Person: Cabrera, Raúl
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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.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.Publication Targeted therapy for immune mediated skin diseases. What should a dermatologist know?(2024) López, Edinson; Cabrera, Raúl; Lecaros, CristóbalBackground: Molecularly targeted therapies, such as monoclonal antibodies (mAbs) and Janus Kinase inhibitors (JAKis), have emerged as essential tools in the treatment of dermatological diseases. These therapies modulate the immune system through specific signaling pathways, providing effective alternatives to traditional systemic immunosuppressive agents. This review aims to provide an updated summary of targeted immune therapies for inflammatory skin diseases, considering their pathophysiology, efficacy, dosage, and safety profiles. Methods: The review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. A systematic search was conducted on PubMed over the past 10 years, focusing on randomized clinical trials, case reports, and case series related to targeted immune therapies in dermatology. Eligibility criteria were applied, and data were extracted from each study, including citation data, study design, and results. Results: We identified 1360 non-duplicate articles with the initial search strategy. Title and abstract review excluded 1150, while a full-text review excluded an additional 50 articles. The review included 143 studies published between 2012 and 2022, highlighting 39 drugs currently under investigation or in use for managing inflammatory skin diseases. Study limitations: The heterogeneity of summarized information limits this review. Some recommendations originated from data from clinical trials, while others relied on retrospective analyses and small case series. Recommendations will likely be updated as new results emerge. Conclusion: Targeted therapies have revolutionized the treatment of chronic skin diseases, offering new options for patients unresponsive to standard treatments. Paradoxical reactions are rarely observed. Further studies are needed to fully understand the mechanisms and nature of these therapies. Overall, targeted immune therapies in dermatology represent a promising development, significantly improving the quality of life for patients with chronic inflammatory skin diseases.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 carcinoma