a child with multiple infantile hemangiomasthat was successfully treated with sirolimus and propranolol after failure of combined propranolol and prednisolone treatment.
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http://dx.doi.org/10.1111/pde.14163DOI Listing
July 2020

Good response to pulsed dye laser in patients with capillary malformation-arteriovenous malformation syndrome (CM-AVM).

Pediatr Dermatol 2020 Mar 15;37(2):342-344. Epub 2020 Jan 15.

Department of Dermatology, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain.

Capillary malformation-arteriovenous malformation syndrome (CM-AVM) is an autosomal dominant disorder caused by heterozygous mutations in RASA1 and EPHB4. Capillary stains in CM-AVM are compatible with Schöbinger's phase I AVMs. Vascular laser has been classically contraindicated for the treatment of AVMs, as there is a fear of accelerating their progression. In this study, we have treated capillary stains in five CM-AVM patients with pulsed dye laser, with improvement and without worsening or recurrence of the lesions after 1 year of clinical and ultrasound follow-up.
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http://dx.doi.org/10.1111/pde.14095DOI Listing
March 2020

Inter- and Intra-rater Agreement of Dermatologic Ultrasound for the Diagnosis of Lobular and Septal Panniculitis.

J Ultrasound Med 2020 Jan 27;39(1):107-112. Epub 2019 Jun 27.

Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Departments of Dermatology, Faculties of Medicine, University of Chile and Pontifical Catholic University of Chile, Santiago, Chile.

Objectives: Dermatologic ultrasound (US) may aid in the diagnosis and classification of panniculitis. The purpose of this study was to assess the capability of dermatologic US for subtyping mainly septal/lobular panniculitis.

Methods: A multicentric and prospective study of the inter- and intra-rater agreement of dermatologic US for subtyping panniculitis was conducted among 4 clinicians with experience in dermatologic US and a radiologist specialized in dermatologic US. Clinicians recruited patients and performed dermatologic US examinations of the most substantial lesion and punch biopsies. A histologic study was considered the reference standard. Then the images were blindly evaluated by all researchers. For intra- and inter-rater agreement, Cohen and Fleiss κ values were calculated.

Results: Sixty-four patients were included. The Cohen intra-rater κ was 0.74. Sensitivity and specificity for lobular panniculitis were 85.19 and 88.57, respectively. The Fleiss inter-rater κ was 0.47. Limitations of the study included the small number of patients and differences in evaluators and their dermatologic US equipment.

Conclusions: This study supports the use of US for diagnosing panniculitis. For subtyping panniculitis, the intra-rater correlation was good. Improvement of inter-rater agreement may depend on access to clinical information, dynamic images, a better definition of criteria, homogeneous configurations of the devices, and the expertise of dermatologic US operators.
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http://dx.doi.org/10.1002/jum.15080DOI Listing
January 2020

Efficacy of Propranolol Between 6 and 12 Months of Age in High-Risk Infantile Hemangioma.

Pediatrics 2018 09 6;142(3). Epub 2018 Aug 6.

Pierre Fabre Dermatologie, Lavaur, France.

Background And Objectives: There is no consensus on optimal treatment duration for propranolol in infantile hemangioma (IH). We evaluated the efficacy and safety of oral propranolol solution administered for a minimum of 6 months up to a maximum of 12 months of age in high-risk IH.

Methods: This single-arm, open-label, phase 3 study was conducted in patients aged 35 to 150 days with high-risk IH in 10 hospitals between 2015 and 2017. The study comprised a 6-month initial treatment period (ITP) plus continuation up to 12 months of age if complete success was not achieved, a follow-up, and a retreatment period. Patients received oral propranolol twice daily (3 mg/kg per day). The primary end point was the success rate at the end of the ITP. Furthermore, the persistence of IH response and efficacy of retreatment was evaluated.

