Aguado, L. (Leyre)
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- Daylight photodynamic therapy for prevention of new actinic keratosis and keratinocyte carcinomas in organ transplants. A cryotherapy-controlled randomized clinical trial(European Academy of Dermatology and Venereology, 2020) Bernad-Alonso, I. (Isabel); Aguado, L. (Leyre); Redondo-Bellón, P. (Pedro); Nuñez-Cordoba, J.M. (Jorge M.)Background Organ transplant recipients (OTR) have a higher risk of actinic keratosis (AK) and keratinocyte carcinomas (KC). There are no clinical trials assessing the effectiveness of daylight photodynamic therapy (DPDT) to prevent new AK and KC in OTR. Objectives To determine whether repeated treatments of field cancerization with DPDT are effective in preventing new AK and KC in OTR. Methods A randomized, intra-subject controlled, evaluator-blind, split-face and/or scalp trial, from April 2016 to Octo- ber 2018. Participants were OTR older than 18 years, 1-year posttransplant, with at least 5 AK on each hemi-face/ hemi-scalp. One side received six field treatments with DPDT: two sessions 15 days apart at baseline, two at 3 months and two at 9 months after baseline. Control side received lesion-directed treatment with cryotherapy (double freeze– thaw) at baseline, 3 and 9 months. Total number of lesions (AK and KC) at 21 months, number of new AK and KC at 3, 9, 15 and 21 months and treatment preferences were analysed. Results Of 24 men included, 23 were analysed at 3 months; and 21, at 9, 15 and 21 months. Mean (SD) age was 69.8 years (9.2). The total number of lesions at 21 months was 4.7 (4.3) for DPDT and 5.8 (5.0) for control side; P = 0.09. DPDT showed significantly lower means [SD] of new lesions compared to control side at 3 months (4.2 [3.4] vs. 6.8 [4.8]; P < 0.001), 9 months (3.0 [3.3] vs. 4.3 [3.4]; P = 0.04) and 15 months (3.0 [4.6] vs. 4.8 [5.0]; P = 0.02), and non-signifi- cant at 21 months (3.7 [3.5] vs. 5.0 [4.5]; P = 0.06). Most participants preferred DPDT. Conclusion DPDT showed potential effectiveness in preventing new AK and KC in OTR by consecutive treatments of field cancerization. The preference for DPDT could facilitate adherence to the long-term treatment necessary in these patients.
- Generalized pustulosis following Covid 19 vaccination in a patient in treatment with adalimumab(Wiley, 2024) Estenaga, Á. (Ángela); Morelló-Vicente, A. (Ana); Mitxelena, J. (Josune); Antoñanzas-Perez, J. (Javier); Laíño-Piñeiro, M. (M.); Aguado, L. (Leyre); Oteiza-Rius, I. (Inés)Dear Editors, Adalimumab is a tumor necrosis factor (TNF)-α inhibitor commonly used for multiple autoimmune diseases. Paradoxical cutaneous reactions under anti-TNF-α drugs have been described in the literature, predominantly linked to adalimumab.1 Although this adverse effect is widely known, mechanisms underlying its induction, as well as possible risk factors, are still unknown. Here we report a case of papulopustular psoriasis induced by a second dose of Covid vaccine in a patient treated with adalimumab. The patient was a 52-year-old woman with history of HLA B27(–) spondylarthritis. No personal or family history of psoriasis was reported. During the previous 9 months she had been in treatment with adalimumab (40 mg) subcutaneously every 2 weeks. No other treatment was initiated during this period. However, she had received the second Covid vaccine the previous week (1st dose: Janssen, 2nd dose: Moderna). The patient presented with an abruptly developed generalized papulopustular reaction that had initiated as a palmoplantar pustulosis (Figure 1). A biopsy was performed and revealed generalized pustulosis (Figure 2). Adalimumab was discontinued and daily topical application of clobetasol propionate 0.05% plus urea 20% resulted in progressive improvement of the lesions. However, although clinical improvement was noted after the use of topical corticosteroids, the patient did not present with complete remission of the lesions.
