Ivor Caro - Academia.edu (original) (raw)

Papers by Ivor Caro

Archives of Dermatology, May 1, 1984

To the Editor.— The longer I am in dermatology, the more cutaneous conditions I discover in mysel... more To the Editor.— The longer I am in dermatology, the more cutaneous conditions I discover in myself (at one time or another). I have been involved in dermatology for 12 years and the list lengthens—Sutton's nevus, seborrheic dermatitis, urticaria, connubial contact dermatitis, 1 Mondor's disease, warts, vitiligo, and now, thanks to Mahood, 2 familial lichen planus. I had lichen planus at the age of 20 years just before examinations. The condition was self-limiting (once the stress of the examinations had passed). Late last year (1982), my 9-year-old, younger son had typical and widespread lichen planus. Although I explained to my wife that no specific therapy was available or required, I still had to dissuade her from seeking a second opinion. The lichen planus did resolve spontaneously in four months. The age distribution in my two cases agrees with that given by Mahood in that familial lichen planus seems to be

Archives of Dermatology, Jun 1, 1979

In 1943, Kitamura and Akamatsu1described a male patient who had a reticulate pattern of freckle-l... more In 1943, Kitamura and Akamatsu1described a male patient who had a reticulate pattern of freckle-like, slightly depressed macules on the extensor surfaces of his hands and feet. Two similar patients were described in 1953 by Kitamura et al.2Seven further cases that were reported by Griffiths3in 1976 were the first to be described outside of Japan. Griffiths' cases came from Asia, Africa, and Europe. We believe that this may be the first case of reticulate acropigmentation of Kitamura (RAPK) to be described in the Americas. Report of a Case A 17-year-old girl was seen in a dermatology clinic with small, 1- to 4-mm, depressed, pitted macules, in a reticulate pattern, on the palmar and dorsal aspects of her hands and on the plantar and dorsal aspects of her feet (Figure). The lesions were first noted when the patient was 3 years old, and they progressively

Dermatology Reports, Dec 1, 2011

Tumor responses in advanced basal cell carcinoma (BCC) have been observed in clinical trials with... more Tumor responses in advanced basal cell carcinoma (BCC) have been observed in clinical trials with vismodegib, a SMO antagonist. The result of SMO antagonism is inhibition Hedgehog Signaling Pathway (HHSP) downstream target genes. HHSP inhibition has been shown to affect stem cells responsible for blood, mammary, and neural development. We report on our experience of treating two patients with advanced BCC participating. These two patients have had no new BCCs develop for at least 2.25 years. Both patients have been receiving ongoing daily treatment with vismodegib for greater than 2.75 years without experiencing any significant side effects. After prolonged continuous daily dosing with a SMO antagonist, we have not observed a significant alteration in hematologic parameters or physical abnormalities of the pectoral regions of two patients with advanced BCC.

