Browsing by Author "Pereira, TM"
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- Allergic contact dermatitis from modified colophonium in wound dressingsPublication . Pereira, TM; Flour, M; Goossens, AThis study concerns a 69-year-old female patient with a longstanding history of venous ulcerations on both lower legs and multiple sensitivities, who developed eczematous lesions with the hydrocolloid dressing Combiderm (Convatec Ltd., a Bristol-Myers Squibb division, Ickenham, Middlesex, UK). Epicutaneous tests were positive to this dressing and to a modified colophonium derivative, i.e. glyceryl rosinate, however not to the unmodified colophonium from the standard series. A review of the literature showed several case reports about sensitization to similar hydrocolloids being distributed under various brand names in different countries and which contain the pentaerythritol ester of the hydrogenated rosin as the tackifying agent. Some of the patients described did, while others did not, react to colophonium but only to a modified derivative. In our patient, the reaction to glyceryl rosinate most probably represent cross-sensitivity with the modified colophonium derivative used in Combiderm, the presence (but not the exact nature) of which was showed by the company. In patients where allergic contact dermatitis from hydrocolloid dressings is strongly suspected and colophonium tests negatively, patch testing to modified colophonium derivatives should therefore be performed. As the complete composition of wound dressings is most often unknown, we urgently advocate legal requirements for labelling of those and in fact all medically used devices.
- Cyclosporin A treatment in severe childhood psoriasisPublication . Pereira, TM; Vieira, AP; Fernandes, JC; Sousa-Basto, AThough used occasionally, systemic therapies in severe childhood psoriasis have not been systematically investigated. Cyclosporin A (CysA) is effective in adults with severe psoriasis but there are no extensive data regarding the efficacy and safety of its use in childhood psoriasis. In this paper, we describe six children aged between 11 months and 13 years (average: 7.6 years) treated with CysA microemulsion formulation for severe psoriasis, who had been unresponsive to other treatments. The CysA dose ranged from 2 to 4 mg/kg/day, for periods varying from 8 to 105 weeks (mean: 54 weeks). Dose tapering was gradual after lesion improvement and adjusted according to clinical response. Adjuvant therapy with topical steroids, vitamin D3 ointments, coal tar preparations or anthralin was used in all children. Acitretin was used in three patients for short periods. The children were regularly monitored for serum renal and liver function and blood pressure. Improvement of skin lesions was achieved after between 4 and 30 (mean: 12) weeks of treatment, with complete remission in three children. Relapse of lesions occurred in the other children during CysA reduction, but they responded to a dose increase. The treatment was found to be well tolerated and with no significant side-effects. CysA can be used in carefully selected and monitored patients and may represent an alternative tool for severe episodes of psoriasis in children, when other therapies are unsuccessful.
- In vivo Skin Irritation Potential of a Castanea sativa (Chestnut) Leaf Extract, a Putative Natural Antioxidant for Topical ApplicationPublication . Almeida, IF; Valentão, P; Andrade, PB; Seabra, RM; Pereira, TM; Amaral, MH; Costa, PC; Bahia, MFTopical application of natural antioxidants has proven to be effective in protecting the skin against ultraviolet-mediated oxidative damage and provides a straightforward way to strengthen the endogenous protection system. However, natural products can provoke skin adverse effects, such as allergic and irritant contact dermatitis. Skin irritation potential of Castanea sativa leaf ethanol:water (7:3) extract was investigated by performing an in vivo patch test in 20 volunteers. Before performing the irritation test, the selection of the solvent and extraction method was guided by the 1,1-diphenyl-2-picryl hydrazyl (DPPH) free radical scavenging test and polyphenols extraction (measured by the Folin Ciocalteu assay). Iron-chelating activity and the phenolic composition (high performance liquid chromatography/diode array detection) were evaluated for the extract obtained under optimized conditions. The extraction method adopted consisted in 5 short extractions (10 min.) with ethanol:water (7:3), performed at 40 degrees. The IC(50) found for the iron chelation and DPPH scavenging assays were 132.94 +/- 9.72 and 12.58 +/- 0.54 microg/ml (mean +/- S.E.M.), respectively. The total phenolic content was found to be 283.8 +/- 8.74 mg GAE/g extract (mean +/- S.E.M.). Five phenolic compounds were identified in the extract, namely, chlorogenic acid, ellagic acid, rutin, isoquercitrin and hyperoside. The patch test carried out showed that, with respect to irritant effects, this extract can be regarded as safe for topical application.
- Melanoma anorectal: a propósito de um caso clínicoPublication . Pereira, TM; Lamelas, J; Vilaça, S; Delgado, M; Mesquita Robrigues, A
- Pitiríase Rubra Pilar em Doente de Raça NegraPublication . Pereira, TM; Duarte, ML; Vieira, AP; Sousa-Basto, A; Pardal, F
- Primary cutaneous leiomyosarcoma of the facePublication . Pereira, TM; Brito, c; Sousa-Basto, A; Pardal, F
- Rosacea with extensive extrafacial lesionsPublication . Pereira, TM; Vieira, AP; Sousa-Basto, ARosacea is a very common skin disorder in the clinical practice that primarily affects the convex areas of the face. Extrafacial rosacea lesions have occasionally been described, but extensive involvement is exceptional. In the absence of its typical clinical or histological features, the diagnosis of extrafacial rosacea may be problematic. We describe an unusual case of rosacea with very exuberant extrafacial lesions, when compared with the limited involvement of the face.