Results: The success rate after 6 months of treatment was 47%, increasing to 76% at the end of the ITP. Of the patients who achieved success, 68% sustained success for 3 months without treatment, and 24% required retreatment. Of the 8 patients who were retreated, 7 achieved success. Adverse events, reported by 80% of patients, were mild, which were expected in this population or known propranolol side effects.

Conclusions: Oral propranolol administered beyond 6 months and up to 12 months of age meaningfully increases the success rate in high-risk IH. Success was sustained in most patients up to 3 months after stopping treatment. Retreatment was efficacious, and the safety profile satisfactory.
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http://dx.doi.org/10.1542/peds.2017-3866DOI Listing
September 2018

Structural Changes of Subcutaneous Tissue Valued by Ultrasonography in Patients with Cellulitis Following Treatment with the PnKCelulitis Program.

J Clin Aesthet Dermatol 2018 Mar 1;11(3):20-25. Epub 2018 Mar 1.

Drs. Roe and Serra are with the Dermatology Department at the Hospital de la Santa Creu i Sant Pau in Barcelona, Spain.

Poor eating habits, a sedentary lifestyle, and limited physical activity are predisposing factors for the development of cellulite. The PnKCelulitis Programme (Pronokal Group, Barcelona, Spain) is a new approach to the treatment of cellulite that combines dietary guidelines, physical exercise, and the application of an anti-cellulite cream. We sought to objectively and via cutaneous ultrasound assess the benefit of the new multidisciplinary anti-cellulite treatment program and to evaluate any visual changes in the appearance of the skin. Twenty women with Grades 1 to 3 cellulite were included in the study. All women underwent the multidisciplinary treatment. Clinical controls assessed the evolution of the degree of cellulite; the anthropometric parameters (e.g., weight, body mass index, and mean and low abdominal circumference) and body composition were assessed by bioimpedance. Ultrasound assessments were performed blinded at the beginning and at the end of treatment to assess the following: thickness of the skin, dermis, and hypodermis; areas of indentation; and changes in the echogenicity of the dermis. The degree of cellulite was reduced in all locations, and 90 percent (18/20) of the sample saw their cellulite reduced by at least one degree. Cellulite in the abdomen disappeared in all of the women who had initially presented with it. Most of the subjects with cellulite in the buttocks (70%, 13/19) completed the treatment with Grade 0. There was a decrease in weight and a reduction of abdominal perimeters at the expense of only body fat. Significant decreases in the thickness of the skin and hypodermis and in areas of indentation were observed (<0.05), in addition to an increase in the echogenicity of the dermis in 18 of the 20 patients. The multidisciplinary treatment program evaluated in this study appears to be an effective and safe treatment for patients with different degrees of cellulite, both clinically and via ultrasound imaging. Additional research with a larger patient cohort is needed to support our findings.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5868780PMC
March 2018

Risk Factors for Degree and Type of Sequelae After Involution of Untreated Hemangiomas of Infancy.

JAMA Dermatol 2016 11;152(11):1239-1243

Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.

Importance: Infantile hemangiomas involute to some extent, but they often leave sequelae that may cause disfigurement. Factors determining the risk of permanent sequelae after regression are of crucial importance in treatment decision making.

Objectives: To describe the sequelae left by infantile hemangiomas after natural involution and to identify clinical characteristics that could predict the most severe or a particular type of sequelae.

Design, Setting, And Participants: Multicentric retrospective cohort study of images from 187 infantile hemangiomas that had not received systemic treatment and had follow-up pictures until regression that were selected from photographic files taken between 2003 and 2013 at 4 university hospitals with large vascular clinics in 3 different countries.

Main Outcomes And Measures: Outcome measures were the type of sequelae classified as residual telangiectasia, anetodermal skin, redundant skin, persistent superficial component, and the degree of sequelae ranging from 1 to 4.

