dermatologia

Single-gene mutations that lead to atopic dermatitis identified

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The findings suggest some the genetic defects underpinning atopic dermatitis could be corrected by glutamine supplementation.

Scientists have identified mutations in the CARD11 gene that lead to atopic dermatitis and say their research suggest a potential therapeutic target.

Through next-generation sequencing on a cohort of patients with severe atopic dermatitis, scientists from the National Institute of Allergy and Infectious Diseases in the US identified eight individuals, from four unrelated families, with novel heterozygous mutations in CARD11. Each of the four families had a distinct mutation that affected a different region of the CARD11 protein, but all the mutations had similar effects on T-cell signalling.

The scientists determined that the mutations led to defective activation of two cell-signalling pathways, one of which is typically activated in part by glutamine. They found growing cultured T-cells from patients with CARD11 mutations with excess glutamine boosted rapamycin complex 1 (mTORC1) activation, suggesting the potential to partially correct the cell-signalling defects that may contribute to atopic dermatitis.

A new study is now planned to assess the effect of supplemental glutamine and leucine, which also activates mTORC1, in people with atopic dermatitis with and without the single gene mutations.

The findings are published in Nature Genetics .

FDA Approves Delafloxacin (Baxdela) for Skin Infections

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Resultado de imagem para skin infection treatment

Robert Lowes
June 19, 2017
The US Food and Drug Administration (FDA) today approved an antibiotic called delafloxacin (Baxdela, Melinta Therapeutics) to treat serious or life-threatening infections, including one that’s particularly tough to beat.
A fluoroquinolone, delafloxacin is specifically indicated in adults with acute bacterial skin and skin structure infections (ABSSSIs) caused by certain gram-positive and gram-negative pathogens, including methicillin-resistant Staphylococcus aureus. The FDA cautions that, for the sake of curbing the development of drug-resistant bacteria, clinicians should order delafloxacin only when an infection is proven or strongly suspected to be bacterial in nature.
Delafloxacin is contraindicated for patients with known hypersensitivity to fluoroquinolones.
The new drug, administered as a tablet or through intravenous infusion, comes with a boxed warning on its label. It states that fluoroquinolones such as delafloxacin are associated with disabling and potentially irreversible adverse events such as tendinitis and tendon rupture, peripheral neuropathy, and central nervous system effects. Clinicians should discontinue the use of delafloxacin if patients experience these adverse events. They also should avoid delafloxacin in patients with a known history of myasthenia gravis, which may be exacerbated by fluoroquinolones.
The FDA determined that delafloxacin was safe and effective based on two randomized clinical trials involving roughly 1500 adults with ABSSSIs that compared the new drug with an intravenous combination of vancomycin plus aztreonam. In one study, delafloxacin was administered intravenously from start to finish, while in the other, patients started out on intravenous delafloxacin and then switched to the tablet version. In both studies, delafloxacin proved just as effective as the combination of vancomycin and aztreonam in shrinking skin lesions by at least 20% within 48 to 72 hours.
The most common adverse events seen in the clinical trials were nausea, diarrhea, headache, higher levels of transaminase, and vomiting.
The FDA had designated delafloxacin as a qualified infectious-disease product, entitling it to an expedited review.
More information about delafloxacin is available on the FDA website.

Acne vulgaris

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Você sabe tratar acne vulgaris? Novas diretrizes indicam a melhor conduta

Você sabe tratar acne vulgaris? Novas diretrizes indicam a melhor conduta

A acne é uma doença que acomete 80% dos jovens brasileiros e provoca importantes efeitos psicológicos e na autoestima das pessoas. A American Academy of Dermatology atualizou as diretrizes de 2007 com novas recomendações para o manejo da acne vulgaris. Separamos os principais pontos.

