Direct-acting antivirals for hepatitis C virus induce a rapid clinical and biochemical remission of porphyria cutanea tarda

Sporadic porphyria cutanea tarda (PCT) is strongly associated with hepatitis C virus (HCV) infection in our population. 1-4 Therapeutic options for PCT include phlebotomies and low-dose 4-aminoquinolines, which show high rates of disease remission. However, some patients with PCT may present frequent relapses attributable to resistance, intolerability or poor adherence to conventional treatments and/or persistence of risk factors. In 2014, we reported the first case of a patient with active PCT and HCV-HIV coinfection cured with direct antiviral agents (DAAs).5 Herein, we present a cohort of patients demonstrating rapid and persistent remission of PCT with DAA regimes administered for HCV infection

Ankle Injuries Associated with Basketball Practice: Current Situation and Literature Review

Introduction: Basketball is one of the most practiced sports in the world. Traditionally, it has been considered that it is a sport of low physical contact, and that sports injuries occur less frequently than in other sports such as football or rugby. However, we have seen the appearance of several recent studies that count basketball as one of the sports with higher injury rates, and among them, especially ankle injuries. Material and methods: In our study, we performed a literature review on ankle injuries associated with basketball practice. We selected the relevant articles of Pubmed using the keywords “basketball”, “ankle” (ankle) and “injury”, published between 2006 and 2015. We limited the selection to those studies that dealt with injuries associated with basketball, whether descriptive or analytical, without taking into account the populations that the authors studied or whether in addition to basketball, other sports were included. The exclusion criteria were as follows: experimental studies, case reports and then whose text is impossible to obtain. Results and discussion: Initially 114 studies were obtained, of which 13 were selected applying the previously mentioned criteria. They observed the incidence of ankle injuries during basketball practice in different population groups, different levels of practice (professional and amateur) and during different periods of time. Among professional athletes, we could observe that ankle sprains account for more than 20% of the injuries suffered by athletes that they are accountable for almost 10% of the matches that a professional player loses because of an injury, and that only about half of them take place during a game, which increases the importance of injuries that occur during practice. When it comes to amateur level basketball, we can observe in several studies that, while the male population is more prone to need medical assistance for ankle injuries during the practice of this sport (from 18.3% of injuries associated with basketball, up to 52%, according to the series), the female population has a greater predisposition for knee injuries (63% of injuries associated with basketball for only 21% of ankle injuries in some jobs). Conclusions: After analysing the recent literature, we could draw among others the following conclusions: basketball is a sport which is closely linked to the appearance of ankle injuries; the most prevalent ankle injury is sprain; the incidence of injuries increases the higher the level of practice, being maximum in professionals; these injuries have an evident impact on the athlete’s usual sports and extrasports practice; and gender may have an influence on the joint affected by basketball related injuries. Basketball is a rising sport at the moment, with a great social and economic impact in the world of today. Its practice is becoming more frequent, and with it the incidence of injuries associated with it, especially those occurring in the ankle joint. It is therefore expected that in the coming years, we are likely to observe the appearance of more works in the literature that confirm this fact, as well as advances in the treatment and recovery of the athletes who suffer them

Ski Lesions Around the Knee: A Literature Review

Ski is a popular sports practiced worldwide although it is considered a high-risk sports with high incidence of injuries. A common place for injuries is the knee, with a wide range from knee sprains to complex ligamentous injuries to fractures. In this chapter, we made a search in PubMed using the words “knee” and “ski.” Later, we selected those articles according to the inclusion criteria. When reviewing the literature, we found that the most common place for a ski-related injury is the knee, with knee sprains and ACL lesions being the most common diagnosis in the latter years with a decreasing incidence of tibia fractures. We could also analyze the risk factors different authors have found, for professional athletes and for recreational skiers. In conclusion, the ACL lesion in the skier presents a high incidence, which suggests an effort should be made to prevent it

Skin manifestations in COVID-19: prevalence and relationship with disease severity

