AB0462 BEHCET'S DISEASE: CLINICAL FEATURES AND OFF-LABEL BIOLOGIC TREATMENT STRATEGIES

Background:The treatment of Behçet's disease (BD) is still mainly based on the evidence derived from case reports, case series, retrospective analyses, and few clinical trials suggesting the safety and potential efficacy of off-label use of biologic agents in refractory cases.1Objectives:To describe clinical manifestations and their management, with particular focus on treatment indications, outcomes and safety of biologic therapy, in a cohort of patients with BD.Methods:Patients with a diagnosis of BD who visited our outpatient clinic until December 2019 were included in the study. Clinical data were recorded since diagnosis until the latest follow-up visit, analyzing clinical features, flares and therapeutic strategies adopted.Results:A total of 95 patients were included in the study with a medium follow-up of 108.54 ± 169.59 months. 20 of them (21. 05%) were treated with biologic agents. Patients treated with biologic therapy compared to those on conventional non-biologic therapies had a higher proportion of musculoskeletal (80% vs 46.67%, p = 0.008), neurological (30% vs 10.67%, p = 0.031), intestinal involvement (40% vs 12%, p = 0.004), and they were treated with a higher dose of glucocorticoids at diagnosis (16.84 mg ±14.01 vs 8.89 mg ± 11.76, p = 0.012). The most frequent indications for biologic step-up therapy were musculoskeletal involvement (40%), eye involvement (25%), neurological involvement (15%) and intestinal involvement (10%). Most patients initiated a biologic treatment within the first year of follow-up. TNF-inhibitor (TNFi) were more frequently prescribed (95%) and one patient was treated with 8 therapeutic cycles of Rituximab (500 mg/weekly for 4 infusions to be repeated after at least 6 months) because of recurrent pancytopenia. All patients experienced non-biologic therapy before starting a TNFi. The preferred first-line TNFi was infliximab (50%), followed by adalimumab (40%) and etanercept (5%). As second line treatment were also prescribed certolizumab (10%) and golimumab (5%). 10 patients switched to a second line treatment because of inefficacy of the first biologic agent, mainly because of refractory arthritis, intestinal and mucocutaneous involvement. One patient switched from infliximab to certolizumab during pregnancy with subsequent worsening of arthritis.85% of patients treated with biologic agents reached a clinical remission by the time of the latest follow up visit without any safety or tolerability issues.Conclusion:A relevant proportion of patients in our BD cohort were treated with biologic therapy, because of severe or refractory manifestations. The most frequent indications were musculoskeletal, neurological or intestinal involvement. Biologic agents were a generally effective and safe therapeutic approach.References:[1]F. Alibaz-Oner, M. H. Sawalha, H. Direskeneli. Management of Behçet disease, Curr. Opin. Rheumatol, 2018Table 1.General characteristics and disease involvement at diagnosisBiologic therapyNo biologic therapyp value20 (21.05%)75 (78.95%)General characteristicsMediaSDMediaSDAge at disease onset(years ± SD)34.5± 10.4938.64± 13.18p = 0.1976Diagnostic delay(months ± SD)45.28± 67.4828.09± 48.42p = 0.1996Glucocorticoids at diagnosis (mg prednisone ± SD)16.84± 14.018.89± 11.76p = 0.0115Glucocorticoids at latest follow up visit (mg prednisone ± SD)6.38± 7.763.83± 4.81p = 0.0707N%N%F / M12 / 860 / 4054 / 4172 / 28p = 0.3030Disease involvement at diagnosisOral ulcers2010075100Genital ulcers11553749,33p = 0.6540Cutaneous lesions15755066,67p = 0.4787Eye involvement6302736p = 0.6184Musculoskeletal involvement16803546,67p = 0.0082Neurological involvement630810,67p = 0.0311Intestinal involvement840912p = 0.0039Thrombosis2101824p = 0.1747Disclosure of Interests:None declare