  • Os retinoides de uso tópico são recomendados como monoterapia para acne comedoniana ou em combinação com antimicrobianos tópicos ou orais em pacientes com acne mista ou primariamente inflamatória
  • Peróxido de benzoíla é um tratamento tópico eficaz para acne
  • A antibioticoterapia tópica (clindamicina ou eritromicina) é recomendada apenas em combinação com peróxido de benzoíla

A antibioticoterapia sistêmica é recomendada para o manejo de acne inflamatória moderada e severa e resistente a tratamentos tópicos

  • O uso sistêmico de antibióticos deve ser limitado à duração mais curta possível, geralmente 3 meses. A terapia tópica concomitante e em andamento com peróxido de benzoíla ou um retinoide tópico é recomendada para manutenção
  • Os contraceptivos orais combinados são eficazes no tratamento da acne inflamatória em meninas e mulheres
  • A isotretinoína oral (roacutan) é recomendada para tratamento de acne nodular grave, recalcitrante moderada ou que produz cicatrizes ou sofrimento psicossocial

O manejo bem sucedido da acne depende da avaliação precisa da morfologia da acne e sua gravidade e do desenvolvimento de um regime de tratamento adequado. Os benefícios do tratamento incluem redução do desconforto, morbidade psicológica e cicatrizes.

O dermatologista é o profissional mais adequado para a avaliação e o tratamento desta doença.

 

Referências:

  • Management of Acne Vulgaris. Roman C Cifu A Stein S K B V G et. al. JAMA, 2016 vol: 316 (13) pp: 1402. DOI: 10.1001/jama.2016.11842

Acne

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Resultado de imagem para acne

Zits breakouts can affect your body as well as your face. No matter where it occurs, there are ways to control it. The following article may help you find a way for you to treat the type of zits you have.

To reduce the occurrence of acne, apply tea tree oil on the pimples prone areas. A natural astringent, tea tree oil will not dry out your skin.

It is crucial that you not pick your pimples. If you pick at spots the bacteria can spread, causing more blemishes. Also, if you repeatedly pick at the same spot, you can break open the skin and leave a scar once it heals.

TIP! Avoid popping your pimples or picking at your acne. Use one of the many acne treatments that are available.

Try ditching your makeup for a while, to help clear up your skin. It is tempting to put makeup on to cover pimples, but it will only clog your pores and make the situation worse. Your skin will stay cleaner and clearer if you avoid these products.

Caffeine in soda, tea, and coffee can also contribute to terrible zits. If you’re able to cut back some on caffeine consumption, your pimples might improve.

TIP! Being too hot or too cold can contribute to acne breakouts. When it is warm outside, your body will sweat more.

Switching out your sheets and cases often will greatly improve your skin’s condition. These oils transfer onto your pillow cases and sheets as you sleep. Then they can wind up back on your skin. Wash your linens regularly to remove these accumulated oils.

Garlic is a natural antioxidant that can help your body in numerous ways including your skin. Garlic works to remove toxins in your system and enables more efficient growth of new skin. Garlic is delicious and can be added to practically anything.

TIP! Try staying away from makeup to improve your acne, or use a makeup that is water-based. Covering up acne with makeup is tempting, but it can clog your pores and make your condition worse.

People with pimples should avoiding touching their faces or popping existing pimples. Fingertips have oil, dirt and other impurities that can clog your pores. Additionally, popping blemishes is risky and can sometimes result in pain, infections and scarring.

If you suffer from pimples, choose a skin care product containing salicylic acid. Its key ingredient used with other beta hydroxyl acids aid the skin by causing the skin cells to shed more quickly.

Cleansing Wipes

You should clean your face whenever you see the opportunity, and this is especially important when you are sweating, or after you just wake up. If you find that you cannot wash your face when you are away from home, take some facial cleansing wipes with you. Cleansing wipes will quickly remove bacteria and impurities. Do not use wipes in the place of your daily cleanser.

TIP! To get rid of your acne, try spending more time outside under the sun. Your skin will dry up once the sun hits it.

If you suffer from pimples, stress could be the cause. Give yourself some time everyday to unwind and relax. Taking part in an enjoyable activity will help with hormonal balance and reduce stress, which can aggravate pimples. You should also avoid caffeine and cigarettes if you have pimples.

Your hands contain dirt and oils, so whenever possible avoid touching your face. Break yourself of unconsciously bringing your hand to your face, as well. When the pores get filled with dirt it will cause pimples.

TIP! Look for skin products that include salicylic acid if you are dealing with acne. When combined with beta hydroxyl acids, skin cell shedding happens more rapidly.

