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diagnosed with SLE 13 years ago&#44; with good clinical and laboratory control&#44; using hydroxychloroquine and dapsone was assessed&#46; She had an ophiasis pattern AA&#44; with yellow and black dots and exclamation mark hairs on dermoscopy&#46; Histopathological examination showed peribulbar lymphocytic infiltrate and miniaturized follicles&#44; excluding the diagnosis of associated lupus alopecia&#46; She underwent topical treatments with no response but showed temporary improvement of the alopecia while receiving MTX15<span class="elsevierStyleHsp" style=""></span>mg&#47;week for the treatment of SLE&#44; discontinued after nine months due to hepatotoxicity&#46; Two years later&#44; it was decided to employ the transepidermal use of this medication&#44; using the MMP&#174; technique&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Exams prior to the procedure showed no changes in blood count&#44; GOT of 26 U&#47;L&#44; GPT of 20 U&#47;L&#44; Gamma-GT of 14 U&#47;L&#44; alkaline phosphatase of 57 U&#47;L&#44; and total bilirubin of 0&#46;45<span class="elsevierStyleHsp" style=""></span>mg&#47;dL &#40;Direct 0&#46;18<span class="elsevierStyleHsp" style=""></span>mg &#47;dL &#8210; Indirect 0&#46;27<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#41;&#46; She underwent an MMP&#174; session with the microinfusion of 20<span class="elsevierStyleHsp" style=""></span>mg of MTX in the alopecia patches&#46; Control exams after one week showed GOT of 37 U&#47;L and GPT of 48 U&#47;L&#46; She was an asymptomatic patient&#44; and did not use any other medications&#44; without alcohol consumption or possible confounding factors&#46; A new control exam was performed after two weeks which revealed that the transaminases had returned to baseline parameters&#46; Treatment was discontinued&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">The MMP&#174; technique consists of the percutaneous administration of drugs using a tattoo device&#46; Its needles allow drug infusion regardless of the molecular weight&#44; chemical characteristics of the medium &#40;lipophilic or hydrophilic&#41;&#44; bleeding&#44; or exudation&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Its use has been described in the treatment of idiopathic guttate hypomelanosis&#44; androgenetic alopecia&#44; and psoriasis&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Other transcutaneous permeation techniques&#44; such as fractional laser&#44; microneedling&#44; radiofrequency&#44; sonophoresis&#44; and iontophoresis have been discussed with promising results&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">The use of systemic MTX for cases of refractory AA has shown satisfactory results&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> However&#44; it carries a risk of myelosuppression and hepatotoxicity&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;5</span></a> The first description of its use with the MMP&#174; technique referred to patients with psoriasis who were intolerant to systemic therapy&#44; with good response and tolerability&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> The advantages of this method include reduced toxicity by avoiding the hepatic first-pass metabolism&#44; and the use of lower doses of medication due to good permeation into the dermis&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The authors chose this technique due to the lower systemic absorption&#44; aiming to prevent the previously reported hepatic adverse effects&#46; However&#44; after just one session of MMP&#174; on the scalp&#44; a highly vascularized region&#44; an elevation of transaminases was identified&#44; which proved to be transient&#46; It is important to note that if the treatment had been continued&#44; a probable worsening of transaminase elevation would have been observed&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">The authors emphasize the importance of the rational use of techniques that involve the permeation of drugs through the skin&#44; taking into consideration the possibility of absorption and systemic adverse effects&#46; As it is an off-label medication for AA&#44; with the transdermal route not being described in the package insert&#44; the authors suggest a cautious use of the drug&#44; with laboratory monitoring and regular clinical evaluation&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Financial support</span><p id="par0045" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Authors&#39; contributions</span><p id="par0050" class="elsevierStylePara elsevierViewall">Bianca Lopes Nogueira&#58; Design and planning of the study&#59; collection&#44; analysis and interpretation of data&#59; drafting and editing of the manuscript and critical review of important intellectual content&#59; critical review of the literature&#59; approval of the final version of the manuscript&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Renan Rangel Bonamigo&#58; Drafting and editing of the manuscript and critical review of important intellectual content&#59; effective participation in research orientation&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the studied cases&#59; critical review of the literature&#59; approval of the final version of the manuscript&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Renata Heck&#58; Design and planning of the study&#59; drafting and editing of the manuscript and critical review of important intellectual content&#59; effective participation in research orientation&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the studied cases&#59; critical review of the literature&#59; approval of the final version of the manuscript&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflicts of interest</span><p id="par0065" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span></span>"
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Letter - Clinical
Elevation of transaminases after MMP® session with methotrexate for alopecia areata treatment – how much do we know about the risks of systemic absorption of the technique?