Transcursa : uma cartografia da criança viada afeminada à performance drag queen

Dissertação (mestrado)—Universidade de Brasília, Instituto de Artes, Programa de Pós-Graduação em Artes, 2019.Poderia uma drag queen permanecer alheia a todas as suas inquietações políticas? Esta pesquisa, materializada em escrita performativa e cartográfica, tem como base a subjetividade inerente ao universo drag queen. O texto é um híbrido de memórias, criações artísticas e contextualização político-social no tema, e conta com o amparo de Foucault (1999, 2006, 2010), Judith Butler (2001, 2003, 2012, 2018), Paul Preciado (2011, 2014, 2017) e a vivência de muitas bichas (em elogio), acadêmicas ou não. Valendo-se do tom paródico, a autora convida seus leitores a trilhar esta Transcursa: um percurso construído com palavras, teorias e imagens que entram e saem da vida de uma acadêmica que foi criança afeminada. Tendo sido um fracasso no processo de masculinização que a sociedade indica e educa, assume-se artista efeminada, performer de gênero e transformista ao encontrar, já adulta, uma drag queen. Essa fada-dos-viados chama para a prática da arte drag dando ensinos caros da arte drag. Depois de muito tempo trabalhando no circuito comercial de entretenimento e vendendo o corpo drag, a autora passa por reflexões filosóficas advindas de um momento de crise da própria existência. Ela sobe novamente nos saltos, arruma a peruca, mas dessa vez para estudar e escrever, ousando compreender as linhas de força sócio-políticas e artísticas que constroem a performance cênica de gênero de um corpo que passa pela condição de abjeção social. Brinca, então, de inserir o papo reto teórico na poética da prática performática e nas estratégias cartográficas de resistência da cultura LGBT (Lésbicas, Gays, Bissexuais, Travestis, Transexuais ou Transgêneros), batendo o leque e abrindo o armário para acompanhar o caso de transformação de um ser abjeto em estágio larvário, experimentando suas primeiras práticas comportamentais consideradas femininas, passando pela arte drag e chegando à metamorfose de um pesquisadora acadêmica LGBT, arriscando-se na educação de suas próprias filhas drags novatas na oficina Berçário. O autor traz, neste texto, a necessidade de abrir caminhos com o corpo em todos os espaços para diálogos e problematizações sobre Gênero e Sexualidade. Sugestão: Leia e monta-te.Could a drag queen remain obliviable to all of her political concerns? This research, materialized in performative and cartographic writing, is based on the drag queen universe. The text is a hybrid of memories, artistic creations and political-social contextualization in the theme and has the support of Foucault (1999, 2006, 2010), Judith Butler (2001, 2003, 2012, 2018), Paul Preciado (2011, 2014, 2017) and the experience of many queers (in praise) academic or not. In the pardic tone, the author invites her readers to tread this Transcourse: a journey built with words, theories and images that enter and leave the life of academic who was na effeminated child. Having been a failure in the processo f masculinization that society indicates and educated, the author is assumed to be effeminized artist, genre performer and transformista to find a drag queen already as an adult. This fairy of faggots calls for the practice of drag art by giving expensive teachings of drag art. After a long time working on the comercial entertainment circuit and selling the drag body, the author goes through philosophical reflections arising from a moment of crisis of her own existence. She rises again in the jumps, arrange the wig, but this time to study and write, daring to understand the lines of sócio-political and artistic strength that construct the scenic gender performance of a body that goes through the condition of social abjection. He then jokes to insert theoretical straight talk in the poetic practice of performance and cartographic strategies of LGBT (Lesbians, Gays, Bissexual, Transvesties, Transsexuals and Transgender) culture resistance beating the fan and opening the closet to accompany the case of transfomation of na abject being in a larval stage, experiencing its first behavioral practices considered feminine, passing through the drag art and achieving at the metamorphosis of na academic LGBT researcher, risking the education of its own young drags daughters in the workshop called Nursery, that is part of Transcourse. The author brings, in this text, the need to open paths with the body in all spaces for dialogue and problematizations about Gender and Sexuality. Tip: read and assemble

A review of the literature of surgical and nonsurgical treatments of invasive squamous cells carcinoma

Cutaneous squamous cell carcinoma (cSCC) is an increasing public health problem. It is a primary malignant skin tumor with Malpighian differentiation and together with basal cell carcinoma is classified among nonmelanoma skin cancers (NMSCs). cSCC usually occurs on photoexposed areas, such as the head, the neck, and the extremities, and its incidence increases with age. Invasive forms of this skin tumor tend to be more aggressive showing a higher metastatic potential, usually regarding regional lymph nodes. Treatment options for invasive cSCCs include both surgical and nonsurgical options. The therapeutic choice depends on several factors, such as anatomic location, risk factors for tumor recurrence, age, and health status of the patient. This review aims to provide an overview of the current evidence on therapeutic surgical and nonsurgical management of invasive cSCC

IL-17 and its role in inflammatory, autoimmune, and oncological skin diseases. State of art

Recent data support the theory of the involvement of IL-17 in the pathogenesis of several chronic inflammatory skin diseases (psoriasis, atopic dermatitis, acne, hidradenitis suppurativa) and autoimmune skin diseases (alopecia areata, vitiligo, bullous diseases). Even if the role of IL-17 in inflammatory and autoimmune diseases has been reported extensively, its role in tumor is still controversial. Some reports show that Th17 cells eradicate tumors, while others reveal that they promote the initiation and early growth of tumors. Herein, we review the role of IL-17 in the involvement of some common dermatologic diseases: psoriasis, atopic dermatitis, hidradenitis suppurativa, acne, vitiligo, melanoma, and nonmelanoma skin cancers

Therapeutic options for the treatment of actinic keratosis with scalp and face localization

Actinic keratosis (AK) is a common skin disease related to ultraviolet chronic exposure, that is now considered a squamous cell carcinoma in situ. Primary skin cancer prevention strategies should be recommended for high risk patients. There is a wide spectrum of treatment options available for AKs, and several variables should be taken into account regarding the best therapeutic choice for each patient. The purpose of this article is to review the current treatment strategies for AKs localized on the face and scalp, with a focus on the practical point of view that could be useful for choosing the best therapeutic option. The two main therapeutic approaches will be distinguished first: lesion-directed and field-directed. Afterwards, the treatment based on clinical type and patient comorbidity will be discusse

Urticaria in an infant with SARS-CoV-2 positivity

Last months have been marked by the global spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), responsible for the coronavirus disease 19 (COVID-19) pandemic

A late onset widespread skin rash in a previous Covid-19 infected patient. Viral or multidrug effect?

In the end of 2019, a series of pneumonia cases emerged in China, with clinical presentations greatly resembling viral pneumonia, caused by Covid-19 o SARS-CoV-2. Currently, several clinicians described an increasingly cases of coronavirus-positive patients reporting skin problems, either in early stage of infection or as late onset manifestation. Recently, Dr. Sebastiano Recalcati analyzed the cutaneous involvement in 148 COVID-19 patients hospitalized in the Lecco Hospital, Lombardy, Italy