British Rhinological Society 16th Annual Meeting Jersey, 19 May 2017

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Applying behavioral economics to psoriasis treatment: interventions to improve patient adherence to biologics

Abstract

Zschocke et al¹ identified factors associated with adherence to biologics for psoriasis. The physician-patient relationship influences adherence considerably.¹ Specific interventions may increase adherence to biologics.

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Hand, foot and mouth disease in adult patients

Abstract

We read with great interest the paper by Balestri et al¹ "atypical presentation of enterovirus infection in adults: outbreak of Hand, Foot, Mouth and Scalp disease in Northern Italy" which confirms the adult involvement in hand, foot and mouth disease (HFMD).

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Cutaneous leishmaniasis by Leishmania infantum: behind granulomatous lesions of unknown etiology

Abstract

Background

Cutaneous leishmaniasis (CL) is underestimated in Spain as in other European countries due to the polymorphism of its clinical manifestations and histopathological features discouraging doctors from suspecting leishmaniasis. Mucosal manifestations (ML) are misdiagnosed due to the fact that they often mimic cancer.

Objectives

Given that leishmaniasis may be masked as different granulomatous diseases in Leishmania infantum endemic areas, the aim of this study is to verify this misdiagnosing and contribute to the improvement of CL/ML diagnosis.

Methodology

A retrospective study involving formalin-fixed paraffin-embedded tissue biopsies with histopathological features of granulomatous lesions of unknown origin (GLUO) detected 17 patients. This study included 13 patients with CL that were used as positive controls, 9 patients with other confirmed diseases used as negative controls and 7 patients with histological features suggestive of CL or ML without confirmation. Molecular analysis was blindly performed using two different PCR techniques.

Results

The PCR detected 15 CL cases in which the diagnosis was neither clinically nor histologically suspected. Leishmaniasis was confirmed in 7 suspected patients in whom the classical techniques failed to detect the parasite. L. infantum was identified in all cases. A systematic review of CL cases in GLUO patients from European countries identified 45 reported cases.

Conclusions

In L. infantum endemic areas, a high percentage of GLUO are due to Leishmania infection. The main consequences are delayed diagnosis and underestimation of the real incidence. PCR performed on paraffin-embedded tissue proved to be a reliable tool for diagnosis of CL/ML and must be performed routinely in any granulomatous dermatitis, even when the morphological features are no stereotypical of leishmaniasis.

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Eruptive keratoacanthomas arising in the setting of lichenoid toxicity after PD1 inhibition with nivolumab

Abstract

We were fascinated to read the observations of Bandino et al. who described two patients who developed keratoacanthomas and squamous cell carcinoma in association with bullous pemphigoid-like lesions after treatment with PD-1 inhibitors, nivolumab or pembrolizumab, in a recent issue of the Journal. Herein we report two patients with no prior history of skin cancer who developed eruptive keratoacanthomas in the setting of lichenoid skin toxicity after starting nivolumab.

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« Malignant » Rosacea as a sign of systemic marginal zone lymphoma

Abstract

Rosacea is a common facial dermatosis for which differential diagnoses have to be considered in the case of atypical features or treatment failure. We report 3 cases of systemic marginal zone lymphomas (MZL), with skin involvement simulating rosacea. A 76-year-old man presented a rhinophyma for one year (Fig 1).

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Oral administration of geranylgeranylacetone to protect vestibular hair cells

We recently reported that the heat shock response played a major role in the protection of hair cells against stress. Oral administration of the heat shock inducer, geranylgeranylacetone (GGA) protected hair cells against intense noise. In our present study, we investigated the effect of GGA on vestibular hair cell death induced by an aminoglycoside.

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