Antonio Paredes - Academia.edu (original) (raw)

Papers by Antonio Paredes

SUMMARY Paradoxical embolism is defi ned as a systemic arterial embolism, produced by the passage... more SUMMARY Paradoxical embolism is defi ned as a systemic arterial embolism, produced by the passage of a venous thrombus to blood circulatory system, associated a right-to-left intracardiac shunt. It is relatively rare, representing about 2% of all cases of arterial embolism. We report the case of 20-year-old women with a history of several episodes of syncope, pulmonary hypertension and patent foramen ovale, admitted to the hospital with dyspnea and abdominal pain associated with purplish erythematous indurated plaques located in right abdomen. Skin biopsy revealed thrombosed venous blood vessels that compromise dermis and hypodermis producing fat necrosis. Because the cutaneous fi ndings and previous history of the patient, we diagnosed her with paradoxical embolism.

Dermatol. …, 2005

Los leiomiomas cutáneos son tumores benignos de la piel poco frecuentes, que surgen del músculo l... more Los leiomiomas cutáneos son tumores benignos de la piel poco frecuentes, que surgen del músculo liso dérmico: músculo piloerector (piloleiomioma) y músculos dartoicos (leiomioma genital o dartoico), los piloleiomiomas pueden ser únicos o múltiples y los leiomiomas genitales ...

Leukemia & Lymphoma

Adult T-cell leukemia/lymphoma (ATLL) is a largely incurable disease. Cutaneous involvement is co... more Adult T-cell leukemia/lymphoma (ATLL) is a largely incurable disease. Cutaneous involvement is common and could be first symptom of the disease. We analyzed 169 patients with ATLL of whom 63 had cutaneous involvement. Cutaneous involvement was found in 48, 27, 17, and 60% of acute, lymphomatous, chronic and smoldering ATLL cases, respectively. Eight cases had primary cutaneous tumoral variant. Erythroderma (24%) and plaques (22%) were the most frequent skin lesions. The presence of cutaneous involvement was associated with better overall survival compared to non-cutaneous involvement (aHR 0.55 [95% CI: 0.37-0.82], p < 0.01; 1-year OS 53 vs. 27%, respectively, p ¼ 0.012). Combination zidovudine and interferon-alpha (AZT-IFN) yielded high response rates (overall response, OR ¼ 100%, n ¼ 8; complete response 62.5%) compared to chemotherapy (OR ¼ 33.3%, n ¼ 12/36). In conclusion, cutaneous involvement was associated with better survival in Latin American patients with ATLL. AZT-IFN demonstrated encouraging responses in ATLL patients with cutaneous involvement.

Blood

INTRODUCTION: Adult T-cell leukemia/lymphoma (ATLL) is an aggressive peripheral T-cell neoplasm c... more INTRODUCTION: Adult T-cell leukemia/lymphoma (ATLL) is an aggressive peripheral T-cell neoplasm caused by the Human T-cell Leukemia Virus Type 1 (HTLV-1). HTLV-1 infects up to 10 million people worldwide and is most endemic in Southwestern Japan, Western Africa, the Caribbean basin and South America. Cutaneous signs of ATLL are varied and may consist of macules (M), plaques (P), multiple papules (MP), tumoral nodules (TN), erythroderma (E) or mixed-lesions (≥2 predominant lesions, ML). M and P forms are believed to carry a better prognosis. However, data on cutaneous presentation of ATLL remains scarce. Herein, we report cases of ATLL with cutaneous involvement diagnosed in 4 Latin American countries over the last 3 decades. METHODS: We retrospectively analyzed patients (pts) diagnosed with ATLL between January 1995 and December 2019. ATLL subtypes were classified according to the Shimoyama criteria into acute, lymphomatous, chronic and smoldering. Primary cutaneous tumoral (PCT) va...

Blood

Background: Selective ligands of retinoid X receptor (i.e. bexarotene) are used in the treatment ... more Background: Selective ligands of retinoid X receptor (i.e. bexarotene) are used in the treatment of early and advanced stages of cutaneous T-cell lymphoma (CTCL). Relapsed or refractory cases of CTCL have poor prognosis and are in need of safe and more effective therapies. Synergy between bexarotene and interferon or phototherapy has been previously described. Objective: Report a Peruvian single-institution experience on eight cases of relapsed or refractory CTCL who were treated with low-dose bexarotene in combination with phototherapy or interferon alfa-2a. Methods: From 2002 to 2007, eight patients with relapsed or refractory CTCL were treated with bexarotene 300 mg by mouth daily in combination with interferon alfa-2a 9 million units subcutaneously three times a week (five patients) or phototherapy (two patients received PUVA therapy and one patient received narrow-wave UVB therapy). Bexarotene, interferon and phototherapy were continuously administered until progression of dise...

