Browsing by Author "Cabrera, Raúl"
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Publication Current knowledge of immunosuppression as a risk factor for skin cancer development(2022) Rollan, María Paz; Cabrera, Raúl; Schwartz, Robert A.This review outlines our current understanding of the relationship between immunosuppression and skin cancer. Primary immunodeficiencies increase the incidence of skin cancer, but due to their low frequency, the establishment of accurate risk ratios remains lacking. Regarding secondary immunosuppression, available data demonstrate a significant increase of skin cancer in solid organ recipients, being the most common malignancy of this population. Immunosuppressive drugs have an important role in these patients, with an impact related to both the cumulative dose and the type of regimen used. The association of skin cancer and immunosuppressive drugs in non-transplant patients is conflictive for most of the drugs except for azathioprine. Many cancers lead to secondary immunosuppression as a mechanism for tumor growth and advancement, increasing the risk of progression of the primary tumor. Novel insights related with tumorigenesis and immune-escape mechanisms have led to promising new treatments in melanoma and squamous cell carcinomaItem Dermatoscopy of an Angiomatoid Spitz Nevus(2011) Cabrera, Raúl; Daza, Francisca; Tom, Denis; Castro, Alex; Prieto, Víctor G.To date, only 12 cases of angiomatoid Spitz nevus have been characterized in the literature. We present the first case of angiomatoid Spitz nevus in which dermatoscopic findings are described.Item Do not forget to check the scalp in systemic light-chain amyloidosis(2021) Larrondo, Jorge; Gosch, Marianne; Pena, Camila; Cabrera, Raúl; Jeraldo, Cecilia; Castro, Alex; McMichael, AmySystemic light chain amyloidosis (AL) is a nonproliferative plasma cell disorder in which fragments of immunoglobulin deposit in tissues. Clinical manifestations are often nonspecific, making diagnosis challenging.Biopsy of involved organs is the gold standard to confirm the diagnosis; however, internal organ biopsy may beunsafe because of a significant risk of bleeding.1 New techniques to improve diagnosis are needed.Item Lamotrigine-induced Sweet syndrome: Possible new drug association(2020) Neely, Gabriel; Fajre, Ximena; Cabrera, Raúl; Castro, AlexPublication New Markers for Cardiovascular Disease in Psoriatic Patients: Preliminary Study on Monocyte Phenotype, ADAMTS7, and mTOR Activity(2023) Loyola, Khanty; Karsulovic, Claudio; Cabrera, Raúl; Pérez, Claudio; Hojman, LíaPsoriasis is a skin disease with occasional involvement of non-cutaneous territories. Beyond the usual, cardiovascular events are more frequent in these patients and correlate only partially with disease activity, suggesting the presence of other unknown factors. We selected ten psoriatic patients without treatment in the last year and matched them for age and gender with eleven healthy subjects. Ficoll-extracted mononuclear cells were analyzed with flow cytometry for monocyte surface phenotype markers, intracellular NFκB/inflammasome-dependent interleukins, and chemotaxis receptor CXCR3. Using ELISA, patient serum was evaluated for ADAMTS7 and CXCL10. Inflammatory M1 monocytes showed higher levels of IL-1β and IL-6 in psoriatic patients. M2 monocytes also showed higher levels of intracellular inflammatory cytokines. Nevertheless, IL-6 values were higher compared to other monocytes and IL-1β. The mTORC activation markers ADAMTS7 and S6Rp were higher in psoriatic patients than in healthy controls. In psoriatic patients, serum levels of ADAMTS7 were elevated, and M2 monocytes showed a distinct inflammatory response with higher relative levels of NFκB-dependent IL-6 and less activity of the CXCR3-CXCL10 chemotactic pathway. These data suggest pathways with potential markers for prediction and early detection of cardiovascular risk in psoriatic patients.Publication Non-Canonical WNT/Wnt5a Pathway Activity in Circulating Monocytes of Untreated Psoriatic Patients: An Exploratory Study of Its Association with Inflammatory Cytokines and Cardiovascular Risk Marker-ADAMTS7(2023) Karsulovic, Claudio; Loyola, Khanty; Cabrera, Raúl; Pérez, Claudio; Hojman, LiaThe leading cause of