DER - Comunicações e Conferências
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Browsing DER - Comunicações e Conferências by Author "Fidalgo, A"
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- Intravenous Immunoglobulin for the Treatment of Quetiapin-Induced Bullous Pemphigoid in an HIV-Infected PatientPublication . Cabete, J; Santos, G; Páris, F; Serrão, V; Fidalgo, AThe authors present the case of a 48-year-old woman with HIV-associated dementia treated with antiretroviral therapy and psychoactive drugs, to whom bullous pemphigoid(BP) was diagnosed. Given incomplete response to corticotherapy, and azathioprine-induced bicytopenia,intravenous immunoglobulin(IVIG) was initiated. Despite transient disease control, recurrent flares suggested a persistent triggering factor. Specifically, quetiapin was implicated and discontinued with an immediate clinical response. Inadvertent re-challenge with olanzapine(a related drug)led to a new eruption, confirming drug-induced BP (DIBP). A total of six IVIG cycles were completed, without severe side effects to report, namely HIV disease progression. HIV-related autoimmune bullous diseases are rare. Treatment of severe drug eruptions is primarily based on immunossupressive drugs, raising concerns regarding additional immunossupression. This case suggests IVIG as a valuable option for the treatment of BP in HIV patients. In addition, quetiapin should be added to the list of neuroleptics previously linked to DIBP.
- Phototherapy in Childhood: a 17-Year Retrospective Study Regarding Effectiveness and SafetyPublication . Brasileiro, A; Campos, S; Páris, F; Fidalgo, A; Apetato, MIntroduction: Skin diseases in paediatric age are often distressing conditions with significant impact in children’s psychosocial development. Additionally, systemic therapeutic options are often limited in childhood, due to its potential toxicity in this vulnerable group. Phototherapy is therefore an endorsed option for photo-responsive dermatological conditions. Objective and Methods:This observational retrospective study aims to access efficacy and safety of Phototherapy in our paediatric population. Relevant clinical data from 1996 to present concerning patients aged 18 years or less was collected. Results: 78 patients were included, of which64,1%was female. Mean age was 12,9 years (range 2-18). Distribution according to diagnosis was:47,4%psoriasis, 34,6% alopecia areata, 9,0% vitiligo, 9,0% other diagnosis. Mean number of cycles was 1,5 (range 1-7), with an average of 16,3 treatments per cycle and mean cumulative dose 134 J/cm2. 70,5% was treated with one single cycle. Topic and systemic PUVA were the first choice in 37,2% and 39,7%, respectively, while UVB TL01 and broadband UVB were used in 11,5% each. On the first cycle 67,5% improved, 14,3% showed no sustained clinical response and 19,5% were lost to follow-up. Psoriasis patients had the best response rates (81,8%), followed by alopecia areata (59,3%). Side effects occurred in 21%, being erythema the most common (12%). None led to therapeutic interruption. Discussion: Phototherapy is a safe and effective option in childhood, yet the withdraw rate might be an important limitation.
- Scalp Porocarcinoma: a Rare DiagnosisPublication . Brasileiro, A; Santos, G; Fidalgo, A; João, AAdnexal skin tumours are rare conditions, and often clinically indistinguishable from other cutaneous neoplasms. Porocarcinoma, a sweat gland malignant tumour, is more commonly found on extremities. Few reports in other anatomic locations can be found in the literature, and those arising on the scalp are even scarcer. The authors report the case of an 84-year-old diabetic man, with a tumour on the left parietal region for 1 year, which histopathological features were consistent with porocarcinoma. The importance of histopathologic diagnosis is hereby emphasized by the more aggressive behaviour of this tumour, therefore requiring clinical actuation accordingly.