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Objective: During its first year, the AWARE study assessed disease activity, patient quality of life (QOL), and treatment patterns in chronic urticaria (CU) refractory to H1-antihistamines (H1-AH) in clinical practice. Methods: We performed an observational, prospective (24 months), international, multicenter study. The inclusion criteria were age ≥18 years and H1-AH–refractory CU (>2 months). At each visit, patients completed questionnaires to assess disease burden (Urticaria Control Test [UCT]), disease activity (7 day-Urticaria Activity Score [UAS7]), and QOL (Dermatology Life Quality index [DLQI], Chronic Urticaria Quality of Life Questionnaire [CU-Q2oL], and Angioedema Quality of Life Questionnaire [AE-QoL]). We present data for Spain. Results: The study population comprised 270 evaluable patients (73.3% female, mean [SD] age, 48.9 [14.7] years). At baseline, 89.3% were prescribed a CU treatment. After 1 year, first- and second-line treatments became less frequent and third-line treatments became more frequent. At baseline, 47.0% of patients experienced angioedema; at 1 year, this percentage had fallen to 11.8%. The mean (SD) AE-QoL score decreased from 45.2 (28.7) to 24.0 (25.8). The mean (SD) UCT score decreased from 7.0 (4.5) to 12.1 (4.1). According to UAS7, 38.2% of patients reported absence of wheals and itch in the previous 7 days at 1 year compared with 8.3% at baseline. The mean (SD) DLQI score decreased from 8.0 (7.4) to 2.8 (4.6). At the 1-year visit, the percentage of patients reporting a high or very high impact on QOL fell from 29.9% to 9.6%. Conclusions: H1-AH–refractory CU in Spain is characterized by absence of symptoms and a considerable impact on QOL. Continuous follow-up of CU patients and third-line therapies reduce disease burden and improve patients’ QOL.

Background: There is limited literature on efficacy in 5-aminolaevulinic acid (BF-200 ALA) and methyl-5-aminolaevulinate (MAL) for superficial basal cell carcinoma (sBCC). Aims: To investigate the efficacy and safety of PDT in sBCC. Methods: Analytical observational study between January 2014 and January 2017. Follow-up at 12, 24 and 52 weeks. Lesions were treated with one BF-200 ALA-PDT or MAL-PDT cycle of two sessions in one week. A second treatment cycle, with the same photosensitizer precursor, was performed in cases of clinical persistence at 12 weeks. Results: A total of 22 patients (30 lesions) were enrolled in the study. By sex, 13 men and 9 women. Average age of 72,14 years. In the 12-month follow-up 15/16 lesions were resolved (93,75%) after one or two BF-200 ALA-PDT cycle and 7/14 lesions (50%) after one or two MAL-PDT cycles. In most patients, tolerance to the therapy was good or regular, with no differences between the two groups. No long-term adverse effects were reported. Limitations: The observational nature and the low number of patients. Conclusion: PDT is a safe and non-invasive treatment option in sBCC. Our results suggest a better response with BF-200 ALA-PDT over MAL-PDT, at 12 months of follow-up.

An observational study was carried out in the photodynamic therapy (PDT) section of Fuenlabrada’s hospital (Madrid, Spain). Our goal was to investigate the efficacy and safety of PDT in Bowen’s disease (BD). Between June 2011-June 2017 171 patients (191 lesions) with diagnosis of BD were enrolled in the study (95 women and 76 men; average age of 74.31 years). Lesions were treated with one 5-aminolaevulinic acid (BF-200 ALA)-PDT or methyl-5-aminolaevulinate (MAL)-PDT cycle of two sessions in one week. A second treatment cycle was performed in cases of clinical persistence at 12 weeks. Our results showed that 47/55 lesions were resolved (84.75%) after one or two ALA-PDT cycle and 75/136 lesions (55.15%) after one or two MAL-PDT cycles, in the 12-month follow-up. In conclusion PDT is a safe and non-invasive treatment option in BD. In addition, our results suggest a better response with ALA-PDT over MAL-PDT. Limits: observational study with a limited number of patients.

Photodynamic therapy (PDT) involves the use of photochemical reactions mediated through the interaction of photosensitizing agents, light, and oxygen for the treatment of malignant or benign diseases. Topical photosensitizers employed in dermatology are 5-aminolevulinic acid (5 ALA) and methyl aminolevulinate, classically used for the treatment of superficial non-melanoma skin cancer and their precursors. Recently the efficacy of PDT has been introduced in other benign diseases. Elastosis perforans serpiginosa (EPS) is a rare skin disorder characterized by transepidermal elimination of abnormal elastic fibers. Management of this condition is complicated, various methods have been used but with limited success. We report a case of EPS in a 30-yeard-old woman treated with 5 ALA-PDT. After 4 sessions the lesions have almost completely disappeared with no residual side effects. Therefore we present an effective and safe alternative for the treatment of EPS.

Resumen Introduccion y objetivos El pilomatricoma es la segunda neoformacion cutanea mas frecuente en la infancia y la juventud, con un amplio diagnostico diferencial. El objetivo principal del estudio fue determinar la incidencia de pilomatricomas en nuestro hospital y sus caracteristicas en relacion con: edad, sexo, localizacion, sintomas, traumatismo previo, diagnostico clinico, enfermedades asociadas, casos multiples, caracteristicas ecograficas, tratamiento quirurgico y tecnica anestesica y complicaciones posteriores. Material y metodo Se recogieron de forma retrospectiva los pilomatricomas extirpados quirurgicamente en nuestro hospital de enero de 2004 a diciembre de 2012 a partir de la base de datos de anatomia patologica. Resultados Se estudiaron 261 pilomatricomas en 239 pacientes, 120 eran mujeres y 119 varones de edades comprendidas entre 1 y 83 anos, con una media de 26,4 anos. La forma de presentacion mas frecuente fue como un nodulo firme, subcutaneo, asintomatico en el 82% de los casos. La localizacion mas frecuente fue la cabeza y el cuello (49,81%). El diagnostico clinico preoperatorio fue acertado en el 54,4%. Cincuenta y nueve pacientes tenian otras enfermedades y 7 recordaban traumatismo previo en la zona. Se registraron 17 casos multiples, uno familiar, y 2 en pacientes con enfermedad de Steinert. En 57 lesiones se realizo ecografia de partes blandas, con imagenes compatibles con pilomatricoma en 48. Ciento ochenta y cinco pilomatricomas se extirparon con anestesia local y 76 con anestesia local y general. Como complicaciones posquirurgicas hubo un caso de cicatriz hipertrofica y otro de dehiscencia. Conclusiones El nuestro es el estudio retrospectivo que recoge el mayor numero de casos en nuestro pais y uno de los que comunica mayor incidencia de casos. Ademas, se estudian variables no recogidas en otras series.