Gloria Sanclemente

Human papillomavirus (HPV) viral load and HPV type in the clinical outcome of HIV-positive patients treated with imiquimod for anogenital warts and anal intraepithelial neoplasia

Objective  To evaluate the efficacy of 5% imiquimod in HIV‐positive male patients with anogenital warts or anal intraepithelial neoplasia (AIN), and to elucidate whether human papillomavirus (HPV) type and viral load were important for clinical outcome and recurrences.

A double-blind, randomized trial of 0.05% betamethasone vs. topical catalase/dismutase superoxide in vitiligo.

Background  Among all the topical immunomodulators, vitiligos mainstay therapy includes topical corticosteroids. Many other non‐immune theories have also been suggested for vitiligos pathogenesis, but the role of oxidative stress has gained more importance in recent years.

Nontuberculous mycobacteria infection after mesotherapy: preliminary report of 15 cases.

Background  Mesotherapy is an increasingly used technique which is currently causing several mycobacterial infections owing to contaminated substances being injected, and also to poor aseptic measures being held by nonprofessional practitioners.

A prospective split‐face double‐blind randomized placebo‐controlled trial to assess the efficacy of methyl aminolevulinate + red‐light in patients with facial photodamage

Background  To date, there is no gold standard therapy for skin photoageing. In the last decade, laser technologies have offered great promise among skin‐rejuvenation therapies; however, both non‐ablative and ablative fractional resurfacing modalities have their own benefits and drawbacks. More recently, open‐label studies and few controlled trials have suggested that photodynamic therapy may have therapeutic potential in photodamage.

Lack of correlation between minimal erythema dose and skin phototype in a Colombian scholar population.

Background: Sun exposure and skin phototype are the most relevant risk factors for skin cancer. Colombia has high levels of ultraviolet radiation during the whole year, therefore, both, high UVIs and outdoor workers daily activities, in our country are very important risk factors for the development of cutaneous cancer. To date no study has evaluated the usefulness of Fitzpatricks skin phototype classification in Colombians and its correlation with the minimal erythema dose (MED) and constitutional skin color. Such information is gaining importance in other nations due to the fact that several countrys population is becoming more ethnically diverse.

Daylight photodynamic therapy with MAL cream for large-scale photodamaged skin based on the concept of ‘actinic field damage’: recommendations of an international expert group

Conventional PDT (c‐PDT) is a widely used and approved non‐invasive treatment for actinic keratosis (AK). Recent clinical, histological and immunohistochemical observations have shown that c‐PDT with methyl aminolevulinate (MAL) may also partially reverse the signs of photodamage. However, pain and the need for special light source equipment are limiting factors for its use, especially in the treatment of large areas. More recently, daylight PDT (DL‐PDT) has been shown to be similar to c‐PDT in the treatment of AK, nearly painless and more convenient to perform. To establish consensus on recommendations for the use of MAL DL‐PDT in patients with large‐scale photodamaged skin. The expert group was comprised of eight dermatologists. Consensus was developed based on the personal experience of the experts in c‐PDT and DL‐PDT, and results of an extensive literature review. MAL DL‐PDT for large areas of photodamaged skin was evaluated and recommendations based on broad clinical experience were provided. As supported by evidence‐based data from multicentre studies conducted in Australia and Europe, the authors defined the concept of ‘actinic field damage’ which refers to photodamage associated with actinic epidermal dysplasia, and provide comprehensive guidelines for the optimal use of DL‐PDT in the treatment of actinic field damage. The authors concluded that MAL DL‐PDT has a similar efficacy to c‐PDT at 3‐month (lesion complete response rate of 89% vs. 93% in the Australian study and 70% vs. 74% in the European study (95% C.I. = [−6.8;−0.3] and [−9.5;2.4] respectively) and 6‐month follow‐ups (97% maintenance of complete lesion response) in the treatment of AKs. The authors agree that DL‐PDT is not only efficacious but also nearly pain‐free and easy to perform, and therefore results in high patient acceptance especially for the treatment of areas of actinic field damage.

Daylight-mediated photodynamic therapy for actinic damage in Latin America: consensus recommendations.

Although conventional photodynamic therapy (c‐PDT) using methyl aminolevulinate cream (MAL) is effective for the treatment of grade I‐II facial and scalp actinic keratosis (AK), it is associated with treatment‐related pain for some patients. Daylight‐mediated PDT (DL‐PDT) has shown similar efficacy to c‐PDT, was nearly painless, and was well tolerated. Overall, DL‐PDT effectively treats AK and offers a simpler and better tolerated treatment option than c‐PDT. This consensus panel provided recommendations on the use of DL‐PDT in Latin America (LATAM) for the treatment of actinic damage associated with few or multiple AKs. The panel was comprised of eight dermatologists from different LATAM countries who have experience using PDT for the treatment of actinic damage. The panel reviewed the relevant literature and provided personal expertise with regard to using DL‐PDT for the treatment of photodamage with or without AK. The recommendations formulated by the expert panel provide evidence‐based guidelines on all aspects of DL‐PDT for the treatment of actinic damage associated with AK in different regions of LATAM. These recommendations provide guidance for dermatologists to ensure maintenance of efficacy and safety of DL‐PDT when treating actinic damage, associated with few or multiple AKs in sun‐exposed skin.

Impact of a sun protection campaign in Medellín (Colombia).

Objective  To evaluate the impact of an educational massive sun protection campaign.

Feasibility of daylight-mediated photodynamic therapy for actinic keratosis throughout the year in Central and South America: a meteorological study.

Daylight‐mediated photodynamic therapy (DL‐PDT) is an efficacious treatment option for thin actinic keratosis (AK) that offers advantages over conventional PDT in terms of tolerability, treatment duration, and cost. A clinical study conducted in Australia determined the mean irradiance during a 2‐hour exposure to be 305.8 W/m2 (range: 40–585 W/m2). The protoporphyrin IX light dose is influenced by latitude, weather conditions, and time of year. A recent study of meteorological data concluded that DL‐PDT can be performed effectively throughout the year in Australia.

Quality assessment of atopic dermatitis clinical practice guidelines in ≤ 18 years

Atopic dermatitis (AD) is a chronic inflammatory skin disease that affects the patients’ quality of life greatly often from a very young age. Its worldwide incidence in children and adults varies, but it is usually among the first ten causes of dermatological consultation worldwide. There is a wide variety of treatment options for this condition including topical and systemic regimes. The decision to choose a treatment option in dermatological diseases is greatly influenced by the personal experience of each specialist, which increases variability in the selection of available therapies. Clinical practice guidelines (CPGs) not only offer recommendations supported on the available scientific evidence, but also are intended to assist in making appropriate decisions in clinical scenarios. To standardize the way in which CPGs should be developed, an instrument called AGREE II (Appraisal of Guidelines for Research and Evaluation) is used. In this study, ten clinical practice guidelines in ≤ 18 years were evaluated. Six domains (scope and purpose, stakeholder involvement, rigor of development, clarity and presentation, applicability, and editorial independence) were assessed for each guideline, by three reviewers. Most of the domains obtained high scores except in the applicability domain. It is suggested that future atopic dermatitis CPGs should emphasize in the facilitating factors and barriers that may influence the application of guideline recommendations.