- Queratosis actínicas en pacientes trasplantados de órgano sólido: revisión de la literatura(Academia Española de Dermatología y Venereología (AEDV), 2023) Morelló-Vicente, A. (Ana); Aguado, L. (Leyre); Oteiza-Rius, I. (Inés)La inmunosupresión farmacológica de los pacientes trasplantados de órgano solido constituye un importante factor de riesgo tanto para la aparición de queratosis actínicas (QA) como para su progresión a carcinomas escamosos (CE). El tratamiento tanto de las lesiones clí- nicas como preclínicas en este grupo de pacientes es obligatorio debido a la elevada posibilidad de evolución a CE. Por otra parte, la prevención presenta también un papel importante que debemos tener en cuenta. Existen un gran número de estudios realizados en pacientes inmunocompetentes sobre el tratamiento y la prevención de QA, pero no en pacientes inmunosuprimidos. Esta revisión pretende resumir el conocimiento actual sobre los tratamientos y medidas de prevención de la QA en loas pacientes trasplantados de órgano sólido.
- Erythema gyratumrepens-like eruption in a patient with epidermolysisbullosaacquisita associated with ulcerative colitis(Wiley-Blackwell, 2007) Sitaru, C. (C.); España, A. (Agustín); Pretel, M. (Maider); Aguado, L. (Leyre); Jimenez, J. (J.)
- Risk of Second Primary Malignancies in Melanoma Survivors: A Population-Based Study(MDPI, 2023) Morelló-Vicente, A. (Ana); Salido-Vallejo, R. (Rafael); Antoñanzas-Perez, J. (Javier); Aguado, L. (Leyre); Redondo-Bellón, P. (Pedro); Garnacho-Saucedo, G.M. (Gloria Maria)(1) Introduction: The association between melanoma (MM) and the occurrence of second primary neoplasms (SPNs) has been extensively studied, with reported incidence rates ranging from 1.5% to 20%. This study aims to evaluate the occurrence of SPNs in patients with a history of primary MM and to describe the factors that make the risk higher in our population. (2) Material and Methods: We conducted a prospective cohort study and calculated the incidence rates and relative risks (RR) for the development of different SPNs in 529 MM survivors from 1 January 2005 to 1 August 2021. Survival and mortality rates were obtained, and the Cox proportional hazards model was used to determine the demographic and MM-related factors that influence the overall risk. (3) Results: Among the 529 patients included, 89 were diagnosed with SPNs (29 prior to MM diagnosis, 11 synchronous, and 49 after MM), resulting in 62 skin tumors and 37 solid organ tumors. The estimated probability of developing SPNs after MM diagnosis was 4.1% at 1 year, 11% at 5 years, and 19% at 10 years. Older age, primary MM location on the face or neck, and histologic subtype of lentigo maligna mm were significantly associated with a higher risk of SPNs. (4) Conclusions: In our population, the risk of developing SPNs was higher in patients with primary MM located on the face and neck and with the histological subtype of lentigo maligna-MM. Age also independently influences the risk. Understanding these hazard factors can aid in the development of MM guidelines with specific follow-up recommendations for individuals with the highest risk.
- Popper’s Dermatitis: An Unusual Diagnostic Challenge(Wiley, 2021) Tomás-Velázquez, A. (Alejandra); Estenaga, Á. (Ángela); Gil-Sanchez, M.P. (María Pilar); Rodríguez-Garijo, N. (Nuria); Antoñanzas-Perez, J. (Javier); Aguado, L. (Leyre)Volatile nitrites, and especially isobutyl nitrite or “Popper”, are popular drugs of abuse in Europe, mainly in men that have sex with men (MSM). Inhalation is the most common route of consumption, but direct contact with skin or muco- sal membranes has been associated with a local adverse event called “Popper’s dermatitis”. To date, just five cases have been reported, most of them on the face, but also on other parts of the body [1, 2].