Blood

4790 Introduction Selective ligands of retinoid X receptor (i.e. bexarotene) are used in the trea... more 4790 Introduction Selective ligands of retinoid X receptor (i.e. bexarotene) are used in the treatment of early and advanced stages of cutaneous T-cell lymphoma (CTCL). The objective of this study is to report a Peruvian single-institution experience on 13 cases of relapsed or refractory CTCL who were treated with low-dose bexarotene alone or in combination with phototherapy or interferon alfa-2a. Methods From 2002 to 2008, thirteen patients with relapsed or refractory CTCL were treated with bexarotene at low dose (75-300 mg/day) as monotherapy (BEX; 3 cases) or in combination with interferon alfa-2a (INF) at 3-9 million units subcutaneously three times a week (5 cases) or phototherapy (PT; 4 cases). Therapy was continuously administered until progression of disease or unacceptable toxicity. Eight patients with mycosis fungoides (MF), two patients with aggressive epidermotropic CD8+ cytotoxic lymphoma (AECL), two patients with Sezary Syndrome (SS) and one with smoldering adult T-cel...

Leukemia & lymphoma, Jul 30, 2017

Dermatol Peru, Dec 1, 1999

En el tratamiento de las cicatrices queloides se ha utilizado múltiples modalidades terapéuticas,... more En el tratamiento de las cicatrices queloides se ha utilizado múltiples modalidades terapéuticas, tales como la infiltración intralesional de triancinolona, tratamientos compresivos, radioterapia superficial, cirugía con bisturí, criocirugía, las terapia o la ...

Folia Dermatol Peru, Dec 1, 2009

... CASO CLÍNICO 1 Médico residente de Dermatología. Hospital Nacional Edgardo Rebagliati Martins... more ... CASO CLÍNICO 1 Médico residente de Dermatología. Hospital Nacional Edgardo Rebagliati Martins, EsSalud. Lima-Perú. 2 Médico asistente del Servicio de Dermatología. Hospital Nacional Edgardo Rebagliati Martins, EsSalud. Lima-Perú. ...

Dermatol Peru, Apr 1, 2003

Dermatol Peru, Dec 1, 2002

Folia Dermatol Peru, Aug 1, 2009

La enfermedad de Rosai-Dorfman cutánea (ERDC) es una entidad inusual, de morfología clínica varia... more La enfermedad de Rosai-Dorfman cutánea (ERDC) es una entidad inusual, de morfología clínica variable, en la que el estudio histológico es importante para el diagnóstico, ya que se evidencia un infiltrado inflamatorio denso, compuesto principalmente por histiocitos y células plasmáticas, y el fenómeno de emperipolesis, caracterizado por histiocitos con diferentes estructuras celulares en su interior, que están siendo fagocitadas, estos histiocitos van a ser positivos para la proteína S100 y CD68. Generalmente tiene un curso clínico benigno con la posibilidad de resolución espontánea. Presentamos el caso de una paciente con el diagnóstico de enfermedad de Rosai-Dorfman cutánea con los criterios característicos de emperipolesis y positividad para S100 y CD68.

Dermatol Peru, Dec 1, 2007

RESUMEN Introducción: varias revisiones y guías de manejo de Micosis Fungoides (MF) y Síndrome Sé... more RESUMEN Introducción: varias revisiones y guías de manejo de Micosis Fungoides (MF) y Síndrome Sézary(SS) han sido publicados. Sin embargo, estrategias terapeúticas para esta entidad varían entre instituciones y países. Existen pocos estudios fase III que permitan tomar decisiones en el tratamiento de MF/SS. Por tanto éste es frecuentemente determinado por las experiencias institucionales. Objetivo: con el objeto de sumarizar la evidencia disponible y revisar las mejores prácticas, es que se realizó un Consenso Peruano llevado a cabo en Setiembre 2008 para establecer guías de diagnóstico y tratamiento de MF/SS. Resultados: este artículo revisa los criterios clínicos, histopatológicos y terapéuticos de MF/SS. Palabras clave: guías de manejo, Micosis fungoides, Síndrome Sézary. ABSTRACT Background: Several reviews and guidelines on the management of Mycosis Fungoides (MF) and Sézary syndrome (SS) have been published; however, treatment strategies for patients with MF/SS vary from inst...