Feel like your pimples will never go away? Skin problems can also be caused by allergens, including mites and hay fever. Finally, eradicate bad stressors from your life. Stress can cause your body to release hormones, many of which can lead to irritation.

If you stay hydrated you will be more prone to get rid of your zits. Be sure to consume sufficient water on a daily basis. People should consume 6-8 glasses of water everyday. Pores can become clogged and additional breakouts can occur.

TIP! Stress and the pressures of life are often times the cause of acne. Take the time to practice relaxation methods regularly.

Reducing the amount of stress you experience will help you to be able to control your acne. Hormones are produced as a result of stress that are harmful to your overall health, causing major problems for your skin. Reducing stress has so many benefits it is well worth the effort, be it by exercise, meditation or simply taking a few minutes a day to be alone with your favorite music. Stress can cause acne flare ups, so make sure to keep your stress levels under control.

Resist the urge to touch your face, especially areas where you are experiencing a breakout. You can spread infection on your face by transferring the dirt and skin oils from your fingers. Make an attempt to keep your hands away from your face. Any gesture that involves the touching of the face, like resting the chin in the hand, can worsen an acne problem.

TIP! Your hands transfer dirt and oils to your face that can cause pimples. Pimples are created by the inflammation caused by dirt trapped in your pores.

If you are having issues with acne, your best bet would be to avoid any type of tanning, whether it be outside or in a tanning bed. As you most likely know, pimples can be made worse by direct sunlight. UV light from tanning beds has the same effect on zits as the radiation from the sun does. Any type of tanning, whether it be indoor or outdoor can be detrimental to your desire to get rid of your acne breakouts.

Stress is a big cause of pimples. Stress is not always easy to avoid, but fortunately, there are several ways to cut back the stress in your daily life. Yoga and other forms of exercise can reduce stress, and make you healthier.

TIP! Are you struggling with acne that won’t respond to treatment? Things that cause allergies, like pollen and dust mites, can be irritating to the skin and cause acne. It is also important to reduce your stress levels.

Exercise is an important part of both treating and reducing pimples. Exercising increases circulation, which helps give oxygen and nutrients to your body, along with eliminating toxins. An exercise regimen can thus, be an important part of body hygiene, maintenance, and toning. Exercise also allows your mind to release its stress. Stress has been shown to aggravate acne problems.

You can experience zits in many locations on your body, as it is not limited to only your face. Keep the helpful hints here in mind and you can start clearing up your pimples with proper treatments and possibly topical creams. Acne can be treated, and with continued treatment, it can eventually fade away.

Tratamento para psoríase pode reduzir progressão da aterosclerose

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corrente sanguinea

Tratamento para psoríase pode reduzir progressão da aterosclerose

O tratamento para psoríase pode reduzir progressão da aterosclerose, segundo as conclusões de um novo artigo publicado no Journal Of The American Medical Association (JAMA).

A psoríase é uma doença inflamatória crônica da pele que está associada ao aumento da inflamação vascular e futuros eventos cardiovasculares. Como já se sabe, a inflamação é crítica no desenvolvimento da aterosclerose.

Para o estudo do JAMA, pesquisadores investigaram a associação entre a alteração da gravidade da psoríase e a alteração da inflamação vascular em 1 ano, e o impacto do tratamento da doença da pele na inflamação vascular.

Para isso, foi feito um estudo de coorte prospectivo com 115 pacientes com psoríase recrutados do US National Institutes of Health (NIH), entre 2013 e 2016.

Entre os participantes, a idade média ao final do seguimento de 1 ano foi de 50,8 anos e 59% eram homens. A coorte teve um baixo risco cardiovascular pelo escore de risco de Framingham e psoríase de leve a moderada, com um índice médio de PASI de 5,2.

Durante o acompanhamento, a coorte teve uma melhora média no índice PASI de 33%, com uso de terapia tópica (60%), terapia biológica (66%) e fototerapia (15%) (p<.001). Essa melhora foi associada a uma redução de 6% na inflamação vascular medida por PET-TC mesmo após o ajuste de fatores de risco tradicionais (p = 0,03). Pacientes que alcançaram uma redução de 75% na gravidade da inflamação da pele tiveram uma melhora de 11% na inflamação vascular (p <0,003).

