Browsing by Author "Fernandes, JC"
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- 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.
- Efficacy and safety of etanercept in patients with psoriasis and hepatitis CPublication . Ventura, F; Gomes, J; Duarte, ML; Fernandes, JC; Brito, C
- Lymphadenopathy after BCG vaccination in a child with chronic granulomatous diseasePublication . Vieira, AP; Vasconcelos, J; Fernandes, JC; Antunes, H; Sousa-Basto, A; Macedo, C; Zaman, A; Santos, E; Melo, JC; Roos, D
- Recalcitrant pemphigus vulgaris: aseptic meningitis associated with intravenous immunoglobulin therapy and successful treatment with rituximabPublication . Ventura, F; Rocha, J; Fernandes, JC; Machado, A; Brito, C
- Topical Imiquimod Treatment of Lentigo MalignaPublication . Ventura, F; Rocha, J; Fernandes, JC; Pardal, F; Brito, CLentigo maligna (LM) is the in situ phase of lentigo maligna melanoma, which may progress to invasive melanoma if left untreated. It mainly occurs on sun-exposed areas of elderly patients. The lesions can be large and conventional surgery can be difficult, particularly on the face. Recent reports indicate that topical imiquimod 5% cream is effective in the treatment of LM. It may be an alternative when surgery or other classical treatments are not possible in elderly patients. We describe an 80-year-old Caucasian woman with a 10-year history of a histologically verified extensive LM of the face. She was treated with imiquimod 5% cream once daily. After four months it showed complete clinical response. One year after the treatment the patient was still free from recurrence.