Vitiligo is a skin disease whose therapy is no easy, we can use phototherapy PUVA and recently UV... more Vitiligo is a skin disease whose therapy is no easy, we can use phototherapy PUVA and recently UVB narrow band.

The American Journal of Dermatopathology, 2014

Extranodal marginal zone lymphoma (MZL) of mucosa-associated lymphoid tissue usually originates f... more Extranodal marginal zone lymphoma (MZL) of mucosa-associated lymphoid tissue usually originates from cutaneous or mucosal surfaces. A rare site of involvement is the subcutaneous tissue of any location. Here, we describe a 58-year-old man who presented with bilateral extranodal MZL of mucosa-associated lymphoid tissue from ocular adnexae that involved subcutaneous tissue and subsequently extended to multiple anatomical locations in the head and neck, upper back, and arm. The neoplastic cells expressed B-cell markers, and the plasma cells expressed IgG4. The unusual pattern of infiltration of this extranodal MZL and the possible significance of IgG4 expression in this case are discussed.

The chronic graft-versus-host-disease (GVHD) is the most frequent and serious complication of the... more The chronic graft-versus-host-disease (GVHD) is the most frequent and serious complication of the allogenic bone marrow transplantation. We present a patient who was refractory to prednisone, cyclosporine A, mycophenolate mofetil, ultraviolet irradiation and psoralen (PUVA), and rituximab.

sisbib.unmsm.edu.pe

La neoplasia blástica plasmocitoide de células dendríticas es un tumor poco frecuente que se pres... more La neoplasia blástica plasmocitoide de células dendríticas es un tumor poco frecuente que se presenta en adultos y tiene un curso clínico desfavorable. El cuadro inicial se manifi esta por afección cutánea y posteriormente evoluciona a una enfermedad extracutánea generalizada. Se presenta el caso de un varón con lesiones tumorales, algunas de ellas necróticas, con infi ltrado monomorfo de células atípicas a nivel de dermis y con inmunohistoquímica CD3 negativo, y CD4, CD56 y CD123 positivos. El cuadro correspondió a una neoplasia blástica plasmocitoide de células dendríticas con buena respuesta inicial a quimioterapia, sin embargo a los 12 meses el paciente falleció debido a un shock séptico.

SUMMARY Paradoxical embolism is defi ned as a systemic arterial embolism, produced by the passage... more SUMMARY Paradoxical embolism is defi ned as a systemic arterial embolism, produced by the passage of a venous thrombus to blood circulatory system, associated a right-to-left intracardiac shunt. It is relatively rare, representing about 2% of all cases of arterial embolism. We report the case of 20-year-old women with a history of several episodes of syncope, pulmonary hypertension and patent foramen ovale, admitted to the hospital with dyspnea and abdominal pain associated with purplish erythematous indurated plaques located in right abdomen. Skin biopsy revealed thrombosed venous blood vessels that compromise dermis and hypodermis producing fat necrosis. Because the cutaneous fi ndings and previous history of the patient, we diagnosed her with paradoxical embolism.

Dermatol. …, 2005

Los leiomiomas cutáneos son tumores benignos de la piel poco frecuentes, que surgen del músculo l... more Los leiomiomas cutáneos son tumores benignos de la piel poco frecuentes, que surgen del músculo liso dérmico: músculo piloerector (piloleiomioma) y músculos dartoicos (leiomioma genital o dartoico), los piloleiomiomas pueden ser únicos o múltiples y los leiomiomas genitales ...

Leukemia & Lymphoma

Adult T-cell leukemia/lymphoma (ATLL) is a largely incurable disease. Cutaneous involvement is co... more Adult T-cell leukemia/lymphoma (ATLL) is a largely incurable disease. Cutaneous involvement is common and could be first symptom of the disease. We analyzed 169 patients with ATLL of whom 63 had cutaneous involvement. Cutaneous involvement was found in 48, 27, 17, and 60% of acute, lymphomatous, chronic and smoldering ATLL cases, respectively. Eight cases had primary cutaneous tumoral variant. Erythroderma (24%) and plaques (22%) were the most frequent skin lesions. The presence of cutaneous involvement was associated with better overall survival compared to non-cutaneous involvement (aHR 0.55 [95% CI: 0.37-0.82], p < 0.01; 1-year OS 53 vs. 27%, respectively, p ¼ 0.012). Combination zidovudine and interferon-alpha (AZT-IFN) yielded high response rates (overall response, OR ¼ 100%, n ¼ 8; complete response 62.5%) compared to chemotherapy (OR ¼ 33.3%, n ¼ 12/36). In conclusion, cutaneous involvement was associated with better survival in Latin American patients with ATLL. AZT-IFN demonstrated encouraging responses in ATLL patients with cutaneous involvement.

