Original article
Severe Adult Atopic Dermatitis: Treatment With Mycophenolate Mofetil in 8 Patients
Tratamiento de la Dermatitis Atópica Grave del adulto con Mofetil Micofenolato en 8 Pacientes
I. Ballester
, J.F. Silvestre, M. Pérez-Crespo, A. Lucas
Autor para correspondencia
ibalnor@coma.es
Correspondence: Nortes. Servicio de Dermatología. C/ Pintor Baeza, s/n. 03010 Alicante. Spain.
Correspondence: Nortes. Servicio de Dermatología. C/ Pintor Baeza, s/n. 03010 Alicante. Spain.
Servicio de Dermatología, Hospital General Universitario de Alicante, Alicante, Spain
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"apellidos" => "Ballester" "email" => array:1 [ 0 => "ibalnor@coma.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor1" ] ] ] 1 => array:2 [ "nombre" => "J.F." "apellidos" => "Silvestre" ] 2 => array:2 [ "nombre" => "M." "apellidos" => "Pérez-Crespo" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Lucas" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Dermatología, Hospital General Universitario de Alicante, Alicante, Spain" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "⁎" "correspondencia" => "Correspondence: Nortes. Servicio de Dermatología. C/ Pintor Baeza, s/n. 03010 Alicante. Spain." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Tratamiento de la Dermatitis Atópica Grave del adulto con Mofetil Micofenolato en 8 Pacientes" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaAceptado" => "2009-04-30" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec84631" "palabras" => array:3 [ 0 => "mycophenolate mofetil" 1 => "atopic dermatitis" 2 => "immunosuppressive agents" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec84632" "palabras" => array:3 [ 0 => "mofetil micofenolato" 1 => "dermatitis atópica" 2 => "agentes inmunosupresores" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p class="elsevierStyleSimplePara elsevierViewall">Atopic dermatitis (AD) includes severe forms that can be refractory to various systemic treatments. Mycophenolate mofetil (MMF) has been found to be useful in patients with severe forms of AD and to have fewer side effects than long-term treatment with oral corticosteroids or cyclosporine.</p> <span class="elsevierStyleSectionTitle">Objectives</span><p class="elsevierStyleSimplePara elsevierViewall">To evaluate the efficacy and adverse effects of MMF in patients seen in our skin allergy unit with severe adult AD refractory to other systemic treatments.</p> <span class="elsevierStyleSectionTitle">Methods</span><p class="elsevierStyleSimplePara elsevierViewall">We performed a retrospective study of 8 patients with severe adult AD treated with MMF, analyzing the baseline characteristics, previous treatments used by the patients, and the outcome and adverse effects of treatment with MMF.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Five patients treated with MMF showed improvement in the fourth week of treatment. In addition, 5 of the 8 patients presented a clear, long-term improvement in their disease. Remission of AD occurred in 1 patient, making it possible to discontinue MMF; this patient remains stable with no relapses after 4 months without treatment. The other 4 patients continue on maintenance therapy. Three patients continued to have frequent acute outbreaks of AD despite treatment with MMF for 16 to 72 weeks. All patients tolerated the treatment and there were few adverse effects.