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[PMID]:29328564
[Au] Autor:Stojkovic-Filipovic J; Lekic B; Milcic D; Milinkovic MV
[Ti] Título:Pemphigus herpetiformis - a case report of a rare form of pemphigus and review of the literature.
[So] Source:Vojnosanit Pregl;73(10):967-72, 2016 Oct.
[Is] ISSN:0042-8450
[Cp] País de publicação:Serbia
[La] Idioma:eng
[Ab] Resumo:Introduction: Pemphigus herpetiformis is the rare variant of pemphigus with characteristic clinical features, histopathological findings different from the convectional pemphigus, and immunological findings consistent with pemphigus. Case report: We presented a 65-year-old woman with initial pruritus followed by pruritic urticarial papules and plaques, some with annular rings of tense vesicles on the periphery, on the trunk and extremities, with no mucous lesions. Histopathological examination demonstrated spongiosis and intraepidermal vesicles in the mid or subcorneal epidermis in some biopsy specimen, with neutrophil and eosinophil infiltrate. Direct immunoflorescent microscopy revealed intercellular IgG deposition, most prominent in the upper layers of epidermis. Indirect immunoflorescent microscopy showed intercellular binding of IgG autoantibodies in the patient's sera. Initially the patient was threated with systemic corticosteroids and azathioprine, but dapson provided complete clinical remission. Conclusion: This entity was established 40 years ago, and around 100 patients have been reported worldwide. It is important to be aware of this particular form of pemphigus because clinical presentation, course of the disease and therapeutic approach are different from conventional forms of pemphigus.
[Mh] Termos MeSH primário: Dermatite Herpetiforme/patologia
Pênfigo/patologia
Pele/patologia
[Mh] Termos MeSH secundário: Corticosteroides/uso terapêutico
Idoso
Autoanticorpos/sangue
Azatioprina/uso terapêutico
Biomarcadores/sangue
Biópsia
Dapsona/uso terapêutico
Dermatite Herpetiforme/tratamento farmacológico
Dermatite Herpetiforme/imunologia
Feminino
Imunofluorescência
Seres Humanos
Imunoglobulina G/sangue
Pênfigo/tratamento farmacológico
Pênfigo/imunologia
Indução de Remissão
Pele/efeitos dos fármacos
Pele/imunologia
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Adrenal Cortex Hormones); 0 (Autoantibodies); 0 (Biomarkers); 0 (Immunoglobulin G); 8W5C518302 (Dapsone); MRK240IY2L (Azathioprine)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180113
[St] Status:MEDLINE
[do] DOI:10.2298/VSP150617044S


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[PMID]:28807114
[Au] Autor:Belum VR; Marchetti MA; Dusza SW; Cercek A; Kemeny NE; Lacouture ME
[Ad] Endereço:Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
[Ti] Título:A prospective, randomized, double-blinded, split-face/chest study of prophylactic topical dapsone 5% gel versus moisturizer for the prevention of cetuximab-induced acneiform rash.
[So] Source:J Am Acad Dermatol;77(3):577-579, 2017 09.
[Is] ISSN:1097-6787
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Erupções Acneiformes/prevenção & controle
Anti-Infecciosos/uso terapêutico
Antineoplásicos/efeitos adversos
Carcinoma de Células Escamosas/tratamento farmacológico
Cetuximab/efeitos adversos
Neoplasias Colorretais/tratamento farmacológico
Dapsona/uso terapêutico
Erupção por Droga/prevenção & controle
[Mh] Termos MeSH secundário: Erupções Acneiformes/induzido quimicamente
Adulto
Idoso
Carcinoma de Células Escamosas/secundário
Neoplasias Colorretais/patologia
Método Duplo-Cego
Erupção por Droga/etiologia
Dermatoses Faciais/induzido quimicamente
Dermatoses Faciais/prevenção & controle
Géis
Seres Humanos
Masculino
Meia-Idade
Estudos Prospectivos
Qualidade de Vida
Creme para a Pele/uso terapêutico
Tórax
[Pt] Tipo de publicação:COMPARATIVE STUDY; LETTER; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Anti-Infective Agents); 0 (Antineoplastic Agents); 0 (Gels); 8W5C518302 (Dapsone); PQX0D8J21J (Cetuximab)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170816
[St] Status:MEDLINE


  3 / 4337 MEDLINE  
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Stefani, Mariane Martins de Araujo
Barreto, Mauricio Lima
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[PMID]:28704363
[Au] Autor:Penna GO; Bührer-Sékula S; Kerr LRS; Stefani MMA; Rodrigues LC; de Araújo MG; Ramos AMC; de Andrade ARC; Costa MB; Rosa PS; Gonçalves HS; Cruz R; Barreto ML; Pontes MAA; Penna MLF
[Ad] Endereço:Tropical Medicine Centre, University of Brasília, Brasília, and Fiocruz Brasília, Brazil.