death in psoriasis is cardiovascular disease. The determinants that induce the increase in this risk are not known. The systemic inflammatory process is dependent on lymphocytes and monocytes, as has been proposed. However, adaptation modules such as mTOR have recently been mentioned as having a role. Other factors, such as WNT and its non-canonical WNT5a-inducing pathway, are relevant in inflammation, cell migration, and neoangiogenesis. Thus, we studied circulating monocytes from untreated severe psoriatic patients and characterized inflammatory cytokines, chemokines, mTOR activity, and the cardiovascular risk marker ADAMTS7. Peripheral blood from ten severely psoriatic patients (Psoriasis severity index greater than 10) was extracted and age- and sex-matched with healthy subjects. Surface and intracellular flow cytometry were performed for cytokine, chemokine receptors, and mTOR activity. ADAMTS7 was measured using ELISA. Psoriatic patients had a higher frequency of WNT5a+ cells in monocytes, which also had higher levels of IL-1β, IL-6, CXCR3, CCR2, and phosphorylated S6R protein. We found that M1 monocytes are dominant in the WNT5a+ cell group, and intracellular levels of WNT5a were also augmented. Levels of WNT5a were correlated with ADAMTS7, a blood marker related to the pathogenesis of atheromatosis. WNT5a could be relevant to the cardiovascular risk of psoriatic patients considering its association with higher levels of inflammatory cytokines, chemokine receptors and the pro-atherogenic profile of circulating monocytes.Publication Paleodermatology: Dermatoscopic findings of "Niño del Plomo" an Incan mummy in Chile(2023) Catalán, Verónica; Castro, Mario; Cabrera, Raúl; Silva, Verónica; Castro, Alex; Lecaros, CristóbalPaleodermatology is a collaborative science that provides insights into the physiology and pathology of ancient populations as well as informs physicochemical properties currently relevant to dermatologic research. Mummification is a taphonomic process antagonistic to putrefaction characterized by dehydration and desiccation of soft tissues. Spontaneous natural mummification requires arid conditions, such as extreme temperatures, dryness, and hypoxia, to prevent cell autolysis, insects from laying eggs, and bacteria growing on the cadaver. Once skin is mummified, it is extremely resistant to decomposition and can remain unchanged for thousands of years. Very well-preserved micro- and ultrastructures have been observed in mummified skin.Item Predictive Model for Response Rate to Narrowband Ultraviolet B Phototherapy in Vitiligo: A Retrospective Cohort Study of 579 Patients(2018) Cabrera, Raúl; Hojman, Lia; Recule, Francisca; Sepúlveda, Rodrigo; Delgado, IrisVitiligo is an acquired depigmenting disorder. To date, there is no predictive model for its response rate to narrowband ultraviolet B (NBUVB) phototherapy. The aim of this study was to investigate the different types of response of patients with non-segmental vitiligo undergoing NBUVB 3 times a week. Many patients who were previously considered non-responders were given the opportunity to continue the treatment. Longterm maintenance of treatment and follow-up of a cohort of 579 patients enabled different subtypes of response (very rapid, rapid, average, slow and “nonresponders”) to be described for the first time, and a predictive model of response to be constructed based on repigmentation rate in the first 48 sessions of NBUVB. Among those patients who did not respond during the first 48 sessions, a new subgroup of patients was found, termed “very-slow” responders, who achieved a low, but significant, level of repigmentation after 96 sessions of NBUVB.Item Reactividad y evolución de 4.022 tests de parche en dermatitis de contacto realizadas entre 1995 y 2011 en Santiago de Chile(Sociedad Médica de Santiago, 2015) Sabatini, Natalia; Cabrera, Raúl; Bascuñán, Claudia; Díaz-Narváez, Víctor; Castillo, Ricardo; Urrutia, Mauricio; Sepúlveda, RodrigoBackground: Allergic Contact Dermatitis is a classic delayed hypersensitivity reaction. Aim: To study the reactivity and evolution in Chilean patients by gender, using the standard European patch test. Materials and Methods: The results of the European standard patch test applied to 4,022 