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">MMF can be an effective option in selected patients with severe forms of atopic dermatitis. Although the response is not as rapid as with oral corticosteroids or cyclosporine, it can be used for maintenance treatment with good clinical control and few adverse effects.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Introducción</span><p class="elsevierStyleSimplePara elsevierViewall">La dermatitis atópica (DA) incluye formas graves que pueden ser refractarias a varios tratamientos sistémicos. Mofetil micofenolato (MMF) ha demostrado ser útil en pacientes con formas graves de DA y produce menos efectos secundarios que el tratamiento a largo plazo con ciclosporina o corticosteroides orales.</p> <span class="elsevierStyleSectionTitle">Objetivos</span><p class="elsevierStyleSimplePara elsevierViewall">Valorar la eficacia y los efectos adversos del MMF en pacientes con DA grave del adulto refractaria a otros tratamientos sistémicos en nuestra Unidad de Alergia Cutánea.</p> <span class="elsevierStyleSectionTitle">Métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Realizamos un estudio retrospectivo de 8 pacientes con DA grave del adulto tratados con MMF. Analizamos las características basales y los tratamientos previos utilizados por los pacientes, así como los resultados y efectos secundarios obtenidos tras el empleo de MMF.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Cinco pacientes tratados con MMF presentaron mejoría en la cuarta semana de tratamiento. Además, en 5 de 8 pacientes se consiguió una clara mejoría de la DA a largo plazo. En uno de ellos se logró una remisión de la DA, lo que permitió la retirada de MMF y después de 4 meses sin tratamiento permanece estable y sin recaídas. Los cuatro restantes siguen con terapia de mantenimiento. Tres pacientes continuaron con brotes agudos frecuentes de DA a pesar de haber mantenido el tratamiento con MMF entre 16-72 semanas. Todos los pacientes toleraron el tratamiento con escasos efectos secundarios.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">MMF puede ser una opción eficaz en pacientes seleccionados con formas graves de DA. Aunque MMF no produce una respuesta tan rápida como la que se obtiene con ciclosporina o con corticoides orales, permite un tratamiento mantenido, con buen control clínico y escasos efectos secundarios.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:18 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Successful treatment of severe refractory atopic dermatitis with mycophenolate mofetil" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Grundmann-Kollmann" 1 => "H.C. Korting" 2 => "S. 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 7 | 7 | 14 |
| 2024 Octubre | 61 | 53 | 114 |
| 2024 Septiembre | 67 | 35 | 102 |
| 2024 Agosto | 93 | 55 | 148 |
| 2024 Julio | 62 | 48 | 110 |
| 2024 Junio | 103 | 26 | 129 |
| 2024 Mayo | 69 | 27 | 96 |
| 2024 Abril | 61 | 34 | 95 |
| 2024 Marzo | 48 | 54 | 102 |
| 2024 Febrero | 53 | 43 | 96 |
| 2024 Enero | 45 | 39 | 84 |
| 2023 Diciembre | 43 | 27 | 70 |
| 2023 Noviembre | 58 | 55 | 113 |
| 2023 Octubre | 58 | 47 | 105 |
| 2023 Septiembre | 52 | 29 | 81 |
| 2023 Agosto | 38 | 19 | 57 |
| 2023 Julio | 27 | 37 | 64 |
| 2023 Junio | 34 | 15 | 49 |
| 2023 Mayo | 42 | 21 | 63 |
| 2023 Abril | 25 | 13 | 38 |
| 2023 Marzo | 27 | 25 | 52 |
| 2023 Febrero | 43 | 25 | 68 |
| 2023 Enero | 54 | 40 | 94 |
| 2022 Diciembre | 40 | 46 | 86 |
| 2022 Noviembre | 23 | 32 | 55 |
| 2022 Octubre | 14 | 21 | 35 |
| 2022 Septiembre | 14 | 35 | 49 |