[Ti] Título:Uniform multidrug therapy for leprosy patients in Brazil (U-MDT/CT-BR): Results of an open label, randomized and controlled clinical trial, among multibacillary patients.
[So] Source:PLoS Negl Trop Dis;11(7):e0005725, 2017 Jul.
[Is] ISSN:1935-2735
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Leprosy control is based on early diagnosis and multidrug therapy. For treatment purposes, leprosy patients can be classified as paucibacillary (PB) or multibacillary (MB), according to the number of skin lesions. Studies regarding a uniform treatment regimen (U-MDT) for all leprosy patients have been encouraged by the WHO, rendering disease classification unnecessary. METHODOLOGY AND FINDINGS: An independent, randomized, controlled clinical trial conducted from 2007 to 2015 in Brazil, compared main outcomes (frequency of reactions, bacilloscopic index trend, disability progression and relapse rates) among MB patients treated with a uniform regimen/U-MDT (dapsone+rifampicin+clofazimine for six months) versus WHO regular-MDT/R-MDT (dapsone+rifampicin+clofazimine for 12 months). A total of 613 newly diagnosed, untreated MB patients with high bacterial load were included. There was no statistically significant difference in Kaplan-Meyer survival function regarding reaction or disability progression among patients in the U-MDT and R-MDT groups, with more than 25% disability progression in both groups. The full mixed effects model adjusted for the bacilloscopic index average trend in time showed no statistically significant difference for the regression coefficient in both groups and for interaction variables that included treatment group. During active follow up, four patients in U-MDT group relapsed representing a relapse rate of 2.6 per 1000 patients per year of active follow up (95% CI [0·81, 6·2] per 1000). During passive follow up three patients relapsed in U-MDT and one in R-MTD. As this period corresponds to passive follow up, sensitivity analysis estimated the relapse rate for the entire follow up period between 2·9- and 4·5 per 1000 people per year. CONCLUSION: Our results on the first randomized and controlled study on U-MDT together with the results from three previous studies performed in China, India and Bangladesh, support the hypothesis that UMDT is an acceptable option to be adopted in endemic countries to treat leprosy patients in the field worldwide. TRIAL REGISTRATION: ClinicalTrials.gov: NCT00669643.
[Mh] Termos MeSH primário: Clofazimina/administração & dosagem
Dapsona/administração & dosagem
Hansenostáticos/administração & dosagem
Hanseníase Multibacilar/tratamento farmacológico
Rifampina/administração & dosagem
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Brasil
Criança
Pré-Escolar
Quimioterapia Combinada/métodos
Feminino
Seres Humanos
Lactente
Recém-Nascido
Masculino
Meia-Idade
Recidiva
Fatores de Tempo
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Leprostatic Agents); 8W5C518302 (Dapsone); D959AE5USF (Clofazimine); VJT6J7R4TR (Rifampin)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170808
[Lr] Data última revisão:
170808
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170714
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pntd.0005725


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[PMID]:28693853
[Au] Autor:Smith CS; Aerts A; Saunderson P; Kawuma J; Kita E; Virmond M
[Ad] Endereço:Institute of Applied Health Sciences, School of Medicine and Dentistry, University of Aberdeen, Foresterhill, Aberdeen, UK. Electronic address: w.c.s.smith@abdn.ac.uk.
[Ti] Título:Multidrug therapy for leprosy: a game changer on the path to elimination.
[So] Source:Lancet Infect Dis;17(9):e293-e297, 2017 Sep.