V600 mutations were eligible. Patients also had to have a life expectancy of at least 3 months, a... more V600 mutations were eligible. Patients also had to have a life expectancy of at least 3 months, an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1, and adequate haematological, hepatic, and renal function. Patients were randomly assigned by interactive voice recognition system to receive either vemurafenib (960 mg orally twice daily) or dacarbazine (1000 mg/m² of body surface area intravenously every 3 weeks). Coprimary endpoints were overall survival and progression-free survival, analysed in the intention-to-treat population (n=675), with data censored at crossover. A sensitivity analysis was done. This trial is registered with ClinicalTrials.gov, NCT01006980. Findings 675 eligible patients were enrolled from 104 centres in 12 countries between Jan 4, 2010, and Dec 16, 2010. 337 patients were randomly assigned to receive vemurafenib and 338 to receive dacarbazine. Median follow-up was 12·5 months (IQR 7·7-16·0) on vemurafenib and 9·5 months (3·1-14·7) on dacarbazine. 83 (25%) of the 338 patients initially randomly assigned to dacarbazine crossed over from dacarbazine to vemurafenib. M edian overall survival was signifi cantly longer in the vemurafenib group than in the dacarbazine group (13·6 months (95% CI 12·0-15·2) vs 9·7 months (7·9-12·8); hazard ratio (HR) 0·70 (95% CI 0·57-0·87); p=0·0008), as was median progression-free survival (6·9 months (95% CI 6·1-7·0) vs 1·6 months (1·6-2·1); HR 0·38 (95% CI 0·32-0·46); p<0·0001). For the 598 (91%) patients with BRAF V600E disease, median overall survival in the vemurafenib group was 13·3 months (95% CI 11·9-14·9) compared with 10·0 months (8·0-14·0) in the dacarbazine group (HR 0·75 (95% CI 0·60-0·93); p=0·0085); median progression-free survival was 6·9 months (95% CI 6·2-7·0) and 1·6 months (1·6-2·1), respectively (HR 0·39 (95% CI 0·33-0·47); p<0·0001). For the 57 (9%) patients with BRAF V600K disease, median overall survival in the vemurafenib group was 14·5 months (95% CI 11·2-not estimable) compared with 7·6 months (6·1-16·6) in the dacarbazine group (HR 0·43 (95% CI 0·21-0·90); p=0·024); median progression-free survival was 5·9 months (95% CI 4·4-9·0) and 1·7 months (1·4-2·9), respectively (HR 0·30 (95% CI 0·16-0·56); p<0·0001). The most frequent grade 3-4 events were cutaneous squamous-cell carcinoma (65 (19%) of 337 patients) and keratoacanthomas (34 (10%)), rash (30 (9%)), and abnormal liver function tests (38 (11%)) in the vemurafenib group and neutropenia (26 (9%) of 287 patients) in the dacarbazine group. Eight (2%) patients in the vemurafenib group and seven (2%) in the dacarbazine group had grade 5 events.

Arquivos da Maternidade Dr. Alfredo da Costa, 2002

PubMed, May 1, 2018

Vismodegib (Erivedge, Genentech-Roche) is the first in class of Hedgehog pathway inhibitors appro... more Vismodegib (Erivedge, Genentech-Roche) is the first in class of Hedgehog pathway inhibitors approved for treatment of metastatic basal cell carcinoma (BCC), or locally advanced BCC that has recurred after surgery or is not amenable to surgery or radiation. Its path to discovery has been unique and traces its origin to corn lilies, sheep, Drosophila flies, and the Hedgehog signaling pathway. J Drugs Dermatol. 2018;17(5):506-508.

Contact Dermatitis, Dec 1, 1978

Journal of The American Academy of Dermatology, Mar 1, 2004

Retinoids have been used for the treatment and suppression of cutaneous malignancies in patients ... more Retinoids have been used for the treatment and suppression of cutaneous malignancies in patients with basal cell nevus syndrome, xeroderma pigmentosum, and in patients with recurrent skin cancers as a result of immunosuppression for renal transplantation. We report a 40-year-old male who began to develop multiple squamous cell carcinomas of the skin after treatment with PUVA for severe psoriasis. The numbers of squamous cell carcinomas increased when acitretin was discontinued and decreased when he was taking the drug at a dose of 25 mg daily. Acitretin should be considered as a maintenance therapy for psoriasis patients developing squamous cell carcinomas as a result of PUVA therapy.

Postgraduate Medicine, Nov 15, 1984

Most changes that occur in the aging face are related to gravity working on skin that is becoming... more Most changes that occur in the aging face are related to gravity working on skin that is becoming progressively thinner, drier, and less elastic. Exposure to sunlight hastens these changes, and protection from the sun is the only proved way to delay them. Dermabrasion, chemabrasion, and collagen implant (Zyderm) injection are safe and effective nonsurgical procedures that can improve the appearance of the aging face. Plastic surgical procedures to remove excess skin at the upper eyelids, raise the eyebrows, tighten the lower lids, and elevate the nasal tip can provide functional as well as cosmetic improvement.