Results: A total of 184 hemangiomas were included. The overall incidence of significant sequelae was 101 of 184 (54.9%). The most common sequelae after involution were telangiectasias (145, 84.3%), fibrofatty tissue (81, 47.1%), and anetodermic skin (56, 32.6%). The average age at which hemangioma completed involution was 3.5 years. Superficial and deep hemangiomas left significantly fewer sequelae than combined hemangiomas (Mann-Whitney; superficial vs deep, OR, 1.6; 95% CI, 0.6-3.8; P = .81; superficial vs combined, OR, 3.3; 95% CI, 1.7-6.3; P < .001; deep vs combined, OR, 2.1; 95% CI, 0.9-5.1; P < .001). Hemangiomas with a step or abrupt border of the superficial component left more severe sequelae than those with a smooth border (χ2,OR, 3.4; 95% CI, 1.8-6.6; P < .001). Superficial hemangiomas with a cobblestone appearance or rough surface left more severe sequelae than those with a smooth surface (Kruskal-Wallis; α, 0.05; P < .001). Using multivariate analysis, combined hemangiomas with a superficial component and a step border were associated with more sequelae.

Conclusions And Relevance: In this retrospective study of sequelae in a large cohort of untreated infants, we quantified the prevalence of permanent scarring and identified clinical features predictive of permanent sequelae. Our observations provide useful information at a time when the treatment paradigm for hemangiomas has changed. Such knowledge may help primary care physicians predict the risk of sequelae and identify high-risk lesions to implement early treatment.
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http://dx.doi.org/10.1001/jamadermatol.2016.2905DOI Listing
November 2016

Vascular Stains: Proposal for a Clinical Classification to Improve Diagnosis and Management.

Pediatr Dermatol 2016 Nov 25;33(6):570-584. Epub 2016 Jul 25.

Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.

Vascular stains are a common reason for consultation in pediatric dermatology clinics. Although vascular stains include all vascular malformations, the term is most often used to refer to capillary malformations, but capillary malformations include a wide range of vascular stains with different clinical features, prognoses, and associated findings. The discovery of several mutations in various capillary malformations and associated syndromes has reinforced these differences, but clinical recognition of these different types of capillary vascular stains is sometimes difficult, and the multitude of classifications and confusing nomenclature often hamper the correct diagnosis and management. From our own experience and a review of the most relevant literature on this topic, we propose categorizing patients with capillary vascular stains into seven major clinical patterns: nevus simplex, port-wine stain, reticulated capillary malformation, geographic capillary malformation, capillary malformation-arteriovenous malformation (CM-AVM), cutis marmorata telangiectatica congenita, and telangiectasia. We also discuss the differential diagnosis of vascular stains as well as other conditions that can closely resemble capillary malformations and thus may potentially be misdiagnosed.
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http://dx.doi.org/10.1111/pde.12939DOI Listing
November 2016

Rebound Growth of Infantile Hemangiomas After Propranolol Therapy.

Pediatrics 2016 Apr 7;137(4). Epub 2016 Mar 7.

Departments of Dermatology and.

Background And Objectives: Propranolol is first-line therapy for problematic infantile hemangiomas (IHs). Rebound growth after propranolol discontinuation is noted in 19% to 25% of patients. Predictive factors for rebound are not completely understood and may alter the management approach. The goal of the study was to describe a cohort of patients with IHs treated with propranolol and to identify predictors for rebound growth.

Methods: A multicenter retrospective cohort study was conducted in patients with IHs treated with propranolol. Patient demographic characteristics, IH characteristics, and specifics of propranolol therapy were obtained. Episodes of rebound growth were recorded. Patients' responses to propranolol were evaluated through a visual analog scale.

