Publications by authors named "Silvia Mendez-Flores"

Background: Generalized lupus erythematosus (LEG) is an autoimmune disease with cutaneous and mucosal manifestations, with lupus cheilitis (LC) being a rare associated oral presentation. The difficulty in early diagnosis of QL lies in its various clinical forms. Although successful treatments have been described, information on specific management is limited, highlighting the importance of early recognition to improve the prognosis and quality of life of patients.

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  • Anti-synthetase syndrome (AS) is a type of inflammatory muscle disease marked by specific autoantibodies and is often associated with myositis and lung issues; it sometimes includes skin lesions like those in dermatomyositis.
  • A case study of a 57-year-old man revealed a rare combination of AS, deep morphea, vasculitic neuropathy, and myelodysplastic syndrome, raising questions about shared underlying mechanisms among these conditions.
  • Despite receiving aggressive treatment, the patient experienced a severe decline and ultimately died from complications, underlining the complex interplay between AS and other inflammatory disorders.
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A 65-year-old woman presented with unexplained weight loss, recurrent fever, and a dermatosis with painful nodules on the extremities. Biopsies showed focal lobular panniculitis with neutrophilic microgranulomas. Comprehensive investigations ruled out infection and hematologic and solid organ neoplasms.

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  • Pseudolymphomatous cutaneous angiosarcoma (cAS) is a rare cancer that can be difficult to diagnose due to its similarity to other lymphoid conditions, showcasing notable lymphocyte presence.
  • A unique case involving a 47-year-old woman with systemic sclerosis (SSc) is presented, characterized by facial swelling and specific imaging findings that led to a skin biopsy showing unusual vascular patterns and dense lymphocyte growth.
  • This case highlights the connection between SSc and higher cancer risk, emphasizing the diagnostic challenges of cAS and the need for early detection and comprehensive management strategies.
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  • The case discusses a 26-year-old woman with a history of lupus who developed Sweet syndrome, presenting with symptoms that resembled a herpetic infection.
  • The patient's symptoms included facial swelling, fever, headache, and joint pain, along with skin lesions that looked like vesicles on inflamed skin, leading to initial confusion in diagnosis.
  • The diagnosis was confirmed through a skin biopsy, and treatment with corticosteroids and antibiotics successfully resolved her symptoms, emphasizing the need for doctors to consider Sweet syndrome in similar cases.
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  • The study aimed to examine the patterns of atrophy of the filiform papillae on the tongue and their links to iron and vitamin B levels in patients with systemic diseases at a tertiary care center.
  • A total of 87 patients were evaluated, with a high prevalence of FP atrophy (90.8%), mostly mild, and common patterns included focalized and "U"-shaped atrophy.
  • Results showed lower serum iron levels linked to certain atrophic patterns and symptom presence, indicating that specific tongue atrophy may reflect underlying health issues.
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Dermatomyositis positive anti-melanoma differentiation-associated gene 5 (anti-MDA5 DM) is a rare disease that represents less than 2%. The prevalence of anti-MDA5 DM ranges from 7 to 60%, with higher prevalence in Asian (11-60%) and women. The clinical picture may be variable and is accompanied by the typical features of dermatomyositis, such as periorbital heliotrope (blue-purple) rash with edema, erythematous rash on the face, or the anterior chest (in a V-sign), and back and shoulders (in a shawl sign), violaceous papules or plaques located on the dorsal part of the metacarpophalangeal or interphalangeal joints, which are pathognomonic by definition; yet, one of the most striking signs is the painful ulceration skin that is found in 82% of cases, which is deep and in punching holes or showing hyperkeratotic crusts.

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Background: Episodic angina-like retrosternal pain is a prevalent symptom for achalasia patients pre- and post-treatment. The cause of postoperative chest pain remains poorly understood. Moreover, there are no reports on their predictive value for chest pain in the long-term post-treatment.

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Introduction: Nail changes in people living with human immunodeficiency virus (HIV) have been scarcely reported. The aim of this study was to establish the frequency and characteristics of nail alterations observed in adults with HIV infection in a third-level hospital in Mexico.

Method: Observational and cross-sectional study carried out in 205 patients receiving care at the HIV/AIDS Clinic of the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ) in Mexico City.