Clinics in Dermatology, Apr 1, 1988

International Journal of Dermatology, Sep 1, 1976

International Journal of Dermatology, Jun 1, 1978

In 1908, Seibenmann, who was professor of otolaryngology in Basel, Switzerland, reported what app... more In 1908, Seibenmann, who was professor of otolaryngology in Basel, Switzerland, reported what appears to be the first case of lipoid proteinosis.1 His patient, a 19-year-old woman, had generalized hyperkeratosis of the skin and thickening of mucosal surfaces, including lips, tongue, soft and hard palate, tonsillar crypts, epiglottis and larynx. Thi s patient had 3 normal sisters. In 1925, Miescher, a Swiss dermatologist, reported 3 similar patients whose parents were first cousins and had a total of 16 children. In 1929, Erich Urbach a dermatologist, and Camillo Wiethe 1

Journal of The American Academy of Dermatology, Sep 1, 1980

American Journal of Ophthalmology, Oct 1, 2014

To determine the frequency of ocular adverse effects associated with vemurafenib (PLX4032) treatm... more To determine the frequency of ocular adverse effects associated with vemurafenib (PLX4032) treatment for metastatic cutaneous melanoma. DESIGN: Retrospective review of the clinical study reports from the clinical pharmacology, phase 1, phase 2, and phase 3 trials of vemurafenib. METHODS: The vemurafenib clinical trials were a multicenter series involving adult patients with histologically confirmed, BRAF V600 mutation-positive, unresectable, stage IIIC or IV melanoma. A total of 855 patients were enrolled in the trials: 568 patients were treated with vemurafenib and 287 patients were treated with dacarbazine. RESULTS: Among the 568 patients treated with vemurafenib, ocular adverse effects developed in 22% (95% confidence interval [CI], 18.5-25.6). The most common ocular diagnosis was uveitis (4.0%; 95% CI, 2.6-6.0), followed by conjunctivitis (2.8%; 95% CI, 1.6-4.5) and dry eyes (2.0%; 95% CI, 1.1-3.7). All were successfully managed while vemurafenib therapy was continued. CONCLUSIONS: Ocular adverse events and symptoms may be seen in more than one-fifth of patients being treated with vemurafenib. However, vemurafenib can be continued while the ocular symptoms are being managed. The pathogenesis of ocular symptoms in this patient population is unclear; additional studies are necessary.

Archives of Dermatology, Nov 1, 1984

Obstetrical & Gynecological Survey, Feb 1, 1978

Seminars in Cutaneous Medicine and Surgery, Mar 1, 2001

Dermatomyositis is a disease that has a characteristic skin eruption that may occur with or witho... more Dermatomyositis is a disease that has a characteristic skin eruption that may occur with or without a proximal myopathy. The disease with cutaneous features only is classified as amyopathic dermatomyositis. The origin is unknown, but autoimmune factors are believed to play an important role. Autoantibodies are found in most patients and some have myositis-specific antibodies. Systemic changes may occur and there appears to be a relationship to internal malignancy, particularly in older patients. Juvenile disease has an associated vasculopathy. Treatment includes systemic corticosteroids and other immunosuppressive agents. The cutaneous changes may be difficult to treat.

Dermatology, 1975

Two cases of pseudoxanthoma elasticum with elastosis perforans serpiginosa are presented. The two... more Two cases of pseudoxanthoma elasticum with elastosis perforans serpiginosa are presented. The two conditions and their association are briefly discussed.

Dermatology, 1973

Aspergillosis is an opportunistic infection. It usually involves the lungs, but rarely involves t... more Aspergillosis is an opportunistic infection. It usually involves the lungs, but rarely involves the skin. An example of cutaneous involvement is presented. AspergiUosis as a cause of granulomatous lesions in debilitated patients is discussed.