Interesante...

PRP might shorten recovery time after lipofilling

Adding platelet-rich plasma to the lipo-graft for facial rejuvenation significantly shortened recovery time but did not result in better cosmetic outcomes or patient satisfaction than lipofilling alone, according to a study published in Plastic and Reconstructive Surgery. Other studies have associated PRP with improved volume retention after lipofilling.

Modern Medicine/The Aesthetic Channel (1/22) 

Benjamin Hidalgo-Matlock

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TLR7 escapes X chromosome inactivation in immune cells | Science Immunology

http://immunology.sciencemag.org/content/3/19/eaap8855

TLR7 escapes X chromosome inactivation in immune cells

1. Mélanie Souyris¹,
2. Claire Cenac¹,
3. Pascal Azar¹,
4. Danièle Daviaud¹,
5. Astrid Canivet¹,
6. Solange Grunenwald²,
7. Catherine Pienkowski³,
8. Julie Chaumeil⁴,
9. José E. Mejía¹ and
10. Jean-Charles Guéry¹,*

Nine of 10 individuals who develop systemic lupus erythematosus (SLE) are women. Furthermore, individuals with Klinefelter syndrome (47,XXY) also have increased incidence of SLE, suggesting that X chromosome dosage could be an important risk factor in SLE. Using sensitive quantification methods, Souyris et al. demonstrate that Toll-like receptor 7 (TLR7) that is encoded from the X chromosome escapes X inactivation in B cells and myeloid cells in females and Klinefelter individuals. TLR7 binds single-stranded RNA and activates type I interferon signaling, a pathway that is also activated in SLE patients. On the basis of this, the authors propose that biallelic expression of TLR7 contributes to greater SLE risk in individuals with two X chromosomes.

Toll-like receptor 7 (TLR7) is critical to the induction of antiviral immunity, but TLR7 dosage is also a key pathogenic factor in systemic lupus erythematosus (SLE), an autoimmune disease with strong female bias. SLE prevalence is also elevated in individuals with Klinefelter syndrome, who carry one or more supernumerary X chromosomes, suggesting that the X chromosome complement contributes to SLE susceptibility. TLR7 is encoded by an X chromosome locus, and we examined here whether the TLR7 gene evades silencing by X chromosome inactivation in immune cells from women and Klinefelter syndrome males. Single-cell analyses of TLR7 allelic expression demonstrated that substantial fractions of primary B lymphocytes, monocytes, and plasmacytoid dendritic cells not only in women but also in Klinefelter syndrome males express TLR7 on both X chromosomes. Biallelic B lymphocytes from women displayed greater TLR7 transcriptional expression than the monoallelic cells, correlated with higher TLR7 protein expression in female than in male leukocyte populations. Biallelic B cells were preferentially enriched during the TLR7-driven proliferation of CD27⁺ plasma cells. In addition, biallelic cells showed a greater than twofold increase over monoallelic cells in the propensity to immunoglobulin G class switch during the TLR7-driven, T cell–dependent differentiation of naive B lymphocytes into immunoglobulin-secreting cells. TLR7 escape from X inactivation endows the B cell compartment with added responsiveness to TLR7 ligands. This finding supports the hypothesis that enhanced TLR7 expression owing to biallelism contributes to the higher risk of developing SLE and other autoimmune disorders in women and in men with Klinefelter syndrome.

Como vacunarse contra Herpes Zoster y cual vacuna usar?

ACIP Publishes Recommendations for New Herpes Zoster Vaccine

By the Editors

The CDC's Advisory Committee on Immunization Practices has published its recommendations on the new recombinant herpes zoster vaccine known as Shingrix. The committee made its recommendations in October and the document is now available in MMWR.

In brief:

• The two-dose recombinant vaccine is recommended for immunocompetent adults aged 50 years and older.
• It is recommended for those who have already received the live zoster vaccine, Zostavax.
• Shingrix is preferred over Zostavax.

MMWR article (Free)

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Benjamin Hidalgo-Matlock

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Cirugia sigue siendo la primera opción en el manejo del cancer de piel No Melanoma.

La academia americana de dermatologia emitió unas guías para el manejo del cancer de piel no melanoma, representado principalmente por el carcinoma epidermoide cutáneo y el carcinoma basocelular (también cutáneo).

Surgery Remains The Most Effective Treatment For Most Patients With Nonmelanoma Skin Cancer, AAD Guidelines Say.