[Is] ISSN:1474-4457
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Leprosy is present in more than 100 countries, where it remains a major cause of peripheral neuropathy and disability. Attempts to eliminate the disease have faced various obstacles, including characteristics of the causative bacillus Mycobacterium leprae: the long incubation period, limited knowledge about its mode of transmission, and its poor growth on culture media. Fortunately, the leprosy bacillus is sensitive to several antibiotics. The first antibiotic to be widely used for leprosy treatment was dapsone in the 1950s, which had to be taken over several years and was associated with increasing bacterial resistance. Therefore, in 1981, WHO recommended that all registered patients with leprosy should receive combination therapy with three antibiotics: rifampicin, clofazimine, and dapsone. Global implementation of this highly effective multidrug therapy took about 15 years. In 1985, 5·3 million patients were receiving multidrug therapy; by 1991, this figure had decreased to 3·1 million (a decrease of 42%) and, by 2000, to 597 232 (a decrease of almost 90%). This reduction in the number of patients registered for treatment was due to shortening of the treatment regimen and achievement of 100% coverage with multidrug therapy. This achievement, which owed much to WHO and the donors of the multidrug therapy components, prompted WHO in 1991 to set a global target of less than one case per 10 000 population by 2000 to eliminate the disease as a public health problem. All but 15 countries achieved this target. Since 2000, about 250 000 new cases of leprosy have been detected every year. We believe an all-out campaign by a global leprosy coalition is needed to bring that figure down to zero.
[Mh] Termos MeSH primário: Erradicação de Doenças
Quimioterapia Combinada/métodos
Hanseníase/epidemiologia
[Mh] Termos MeSH secundário: Clofazimina/uso terapêutico
Dapsona/uso terapêutico
Seres Humanos
Hansenostáticos/uso terapêutico
Hanseníase/tratamento farmacológico
Hanseníase/prevenção & controle
Hanseníase/transmissão
Mycobacterium leprae/efeitos dos fármacos
Rifampina/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Leprostatic Agents); 8W5C518302 (Dapsone); D959AE5USF (Clofazimine); VJT6J7R4TR (Rifampin)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170911
[Lr] Data última revisão:
170911
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170712
[St] Status:MEDLINE


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Araujo, Sergio
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[PMID]:28570560
[Au] Autor:Araujo S; Goulart LR; Truman RW; Goulart IMB; Vissa V; Li W; Matsuoka M; Suffys P; Fontes AB; Rosa PS; Scollard DM; Williams DL
[Ad] Endereço:National Reference Center for Sanitary Dermatology and Leprosy, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil.
[Ti] Título:qPCR-High resolution melt analysis for drug susceptibility testing of Mycobacterium leprae directly from clinical specimens of leprosy patients.
[So] Source:PLoS Negl Trop Dis;11(6):e0005506, 2017 Jun.
[Is] ISSN:1935-2735
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Real-Time PCR-High Resolution Melting (qPCR-HRM) analysis has been recently described for rapid drug susceptibility testing (DST) of Mycobacterium leprae. The purpose of the current study was to further evaluate the validity, reliability, and accuracy of this assay for M. leprae DST in clinical specimens. METHODOLOGY/PRINCIPAL FINDINGS: The specificity and sensitivity for determining the presence and susceptibility of M. leprae to dapsone based on the folP1 drug resistance determining region (DRDR), rifampin (rpoB DRDR) and ofloxacin (gyrA DRDR) was evaluated using 211 clinical specimens from leprosy patients, including 156 multibacillary (MB) and 55 paucibacillary (PB) cases. When comparing the results of qPCR-HRM DST and PCR/direct DNA sequencing, 100% concordance was obtained. The effects of in-house phenol/chloroform extraction versus column-based DNA purification protocols, and that of storage and fixation protocols of specimens for qPCR-HRM DST, were also evaluated. qPCR-HRM results for all DRDR gene assays (folP1, rpoB, and gyrA) were obtained from both MB (154/156; 98.7%) and PB (35/55; 63.3%) patients. All PCR negative specimens were from patients with low numbers of bacilli enumerated by an M. leprae-specific qPCR. We observed that frozen and formalin-fixed paraffin embedded (FFPE) tissues or archival Fite's stained slides were suitable for HRM analysis. Among 20 mycobacterial and other skin bacterial species tested, only M. lepromatosis, highly related to M. leprae, generated amplicons in the qPCR-HRM DST assay for folP1 and rpoB DRDR targets. Both DNA purification protocols tested were efficient in recovering DNA suitable for HRM analysis. However, 3% of clinical specimens purified using the phenol/chloroform DNA purification protocol gave false drug resistant data. DNA obtained from freshly frozen (n = 172), formalin-fixed paraffin embedded (FFPE) tissues (n = 36) or archival Fite's stained slides (n = 3) were suitable for qPCR-HRM DST analysis. The HRM-based assay was also able to identify mixed infections of susceptible and resistant M. leprae. However, to avoid false positives we recommend that clinical specimens be tested for the presence of the M. leprae using the qPCR-RLEP assay prior to being tested in the qPCR-HRM DST and that all specimens demonstrating drug resistant profiles in this assay be subjected to DNA sequencing. CONCLUSION/SIGNIFICANCE: Taken together these results further demonstrate the utility of qPCR-HRM DST as an inexpensive screening tool for large-scale drug resistance surveillance in leprosy.