Results: A total of 997 patients were enrolled. The incidence of rebound growth was 231 of 912 patients (25.3%). Mean age at initial rebound was 17.1 months. The odds of rebound among those who discontinued therapy at <9 months was 2.4 (odds ratio [OR]: 2.4; 95% confidence interval [CI]: 1.3 to 4.5; P = .004) compared with those who discontinued therapy between 12 to 15 months of life. Female gender, location on head and neck, segmental pattern, and deep or mixed skin involvement were associated with rebound on univariate analysis. With multivariate analysis, only deep IHs (OR: 3.3; 95% CI: 1.9 to 6.0; P < .001) and female gender (OR: 1.7; 95% CI: 1.1 to 2.6; P = .03) were associated. Of those with rebound growth, 83% required therapeutic modification including 62% of patients with modifications in their propranolol therapy.

Conclusions: Rebound growth occurred in 25% of patients, requiring modification of systemic therapy in 15%. Predictive factors for rebound growth included age of discontinuation, deep IH component, and female gender. Patients with these predictive factors may require a prolonged course of therapy.
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http://dx.doi.org/10.1542/peds.2015-1754DOI Listing
April 2016

Anti-tumour necrosis factor-induced visceral and cutaneous leishmaniasis: case report and review of the literature.

Dermatology 2015 23;230(3):204-7. Epub 2015 Jan 23.

Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.

Background: Leishmaniasis is a chronic protozoan disease in which organisms are found within phagolysosomes of the mononuclear phagocyte system. There are three major forms: cutaneous, mucocutaneous and visceral. We report the first case of visceral leishmaniasis with cutaneous involvement in a patient with rheumatoid arthritis treated with the anti-tumour necrosis factor (anti-TNF) adalimumab.

Objective: To highlight cutaneous leishmaniasis as the first indicator of a kala-azar disease in a patient treated with anti-TNF and to review the literature on leishmaniasis in the context of anti-TNF therapy.

Case Report: A 59-year-old woman presented with a crusted plaque on the right elbow 34 months after the initiation of adalimumab. A cutaneous biopsy showed intracellular amastigotes. No Leishmania parasites were observed in a bone marrow aspirate, but laboratory tests showed anaemia and impaired liver function, abdominal ultrasonography showed hepatomegaly, and ELISA serology was strongly positive for Leishmania antibodies in serum and urine. Adalimumab was withdrawn and treatment combining intralesional pentavalent antimonials and liposomal amphotericin was started. Eight weeks later, the leishmaniasis had resolved.

Conclusion: A skin biopsy disclosing leishmaniasis should prompt tests to rule out visceral leishmaniasis, especially in an area such as the Mediterranean where the prevalence of latent Leishmania infection is high.
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http://dx.doi.org/10.1159/000370238DOI Listing
September 2015

Acute severe methotrexate toxicity in patients with psoriasis: a case series and discussion.

Dermatology 2014 12;229(4):306-9. Epub 2014 Nov 12.

Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.

Background: Methotrexate (MTX) is considered a relatively safe drug when prescribed at low-dose regimens not exceeding 25 mg/week. Severe acute toxicity is rare and presents with mucositis, cutaneous ulceration and pancytopenia. Most cases occur as the result of inadvertent overdosing due to erroneously taking the drug daily. However, concomitant factors such as older age, co-medication and renal failure may increase the drug's toxicity.

Case Reports: We report four consecutive cases of acute MTX toxicity in patients with psoriasis vulgaris. In three patients, MTX was erroneously taken daily for 2-4 weeks. All three patients recovered following MTX withdrawal and intensive treatment. The fourth patient was taking 7.5 mg weekly MTX as prescribed, but had concomitant factors and died.

Conclusion: Although low-dose MTX appears to be a safe medication, acute MTX toxicity can be a life-threatening emergency. Greater awareness of possible MTX toxicity is still needed for its prevention, early diagnosis and management.
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http://dx.doi.org/10.1159/000366501DOI Listing
September 2015

Pediatric cutaneous lupus erythematosus treated with pulsed dye laser.

Pediatr Dermatol 2014 Jan-Feb;31(1):113-5. Epub 2013 Nov 14.

Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.

