Actas dermo-sifiliograficas最新文献

Background and objective: Hidradenitis suppurativa (HS) is a chronic, progressive inflammatory disease with a substantial impact on quality of life. Accessibility to specialized units and referral methods may significantly influence clinical characteristics and therapeutic decisions. This study aims to analyze the relationship between geographical distance, referral method, and the clinical and therapeutic characteristics of patients with HS.

Materials and methods: This was a cross-sectional study including 557 consecutive patients treated between 2017 and 2024 at the HS Unit of Hospital Universitario Virgen de las Nieves. Clinical, demographic, and treatment-related variables were collected. Geographical distance was calculated based on postal codes, and differences between referral methods (teledermatology vs conventional) were analyzed using descriptive and comparative statistical methods.

Results: Patients residing at greater distances presented with more severe disease (Hurley stage III, higher IHS4 scores) and poorer quality of life (DLQI). They also required more intensive treatment regimens, with increased use of biological immunomodulatory drugs. Patients referred via teledermatology were generally younger, had a shorter disease duration, and exhibited milder disease severity at the time of consultation.

Conclusions: Geographical distance and referral method may significantly influence the clinical and therapeutic profiles of patients with HS. These findings underscore the need for strategies to improve accessibility and ensure equitable management. Teledermatology emerges as a valuable tool for early-stage cases, although it should be complemented with in-person assessments for more complex cases.

Introduction: Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are the current first-line therapy for non-small cell lung cancer (NSCLC). Acneiform rash is a common adverse effect of this treatment, leading to treatment interruption and affecting the patients' quality of life.

Methods: We conducted a systematic review to assess the role of oral tetracyclines in the prevention of acneiform rash on patients with NSCLC on EGFR TKIs. We conducted a search across Pubmed, Web of Science and Cochrane databases in January 2025. Studies were included if they evaluated prophylactic treatment with oral tetracyclines for acneiform rash in patients with non-small cell lung cancer initiating concomitant epidermal growth factor receptor tyrosine kinase inhibitor therapy.

Results: Two of the 7 selected studies found tetracyclines to reduce all-grade rash - doxycycline (74.2% to 57.2%) and tetracycline (75.6% to 44.5%; p = 0.046). Two found tetracyclines did not reduce all-grade rash but were effective in reducing high-grade rash - doxycycline (19% to 4%; p < 0.001) and minocycline (28% to 12%; p = 0.0455). Single-arm studies reported varying rash incidences rates with minocycline (from 44.8% to 68.3%), inferior to those found in the major trials used for comparison (67% and 77.7%).

Conclusion: Oral tetracyclines appear to reduce the incidence of all-grade acneiform rash or, alternatively, to decrease the incidence of high-grade rash. Preventive treatment for acneiform rash at the initiation of epidermal growth factor receptor tyrosine kinase inhibitor therapy should therefore be considered. Further controlled trials are needed to confirm the efficacy of oral tetracyclines in preventing acneiform rash.