| 2022 Agosto | 21 | 29 | 50 |
| 2022 Julio | 15 | 30 | 45 |
| 2022 Junio | 13 | 30 | 43 |
| 2022 Mayo | 30 | 44 | 74 |
| 2022 Abril | 45 | 39 | 84 |
| 2022 Marzo | 45 | 57 | 102 |
| 2022 Febrero | 29 | 29 | 58 |
| 2022 Enero | 31 | 42 | 73 |
| 2021 Diciembre | 29 | 39 | 68 |
| 2021 Noviembre | 44 | 52 | 96 |
| 2021 Octubre | 39 | 49 | 88 |
| 2021 Septiembre | 36 | 40 | 76 |
| 2021 Agosto | 41 | 38 | 79 |
| 2021 Julio | 24 | 31 | 55 |
| 2021 Junio | 31 | 33 | 64 |
| 2021 Mayo | 26 | 31 | 57 |
| 2021 Abril | 68 | 62 | 130 |
| 2021 Marzo | 56 | 26 | 82 |
| 2021 Febrero | 43 | 40 | 83 |
| 2021 Enero | 27 | 22 | 49 |
| 2020 Diciembre | 27 | 23 | 50 |
| 2020 Noviembre | 24 | 34 | 58 |
| 2020 Octubre | 22 | 10 | 32 |
| 2020 Septiembre | 18 | 16 | 34 |
| 2020 Agosto | 15 | 35 | 50 |
| 2020 Julio | 11 | 6 | 17 |
| 2020 Junio | 24 | 21 | 45 |
| 2020 Mayo | 22 | 21 | 43 |
| 2020 Abril | 28 | 22 | 50 |
| 2020 Marzo | 26 | 22 | 48 |
| 2020 Febrero | 1 | 1 | 2 |
| 2020 Enero | 0 | 6 | 6 |
| 2019 Diciembre | 0 | 13 | 13 |
| 2019 Noviembre | 0 | 1 | 1 |
| 2019 Septiembre | 0 | 5 | 5 |
| 2019 Agosto | 0 | 2 | 2 |
| 2019 Julio | 0 | 6 | 6 |
| 2019 Junio | 0 | 9 | 9 |
| 2019 Mayo | 2 | 40 | 42 |
| 2019 Abril | 0 | 7 | 7 |
| 2019 Marzo | 0 | 5 | 5 |
| 2019 Febrero | 0 | 10 | 10 |
| 2019 Enero | 0 | 3 | 3 |
| 2018 Diciembre | 0 | 7 | 7 |
| 2018 Septiembre | 0 | 7 | 7 |
| 2018 Agosto | 0 | 13 | 13 |
| 2018 Julio | 0 | 22 | 22 |
| 2018 Junio | 0 | 16 | 16 |
| 2018 Mayo | 0 | 18 | 18 |
| 2018 Abril | 0 | 19 | 19 |
| 2018 Marzo | 1 | 12 | 13 |
| 2018 Febrero | 17 | 49 | 66 |
| 2018 Enero | 14 | 69 | 83 |
| 2017 Diciembre | 19 | 36 | 55 |
| 2017 Noviembre | 18 | 67 | 85 |
| 2017 Octubre | 14 | 62 | 76 |
| 2017 Septiembre | 21 | 42 | 63 |
| 2017 Agosto | 19 | 56 | 75 |
| 2017 Julio | 18 | 53 | 71 |
| 2017 Junio | 26 | 83 | 109 |
| 2017 Mayo | 20 | 62 | 82 |
| 2017 Abril | 27 | 45 | 72 |
| 2017 Marzo | 20 | 77 | 97 |
| 2017 Febrero | 15 | 120 | 135 |
| 2017 Enero | 15 | 80 | 95 |
| 2016 Diciembre | 31 | 60 | 91 |
| 2016 Noviembre | 23 | 51 | 74 |
| 2016 Octubre | 31 | 49 | 80 |
| 2016 Septiembre | 41 | 70 | 111 |
| 2016 Agosto | 50 | 35 | 85 |
| 2016 Julio | 34 | 14 | 48 |
| 2016 Junio | 7 | 9 | 16 |
| 2016 Mayo | 5 | 14 | 19 |
| 2016 Abril | 4 | 1 | 5 |
| 2016 Marzo | 3 | 8 | 11 |
| 2016 Febrero | 8 | 28 | 36 |
| 2016 Enero | 11 | 21 | 32 |
| 2015 Diciembre | 8 | 8 | 16 |
| 2015 Noviembre | 11 | 1 | 12 |
| 2015 Octubre | 5 | 27 | 32 |
| 2015 Septiembre | 7 | 16 | 23 |
| 2015 Agosto | 9 | 3 | 12 |
| 2015 Julio | 32 | 22 | 54 |
| 2015 Junio | 33 | 17 | 50 |
| 2015 Mayo | 55 | 39 | 94 |
| 2015 Abril | 38 | 19 | 57 |
| 2015 Marzo | 28 | 17 | 45 |
| 2015 Febrero | 38 | 20 | 58 |
| 2015 Enero | 35 | 16 | 51 |
| 2014 Diciembre | 35 | 15 | 50 |
| 2014 Noviembre | 37 | 18 | 55 |
| 2014 Octubre | 27 | 17 | 44 |
| 2014 Septiembre | 35 | 16 | 51 |
| 2014 Agosto | 33 | 24 | 57 |
| 2014 Julio | 53 | 24 | 77 |
| 2014 Junio | 42 | 14 | 56 |
| 2014 Mayo | 47 | 17 | 64 |
| 2014 Abril | 40 | 15 | 55 |
| 2014 Marzo | 42 | 27 | 69 |
| 2014 Febrero | 27 | 35 | 62 |
| 2014 Enero | 23 | 32 | 55 |
| 2013 Diciembre | 26 | 22 | 48 |
| 2013 Noviembre | 26 | 25 | 51 |
| 2013 Octubre | 30 | 23 | 53 |
| 2013 Septiembre | 28 | 29 | 57 |
| 2013 Agosto | 25 | 44 | 69 |
| 2013 Julio | 36 | 48 | 84 |
| 2013 Junio | 17 | 57 | 74 |
| 2013 Mayo | 28 | 36 | 64 |
| 2013 Abril | 41 | 30 | 71 |
| 2013 Marzo | 35 | 34 | 69 |
| 2013 Febrero | 19 | 26 | 45 |
| 2013 Enero | 2 | 1 | 3 |
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