Pelos resultados, os pesquisadores concluíram que a melhoria na gravidade da psoríase foi associada à melhora da inflamação vascular aórtica por por PET-TC. Esses achados sugerem que o controle da inflamação remota dos órgãos-alvo (como, por exemplo, na pele) pode melhorar as doenças cardiovasculares; no entanto, estudos clínicos randomizados são necessários para confirmar esses dados.

 

Referências:

  • Dey AK, Joshi AA, Chaturvedi A, Lerman JB, Aberra TM, Rodante JA, Teague HL, Harrington CL, Rivers JP, Chung JH, Kabbany MT, Natarajan B, Silverman JI, Ng Q, Sanda GE, Sorokin AV, Baumer Y, Gerson E, Prussick RB, Ehrlich A, Green LJ, Lockshin BN, Ahlman MA, Playford MP, Gelfand JM, Mehta NN. Association Between Skin and Aortic Vascular Inflammation in Patients With PsoriasisA Case-Cohort Study Using Positron Emission Tomography/Computed Tomography. JAMA Cardiol. Published online May 31, 2017. doi:10.1001/jamacardio.2017.1213

Latest ransomware attack targets patients of cosmetic clinic

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After a previous attempt to extort money from the clinic failed, the hackers are now demanding ransoms from the patients.

Patients who attended a Lithuanian cosmetic surgery clinic are being forced to pay ransoms to prevent private photographs and personal data being published online.
An investigation is underway after patient images were made public on Tuesday (May 30) by a hacking group calling themselves ‘Tsar Team’. After a previous attempt to extract a ransom from the clinic itself failed, the group is now demanding ransoms from the clients who attended the clinic from more than 60 countries around the world. Ransoms range from €50 and €2,000, depending on the sensitivity of the data.

The incident comes at a time when healthcare systems are being increasingly targeted by hackers. The UK’s National Health Service was crippled for a number of days last month when its systems were infected with WannaCry ransomware. The attack affected 47 NHS trusts leaving doctors without access to critical online supports. Thousands of computers in 150 countries were affected by the attack.

Last year, data company, Experian, warned that the healthcare sector would be a focal point for hackers in 2017 as medical identity theft remains lucrative and easy for cyber criminals to exploit, with electronic health records likely to be a primary target for attackers.

La utilización de calzado transpirable evita que el calor se estanque en los pies y produzca hongos

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En verano el paciente toma consciencia de los problemas causados en los pies por no haberlos cuidado durante el resto del año.

En verano el paciente toma consciencia de los problemas causados en los pies por no haberlos cuidado durante el resto del año.

La utilización de calzado transpirable evita que el calor se estanque en los pies, ya que esto favorece la sudoración, el reblandecimiento de la piel y propiciar la aparición de hongos, han indicado desde el Ilustre Colegio Oficial de Podólogos de la Comunidad Valenciana (ICOPCV).

La subida de las temperaturas provoca que se abandone el uso de calcetines, lo que hace que el pie esté en contacto directo con el zapato, de forma que se favorezca un exceso de roce. Este, en caso de que el calzado no sea confortable y el pie esté adecuadamente tratado e hidratado, podría causar la aparición de rozaduras, ampollas y otras lesiones dérmicas, ha destacado la vicepresidenta del ICOPCV, Estefania Soriano.

Con la llegada del calor es frecuente que los pies comiencen a hincharse y el exceso de sudoración les afecte, lo que propicia un mayor número de consultas por dolor debido a la existencia de ‘ojos de pollo’ entre los dedos o el dolor en los juanetes.

“En general, es el momento en el que el paciente toma consciencia de los problemas causados en los pies por no haberlos cuidado durante el resto del año”, ha afirmado Soriano.

Como paso principal, el ICOPCV recomienda realizar una visita al podólogo para explorar los pies detenidamente y comprobar que no existe ninguna patología que se podría agravar más en verano.

Además, es fundamental que el especialista elimine posibles durezas, helomas u otras patologías dérmicas que podrían existir, así como dar el tratamiento adecuado para evitar las dolorosas grietas en los talones.

También hay que realizar un buen corte y limado de uñas para realzar su estado natural tras el pulido y poder detectar a tiempo cualquier anomalía como los hongos.