patients aged 1 to 93 years (64% female) with Allergic Contact Dermatitis, diagnosed between January 1995 and August 2011, were retrospectively analyzed. Results: From a total of 4,022 patients, 2,439 (60.6%) had a positive reaction. Among reactive patients, 1,854 (76.04%) were female and 584 (23.96%) male. The most common positive allergens were nickel (35.3%), cobalt (15.1%), fragrance mix (14%), chromium (8.7%) and balsam of Peru (8.5%). In females, nickel was the most common reactive antigen (34.28%), and in males, fragrance mix (15.7%). During the period 2003-2011, an increased reactivity to nickel (26.6%) and a decreased reactivity to p-phenylenediamine (29.6%) and fragrance (42.8%), was observed. Conclusions: Fragrance mix is the most common reactive allergen in males and the third for females. Nickel is the leading allergen in the female group and the second of importance for males, making it the most significant allergen for the Chilean population. We also observed that the reactivity of some allergens evolves and varies over time.Item The Role of CXCL10 and IL-18 as Markers of Repigmentation Response in Nonsegmental Vitiligo Treated with Narrowband UVB Phototherapy: A Prospective Cohort Study(2021) Hojman, Lía; Cabrera, Raúl; Karsulovic, Claudio; Tempio, Fabian; Pérez, Claudio; López, MercedesItem Tiña negra (tinea nigra): comunicación de un caso alóctono en Chile(Sociedad Chilena de Infectología, 2013) Cabrera, Raúl; Sabatini, Natalia; Urrutia, Mauricio; Sepúlveda, RodrigoTinea nigra is a superficial mycosis caused by Hortaea werneckii. It is an infrequent asymptomatic infection that affects mainly human palms and soles, and it is mostly seen in tropical countries. It has not been reported in Chile yet. The clinical presentation is generally a single macule, not symptomatic, of brown color in palms and soles. We report a case of a Chilean woman that developed brown macules on both soles after travel to the United States and Central America. The diagnosis of Tinea nigra was confirmed by direct microscopic examination and mycological culture. She had a good response to treatment with oral itraconazol.Publication Tinea faciei por Trichophyton violaceum: primer caso alóctono reportado en Chile(2022) Cabrera, Raúl; Guelfand, Sofía; Caussade, Marie; Velázquez, Daniel; Álvarez, EduardoTrichophyton violaceum es un dermatofito antropofílico endémico en África, Europa, Centroamérica y China. El incremento de los fenómenos de movilidad humana ha contribuido a su aparición en áreas no endémicas. Su principal manifestación clínica es la tinea capitis, seguida por la tinea corporis. En la población pediátrica afecta con mayor frecuencia el cuero cabelludo; y en adultos, la piel glabra. Presentamos el primer caso en Chile de tinea causada por T violaceum. Correspondió a una mujer chilena de 21 años que presentó placas faciales de un mes de evolución después de un viaje a Tanzania, África, sin respuesta a tratamientos médicos previos. Se sospechó una dermatofitosis alóctona y mediante cultivos especiales, se identificó una colonia de crecimiento lento, coloración violeta-negruzca, superficie cerosa y rugosa, con vellosidades aterciopeladas; compatible con T violaceum. Se confirmó mediante secuenciación de ADN ribosomal amplificando la región ITS. Se trató con terbinafina oral con respuesta clínica completa. Trichophyton violaceum is an anthropophilic dermatophyte endemic in Africa, Europe, Central America and China. The increase in human mobility has recently contributed to the appearance in non-endemic areas. The main clinical manifestation is tinea capitis followed by tinea corporis. We present the first case in Chile of tinea caused by T violaceum. The case was a 21 year-old Chilean woman who presented asymptomatic facial plaques one month after arriving from Tanzania, Africa, with no clinical response to previous medical treatments. An allochthonous dermatophytosis was suspected and with special cultures, a slow-growing colony was identified with a violet-blackish color, waxy and rough surface, and velvety villi; all characteristics of T violaceum. The diagnosis was confirmed by ribosomal DNA sequencing amplifying the ITS region. She was treated with oral terbinafine obtaining a complete clinical response.