Pulsed dye laser (PDL) has been used in adults to treat refractory cutaneous lupus erythematosus (CLE). We report the first case of CLE in a child successfully treated with PDL.
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http://dx.doi.org/10.1111/pde.12248DOI Listing
September 2014

Neutrophilic dermatoses in a patient with collagenous colitis.

Dermatol Reports 2010 Jan 15;2(1):e5. Epub 2010 Feb 15.

Department of Dermatology.

We report the case of a 75-year old woman with collagenous colitis who presented with erythematous and edematous plaques on the periorbital and eyelid regions, accompanied by oral ulcers. Histopathology showed a dermal neutrophilic infiltrate plus mild septal and lobular panniculitis with lymphocytes, neutrophils and eosinophils. Five years earlier she had presented a flare of papules and vesicles on the trunk, together with oral ulcers; a skin biopsy revealed a neutrophilic dermal infiltrate and Sweet's syndrome was diagnosed. Both the neutrophilic panniculitis and the Sweet's syndrome were accompanied by fever, malaise and diarrhea. Cutaneous and intestinal symptoms disappeared with corticoid therapy. The two types of neutrophilic dermatoses that appeared in periods of colitis activity suggest that intestinal and cutaneous manifestations may be related.
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http://dx.doi.org/10.4081/dr.2010.e5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4211476PMC
January 2010

Cutaneous adverse effects of biological therapies for psoriasis.

Eur J Dermatol 2008 Nov-Dec;18(6):693-9. Epub 2008 Oct 27.

Department of Dermatology. Hospital de la Santa Creu i Sant Pau, Mas Casanovas 90 08025 Barcelona. Spain.

Psoriasis is a common immune-mediated disease that affects approximately 2% of the world's population. Most patients require lifelong treatment and many of the current systemic therapies are complicated by significant toxicities or inconvenience when administered long-term. New biological psoriasis therapies have been developed, which are thought to act through targeted molecular pathways, so as to administer them continuously without causing any relevant toxicity. Nevertheless, acute and chronic dermatological adverse effects are frequently observed, but knowledge about them is limited and the potential pathogenic mechanisms have not yet been identified. We present 7 patients from our dermatological department who presented different cutaneous adverse effects (2 erythrodermias, 1 palmoplantar pustulosis, 1 flexural psoriasis, 1 eczema, 1 neutrophilic dermatosis and 1 papular eruption) during treatment with biological drugs (4 patients with efaluzimab, 2 patients with infliximab and 1 patient with etanercept). The use of biological agents is expanding worldwide as new alternative treatments for psoriasis and other chronic inflammatory diseases. The increased use of these treatments has allowed identification of their acute and chronic systemic adverse events. Nevertheless, the dermatological adverse events of these biological drugs are less well known due to few reports about them and lack of information about their pathogenic mechanisms. Exact diagnosis of these cutaneous eruptions is very important in order to decide the need for discontinuation of the biological treatment.
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http://dx.doi.org/10.1684/ejd.2008.0521DOI Listing
March 2009

Description and management of cutaneous side effects during cetuximab or erlotinib treatments: a prospective study of 30 patients.

J Am Acad Dermatol 2006 Sep 13;55(3):429-37. Epub 2006 Jul 13.

Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.

Background: Drugs such as cetuximab or erlotinib, which inhibit the epidermal growth factor receptor, are increasingly being used in treatment of solid tumors. This has led to the appearance of new secondary effects.

Objective: We sought to describe the cutaneous side effects and their management in patients with cancer treated with cetuximab or erlotinib.

Methods: We clinically examined 30 patients determining type, frequency, treatment, and evolution of side effects.

Results: Most patients presented with a cutaneous reaction consisting of a follicular eruption, typically appearing in seborrheic areas within the first 15 days of treatment. Painful fissures in palms and soles and paronychia were the second most common cutaneous toxicities. We also noticed an alteration in hair growth at several months' follow-up. As these secondary effects responded well to treatment, few patients discontinued the antineoplastic therapy because of cutaneous toxicity.