- Prognostic Outcomes of Cutaneous Squamous Cell Carcinoma in Solid Organ Transplant Recipients: A Retrospective Comparative Cohort Study(MDPI, 2023) Escribano-Castillo, L. (Lourdes); Salido-Vallejo, R. (Rafael); Antoñanzas-Perez, J. (Javier); Aguado, L. (Leyre); Vélez, A. (Antonio); Roldán-Córdoba, C. (Claudia)Introduction: Cutaneous squamous cell carcinoma (cSCC) is the second most common cutaneous neoplasm, and its incidence is on the rise. While most cSCCs have an excellent prognosis, certain risk factors, especially immunosuppression, have been associated with higher rates of local recurrence (LR), metastasis, and poor prognosis. This study aims to assess the risk factors for LR and metastasis development in cSCC among solid organ transplant recipients (SOTRs) and compare these rates with those in immunocompetent patients. Materials and Methods: A retrospective observational study included cSCC cases from the University Hospital Reina Sofía in Córdoba, Spain, between 2002 and 2019. Demographic, clinical, and histopathological data were collected. Local recurrence and metastasis rates were analyzed, along with progression-free survival. Univariate analyses were performed to identify prognostic factors in SOTRs. Results: Among 849 cSCC cases, we found higher rates of local recurrence and metastasis in tumors developed by SOTRs compared to those in immunocompetent individuals. However, no significant differences in local recurrence, metastasis, or progression-free survival were observed between the two groups. Risk factors for adverse outcomes in SOTRs included tumor size > 2 cm, depth > 4 mm, and a higher Clark level. A total of 34.4% of SOTRs developed a second primary cSCC during the follow-up. Conclusions: In our study, cSCCs in SOTRs did not exhibit statistically significant differences in the rates of adverse outcomes compared to immunocompetent patients. The prognosis of cSCCs in SOTRs may be more related to other tumor-dependent risk factors than to the immunosuppression status itself. Future studies are needed to refine risk stratification and follow-up protocols to ensure the optimal management of high-risk cSCC cases, particularly among immunosuppressed patients.
- A Novel Missense Mutation in the CYLD Gene in a Spanish Family With Multiple Familial Trichoepithelioma(Springer, 2007) España, A. (Agustín); Garcia-Amigot, F. (Fermín); Garcia-Foncillas, J. (Jesús); Aguado, L. (Leyre)
- Methotrexate-induced epidermal necrosis in a child with osteosarcoma(John Wiley & Sons Ltd., 2020) Tomás-Velázquez, A. (Alejandra); Gutierrez-Jimeno, M. (Miriam); Moreno, E. (Esther); Rodríguez-Garijo, N. (Nuria); Aguado, L. (Leyre); Querol-Cisneros, E. (Elena)Methotrexate is a folic acid antagonist used to treat psoria-sis, rheumatoid arthritis and neoplasms. It is renally excreted unchanged, at levels of about 90% within 24 hours. Several risk factors for intoxication have been described, including folate deficiency, liver cirrhosis, renal failure or the use of me-dications such as sulfonamides, salicylate and nonsteroidal anti-inflammatory drugs. Adverse cutaneous reactions such as photosensitivity, alopecia, urticaria, mucositis, erythe-ma, desquamation, Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN) are well known. Methotrexate epidermal necrosis (MEN) should also be considered because of its severity, its similarity to TEN and the importance of rapidly administering appropriate treatment. Some cases of MEN have been reported in psoriasis patients, in whom the occurrence with an underlying skin disease has been found to be more common.
- Actualización en malformaciones venosas(Gobierno de Navarra. Departamento de Salud, 2010) Aguado, L. (Leyre); Redondo-Bellón, P. (Pedro)Venous malformations represent 2/3rds of all vascular malformations and are frequently much more complex than they appear to be. Patients with large venous malformations require a deep analytical and radiological study, as well as specific treatment to control any possible localised intravascular coagulation. If the lesions are extensive, especially in the lower member, a study should be made to detect the presence of an underlying osteoporosis with the idea of preventing pathological fractures. Equally, a check must be made for arthropathy, and an early prophylactic synovectomy must be considered when the radiological extension makes this advisable, with the idea of avoiding irreversible damage to the joints with the passage of time. Currently, microfoam scleropathy is favoured as the treatment of choice for low-flow vascular malformations. In the not too distant future, the use of selective antiangiogenic medicines, besides low-molecularweight heparins,