Gustavo Deza

Contact sensitization to limonene and linalool hydroperoxides in Spain: a GEIDAC(*) prospective study.

Limonene and linalool are common fragrance terpenes widely used in cosmetic, household and hygiene products. Their primary oxidation products formed after air exposure, the hydroperoxides, have been recognized as important contact haptens.

Basophil FcεRI expression in chronic spontaneous urticaria: A potential immunological predictor of response to omalizumab therapy.

Although the efficacy of omalizumab has been clearly demonstrated in the treatment of chronic spontaneous urticaria (CSU), its mechanism of action, which results in improvement in CSU symptoms, is not entirely understood. This study investigated the effect of omalizumab on expression of the high-affinity IgE receptor (FcεRI) on blood basophils from patients with active CSU, and its association with the clinical response. Patients exhibiting significant clinical improvement showed a sharp reduction in the levels of basophil FcεRI after 4 weeks, which was maintained throughout the total duration of the treatment. Such evolution was not observed in non-responder patients. Furthermore, non-responders showed significantly lower baseline levels of FcεRI than responders. Baseline basophil FcεRI expression was found to be a potential immunological predictor of response to omalizumab (100% sensitivity and 73.2% specificity). The results of this study contribute to our knowledge of the therapeutic benefit and mechanism of action of anti-IgE therapy in CSU.

Isolation of Haemophilus influenzae and Haemophilus parainfluenzae in urethral exudates from men with acute urethritis: a descriptive study of 52 cases

Objectives To describe the clinical characteristics and therapeutic outcomes from male patients diagnosed of Haemophilus spp urethritis. Methods A chart review of patients who presented to our hospital from January 2013 to December 2014 with symptoms of acute urethritis in which Haemophilus spp was isolated in their urethral samples was performed. Results Haemophilus spp was isolated in 52 out of 413 urethral samples (12.6%) received in our laboratory from patients with symptoms of acute urethritis during the study period. Seven cases corresponded to Haemophilus influenzae and 45 cases to Haemophilus parainfluenzae. The most common clinical presentation was mucopurulent urethral discharge (71%). Eight per cent were HIV-infected patients, and 60% were men who have sex with men. Haemophilus spp was isolated as a single pathogen in 6.8% (28 of 413) of cases. Seventeen per cent of Haemophilus spp were β-lactamase producers. All patients reported having practiced unprotected insertive oral sex the month before consultation, and five of them denied having had another sexual contact apart from this exposure. In all cases in which follow-up was available, empirical treatment achieved a complete clinical resolution. Conclusions Haemophilus spp was considered a pathogen in at least 6.8% of the patients from the evaluated area. It affected men regardless their sexual orientation or HIV status. Unprotected oral sex could play a role in its transmission. The limitations of the study (small sample size and lack of a representative control group) do not allow to prove the true pathogenic role of Haemophilus spp in acute urethritis.

Contact allergy to preservatives: ESSCA* results with the baseline series, 2009-2012.

Allergic contact dermatitis caused by biocides is common and causes significant patient morbidity.

Successful treatment of hypertrophic herpes simplex genitalis in HIV-infected patient with topical imiquimod

Hypertrophic herpes simplex genitalis is an atypical presentation of genital herpes described in the context of immunosuppression, particularly HIV‐positive patients. This situation can become a diagnostic and therapeutic challenge. For this reason, alternative therapies are currently being discussed in the literature. We report a case of hypertrophic genital herpes in a HIV‐positive patient who was successfully treated with topical 5% imiquimod after treatment failures with oral and i.v. antivirals.