Blood

INTRODUCTION: Adult T-cell leukemia/lymphoma (ATLL) is an aggressive peripheral T-cell neoplasm c... more INTRODUCTION: Adult T-cell leukemia/lymphoma (ATLL) is an aggressive peripheral T-cell neoplasm caused by the Human T-cell Leukemia Virus Type 1 (HTLV-1). HTLV-1 infects up to 10 million people worldwide and is most endemic in Southwestern Japan, Western Africa, the Caribbean basin and South America. Cutaneous signs of ATLL are varied and may consist of macules (M), plaques (P), multiple papules (MP), tumoral nodules (TN), erythroderma (E) or mixed-lesions (≥2 predominant lesions, ML). M and P forms are believed to carry a better prognosis. However, data on cutaneous presentation of ATLL remains scarce. Herein, we report cases of ATLL with cutaneous involvement diagnosed in 4 Latin American countries over the last 3 decades. METHODS: We retrospectively analyzed patients (pts) diagnosed with ATLL between January 1995 and December 2019. ATLL subtypes were classified according to the Shimoyama criteria into acute, lymphomatous, chronic and smoldering. Primary cutaneous tumoral (PCT) va...

Blood

Background: Selective ligands of retinoid X receptor (i.e. bexarotene) are used in the treatment ... more Background: Selective ligands of retinoid X receptor (i.e. bexarotene) are used in the treatment of early and advanced stages of cutaneous T-cell lymphoma (CTCL). Relapsed or refractory cases of CTCL have poor prognosis and are in need of safe and more effective therapies. Synergy between bexarotene and interferon or phototherapy has been previously described. Objective: Report a Peruvian single-institution experience on eight cases of relapsed or refractory CTCL who were treated with low-dose bexarotene in combination with phototherapy or interferon alfa-2a. Methods: From 2002 to 2007, eight patients with relapsed or refractory CTCL were treated with bexarotene 300 mg by mouth daily in combination with interferon alfa-2a 9 million units subcutaneously three times a week (five patients) or phototherapy (two patients received PUVA therapy and one patient received narrow-wave UVB therapy). Bexarotene, interferon and phototherapy were continuously administered until progression of dise...

Blood

4790 Introduction Selective ligands of retinoid X receptor (i.e. bexarotene) are used in the trea... more 4790 Introduction Selective ligands of retinoid X receptor (i.e. bexarotene) are used in the treatment of early and advanced stages of cutaneous T-cell lymphoma (CTCL). The objective of this study is to report a Peruvian single-institution experience on 13 cases of relapsed or refractory CTCL who were treated with low-dose bexarotene alone or in combination with phototherapy or interferon alfa-2a. Methods From 2002 to 2008, thirteen patients with relapsed or refractory CTCL were treated with bexarotene at low dose (75-300 mg/day) as monotherapy (BEX; 3 cases) or in combination with interferon alfa-2a (INF) at 3-9 million units subcutaneously three times a week (5 cases) or phototherapy (PT; 4 cases). Therapy was continuously administered until progression of disease or unacceptable toxicity. Eight patients with mycosis fungoides (MF), two patients with aggressive epidermotropic CD8+ cytotoxic lymphoma (AECL), two patients with Sezary Syndrome (SS) and one with smoldering adult T-cel...

Leukemia & lymphoma, Jul 30, 2017

Dermatol Peru, Dec 1, 1999

En el tratamiento de las cicatrices queloides se ha utilizado múltiples modalidades terapéuticas,... more En el tratamiento de las cicatrices queloides se ha utilizado múltiples modalidades terapéuticas, tales como la infiltración intralesional de triancinolona, tratamientos compresivos, radioterapia superficial, cirugía con bisturí, criocirugía, las terapia o la ...

Folia Dermatol Peru, Dec 1, 2009

... CASO CLÍNICO 1 Médico residente de Dermatología. Hospital Nacional Edgardo Rebagliati Martins... more ... CASO CLÍNICO 1 Médico residente de Dermatología. Hospital Nacional Edgardo Rebagliati Martins, EsSalud. Lima-Perú. 2 Médico asistente del Servicio de Dermatología. Hospital Nacional Edgardo Rebagliati Martins, EsSalud. Lima-Perú. ...

