Julio César Salas Alanís

Coccidioidomycosis and the skin: a comprehensive review

Coccidioidomycosis is a highly prevalent disease in the Western hemisphere. It is considered one of the most virulent primary fungal infections. Coccidioides species live in arid and semi-arid regions, causing mainly pulmonary infection through inhalation of arthroconidia although many other organs can be affected. Primary inoculation is rare. Since the first case of coccidioidomycosis was reported in 1892, the skin has been identified as an important target of this disease. Knowledge of cutaneous clinical forms of this infection is important and very useful for establishing prompt diagnosis and treatment. The purpose of this article is to provide a review of this infection, emphasizing its cutaneous manifestations, diagnostic methods and current treatment.

Measuring quality of life in epidermolysis bullosa in Mexico: Cross-cultural validation of the Hispanic version of the Quality of Life in Epidermolysis Bullosa questionnaire

To the Editor: The Quality of Life in Epidermolysis Bullosa (QOLEB) questionnaire is a valid and reliable epidermolysis bullosa (EB)-specific quality-ofLife (QOL) measurement tool. It aims to reflect clinically significant changes in disease status and well-being as opposed to purely physical attributes such as new blister formation, which may improve with interventions but have no clinically significant impact upon function, emotional status, or survival. Cross-cultural validation of questionnaires enable the use of questionnaires in international multicenter clinical research, allow comparison of burden of disease, and encourage much-needed funding, particularly in regions or population groups where health care is not widely accessible or affordable. This study aims to develop a valid, culturally appropriate translation of the QOLEB questionnaire for use in Hispanic populations. The validated, guideline-based methodology of this study comprised 5 separate steps: ethical approval, forward and backward translation, expert committee review, pretesting, and statistical analysis. The final Hispanic translation of the QOLEB questionnaire is available directly from the corresponding author. Patient burden was low, the average time being 4.6 minutes to complete the questionnaire. Of patients, 100% completed the QOLEB questionnaire and the accompanying Skindex-29 questionnaire. Four patients only partially completed the ShortForm 36 (SF-36) questionnaire and these incomplete questionnaires were excluded from analysis.

Cutaneous graft-versus-host disease after hematopoietic stem cell transplant - a review.

Graft-versus-host disease (GVHD) is a major complication of allogeneic hematopoietic stem cell transplants (allo-HSCT) associated with significant morbidity and mortality. The earliest and most common manifestation is cutaneous graft-versus-host disease. This review focuses on the pathophysiology, clinical features, prevention and treatment of cutaneous graft-versus-host disease. We discuss various insights into the diseases mechanisms and the different treatments for acute and chronic skin graft-versus-host disease.

Monitoring to Prevent Complications: Anemia, Infections, Osteopenia, Failure to Thrive, Renal Disease, Squamous Cell Carcinoma, Cardiomyopathy

There have been many comorbidities identified in EB patients; the most commonly seen are anemia, infections, osteopenia, failure to thrive, renal disease, squamous cell carcinoma, and cardiomyopathy. Physicians caring for EB patients should be aware of all these complications, initially to prevent some of these from developing by establishing preventive measures and secondly to monitor closely and identify early signs and symptoms of these complications for better clinical outcomes.