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We read with great interest the recent article by Caesar I et al i .1 in I Clinical and Experimental Dermatology i , which reported a case of erythema annulare centrifugum (EAC) showing complete response after narrowband ultraviolet B (NB-UVB) phototherapy. NB-UVB is usually well tolerated and could be a good alternative in refractory cases, although it may be necessary to prescribe topical therapy, or subsequent cycles of phototherapy to maintain the clinical response. [Extracted from the article]

Objective: To investigate the effectiveness and safety of belimumab in patients with active systemic lupus erythematosus (SLE) in a real-life setting.Methods: All SLE patients treated with belimumab in the Department of Autoimmune Diseases of the Hospital Clinic of Barcelona were retrospectively analysed. The Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) score, clinical SLEDAI-2K, levels of anti-double-stranded DNA (anti-dsDNA) antibody, complement components C3 and C4, and 50% haemolytic complement activity (CH50) were recorded at baseline and at 6, 12, and 24 months. Adverse events were also collected.Results: Twenty-three patients (100% women) were enrolled in the study. The most frequent manifestations that led to belimumab use were arthritis (91%) and skin involvement (39%). Both SLEDAI-2K and clinical SLEDAI-2K improved over time at all time-points (p < 0.005). Complement levels increased and the values of anti-dsDNA antibody decreased during treatment. The mean dose of prednisone could be tapered at all time-points and achieved maximum and significant reduction at 24 months (10.4 ± 4.8 mg/day to 4.8 ± 2.1 mg/day; p < 0.0005). Belimumab was well tolerated and only six patients (26%) experienced adverse events, all of which were classified as infections (one urinary tract infection without bacterial detection in urine culture and five viral infections). No deaths, severe infusion reactions, or hypersensitivity reactions were noted.Conclusion: In our patients with SLE, belimumab decreased disease activity and allowed tapering of the daily glucocorticoid dose with a good safety profile. [ABSTRACT FROM AUTHOR]

Cutis verticis gyrata (CVG) is a rare condition of the scalp characterized by skin folds and deep furrows that mimic the outer layer of the brain. (b) Complete resolution of the skin condition after chemotherapy. gl Skin biopsies were taken from the scalp and from the papules on the trunk. CVG secondary to specific leukaemic infiltration is an extremely rare condition, which has been described mainly in leukaemias of myeloid lineage. [Extracted from the article]

BACKGROUND: Few studies have prospectively evaluated predictors of mortality or decline in functional capacity in nonagenarians. The aim of this study is to determine predictors of death or functional decline in basic activities of daily living in nonagenarians after 2 years of follow-up. METHODS: One hundred and seventy-six nonagenarians were prospectively evaluated. Functional status was determined by the Lawton-Brody index (LI) and the Barthel Index (BI), and cognition by the Spanish version of the Mental State Examination. The Charlson score was used to measure co-morbidity. Nutritional status was evaluated by the short version of the Mini Nutritional Assessment questionnaire. RESULTS: The sample comprised 135 women (76.3%) and 41 men. Mean age was 93 +/- 3.2 years. Mortality after 2 years was 36.3%. Forty-six (41%) of the 112 survivors presented BI losses >19%. One hundred and ten subjects (63%) presented the combined negative outcome item (death or functional decline). A multiple stepwise logistic regression analysis identified two variables associated with a fall of >19% on the BI or death: a low LI (odds ratio 0.785, 95% CI 0.656-0.940) and a low score at baseline on the Spanish version of the Mental State Examination (odds ratio 0.950, 95% CI 0.914-0.987). CONCLUSION: Better cognitive status and higher capacity to perform instrumental activities of daily living (ADL) at baseline are the best predictors to identify which nonagenarians survived without major functional decline after a 2-year follow-up period. [ABSTRACT FROM AUTHOR]

BACKGROUND: The addition of calcipotriol ointment to PUVA therapy for psoriasis vulgaris results in a lower total UVA dose and a faster onset of response. The addition of calcipotriol cream to PUVA, however, has not been studied. OBJECTIVE: To investigate whether combining calcipotriol cream with PUVA therapy has a UVA sparing effect. METHODS: We performed a randomized, multicentre, vehicle-controlled, double-blind, 12-week comparative study including 120 patients with psoriasis covering 20-50% body surface area. The study consisted of a washout phase followed by a 10-week treatment phase. PUVA therapy three times weekly was added within 1 week after randomization. Efficacy was assessed by the Psoriasis Area and Severity Index (PASI). RESULTS: At baseline the mean PASI scores were 17.5 and 19.2 in the calcipotriol and vehicle (placebo) groups, respectively. At the end of treatment, the mean PASI scores were 2.65 and 7.03 ( p <0.01), respectively. A reduction in PASI score >90% was observed in 69% of the patients in the calcipotriol-treated group and in 36.4% of the patients in the vehicle group ( p <0.01). CONCLUSION: Calcipotriol cream plus PUVA clearly reduces the cumulative dose of UVA and improves the response of psoriasis vulgaris to PUVA. [ABSTRACT FROM AUTHOR]

Two cases of graft-vs-host reaction (GVHR) after allogeneic bone marrow transplantation were studied by transmission electron microscopy. One was observed only in the acute phase and the other, after a mild acute reaction, showed a chronic lichen planus-like pattern. All types of skin damage described in experimental GVHR have been confirmed in both cases. Our findings indicate an involvement of aggressor lymphocytes against keratinocytes as the chief pathogenetic mechanism of the disease, even in its chronic form, although the participation of humoral factors in some phases of the disorder cannot be excluded. The participation of Langerhans cells and macrophages in the reaction could not be demonstrated in these cases. [ABSTRACT FROM AUTHOR]