Dermatologic therapy
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Dermatologic therapy · Jan 2014
Case ReportsItch in familial lichen amyloidosis: effective treatment with amitriptyline in two cases.
Itch is a characteristic feature of lichen amyloidosis and the symptom can be debilitating. Treatments, however, are generally not effective. We report amitriptyline as a novel therapy in treating itch in two patients with familial lichen amyloidosis who did not respond to prior potent topical corticosteroids and antihistamines. ⋯ In the latter, his DLQI concurrently reduced from 14 to 6 of 30. Pathophysiology of itch in lichen amyloidosis may involve both cutaneous and neural components and amitriptyline is known to be useful for neuropathic itch. Low-dose amitriptyline poses little risk of side effects and may offer an effective and safe alternative for the treatment of itch in familial cutaneous amyloidosis.
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Bexarotene is a retinoid that specifically binds retinoid X receptors and has numerous effects on cellular growth and differentiation. It is approved for the treatment of cutaneous T cell lymphoma both topically and systemically. Adverse effects include hyperlipidemia, central hypothyroidism, and neutropenia with bexarotene capsules, and an irritant dermatitis with bexarotene gel. With aggressive management of these potential side effects, bexarotene is an additional option in the armamentarium for management of cutaneous T cell lymphoma.
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Dermatologic therapy · Mar 2013
ReviewPruritus to anticancer agents targeting the EGFR, BRAF, and CTLA-4.
In the past decade, the expanded use of targeted anticancer drugs has significantly prolonged survival in patients treated for a variety of cancers. Despite their increased specificity, agents such as epidermal growth factor receptor inhibitors (EGFRIs), BRAF inhibitors, and targeted immunotherapies have commonly been associated with a number of dermatologic adverse events, often necessitating treatment modifications and negatively impacting patients' quality of life. Although toxicities such as rash and xerosis are frequently discussed, symptomatic pruritus, or itch, has emerged as an important, and frequently neglected, event. The present study reviews the incidence and clinical presentation of pruritus with the EFGRIs, and with two novel anti-melanoma drugs, vemurafenib and ipilimumab, with a focus on the putative underlying pathophysiology, and current management strategies.
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Vitiligo is a depigmenting disorder stemming from melanocyte loss or dysfunction. It has a complex, multifaceted etiology. ⋯ This vitiligo map identifies known inducers/triggers of vitiligo onset and progression that cultivate a microenvironment for melanocyte disappearance, real or functional. This map describes the molecular mechanisms of currently utilized clinical and experimental treatments of vitiligo that facilitate repigmentation.
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Dermatologic therapy · Sep 2012
New therapeutical strategies in the treatment of metastatic disease.
Metastatic melanoma is a very aggressive cancer. For decades, although dacarbazine has been the standard of care as first-line therapy, new therapies have now been shown their superiority either alone or in association with dacarbazine. Ipilimumab (anti-CTLA4 monoclonal antibody) and vemurafenib (BRAF V600E inhibitor) have been recently approved by the Food and Drugs Association and European Medicine Agency for their use in metastatic melanoma patients. ⋯ Along with the development of these targeted agents, an initial molecular characterization of each patient melanoma has become the first step to define the best therapeutic options. The recent published data shed the light on advanced melanoma management. Herein we review the latest development of these molecules and their impact on the treatment strategy.