Browsing by Author "Torres, T."
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- Biologic therapy for psoriasis - still searching for the best target.Publication . Pinto-Almeida, T.; Torres, T.Psoriasis is a chronic skin disease that results from the complex interaction between genetic and environmental factors. Over the last few decades, scientific evidence has redirected the focus of therapeutic studies to the immunologic pathways underlying its pathogenesis. This led to the biologic boom that we are currently experiencing, with the development and approval of targeted progressively more selective biological therapies and ongoing clinical trials of increasingly specific drugs, given their important implications for long-term efficacy and safety. Nevertheless, the search for the optimal biologic is still ongoing, and the best target has yet to be found.
- Biosimilar Agents for Psoriasis Treatment: The Perspective of Portuguese PatientsPublication . Azevedo, A.; Bettencourt, A.; Selores, M.; Torres, T.INTRODUCTION: Biosimilars are highly similar copies of previously approved original biologic medicines. Their introduction on the market may yield cost reduction. The aim of this study was to evaluate the perspectives of psoriasis patients on biosimilar medications. MATERIALS AND METHODS: We conducted a 14 questions survey of psoriasis patients receiving biological therapy and followed-up in a dermatology department of a Portuguese tertiary care hospital. RESULTS: From a total of 108 patients included, 70.4% of patients did not know the definition of biosimilar agent and 76.6% of patients showed partial or total interest in using a biosimilar drug. Nearly 80% of patients partially or totally agreed in using a biosimilar drug in order to reduce healthcare costs with psoriasis treatment. However, the lack of studies in the European population and in psoriatic patients led most of the patients (72.2% and 75.0%, respectively) to somewhat or completely oppose to the use of biosimilars. Demographic variables, household income and type of current biologic therapy did not affect patient preferences. DISCUSSION: Despite of the unfamiliarity of the respondents with biosimilars, most patients seem receptive to their use. Nevertheless, there are two issues of concern: i) the use of biosimilars that are not tested in a European population, and ii) its approval for psoriasis without trials in this disease. Thus, an immediate need exists for patient education about biosimilars. CONCLUSION: Biosimilars may increase patient access to biologic therapies. Improved communication and the involvement of patients in decision-making regarding biosimilars may increase their acceptance in future.
- Caso dermatológico: Herpes neonatalPublication . Torres, T.; Fernandes, I.; Selores, M.
- Caso dermatológico: mastocitoma solitárioPublication . Torres, T.; Selores, M.
- Caso dermatológico: Nevo melanocítico subungueal com pseudo-sinal de HutchinsonPublication . Torres, T.; Fernandes, I.; Caetano, M.; Costa, V.; Selores, M.ABSTRACT Hutchinson’s sign is characterized by extension of brown-black pigment from the nail bed, matrix, and nail plate onto the adjacent cuticle and proximal and/or lateral nailfolds. It is an important indicator of subungual melanoma. However, experience has demonstrated that Hutchinson’s sign, although valuable, is not an infallible predictor of melanoma. In fact, periungual pigmentation may be caused by a variety of benign disorders (pseudo-HS) and is not pathognomonic of melanoma. The authors present the clinical case of subungual melanocytic nevus with pseudo-Hutchinson sign in a seven year-old boy. He presented with subungual pigmentation of the second toe of the left foot, associated with periungual pigmentation compatible with Hutchinson sign. However, the biopsy of the lesion revealed a melanocytic nevus. Diagnosis: Subungual melanocytic nevus with pseudo-Hutchinson sign
- Development of erythematous scaly lesions in a cervical surgical scarPublication . Silva, C; Torres, T.
- Efeito do Mês de Nascimento no Risco de Desenvolver PsoríasePublication . Martins, A.; Bettencourt, A.; Torres, T.Introdução: A psoríase é uma dermatose imunomediada caraterizada por inflamação crónica, proliferação e diferenciação anormal dos queratinócitos, hiperplasia vascular e infiltração de células inflamatórias. É uma doença multifatorial influenciada por alterações genéticas e epigenéticas despoletadas por estímulos ambientais. O clima e a exposição solar parecem afetar a prevalência da psoríase e a radiação ultravioleta é útil na abordagem terapêutica. O nosso objectivo foi avaliar a influência do mês de nascimento (como marcador da época de gestação) no risco de desenvolver psoríase. Métodos: Comparação da distribuição dos meses de nascimentos nos pacientes com psoríase (n = 755) seguidos no Centro Hospitalar e Universitário do Porto com uma população controlo constituída pelos cidadãos portugueses nascidos no mesmo período e área geográfica dos pacientes com psoríase (n = 6 560 032). Resultados: Observou-se uma diminuição do número de nascimentos de pacientes com psoríase no mês de outubro estatisticamente significativa (OR 0,74; 95% CI 0,55 – 0,99; p 0,041). Após correção de Bonferroni e após agrupar os meses por trimestres, não se observaram diferenças estatisticamente significativas. Conclusão: As diferenças estatísticas pouco significativas e não significativas apresentadas podem ser explicadas pelas características meteorológicas particulares de Portugal que podem tornar a síntese de vitamina D relativamente estável durante o ano. A perceção da influência ambiental no desenvolvimento de determinada patologia é importante porque permite o estabelecimento de medidas preventivas que conduzirão à diminuição da sua incidência.
- Effectiveness of Aprepitant in Patients with Refractory Pruritus Secondary to Sézary SyndromePublication . Fernandes, I.; Torres, T.; Selores, M.; Alves, R.; Lima, M.Background: In advanced stages, patients with Sézary Syndrome (SS) commonly report an ill-defined, severe and diffuse pruritus. Recently, it has been reported that Aprepitant, an oral neurokinin-1-receptor (NK1) antagonist, may have an important role in relief of refractory pruritus in patients with SS. Material and methods: A prospective study which included four patients with SS, in whom pruritus is the main symptom, was performed. Our purpose was to assess efficacy of Aprepitant for treatment of refractory pruritus, secondary to SS. Patients were treated with Aprepitant 80 mg/d during 10 days and then the dosage was reduced to alternate days. The length of treatment ranged between 4 and 23 weeks. Improvement was assessed by the Dermatology Life Quality Index (DLQI) questionnaire, which ranges from 0 to 30, with high scores indicating worse outcome and by Visual Analogue Scale (VAS) which varies from 0 to 10, with higher scores meaning severe pruritus. Results: Prior to treatment, subjects had severe pruritus with mean DLQI score of 21.5 (SD ± 2.4) and mean VAS score of 9.0 (SD ± 0.8). At the end of the treatment, a statistically significant reduction in both indexes (p<0.05) was evident. In all patients, an improvement of pruritus was rapidly observed after the first week of therapy. No side effects were reported. Conclusion: The study confirms the effectiveness and safety of Aprepitant as an antipruritic agent in patients with refractory pruritus secondary to SS.