Dermatol Peru, Apr 1, 2003

Dermatol Peru, Dec 1, 2002

Folia Dermatol Peru, Aug 1, 2009

La enfermedad de Rosai-Dorfman cutánea (ERDC) es una entidad inusual, de morfología clínica varia... more La enfermedad de Rosai-Dorfman cutánea (ERDC) es una entidad inusual, de morfología clínica variable, en la que el estudio histológico es importante para el diagnóstico, ya que se evidencia un infiltrado inflamatorio denso, compuesto principalmente por histiocitos y células plasmáticas, y el fenómeno de emperipolesis, caracterizado por histiocitos con diferentes estructuras celulares en su interior, que están siendo fagocitadas, estos histiocitos van a ser positivos para la proteína S100 y CD68. Generalmente tiene un curso clínico benigno con la posibilidad de resolución espontánea. Presentamos el caso de una paciente con el diagnóstico de enfermedad de Rosai-Dorfman cutánea con los criterios característicos de emperipolesis y positividad para S100 y CD68.

Dermatol Peru, Dec 1, 2007

RESUMEN Introducción: varias revisiones y guías de manejo de Micosis Fungoides (MF) y Síndrome Sé... more RESUMEN Introducción: varias revisiones y guías de manejo de Micosis Fungoides (MF) y Síndrome Sézary(SS) han sido publicados. Sin embargo, estrategias terapeúticas para esta entidad varían entre instituciones y países. Existen pocos estudios fase III que permitan tomar decisiones en el tratamiento de MF/SS. Por tanto éste es frecuentemente determinado por las experiencias institucionales. Objetivo: con el objeto de sumarizar la evidencia disponible y revisar las mejores prácticas, es que se realizó un Consenso Peruano llevado a cabo en Setiembre 2008 para establecer guías de diagnóstico y tratamiento de MF/SS. Resultados: este artículo revisa los criterios clínicos, histopatológicos y terapéuticos de MF/SS. Palabras clave: guías de manejo, Micosis fungoides, Síndrome Sézary. ABSTRACT Background: Several reviews and guidelines on the management of Mycosis Fungoides (MF) and Sézary syndrome (SS) have been published; however, treatment strategies for patients with MF/SS vary from inst...

Vitiligo is a skin disease whose therapy is no easy, we can use phototherapy PUVA and recently UV... more Vitiligo is a skin disease whose therapy is no easy, we can use phototherapy PUVA and recently UVB narrow band.

The American Journal of Dermatopathology, 2014

Extranodal marginal zone lymphoma (MZL) of mucosa-associated lymphoid tissue usually originates f... more Extranodal marginal zone lymphoma (MZL) of mucosa-associated lymphoid tissue usually originates from cutaneous or mucosal surfaces. A rare site of involvement is the subcutaneous tissue of any location. Here, we describe a 58-year-old man who presented with bilateral extranodal MZL of mucosa-associated lymphoid tissue from ocular adnexae that involved subcutaneous tissue and subsequently extended to multiple anatomical locations in the head and neck, upper back, and arm. The neoplastic cells expressed B-cell markers, and the plasma cells expressed IgG4. The unusual pattern of infiltration of this extranodal MZL and the possible significance of IgG4 expression in this case are discussed.

The chronic graft-versus-host-disease (GVHD) is the most frequent and serious complication of the... more The chronic graft-versus-host-disease (GVHD) is the most frequent and serious complication of the allogenic bone marrow transplantation. We present a patient who was refractory to prednisone, cyclosporine A, mycophenolate mofetil, ultraviolet irradiation and psoralen (PUVA), and rituximab.

sisbib.unmsm.edu.pe

La neoplasia blástica plasmocitoide de células dendríticas es un tumor poco frecuente que se pres... more La neoplasia blástica plasmocitoide de células dendríticas es un tumor poco frecuente que se presenta en adultos y tiene un curso clínico desfavorable. El cuadro inicial se manifi esta por afección cutánea y posteriormente evoluciona a una enfermedad extracutánea generalizada. Se presenta el caso de un varón con lesiones tumorales, algunas de ellas necróticas, con infi ltrado monomorfo de células atípicas a nivel de dermis y con inmunohistoquímica CD3 negativo, y CD4, CD56 y CD123 positivos. El cuadro correspondió a una neoplasia blástica plasmocitoide de células dendríticas con buena respuesta inicial a quimioterapia, sin embargo a los 12 meses el paciente falleció debido a un shock séptico.