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To describe the pain management and clinical course of patients with severe Pemphigus Vulgaris (PV) admitted to a third-level Intensive Care Unit (ICU). This was a retrospective cohort study conducted in the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán over the period 2013-2020. Study population comprised patients with severe PV admitted to the ICU.

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Cutaneous drug-induced reactions are immune-mediated responses that can lead to life-threatening diseases such as drug reaction with eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome, and toxic epidermal necrolysis, collectively known as severe cutaneous adverse reactions (SCARs). Unfortunately, they cannot be predicted during drug development, and, at present, a prognostic biomarker is not available nor are validated assays for diagnosis. Thus, by using proteomic and microarray miRNA analysis, the cargo of extracellular vesicles obtained from SCARs patients was analyzed and correlated with the severity of the reaction.

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  • Cutaneous involvement is common in rheumatoid arthritis (RA) patients, with 77% showing skin findings, though many of these are nonspecific rather than directly related to RA.
  • Key factors associated with skin involvement include age and concerns about skin health; emotional health and the quantity of skin findings relate to reduced dermatological quality of life (DQoL).
  • The study emphasizes the impact of skin manifestations on patients' emotional well-being, suggesting the need for better awareness and management in RA care settings.
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Objectives: Cutaneous involvement is an extra-articular manifestation of rheumatoid arthritis (RA). This includes nail abnormalities, which are often overlooked. We described nail findings in RA patients currently attending an early arthritis cohort (n=145), and associated them with disease activity and/or damage, as well as patient-reported outcomes.

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  • - The Mexican Academy of Dermatology (AMD) supports the use of certain biosimilars for psoriasis treatment, indicating that some, like adalimumab, infliximab, and etanercept, have comparable pharmacokinetics and pharmacodynamics.
  • - However, the AMD states that there isn't enough evidence to recommend these biosimilars as interchangeable or to broaden their indications without careful consideration.
  • - They emphasize the importance of strict pharmacovigilance to monitor adverse effects and ensure patient safety, stressing that economic benefits should not compromise scientific rigor in treatment effectiveness.
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Background: The role of miRNAs in the pathogenesis of cutaneous lupus has not been studied.

Objective: It was to assess the levels of a selected panel of circulating miRNAs that could be involved in the regulation of the immune response, inflammation, and fibrosis in cutaneous lupus.

Methods: It was a cross-sectional study.

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Lamotrigine is an antiepileptic drug that has been widely used for epilepsy, as a mood stabilizer (for type 1 bipolar disorder) and in the management of neuropathic pain, it is used both in monotherapy and in complementary therapy. Considered relatively new, approved by the Food and Drug Administration in 1994, its benefits include a greater margin of safety compared to other anticonvulsants. However, although in a lower percentage, it causes severe adverse skin reactions such as Stevens-Johnson syndrome and toxic epidermal necrolysis.

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Introduction: Surgery is performed more frequently now at days, due to the increasing incidence of melanoma and no-melanoma skin cancer. There are different opinions among dermatologic surgeons between to continue or discontinue antithrombotic therapy prior to the procedure, which increases the risk of thromboembolic events. Prophylaxis with oral antibiotics in the postsurgical period is controversial.

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Background: The mucocutaneous clinical profile of patients with amyloidosis in Latin America has been scarcely reported.

Objective: To describe clinical characteristics of skin and mucosal manifestations in systemic amyloidosis in a tertiary care center in Mexico City.

Methods: A cross sectional, retrospective analytical study was performed in patients with systemic amyloidosis over a 15-year period.

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We compared the chemokine/receptor expression in skin biopsies of discoid (SLE/DLE) and subacute lupus (SLE/SCLE) and correlated it with tissue and circulating effector CD4 T cells/regulatory cells. Skin biopsies and peripheral blood from 9 active SLE/DLE patients, 9 SLE/SCLE patients, 5 control SLE patients without cutaneous lesions and 10 control healthy donors were included. Clinical skin activity was measured by Cutaneous Lupus Erythematosus Disease Area and Severity Index scoring, and systemic activity was measured by a modified SLEDAI-2K excluding the cutaneous items.

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