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      Angiotensin II receptor blockers as a risk factor for skin ulcers Translated title: Bloqueadores de angiotensina II como factor de riesgo para úlceras cutáneas

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          Abstract

          Abstract Objective: The aim of the study was to determine the risk factors associated with skin ulcers that were not of vascular, paraneoplastic, rheumatologic, or pressure origin. Methods: This was an observational, case- and control-designed, and retrospective trial. The group of cases was patients who presented skin ulcers that were not of vascular, paraneoplastic, or pressure origin. The control group was formed by ill subjects with no skin ulcers paired in age, sex, and chronic diseases. The cases were defined with the presence of an ulcer, at the 1st time consultation; treatment with medication, symptoms, progression time, and substance abuse were entered in a database. The statistical analysis of the results was performed using the EpiInfo software, version 7.2.2.6. Results: Between July 2005 and December 2020, 69 patients suffering from skin ulcers without apparent etiology were enrolled. Following the statistical analysis of all variables, a significant difference in favor of the cases with antihypertensive treatment with angiotensin II receptor blockers (ARBs) was obtained, with p ≤ 0.02 and odds ratio 2.24 with confidence interval 95 % (1.1–4.5). Conclusion: ARB medications are a risk factor for the presence of skin ulcers.

          Translated abstract

          Resumen Objetivo: Determinar los factores de riesgo que se asocian a úlceras cutáneas que no fueran de origen vascular, paraneoplásico, reumatológicas o por presión. Métodos: Estudio observacional con diseño de casos y controles, retrospectivo. El grupo de casos fueron pacientes que presentaban úlceras cutáneas que no fueran de origen vascular, paraneoplásico, reumatológicas o por presión. El grupo control se integró con enfermos sin úlceras cutáneas pareados por edad, sexo y enfermedades crónicas. Se definieron los casos con presencia de úlcera en la consulta de primera vez. Se capturó en una base de datos el tratamiento con medicamentos, los síntomas, el tiempo de evolución y las toxicomanías. El análisis estadístico de los resultados se realizó utilizando el programa de EpiInfo versión 7.2.2.6. Resultados: Entre julio del 2005 y diciembre del 2020 se registraron 69 pacientes con úlceras cutáneas sin etiología aparente. Después del análisis estadístico de todas las variables se obtuvo una diferencia significativa en favor de los casos con tratamiento antihipertensivos con antagonistas de los receptores de la angiotensina II (ARA II), con p < 0. 02 y razón de momios 2.24 (intervalo de confianza del 95%: 1.1-4.5). Conclusiones: Los medicamentos tipo ARA II son un factor de riesgo para la presencia de úlcera cutáneas.

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          Most cited references17

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          2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.

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            Revision of the CEAP classification for chronic venous disorders: consensus statement.

            The CEAP classification for chronic venous disorders (CVD) was developed in 1994 by an international ad hoc committee of the American Venous Forum, endorsed by the Society for Vascular Surgery, and incorporated into "Reporting Standards in Venous Disease" in 1995. Today most published clinical papers on CVD use all or portions of CEAP. Rather than have it stand as a static classification system, an ad hoc committee of the American Venous Forum, working with an international liaison committee, has recommended a number of practical changes, detailed in this consensus report. These include refinement of several definitions used in describing CVD; refinement of the C classes of CEAP; addition of the descriptor n (no venous abnormality identified); elaboration of the date of classification and level of investigation; and as a simpler alternative to the full (advanced) CEAP classification, introduction of a basic CEAP version. It is important to stress that CEAP is a descriptive classification, whereas venous severity scoring and quality of life scores are instruments for longitudinal research to assess outcomes.
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              Cutaneous reactions to drugs. An analysis of spontaneous reports in four Italian regions.

              Cutaneous manifestations are frequently reported in association with drug use. The aim of this study was to analyse the skin reactions reported to the spontaneous surveillance systems of four Italian regions (Friuli Venezia Giulia, Lombardy, Sicily and the Veneto), and correlate the reports with estimated drug consumption during the same period, paying particular attention to the reactions to antimicrobial agents and nonsteroidal anti-inflammatory drugs (NSAIDs). All of the adverse drug reactions (ADRs) reported spontaneously between January 1996 and December 1997 to the surveillance systems of four Italian regions (a total population of about 20 million people) were analysed by a panel of experts including dermatologists. On the basis of the Critical Term List of the World Health Organization (WHO), the reactions were classified as either serious or nonserious events. Drug consumption was expressed as a daily defined dose (DDD)/1000 inhabitants/day. A total of 2224 adverse skin reaction reports (44.7% of all of the reported ADRs) were identified, making a reporting rate of about 5.5 per 100 000 inhabitants/year. The female/male ratio was 1.58, and the reporting rate progressively increased with age. The drug categories with the highest number of cutaneous reactions were antimicrobials, followed by NSAIDs, analgesics and radiology contrast media. There was a total of 372 (16.9%) serious reaction reports, the most frequent being angioedema (171 cases), erythema multiforme (68 cases) and photosensitivity (37 cases). Co-trimoxazole, followed by the cephalosporins and fluoroquinolones, were associated with the highest consumption-related reporting rate among the antimicrobials, and aspirin and dipyrone among the NSAIDs and analgesics. Spontaneous reports from four Italian regions revealed that the skin was the organ most frequently affected by ADRs. The paper shows the validity of a regional decentralized system in Italy.
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                Author and article information

                Journal
                rmang
                Revista mexicana de angiología
                Rev. mex. angiol.
                Sociedad Mexicana de Angiología, Cirugía Vascular y Endovascular A.C. (Ciudad de México, Ciudad de México, Mexico )
                0377-4740
                2696-130X
                December 2021
                : 49
                : 4
                : 113-116
                Affiliations
                [1] Querétaro orgnameSan Luca Centro Vascular orgdiv1Research Department Mexico
                Article
                S2696-130X2021000400113 S2696-130X(21)04900400113
                10.24875/rma.21000040
                8253b9ec-dda6-451c-9aa7-c1aaa96136ad

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 20 September 2021
                : 24 October 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 17, Pages: 4
                Product

                SciELO Mexico

                Categories
                Original articles

                ARA II,Úlceras cutáneas,Nonvascular ulcers,Úlceras no vasculares,Skin ulcers,Angiotensin II receptor blockers

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