MedPage Today (1/25, Bankhead) reports surgery remains the most effective treatment for "most patients with nonmelanoma skin cancer, according to new clinical guidelines from the American Academy of Dermatology (AAD)." Dr. Christopher K. Bichakjian, the AAD working group co-chair, said in a statement, "These two guidelines will help doctors provide the best possible care for patients with basal cell carcinoma and squamous cell carcinoma. If they are left untreated, some nonmelanoma skin cancers may grow and spread, potentially leading to disfigurement and even death. When detected early, however, these skin cancers are highly treatable."

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Benjamin Hidalgo-Matlock

Skin Care Physicians of Costa Rica

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Uso de filtro solar es y será muy importante...

EPIDEMIOLOGY

How many melanomas might be prevented if more people applied sunscreen regularly? (pages 140–147)

C.M. Olsen, L.F. Wilson, A.C. Green, N. Biswas, J. Loyalka and D.C. Whiteman

Version of Record online: 14 DEC 2017 | DOI: 10.1111/bjd.16079What's already known about this topic?

Sunscreen prevents sunburn and protects skin cells (including melanocytes) from mutations induced by ultraviolet radiation.

Prospective cohort studies and one randomized trial suggest regular sunscreen use reduces risk of melanoma.

Regular use of sunscreen is uncommon, even in populations residing in areas of high ambient sunlight levels.

What does this study add?

Under plausible scenarios of increasing prevalence of sunscreen use, cumulative incidence of melanoma between 2012 and 2031 could reduce by ˜10% in high-incidence populations.

Monitoring sunscreen use in populations is necessary to inform melanoma control efforts.

Mejora de Psoriasis Recalcitrante al tratar Hepatitis C subyacente.

Es un interesante reporte que nos recuerda ante la no respuesta a tratamiento adecuado, el buscar otras fuentes de inflamación.

Psoriasis Remission Described After Hepatitis C Virus Treatment

Case report: After initiation of ledipasvir-sofosbuvir, HCV RNA decreased, and skin lesions improved

A case of remission of psoriasis after treatment of chronic hepatitis C virus has been described in a research letter published online Jan. 16 in the Annals of Internal Medicine.

WEDNESDAY, Jan. 17, 2018 (HealthDay News) -- A case of remission of psoriasis after treatment of chronic hepatitis C virus (HCV) has been described in a research letter published online Jan. 16 in the Annals of Internal Medicine.

Masaru Enomoto, M.D., from Osaka City University in Japan, and colleagues present the case of an 80-year-old man with a nine-year history of refractory psoriasis, with a Psoriasis Area and Severity Index score of 8.3. The patient was treated with topical therapy with the corticosteroid clobetasol and the vitamin D3analogue maxacalcitol; narrowband ultraviolet B phototherapy was added. Even after topical therapy was replaced with betamethasone and the vitamin D3analogue calcipotriol, the patient's symptoms and signs persisted.

The researchers found that the patient had chronic HCV genotype 1b infection of unknown duration, and had not been treated for HCV infection. A 12-week course of ledipasvir-sofosbuvir was initiated. After initiation of ledipasvir-sofosbuvir therapy, the HCV RNA level decreased rapidly, became undetectable on polymerase chain reaction testing by week four, and remained undetectable for 24 weeks after completion of therapy. The skin lesions started to resolve gradually soon after initiation of ledipasvir-sofosbuvir therapy. The dose of topical agents and frequency of phototherapy were reduced and the Psoriasis Area and Severity Index score decreased to 2.0.

"Here, we present what we believe to be the first report of a patient whose psoriasis improved when therapy with these agents was initiated," the authors write.

One author disclosed financial ties to Gilead Sciences.

Copyright © 2018 ScoutNews, LLC. All rights reserved.

Guias sobre aislamiento.

Guias de aislamineto ante la presencia de bacterias multiresistentes en pacientes hospitalizados.

Guidelines Issued on Contact Precautions for MRSA, C. difficile

By Amy Orciari Herman

Edited by André Sofair, MD, MPH, and William E. Chavey, MD, MS

The Society for Healthcare Epidemiology of America has issued guidelines on how long contact precautions in acute-care hospitals should persist for numerous drug-resistant infections and Clostridium difficile.