[Mh] Termos MeSH primário: Farmacorresistência Bacteriana/genética
Hanseníase/tratamento farmacológico
Testes de Sensibilidade Microbiana/métodos
Mycobacterium leprae/efeitos dos fármacos
Reação em Cadeia da Polimerase em Tempo Real/métodos
[Mh] Termos MeSH secundário: Proteínas de Bactérias/genética
DNA Bacteriano/genética
Dapsona/farmacologia
Seres Humanos
Hansenostáticos/farmacologia
Hanseníase/microbiologia
Mycobacterium leprae/isolamento & purificação
Ofloxacino/farmacologia
Reprodutibilidade dos Testes
Rifampina/farmacologia
Sensibilidade e Especificidade
Análise de Sequência de DNA
Pele/microbiologia
Pele/patologia
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Bacterial Proteins); 0 (DNA, Bacterial); 0 (Leprostatic Agents); 8W5C518302 (Dapsone); A4P49JAZ9H (Ofloxacin); VJT6J7R4TR (Rifampin)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170721
[Lr] Data última revisão:
170721
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170602
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pntd.0005506


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[PMID]:28533859
[Au] Autor:Aounallah A; Jrad M; Ksiaa M; Mokni S; Saidi W; Boussofara L; Sriha B; Denguezli M; Ghariani N; Belajouza C; Nouira R
[Ad] Endereço:Université de Sousse, Tunisie.
[Ti] Título:[A particular type of cicatricial Pemphigoid with unique IgA deposit].
[Ti] Título:Forme particulière de Pemphigoide cicatricielle à dépôt unique d'IgA..
[So] Source:Pan Afr Med J;26:136, 2017.
[Is] ISSN:1937-8688
[Cp] País de publicação:Uganda
[La] Idioma:fre
[Ab] Resumo:Cicatricial Pemphigoid is a subepithelial bullous dermatosis which essentially involves the mucous membranes with cicatricial evolution We report the case of a 66-year old patient hospitalized with erosive gingivitis associated with dysphagia, dyspnea and blurred vision. Dermatologic examination showed erosive lesions involving the palate and the pharynx. Ophthalmologic examination showed symblepharons, ectropion and bilateral cataract. Gingival biopsy revealed a necrotic detachment of the buccal epithelium. Direct immunofluorescence showed linear IgA deposit at the dermo-epidermal junction. Indirect immunofluorescence test was negative. The diagnosis of cicatricial pemphigoid was confirmed. Esophagogastroduodenoscopy objectified double stenosis of the esophagus. Nasopharyngeal and bronchial endoscopy showed ulceration of the epiglottis, hypopharynx, pharynx and bronchial tree. The patient was treated with Solumedrol bolus corresponding to 0.5mg/kg/day prednisone associated with 100mg/day disulone. The patient showed a favorable early clinical outcome complicated because of the aggravation of dysphagia and esophageal stenosis after 2 months. Our case study is singular due to the occurrence of a cicatricial pemphigoid in a male patient with a serious clinical picture due to lesions extending to conjunctival, oral, nasal, esophageal and bronchial mucous membranes associated with direct immunofluorescence only showing IgA deposit.
[Mh] Termos MeSH primário: Dapsona/administração & dosagem
Imunoglobulina A/imunologia
Hemissuccinato de Metilprednisolona/administração & dosagem
Penfigoide Mucomembranoso Benigno/fisiopatologia
[Mh] Termos MeSH secundário: Idoso
Transtornos de Deglutição/etiologia
Endoscopia do Sistema Digestório
Estenose Esofágica/etiologia
Técnica Direta de Fluorescência para Anticorpo
Seres Humanos
Masculino
Penfigoide Mucomembranoso Benigno/diagnóstico
Penfigoide Mucomembranoso Benigno/imunologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Immunoglobulin A); 5GMR90S4KN (Methylprednisolone Hemisuccinate); 8W5C518302 (Dapsone)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170613
[Lr] Data última revisão:
170613
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170524
[St] Status:MEDLINE
[do] DOI:10.11604/pamj.2017.26.136.9702


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Trindade, Maria Angela Bianconcini
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[PMID]:28438129
[Au] Autor:Vieira AP; Trindade MAB; de Paula FJ; Sakai-Valente NY; Duarte AJDS; Lemos FBC; Benard G
[Ad] Endereço:Laboratory of Medical Investigation Unit 56, Division of Clinical Dermatology, Medical School, University of São Paulo, São Paulo, Brazil.