Bianca Lopes Nogueiraa,
Corresponding author
, Renan Rangel Bonamigoa,b,c, Renata Heckb
a Dermatology Service, Ambulatory of Sanitary Dermatology, Secretaria de Saúde do Estado do Rio Grande do Sul, Porto Alegre, RS, Brazil
b Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
c Dermatology Service, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">There is a higher incidence of alopecia areata &#40;AA&#41; in patients with lupus erythematosus&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Some cases of AA are refractory to the established treatments&#46; Percutaneous drug induction techniques have shown promising results&#44;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> including the microinfusion of drugs into the skin &#40;MMP&#174;&#44; <span class="elsevierStyleItalic">Microinfus&#227;o de Medicamentos na Pele</span>&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Given its recent use&#44; little is known about its safety&#46; This case report describes a case of transaminase elevation after a session of MMP&#174; with methotrexate &#40;MTX&#41; in a patient with AA associated with systemic lupus erythematosus &#40;SLE&#41;&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">A 37-year-old white female patient&#44; diagnosed with SLE 13 years ago&#44; with good clinical and laboratory control&#44; using hydroxychloroquine and dapsone was assessed&#46; She had an ophiasis pattern AA&#44; with yellow and black dots and exclamation mark hairs on dermoscopy&#46; Histopathological examination showed peribulbar lymphocytic infiltrate and miniaturized follicles&#44; excluding the diagnosis of associated lupus alopecia&#46; She underwent topical treatments with no response but showed temporary improvement of the alopecia while receiving MTX15<span class="elsevierStyleHsp" style=""></span>mg&#47;week for the treatment of SLE&#44; discontinued after nine months due to hepatotoxicity&#46; Two years later&#44; it was decided to employ the transepidermal use of this medication&#44; using the MMP&#174; technique&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Exams prior to the procedure showed no changes in blood count&#44; GOT of 26 U&#47;L&#44; GPT of 20 U&#47;L&#44; Gamma-GT of 14 U&#47;L&#44; alkaline phosphatase of 57 U&#47;L&#44; and total bilirubin of 0&#46;45<span class="elsevierStyleHsp" style=""></span>mg&#47;dL &#40;Direct 0&#46;18<span class="elsevierStyleHsp" style=""></span>mg &#47;dL &#8210; Indirect 0&#46;27<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#41;&#46; She underwent an MMP&#174; session with the microinfusion of 20<span class="elsevierStyleHsp" style=""></span>mg of MTX in the alopecia patches&#46; Control exams after one week showed GOT of 37 U&#47;L and GPT of 48 U&#47;L&#46; She was an asymptomatic patient&#44; and did not use any other medications&#44; without alcohol consumption or possible confounding factors&#46; A new control exam was performed after two weeks which revealed that the transaminases had returned to baseline parameters&#46; Treatment was discontinued&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">The MMP&#174; technique consists of the percutaneous administration of drugs using a tattoo device&#46; Its needles allow drug infusion regardless of the molecular weight&#44; chemical characteristics of the medium &#40;lipophilic or hydrophilic&#41;&#44; bleeding&#44; or exudation&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Its use has been described in the treatment of idiopathic guttate hypomelanosis&#44; androgenetic alopecia&#44; and psoriasis&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Other transcutaneous permeation techniques&#44; such as fractional laser&#44; microneedling&#44; radiofrequency&#44; sonophoresis&#44; and iontophoresis have been discussed with promising results&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">The use of systemic MTX for cases of refractory AA has shown satisfactory results&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> However&#44; it carries a risk of myelosuppression and hepatotoxicity&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;5</span></a> The first description of its use with the MMP&#174; technique referred to patients with psoriasis who were intolerant to systemic therapy&#44; with good response and tolerability&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> The advantages of this method include reduced toxicity by avoiding the hepatic first-pass metabolism&#44; and the use of lower doses of medication due to good permeation into the dermis&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The authors chose this technique due to the lower systemic absorption&#44; aiming to prevent the previously reported hepatic adverse effects&#46; However&#44; after just one session of MMP&#174; on the scalp&#44; a highly vascularized region&#44; an elevation of transaminases was identified&#44; which proved to be transient&#46; It is important to note that if the treatment had been continued&#44; a probable worsening of transaminase elevation would have been observed&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">The authors emphasize the importance of the rational use of techniques that involve the permeation of drugs through the skin&#44; taking into consideration the possibility of absorption and systemic adverse effects&#46; As it is an off-label medication for AA&#44; with the transdermal route not being described in the package insert&#44; the authors suggest a cautious use of the drug&#44; with laboratory monitoring and regular clinical evaluation&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Financial support</span><p id="par0045" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Authors&#39; contributions</span><p id="par0050" class="elsevierStylePara elsevierViewall">Bianca Lopes Nogueira&#58; Design and planning of the study&#59; collection&#44; analysis and interpretation of data&#59; drafting and editing of the manuscript and critical review of important intellectual content&#59; critical review of the literature&#59; approval of the final version of the manuscript&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Renan Rangel Bonamigo&#58; Drafting and editing of the manuscript and critical review of important intellectual content&#59; effective participation in research orientation&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the studied cases&#59; critical review of the literature&#59; approval of the final version of the manuscript&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Renata Heck&#58; Design and planning of the study&#59; drafting and editing of the manuscript and critical review of important intellectual content&#59; effective participation in research orientation&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the studied cases&#59; critical review of the literature&#59; approval of the final version of the manuscript&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflicts of interest</span><p id="par0065" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span></span>"
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                        "paginaFinal" => "755"
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Article information
ISSN: 03650596
Original language: English
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