Topical sirolimus seems to be an effective and safe medical alternative to surgery or laser-based treatments in patients with TSC-associated facial angiofibromas.

This is the first study using molecular and culture-based methods aimed at investigating the composition of the intestinal yeast microbiota of wild and reared carnivorous salmonids, croaker and yellowtail, to characterize their cores and to evaluate the enzymatic activities of the cultivated yeast. Among 103 samples from salmonids, croaker and yellowtail, yeast were detected in 85.4%, with 43 species identified. The core of reared fish was composed of eight species, in contrast to the wild fish core, which consisted of two species: Debaryomyces hansenii and Rhodotorula mucilaginosa. Despite the smaller diversity of the wild fish core, similar enzymatic profiles were detected for the species from the wild and reared cores. For principal component analysis, samples grouped together independently of host species, domestication status and location. A high proportion of yeast produced aminopeptidases and lipases, which may be explained by the high proportion of protein and lipids in the carnivorous diet. This study reveals the presence of a yeast community in the fish gut that appears to be strongly shaped by a carnivorous diet. Yeast in the gut increases the repertoire of microorganisms interacting with the host intestine, which could influence health and disease.

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Neoadjuvant MTX-il reduced the presurgical size of cSCC lesions and could simplify their subsequent surgery.

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We report the case of a non-HIV patient suffering from a metastatic renal adenocarcinoma who developed trichomegaly 3 months before death. The patient also developed generalized hypertrichosis of the terminal hair, a feature that has been previously described in malnutrition. Other cases of hypertrichosis, including ectopic hormone production, were excluded and the differential diagnosis with paraneoplastic acquired hypertrichosis lanuginosa is discussed. Although trichomegaly is usually considered as a cutaneous marker of AIDS, we suggest that both trichomegaly and hypertrichosis of the terminal hair were secondary to malnutrition.

Eosinophilic ulcer of the oral mucosa (EUOM) is an uncommon lesion that usually affects the tongue. The lesion is benign and self-limiting, develops rapidly and usually disappears after several weeks without treatment. Microscopically, it contains a diffuse polymorphous cell infiltrate composed mainly of eosinophils. The cause of EUOM is unknown, but the condition has been attributed to trauma. We now describe a case of EUOM on the lateral surface of the tongue with recurrence on its dorsal surface 3 years later. The occurrence of multiple lesions, whether at the same time or subsequently as reported here, makes a purely traumatic origin rather unlikely and suggests that there may be a predisposition of some patients to develop EUOM. Eosinophilic ulcer of the oral mucosa (EUOM) is an uncommon lesion that is very rarely reported in the dermatological literature. It usually affects the tongue and presents clinically as an ulcer with elevated and indurated borders. Recognition is important because it often mimicks tongue cancer; however, the lesion is benign and self-limiting, develops rapidly and usually disappears after several weeks without treatment. Usually the ulcer occurs in a single episode, but the possibility of recurrence at other sites has been poorly emphasized.

IntroductionPharmacoeconomic studies examining the cost-effectiveness of biological agents to treat moderate-to-severe psoriasis in real-life clinical practice are scarce. The aim of this study was to assess the efficiency, in terms of incremental cost-effectiveness, of etanercept and adalimumab in a real clinical setting.MethodsDirect and indirect costs were assessed from a Spanish societal perspective in a historical hospital cohort of patients with moderate-to-severe psoriasis attending a tertiary referral hospital over a 1-year period. The data examined included drug-related variables, use of health-care resources, transportation and work productivity losses. Effectiveness was measured as the proportion of patients achieving a reduction of at least 75% with respect to the baseline value for the Psoriasis Area Severity Index (PASI 75) during the first 52 weeks of treatment.ResultsNo statistically significant differences in effectiveness between etanercept (n = 135) and adalimumab (n = 48) were found (PASI 75 80% vs. 85.7%; RR = 1.07 [0.90, 1.27]; RRA = 5.7 [−8.9, 20.2]; p = 0.943). There were no significant differences in total cost per patient with etanercept as compared to adalimumab (14,843.73 ± 6,178.98 € vs. 15,405.91 ± 9,106.50 €; p = 0.768).ConclusionUnder conditions of daily clinical practice in our hospital, total health-care costs associated with the treatment of moderate-to-severe psoriasis with etanercept appear to be equivalent to those with adalimumab in the first year of treatment.Electronic supplementary materialThe online version of this article (doi:10.1007/s13555-013-0030-1) contains supplementary material, which is available to authorized users.