Among the recommendations, published in Infection Control and Hospital Epidemiology:

• Clostridium difficile: Contact precautions should remain in place for at least 48 hours after diarrhea resolves.
• Methicillin-resistant Staphylococcus aureus: For patients not receiving an antibiotic that's active against MRSA, one to three negative cultures should be obtained before discontinuing contact precautions.
• Vancomycin-resistant Enterococci: After treatment, patients should have one to three negative cultures (using stool or rectal swabs) before stopping precautions. If more than one culture is obtained, they should be 1 week apart.
• Multidrug-resistant Enterobacteriaceae: When carbapenem-resistant Enterobacteriaceae and extended-spectrum beta-lactamase-producing organisms are first detected, contact precautions should be in place throughout hospitalization.

SHEA guidance in Infection Control and Hospital Epidemiology (Free abstract)

SHEA news release (Free)

Background: NEJM Journal Watch Infectious Diseases coverage of colonization of healthcare personnel (Your NEJM Journal Watch registration required)

Benjamin Hidalgo-Matlock

Skin Care Physicians of Costa Rica

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Radiación ok para pacientes con cancer se mama y esclerodermia

Radiation Therapy May Be OK For Breast Cancer Patients Who Have Scleroderma, Research Suggests.

MedPage Today (1/10, Walsh) reports that research suggests "long-term cutaneous fibrosis can occur following radiation therapy for breast cancer among women with scleroderma, although acute toxicity from radiation was rare and the autoimmune disease did not flare." Researchers found that "few patients who received radiation had acute skin toxicity such as blistering or ulceration, but" approximately "half (48.4% to 54.6%) experienced long-term radiation-induced skin fibrosis or thickening that was localized to the field of radiation." At one year "after the cancer diagnosis, there was no evidence of scleroderma disease flare, in that no significant difference was seen on modified Rodnan skin scores between patients who had received radiation and those without radiation." The findings were published online in Arthritis Care & Research.

Benjamin Hidalgo-Matlock

Skin Care Physicians of Costa Rica

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Se peohiben las microesferas plasticas

"Microbeads" Ban Goes Into Effect In UK.

USA Today (1/9, Hjelmgaard) reports in the UK, "a ban on environmentally damaging microbeads found in toothpastes, face scrubs and shower gels came into effect Tuesday." The article explains that "the small pieces of plastic" may harm "marine plant and animal life" in the oceans, as well as people who consume fish that have absorbed microbeads.

Benjamin Hidalgo-Matlock

Skin Care Physicians of Costa Rica

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Metformin and Skin Cancer Risk in Taiwanese Patients With Type 2 Diabetes | PracticeUpdate

Published in Dermatology

Journal Scan / Research · January 04, 2018

Metformin and Skin Cancer Risk in Taiwanese Patients With Type 2 Diabetes

Journal of the American Academy of Dermatology

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• In this retrospective study, the authors evaluated the association of skin cancer risk with the use of metformin. Skin cancer incidence was lower among patients with exposure to metformin (45.59 per 100,000 person-years) than those who never used metformin (83.90 per 100,000 person-years; HR, 0.540). In the subtype analysis, a lower risk associated with metformin use was demonstrated for both melanoma (although not statistically significant) and nonmelanoma skin cancers (statistically significant).

• In concordance with previous studies that demonstrated metformin's preventive effect against malignancies, these data suggest that metformin use might be associated with a lower risk for skin cancer. The authors suggest that metformin may be a good choice for patients with type 2 diabetes at high risk for skin cancer. Prospective study is warranted to substantiate these findings.

  – InYoung Kim, MD, PhD

http://www.practiceupdate.com/content/metformin-and-skin-cancer-risk-in-taiwanese-patients-with-type-2-diabetes/62441

Benjamin Hidalgo-Matlock

Skin Care Physicians of Costa Rica

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Mensacarcina para Melanoma...

Molecule Produced By Soil Bacteria May Be Lethal To Melanoma Cells, Study Suggests.

Genetic Engineering & Biotechnology News (1/5) reported researchers found the soil bacteria Streptomyces bottropensis produces mensacarcin, which kills melanoma cells. The findings were published in the Journal of Biological Chemistry. The article noted that the researchers at Oregon State University tested the molecule against the National Cancer Institute's "cell line panel."

Alopecia central centrifuga y fibromas...

Black Women With Central Centrifugal Cicatricial Alopecia May Have High Risk For Developing Fibroids, Research Suggests.

HealthDay (1/5, Mozes) reported that research suggests "black women with" central centrifugal cicatricial alopecia (CCCA), "a relatively common form of hair loss, may also face a high risk for developing fibroids." Investigators looked at data on approximately 487,000 black women. The data indicated that "nearly 14 percent of women with CCCA also had fibroids," but only "3 percent of those who did not have CCCA had fibroids." The findings were published in a research letter in JAMA Dermatology.