Limitations: This was a prospective but uncontrolled study.

Conclusion: Although these new targeted therapies have low systemic toxicity because of their high specificity, cutaneous side effects are common and may be serious.
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http://dx.doi.org/10.1016/j.jaad.2006.04.062DOI Listing
September 2006

Skin reaction to hydroxyzine (Atarax): patch test utility.

Contact Dermatitis 2006 Apr;54(4):216-7

Dermatology Department, Hospital de Sant Pau, Barcelona, Spain.

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http://dx.doi.org/10.1111/j.0105-1873.2006.0775d.xDOI Listing
April 2006

Use of patch test in fixed drug eruption due to metamizole (Nolotil).

Contact Dermatitis 2006 Feb;54(2):127-8

Servicio de Dermatología, Hospital de Sant Pau, Barcelona, Spain.

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http://dx.doi.org/10.1111/j.0105-1873.2006.0560i.xDOI Listing
February 2006

[Scurvy: follicular purpura as a diagnostic sign].

Actas Dermosifiliogr 2005 Jul-Aug;96(6):400-2

Servicio de Dermatología, Hospital de Sant Pau, Barcelona, Spain.

Scurvy is a set of clinical manifestations characterized by general weakness, anemia, gingivitis and cutaneous bleeding, caused by a lack of ascorbic acid in the diet. This pathology is currently a clinical rarity, although it can still be seen in cases of malnutrition associated with alcoholism or with dietary deficiencies, especially in childhood and old age. We present the case of a 45-year-old male who consulted his physician because of lower limb edema with follicular purpura, accompanied by asthenia, polyarthralgia and bleeding gums. After treatment with 1 g/day of vitamin C was initiated, the patient's symptoms quickly improved. The diagnosis of scurvy was based on the patient's clinical symptoms, dietary history and the rapid resolution of the symptoms when vitamin C supplements were initiated.
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http://dx.doi.org/10.1016/s0001-7310(05)73101-xDOI Listing
May 2006

Lichen striatus: clinical and epidemiological review of 23 cases.

Eur J Pediatr 2006 Apr 13;165(4):267-9. Epub 2006 Jan 13.

Department of Dermatology, Hospital de la Santa Creu i Sant Pau, St. Antoni Ma Claret, 167, 08025, Barcelona, Spain.

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http://dx.doi.org/10.1007/s00431-005-0032-9DOI Listing
April 2006

Cutaneous necrosis after injection of polyethylene glycol-modified interferon alfa.

J Am Acad Dermatol 2005 Jul;53(1):62-6

Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.

Pegylated interferon alfa-2b is a formulation of recombinant human interferon conjugated with polyethylene glycol. Compared with standard interferon alfa injections, this preparation has a longer half-life allowing for once-weekly injections and superior antiviral efficacy in the treatment of hepatitis C when used in combination with ribavirin. Cutaneous side effects caused by interferon are well known. Cutaneous necrosis as a result of interferon alfa is an infrequent complication with unknown pathogenesis, in which a cutaneous local immune-mediated inflammatory process might be involved. We report 5 patients (3 patients with chronic hepatitis C treated with pegylated interferon alfa-2b in association with oral ribavirin and two patients with chronic myelocytic leukemia) who developed local cutaneous reactions at sites of injection after the administration of weekly subcutaneous injections of pegylated interferon alfa-2b at different doses. The ulcers slowly healed with local therapy, but two patients required dose modification of the pegylated interferon alfa-2b and one patient required treatment withdrawal. We review the literature on previously reported cases of cutaneous necrosis after injection of standard interferon alfa or pegylated interferon alfa-2b and discuss the different pathophysiologic mechanisms that might be involved.
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http://dx.doi.org/10.1016/j.jaad.2005.02.031DOI Listing
July 2005