The use of tumor necrosis factor antagonists (anti-TNF) has become a usual
practice to treat various inflammatory diseases. Although indicated for the
treatment of psoriasis, anti-TNF may paradoxically trigger a psoriasiform
condition. We present a case of a female patient who, during the use of
infliximab for rheumatoid arthritis, developed psoriasis. In an attempt to
switch anti-TNF class, we observed a cumulative worsening of the lesions
requiring suspension of the immunobiological agent and the introduction of other
drugs for clinical control. The therapeutic challenge of this paradoxical form
of psoriasis is the focus of our discussion. The use of another anti-TNF in
these patients is a matter of debate among experts.
BACKGROUNDAesthetic procedures are widely performed by dermatologists and plastic surgeons, often with subjective results. In cosmetic dermatology, there is a lack of studies that use accurate instruments to assess result outcomes. Quality of life (QoL) questionnaires can objectively assess results.OBJECTIVETo assess the impact of nonsurgical facial cosmetic procedures on QoL.MATERIALS AND METHODSThis was a longitudinal observational study performed with 81 patients who underwent facial cosmetic procedures at a University Hospital in Rio de Janeiro, Brazil. The Skin Rejuvenation Outcome Evaluation questionnaire, previously adapted and translated to the Portuguese language spoken in Brazil, was selected, and the results were compared with the Dermatology Life Quality Index. The impact on QoL was statistically evaluated after the interventions.RESULTSThe Skin Rejuvenation Outcome Evaluation scores after the procedures were significantly higher than before (p < .001), independent of sociodemographic characteristics. Patients treated with botulinum toxin and dermal fillers showed greater satisfaction than those treated with laser, chemical peels or microneedling.CONCLUSIONMinimally invasive cosmetic procedures result in improvements in QoL. The use of translated, adapted, and validated questionnaires favors the comparison of results among different populations and reinforces the confidence on the results of established cosmetic treatments.
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