[Ti] Título:Severe type 1 upgrading leprosy reaction in a renal transplant recipient: a paradoxical manifestation associated with deficiency of antigen-specific regulatory T-cells?
[So] Source:BMC Infect Dis;17(1):305, 2017 Apr 24.
[Is] ISSN:1471-2334
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Due to its chronic subclinical course and large spectrum of manifestations, leprosy often represents a diagnostic challenge. Even with proper anti-mycobacteria treatment, leprosy follow up remains challenging: almost half of leprosy patients may develop reaction episodes. Leprosy is an infrequent complication of solid organ transplant recipients. This case report illustrates the challenges in diagnosing and managing leprosy and its reactional states in a transplant recipient. CASE PRESENTATION: A 53-year-old man presented 34 months after a successful renal transplantation a borderline-tuberculoid leprosy with signs of mild type 1 upgrading reaction (T1R). Cutaneous manifestations were atypical, and diagnosis was only made when granulomatous neuritis was found in a cutaneous biopsy. He was successfully treated with the WHO recommended multidrug therapy (MDT: rifampicin, dapsone and clofazimine). However he developed a severe T1R immediately after completion of the MDT but no signs of allograft rejection. T1R results from flare-ups of the host T-helper-1 cell-mediated immune response against Mycobacterium leprae antigens in patients with immunologically unstable, borderline forms of leprosy and has been considered an inflammatory syndrome in many aspects similar to the immune reconstitution inflammatory syndromes (IRS). The T1R was successfully treated by increasing the prednisone dose without modifying the other immunosuppressive drugs used for preventing allograft rejection. Immunological study revealed that the patient had a profound depletion of both in situ and circulating regulatory T-cells and lack of expansion of the Tregs upon M. leprae stimulation compared to T1R leprosy patients without iatrogenic immunosuppression. CONCLUSIONS: Our case report highlights that leprosy, especially in the transplant setting, requires a high degree of clinical suspicion and the contribution of histopathology. It also suggests that the development of upgrading inflammatory syndromes such as T1R can occur despite the sustained immunosuppressors regimen for preventing graft rejection. Our hypothesis is that the well-known deleterious effects of these immunosuppressors on pathogen-induced regulatory T-cells contributed to the immunedysregulation and development T1R.
[Mh] Termos MeSH primário: Antígenos de Bactérias/imunologia
Síndrome Inflamatória da Reconstituição Imune/diagnóstico
Transplante de Rim
Hansenostáticos/administração & dosagem
Hanseníase/diagnóstico
Mycobacterium leprae/imunologia
[Mh] Termos MeSH secundário: Dapsona/administração & dosagem
Quimioterapia Combinada
Rejeição de Enxerto/prevenção & controle
Seres Humanos
Síndrome Inflamatória da Reconstituição Imune/tratamento farmacológico
Síndrome Inflamatória da Reconstituição Imune/imunologia
Síndrome Inflamatória da Reconstituição Imune/microbiologia
Imunossupressão
Hanseníase/tratamento farmacológico
Hanseníase/imunologia
Hanseníase/microbiologia
Masculino
Meia-Idade
Mycobacterium leprae/efeitos dos fármacos
Mycobacterium leprae/isolamento & purificação
Prednisona/administração & dosagem
Rifampina/administração & dosagem
Pele/imunologia
Pele/microbiologia
Pele/patologia
Linfócitos T Reguladores/imunologia
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antigens, Bacterial); 0 (Leprostatic Agents); 8W5C518302 (Dapsone); VB0R961HZT (Prednisone); VJT6J7R4TR (Rifampin)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170426
[St] Status:MEDLINE
[do] DOI:10.1186/s12879-017-2406-9


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[PMID]:28434260
[Au] Autor:Garcia D; Cohen PR
[Ad] Endereço:a School of Medicine , University of California San Diego , La Jolla , CA , USA.
