Biologic drugs represent a substantial progress in the treatment of chronic inflammatory immunologic diseases. However, its crescent use has revealed seldom reported or unknown adverse reactions, mainly associated with anti-tumor necrosis factor (anti-TNF). Psoriasiform cutaneous reactions and few cases of alopecia can occur in some patients while taking these drugs. Two cases of alopecia were reported after anti-TNF therapy. Both also developed psoriasiform lesions on the body. This is the second report about a new entity described as 'anti-TNF therapy-related alopecia', which combines clinical and histopathological features of both alopecia areata and psoriatic alopecia. The recognition of these effects by specialists is essential for the proper management and guidance of these patients.

Ti t l e Evi d e n c e-b a s e d r a dio g r a p hy : a n e w m e t h o d olo gy o r t h e sy s t e m a ti s a tio n of a n ol d p r a c tic e ?

No abstract

The rate of S-nitrosocysteine decomposition in a pH range between 0.7 < pH < 13 exhibits first- and second-order dependence on total cysteine concentration. The second-order term is only observed for pH values between 6.9 < pH < 12. Both first- and second-order terms show a complex dependence on the acidity of the medium. They increase with increasing pH, reaching a maximum value around pH = 8 and then decrease with further increase in pH. An analysis of the reaction products reveals the absence of nitrite ion and ammonia. No evidence of catalysis by copper ions is observed. These results suggest the existence of a new decomposition pathway for S-nitrosocysteine, which proceeds via an intramolecular nitroso group transfer producing a primary N-nitrosamine that decomposes rapidly to give the corresponding diazonium salt. The nitroso group transfer reaction occurs intermolecularly for the decomposition pathway exhibiting a quadratic dependence on cysteine concentration. Both nitroso group transfer pathways are subject to acid catalysis by cysteine. Kinetic results indicate that the extent of S...NO bond cleavage in the transition state is ahead of protonation of the AH...S sulfur atom. The results obtained show the existence of a new decomposition pathway for the S-nitrosocysteine where NO is not released, and hence, it has a significant biological impact due to the potential use of nitrosothiols as NO donors.