Background: Data on the clinical patterns and histopathology of SARS-CoV-2 related skin lesions, as well as on their relationship with the severity of COVID-19 are limited. Methods and Materials: Retrospective analysis of a prospectively collected cohort of patients with SARS-CoV-2 infection in a teaching hospital in Barcelona, Spain, from 1 April to 1 May 2020. Clinical, microbiological and therapeutic characteristics, clinicopathological patterns of skin lesions, and direct immunofluorescence and immunohistochemical findings in skin biopsies were analyzed. Results: Fifty-eight out of the 2761 patients (2.1%) either consulting to the emergency room or admitted to the hospital for COVID-19 suspicion during the study period presented COVID-19 related skin lesions. Cutaneous lesions could be categorized into six patterns represented by the acronym "GROUCH": Generalized maculo-papular (20.7%), Grover's disease and other papulo-vesicular eruptions (13.8%), livedo Reticularis (6.9%), Other eruptions (22.4%), Urticarial (6.9%), and CHilblain-like (29.3%). Skin biopsies were performed in 72.4%, including direct immunofluorescence in 71.4% and immunohistochemistry in 28.6%. Patients with chilblain-like lesions exhibited a characteristic histology and were significantly younger and presented lower rates of systemic symptoms, radiological lung infiltrates and analytical abnormalities, and hospital and ICU admission compared to the rest of patients. Conclusion: Cutaneous lesions in patients with COVID-19 appear to be relatively rare and varied. Patients with chilblain-like lesions have a characteristic clinicopathological pattern and a less severe presentation of COVID-19

Brentuximab vedotin in the treatment of cutaneous T-cell lymphomas: Data from the Spanish Primary Cutaneous Lymphoma Registry

[Background] Brentuximab vedotin (BV) has been approved for CD30-expressing cutaneous T-cell lymphoma (CTCL) after at least one previous systemic treatment. However, real clinical practice is still limited.[Objectives] To evaluate the response and tolerance of BV in a cohort of patients with CTCL.[Methods] We analysed CTCL patients treated with BV from the Spanish Primary Cutaneous Lymphoma Registry (RELCP).[Results] Sixty-seven patients were included. There were 26 females and the mean age at diagnosis was 59 years. Forty-eight were mycosis fungoides (MF), 7 Sézary syndrome (SS) and 12 CD30+ lymphoproliferative disorders (CD30 LPD). Mean follow-up was 18 months. Thirty patients (45%) showed at least 10% of CD30+ cells among the total lymphocytic infiltrate. The median number of BV infusions received was 7. The overall response rate (ORR) was 67% (63% in MF, 71% in SS and 84% in CD30 LPD). Ten of 14 patients with folliculotropic MF (FMF) achieved complete or partial response (ORR 71%). The median time to response was 2.8 months. During follow-up, 36 cases (54%) experienced cutaneous relapse or progression. The median progression free survival (PFS) was 10.3 months. The most frequent adverse event was peripheral neuropathy (PN) (57%), in most patients (85%), grades 1 or 2.[Conclusions] These results confirm the efficacy and safety of BV in patients with advanced-stage MF, and CD30 LPD. In addition, patients with FMF and SS also showed a favourable response. Our data suggest that BV retreatment is effective in a proportion of cases.The Spanish Primary Cutaneous Lymphoma Registry (RELCP) is promoted by the Fundación Piel Sana Academia Española de Dermatología y Venereología, which received an unrestricted grant support from Kyowa Kirin.Peer reviewe

Skin Manifestations in COVID-19: Prevalence and Relationship with Disease Severity

Background: Data on the clinical patterns and histopathology of SARS-CoV-2 related skin lesions, as well as on their relationship with the severity of COVID-19 are limited. Methods and Materials: Retrospective analysis of a prospectively collected cohort of patients with SARS-CoV-2 infection in a teaching hospital in Barcelona, Spain, from 1 April to 1 May 2020. Clinical, microbiological and therapeutic characteristics, clinicopathological patterns of skin lesions, and direct immunofluorescence and immunohistochemical findings in skin biopsies were analyzed. Results: Fifty-eight out of the 2761 patients (2.1%) either consulting to the emergency room or admitted to the hospital for COVID-19 suspicion during the study period presented COVID-19 related skin lesions. Cutaneous lesions could be categorized into six patterns represented by the acronym “GROUCH”: Generalized maculo-papular (20.7%), Grover’s disease and other papulo-vesicular eruptions (13.8%), livedo Reticularis (6.9%), Other eruptions (22.4%), Urticarial (6.9%), and CHilblain-like (29.3%). Skin biopsies were performed in 72.4%, including direct immunofluorescence in 71.4% and immunohistochemistry in 28.6%. Patients with chilblain-like lesions exhibited a characteristic histology and were significantly younger and presented lower rates of systemic symptoms, radiological lung infiltrates and analytical abnormalities, and hospital and ICU admission compared to the rest of patients. Conclusion: Cutaneous lesions in patients with COVID-19 appear to be relatively rare and varied. Patients with chilblain-like lesions have a characteristic clinicopathological pattern and a less severe presentation of COVID-19