[Ti] Título:Dapsone-associated fixed drug eruption.
[So] Source:Expert Rev Clin Pharmacol;10(7):717-725, 2017 Jul.
[Is] ISSN:1751-2441
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Dapsone is a sulfone drug used to treat infectious conditions and also numerous dermatologic diseases. Fixed drug eruption is a distinctive adverse cutaneous reaction associated with the initial administration and subsequent delivery of a specific agent. Areas covered: The authors preformed a literature search using the following keywords: dapsone, fixed drug eruption, and adverse cutaneous drug reaction. Bibliographies were also reviewed for pertinent articles. The results were combed for relevant papers and reviewed. Articles pertaining to dapsone-associated fixed drug eruption were included. Expert commentary: The majority of cases of dapsone-associated fixed drug eruption in the literature come from Africa or India where there is a high prevalence of patients treated for leprosy. Characteristics of these cases are similar to fixed drug eruption described in the western literature, with differences in frequency of multiple versus solitary lesions. Dapsone-associated fixed drug eruption should be considered when reviewing the drug history of a patient with fixed drug eruption. In the case of darker pigmented individuals, multiple fixed drug eruption lesions may be more common. Multiple lesions may mimic Kaposi's sarcoma in human immunodeficiency virus positive patients. Dapsone-associated fixed drug eruption should be considered in the differential diagnosis of multiple hyperpigmented lesions.
[Mh] Termos MeSH primário: Anti-Infecciosos/efeitos adversos
Dapsona/efeitos adversos
Erupção por Droga/etiologia
[Mh] Termos MeSH secundário: Anti-Infecciosos/administração & dosagem
Dapsona/administração & dosagem
Fármacos Dermatológicos/administração & dosagem
Fármacos Dermatológicos/efeitos adversos
Diagnóstico Diferencial
Erupção por Droga/diagnóstico
Erupção por Droga/patologia
Seres Humanos
Hansenostáticos/administração & dosagem
Hansenostáticos/efeitos adversos
Hanseníase/tratamento farmacológico
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anti-Infective Agents); 0 (Dermatologic Agents); 0 (Leprostatic Agents); 8W5C518302 (Dapsone)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170629
[Lr] Data última revisão:
170629
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170425
[St] Status:MEDLINE
[do] DOI:10.1080/17512433.2017.1322508


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[PMID]:28287010
[Au] Autor:White PL; Backx M; Barnes RA
[Ad] Endereço:a Public Health Wales Microbiology Cardiff, UHW , Cardiff , UK.
[Ti] Título:Diagnosis and management of Pneumocystis jirovecii infection.
[So] Source:Expert Rev Anti Infect Ther;15(5):435-447, 2017 May.
[Is] ISSN:1744-8336
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Pneumocystis jirovecii is a ubiquitous fungus, which causes pneumonia in humans. Diagnosis was hampered by the inability to culture the organism, and based on microscopic examination of respiratory samples or clinical presentation. New assays can assist in the diagnosis and even aid with the emergence of resistant infections. Areas covered: This manuscript will provide background information on Pneumocystis pneumonia (PcP). Diagnosis, from radiological to non-microbiological (e.g. Lactate dehydrogenase) and microbiological investigations (Microscopy, PCR, ß-D-Glucan) will be discussed. Recommendations on prophylactic and therapeutic management will be covered. Expert commentary: PcP diagnosis using microscopy is far from optimal and false negatives will occur. With an incidence of 1% or less, the pre-test probability of not having PcP is 99% and testing is suited to excluding disease. Microscopy provides a high degree of diagnostic confidence but it is not infallible, and its lower sensitivity limits its application. Newer diagnostics (PCR, ß-D-Glucan) can aid management and improve performance when testing less invasive specimens, such as upper respiratory samples or blood, alleviating clinical pressure. Combination testing may allow PcP to be both diagnosed and excluded, and molecular testing can assist in the detection of emerging resistant PcP.
