Management of Chronic Spontaneous Urticaria Exacerbated by Antihistamines: When Treatment Can Act as a Causal Agent Itself.

AlthoughH1- antihistaminescurrentlyconstitutethelargestclassofmedicationsusedinthetreatmentofallergicdisorders,somecasesofhypersensitivityreactionsduetovariousantihistaminepreparations,suchasfixeddrugeruptions,contactdermatitis,maculo- papularrash,andurticarialreactions,havebeenreported(1).Wereporthereintwopatientswithchronicspontaneousurticaria(CSU)inwhichantihistaminesactedasexacerbatingfactorsofthediseaseandrequiredanalternativetreatment.Theunderlyingmechanismintheseparticularcasesisnotentirelyclear,butatype-I(immediate)hypersensitivityreactionshouldbeconsideredAMG-A is Medical Advisor for Uriach Pharma, Genentech, Novartis. Research Grants supported by Intendis – Bayer, Uriach Pharma, Novartis. Educational activities sponsored by Uriach Pharma, Novartis, Genentech, Menarini, Glaxo Smith & Kline, Merck MSD, Almirall Pharm

Persistent cutaneous abdominal ulcerations secondary to diffuse dermal angiomatosis: an underestimated sign for severe atherosclerosis: A case report.

BACKGROUND: Diffuse dermal angiomatosis (DDA) is a rare, acquired, reactive vascular proliferation, clinically characterized by livedoid erythematous-violaceous plaques, which frequently evolve to ulceration and necrosis. Histopathologically, it is manifested by a diffuse proliferation of endothelial cells within the full thickness of the dermis. DDA has been mainly associated with severe peripheral atherosclerosis. METHODS: We report a 63-year-old woman who presented with multiple erythematous-violaceous plaques with central deep skin ulcers on thighs, lower abdomen, and perianal area, associated with intermittent claudication, low-grade fever, and weight loss. Initially, the clinical picture along with positive cultures for Klebsiella pneumoniae suggested a multifocal ecthyma gangrenosum; nevertheless, a skin biopsy showed a diffuse dermal proliferation of endothelial cells interstitially arranged between collagen bundles. A computed tomography scan revealed severe aortic atheromatosis with complete luminal occlusion of the infrarenal aorta and common iliac arteries. RESULTS: The diagnosis of DDA secondary to severe atherosclerosis was established. The patient underwent a left axillofemoral bypass surgery with a rapidly healing of the ulcers in the next weeks./nCONCLUSIONS: DDA should be considered in the differential diagnosis of livedoid ischemic lesions. Recognition of DDA as a cutaneous sign of severe peripheral vascular disease is important for both dermatologists and internists. Recognition of risk factors and their management with an early intervention to correct tissue ischemia can be curative

Epigenetic Silencing of Tumor Suppressor miR-124 Directly Supports STAT3 Activation in Cutaneous T-Cell Lymphoma

Increasing evidence supports a potential role for STAT3 as a tumor driver in cutaneous T-cell lymphomas (CTCL). The mechanisms leading to STAT3 activation are not fully understood; however, we recently found that miR-124, a known STAT3 regulator, is robustly silenced in MF tumor-stage and CTCL cells. Objective: We studied here whether deregulation of miR-124 contributes to STAT3 pathway activation in CTCL. Methods: We measured the effect of ectopic mir-124 expression in active phosphorylated STAT3 (p-STAT3) levels and evaluated the transcriptional impact of miR-124-dependent STAT3 pathway regulation by expression microarray analysis. Results: We found that ectopic expression of miR-124 results in massive downregulation of activated STAT3 in different CTCL lines, which resulted in a significant alteration of genetic signatures related with gene transcription and proliferation such as MYC and E2F. Conclusions: Our study highlights the importance of the miR-124/STAT3 axis in CTCL and demonstrates that the STAT3 pathway is regulated through epigenetic mechanisms in these cells. Since deregulated STAT3 signaling has a major impact on CTCL initiation and progression, a better understanding of the molecular basis of the miR-124/STAT3 axis may provide useful information for future personalized therapies

Epigenetic silencing of tumor suppressor miR-124 directly supports STAT3 activation in cutaneous T-Cell lymphoma

Increasing evidence supports a potential role for STAT3 as a tumor driver in cutaneous T-cell lymphomas (CTCL). The mechanisms leading to STAT3 activation are not fully understood; however, we recently found that miR-124, a known STAT3 regulator, is robustly silenced in MF tumor-stage and CTCL cells. Objective: We studied here whether deregulation of miR-124 contributes to STAT3 pathway activation in CTCL. Methods: We measured the effect of ectopic mir-124 expression in active phosphorylated STAT3 (p-STAT3) levels and evaluated the transcriptional impact of miR-124-dependent STAT3 pathway regulation by expression microarray analysis. Results: We found that ectopic expression of miR-124 results in massive downregulation of activated STAT3 in different CTCL lines, which resulted in a significant alteration of genetic signatures related with gene transcription and proliferation such as MYC and E2F. Conclusions: Our study highlights the importance of the miR-124/STAT3 axis in CTCL and demonstrates that the STAT3 pathway is regulated through epigenetic mechanisms in these cells. Since deregulated STAT3 signaling has a major impact on CTCL initiation and progression, a better understanding of the molecular basis of the miR-124/STAT3 axis may provide useful information for future personalized therapies

Tratamientos Psicológicos Empíricamente Apoyados Para la Infancia y Adolescencia: : Estado de la Cuestión

Background: The empirical evidence accumulated on the effi cacy, effectiveness, and effi ciency of psychotherapeutic treatments in children and adolescents calls for an update. The main goal of this paper objective was to carry out a selective review of empirically supported psychological treatments for a variety of common psychological disorders and problems in childhood and adolescence. Method: A review was carried out of the psychological treatments for different psychological disorders and problems in socialemotional or behavioral adjustment in the child-adolescent population according to the Spanish National Health System (Clinical Practice Guidelines) levels of evidence and degrees of recommendation. Results: The fi ndings suggest that psychological treatments have empirical support for addressing a wide range of psychological problems in these developmental stages. The degree of empirical support ranges from low to high depending on the phenomenon analyzed. The review suggests unequal progress in the different fi elds of intervention. Conclusions: From this update, psychologists will be able to make informed decisions when implementing those empirically supported treatments to address the problems that occur in childhood and adolescence.Antecedentes: la evidencia empírica acumulada en los últimos años sobre la efi cacia, efectividad y efi ciencia de los tratamientos psicológicos en la infancia y adolescencia reclama una actualización. El principal objetivo de este artículo es el de llevar a cabo una revisión de los tratamientos psicológicos empíricamente apoyados para una diversidad de problemas psicológicos habituales en la infancia y la adolescencia. Método: se revisan los tratamientos psicológicos para diferentes trastornos psicológicos y problemas en el ajuste socioemocional o conductual en población infanto-juvenil en función de los niveles de evidencia y grados de recomendación del Sistema Nacional de Salud de España (Guías de Práctica Clínica). Resultados: los hallazgos sugieren que los tratamientos psicológicos específi camente dirigidos a niños, niñas y adolescentes disponen de apoyo empírico para el abordaje de un amplio elenco de problemas psicológicos. Este grado de apoyo empírico oscila de bajo a alto en función del problema analizado. La revisión muestra un avance desigual en los diferentes campos de intervención. Conclusiones: a partir de esta actualización, los profesionales de la psicología podrán tomar decisiones informadas a la hora de implementar aquellas intervenciones psicológicas con apoyo empírico para el abordaje de los problemas en la infancia y la adolescenci