Emerging Biomarkers and Therapeutic Pipelines for Chronic Spontaneous Urticaria

Chronic spontaneous urticaria (CSU) is defined as the appearance of evanescent wheals, angioedema, or both, for at least 6 weeks. CSU is associated with intense pruritus and poor quality of life, with higher odds of reporting depression, anxiety, and sleep difficulty. As of yet, the assessment of the activity and course of the disease along with the response to several treatments in CSU are based purely on the patients medical history and the use of the patient-reported outcomes. Recently, several reports have suggested that certain parameters could be considered as potential disease-related biomarkers. Moreover, with the advent of such biomarkers, newer biologic agents are coming forth to revolutionize the management of potential refractory diseases such as CSU. The purpose of this article is to review the most promising biomarkers related to important aspects of CSU, such as the disease activity, the therapeutic response, and the natural history of the disease, and discuss the mechanisms of action and therapeutic effectiveness of the latest agents available or currently under investigation for the management of antihistamine-refractory CSU. The knowledge of these features could have an important impact on the management and follow-up of patients with CSU.

Solitary Plaque-type Morphea with Dystrophic Calcinosis Cutis

An otherwise healthy 54-year-old Caucasian man presented to our department in winter 2004 with a 3-month history of itchy skin lesion on his right shoulder. Physical examination showed an irregular and slightly hyperpigmented 7×5 cm plaque with central whitish areas, hypotrichosis and prominent induration (Fig. 1a, b). Histopathological examination revealed thickened collagen bundles in the upper and middle dermis, mild perivascular lymphocytic infiltrate and loss of skin appendages (Fig. 1c). Diagnosis of solitary plaque-type morphea was established, and treatment with high-potency topical corticosteroids was prescribed with marked improvement of the pruritus. The patient reported that the lesion had remained unmodified for 10 years without treatment, but in recent months it had become itchy and more infiltrated. Topical corticosteroids were prescribed without improvement; therefore oral corticosteroids in decreasing doses plus oral methotrexate, 15 mg weekly, were initiated. After a few months, a rough surface was detected in the middle of the lesion, accompanied by feelings of tightness according to the patient. There was no history of trauma, previous injection or infiltration around the lesion. An 18-MHz ultrasound image revealed an increased thickness of dermis compared with the contralateral side (0.73 vs. 0.42 cm, respectively) and multiple hyperechoic foci with distal acoustic shadowing, which suggested the presence of calcinosis in the dermis (Fig. 1d). Skin biopsy from the affected area revealed broad sclerotic collagen bundles in the dermis and calcium deposition at the center of the specimen (Fig. 1e). Multiple soft Solitary Plaque-type Morphea with Dystrophic Calcinosis Cutis

Management of Chronic Spontaneous Urticaria Exacerbated by Antihistamines: When Treatment Can Act as a Causal Agent Itself.

AMG-A is Medical Advisor for Uriach Pharma, Genentech, Novartis. Research Grants supported by Intendis – Bayer, Uriach Pharma, Novartis. Educational activities sponsored by Uriach Pharma, Novartis, Genentech, Menarini, Glaxo Smith & Kline, Merck MSD, Almirall Pharma

Basophil FcɛRI expression is linked to time to omalizumab response in chronic spontaneous urticaria

This study suggests that baseline levels of basophil FcεRI receptor may predict time to response to anti-IgE therapy in chronic spontaneous urticaria.

Inflammatory linear verrucous epidermal nevus associated with erosive monoarthritis

Inflammatory linear verrucous epidermal nevus and linear psoriasis are different entities with clinical and histopathologic similarities. Isolated reports of inflammatory linear verrucous epidermal nevus with concomitant psoriasis or a positive family history of psoriasis have been described, and the possibility that inflammatory linear verrucous epidermal nevus may be a mosaic form of cutaneous psoriasis has been postulated. We report a 17‐year‐old boy with a congenital, linear, erythematous, keratotic plaque on the dorsum of the fifth finger of the left hand with ipsilateral nail dystrophy. Histopathologic examination showed epidermal hyperplasia with alternating orthokeratosis and parakeratosis. During follow‐up, he developed erosive monoarthritis of the distal interphalangeal joint. This case seems to confirm the association between inflammatory linear verrucous epidermal nevus and arthritis and supports a possible relationship between inflammatory linear verrucous epidermal nevus and psoriasis.