[Mh] Termos MeSH primário: Antifúngicos/uso terapêutico
Dapsona/uso terapêutico
Pneumocystis carinii/efeitos dos fármacos
Pneumonia por Pneumocystis/tratamento farmacológico
Combinação Trimetoprima e Sulfametoxazol/uso terapêutico
[Mh] Termos MeSH secundário: Biomarcadores/metabolismo
Gerenciamento Clínico
Seres Humanos
Incidência
L-Lactato Desidrogenase/metabolismo
Microscopia
Pneumocystis carinii/crescimento & desenvolvimento
Pneumocystis carinii/patogenicidade
Pneumonia por Pneumocystis/diagnóstico por imagem
Pneumonia por Pneumocystis/epidemiologia
Pneumonia por Pneumocystis/microbiologia
Reação em Cadeia da Polimerase
Radiografia Torácica
beta-Glucanas/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Antifungal Agents); 0 (Biomarkers); 0 (beta-1,3-D-glucan); 0 (beta-Glucans); 8064-90-2 (Trimethoprim, Sulfamethoxazole Drug Combination); 8W5C518302 (Dapsone); EC 1.1.1.27 (L-Lactate Dehydrogenase)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171023
[Lr] Data última revisão:
171023
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170314
[St] Status:MEDLINE
[do] DOI:10.1080/14787210.2017.1305887


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[PMID]:28234744
[Au] Autor:Nazir HF; Elshinawy M; AlRawas A; Khater D; Zadjaly S; Wali Y
[Ad] Endereço:*Child Health Department ‡Pharmacy Department, Sultan Qaboos University Hospital, Muscat, Oman †Department of Pediatrics, Faculty of Medicine, University of Alexandria, Alexandria, Egypt.
[Ti] Título:Efficacy and Safety of Dapsone Versus Trimethoprim/Sulfamethoxazol for Pneumocystis Jiroveci Prophylaxis in Children With Acute Lymphoblastic Leukemia With a Background of Ethnic Neutropenia.
[So] Source:J Pediatr Hematol Oncol;39(3):203-208, 2017 Apr.
[Is] ISSN:1536-3678
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:STUDY OBJECTIVE: To study dapsone in comparison with trimethoprim/sulfamethoxazole (TMP/SMX) for Pneumocystis jiroveci (PJP) prophylaxis in children with acute lymphoblastic leukemia (ALL). DESIGN: A retrospective study with a prospective follow-up. PATIENTS: Pediatric ALL patients diagnosed between May 2009 and May 2014, who are still receiving or have completed their maintenance chemotherapy. Patients who completed chemotherapy were prospectively followed up for neutropenia. METHODS: TMP/SMX was used as the initial PJP prophylaxis. An alternative drug was indicated if the patient remained cytopenic for >3 weeks. Average absolute neutrophilic count (ANC), average % of oral mercaptopurine (6-MP), and methotrexate doses were calculated over a period of 6 months before and after shifting to dapsone. RESULTS: Sixty-two ALL patients were eligible for analysis. Twenty-four patients (38.7%) received TMP/SMX for PJP prophylaxis, whereas 34 patients received Dapsone (54.8%). Only 3 patients received IV pentamidine (4.8%), whereas 1 patient (1.6%) received atovaquone. The incidence of prophylaxis failure was 1/1041 months on TMP/SMX and 1/528 months on dapsone. After shifting to dapsone, patients maintained significantly higher ANC (1.46±0.46 vs. 1.17±0.40, P=0.0053), and received significantly higher doses of 6-MP (62.61%±11.45 vs. 57.45±10.14, P=0.0081) and methotrexate (64.9%±14.29 vs. 56.5%±9.9, P=0.0176), with a significantly shorter duration of chemotherapy interruption (1.94±1.2 vs. 3.25±1.29 wk, P=0.0002). CONCLUSIONS: Dapsone for PJP prophylaxis in ALL allowed patients to maintain higher ANC and to receive higher doses of chemotherapy, while maintaining a low incidence of PJP breakthrough infection.
[Mh] Termos MeSH primário: Dapsona/uso terapêutico
Pneumonia por Pneumocystis/tratamento farmacológico
Leucemia-Linfoma Linfoblástico de Células Precursoras/complicações
Combinação Trimetoprima e Sulfametoxazol/uso terapêutico
[Mh] Termos MeSH secundário: Antibioticoprofilaxia/métodos
Criança
Pré-Escolar
Feminino
Seres Humanos
Lactente
Masculino
Neutropenia/etnologia
Pneumocystis carinii
Pneumonia por Pneumocystis/prevenção & controle
Leucemia-Linfoma Linfoblástico de Células Precursoras/etnologia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
8064-90-2 (Trimethoprim, Sulfamethoxazole Drug Combination); 8W5C518302 (Dapsone)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171005
[Lr] Data última revisão:
171005
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170225
[St] Status:MEDLINE
[do] DOI:10.1097/MPH.0000000000000804



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