Imiquimod is an immunomodulator of the imidazoquinoline group which possesses antiviral and antitumour activities. Although its mechanism of action has not been entirely elucidated yet, imiquimod 5% cream has been shown to be an efficient, long-lasting and safe therapy for multiple actinic keratoses in non-immunosuppressed patients and in transplant recipients. We report the case of a 44-year-old patient with a third renal transplant who developed an acute tubular necrosis confirmed by renal biopsy after the use of imiquimod 5% cream. The result of a literature search revealed a wide variety of side effects attributable to the use of imiquimod.

Biological drugs have prompted a revolution in the treatment of patients with psoriasis because of their favourable efficacy/risk profile. The aims of our study are to determine whether there is any difference in the pattern of use of biological treatments for older (65+ years) and younger patients diagnosed with plaque psoriasis by the Dermatology Service of the Hospital Universitario de Asturias (HUCA), to understand the survival of these drugs, and to identify the factors that predict the discontinuation of treatments. We report a retrospective observational hospital-based study of 300 patients registered at HUCA’s Dermatology Service who were receiving one of the following biological treatments for psoriasis on 30 November 2020: adalimumab, ustekinumab, secukinumab, or ixekizumab. The age groups were compared using Student’s t-test for quantitative variables and the chi-squared test for qualitative variables. We used the Kaplan–Meier estimator to estimate the survival function and the log-rank test to measure differences. No statistically significant differences in the frequency of use were noted between the younger and older groups, for any of the drugs studied. Survival on a drug regime, globally and individually, was similar in the two age groups. Factors predicting lower overall survival were being female, obesity, and having undergone previous biological treatment. The first three factors were influential in the under-65-year-old group, while arthritis was a significant factor for the older group.

Background and objectives: The efficacy and safety of ustekinumab have been proved in clinical trials. In daily clinical practice, knowing the factors that determine survival differences of biological drugs allows psoriasis treatment to be optimized as a function of patient characteristics. The main objectives of this work are to understand ustekinumab drug survival in patients diagnosed with plaque psoriasis in the Hospital Universitario Central de Asturias (HUCA Dermatology Department, and to identify the predictors of drug discontinuation. Materials and Methods: A retrospective hospital-based study, including data from 148 patients who were receiving ustekinumab (Stelara^®) between 1 February 2009 and 30 November 2019, were collected. Survival curves were approximated through the Kaplan–Meier estimator and compared using the log-rank test. Proportional hazard Cox regression models were used for multivariate analyses while both unadjusted and adjusted hazard ratios (HR) were used for summarizing the studied differences. Results: The average duration of the treatment before discontinuation was 47.57 months (SD 32.63 months; median 41 months). The retention rates were 82% (2 years), 66% (5 years), and 58% (8 years). Median survival was 80 months (95% confidence interval. CI 36.9 to 123.01 months). The survival study revealed statistically significant differences between patients with arthritis (log-rank test, p < 0.001) and those who had previously received biological treatment (log-rank test, p = 0.026). The five-year prevalence in patients still under treatment was 80% (those without arthritis) and 54% (arthritis patients). In the multivariate analysis, only the patients with arthritis had a lower rate of drug survival. No statistically significant differences were observed for any of the other comorbidities studied. The first and second most frequent causes of discontinuation were secondary failure and arthritis inefficacy, respectively. Conclusion: Ustekinumab is a biological drug conferring high survival in plaque psoriasis patients. Ustekinumab survival is lower in patients with arthritis.

Background/Objectives: The incidence of both non-melanoma and melanoma skin cancers has increased significantly in recent years. Understanding their epidemiology is essential for implementing effective community prevention strategies and optimizing healthcare resource planning. This study aimed to (1) quantify the number of skin tumors diagnosed at the Central University Hospital of Asturias (HUCA) from 2014 to 2023; (2) describe temporal trends in the incidence of basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma; and (3) analyze the clinical and histopathological features of melanoma and estimate age-standardized incidence rates. Methods: A retrospective study was conducted using data from the Pathology Registry of HUCA. Diagnosed cases were collected in an Excel database and analyzed with SPSS v.27. Quantitative variables were expressed as mean ± standard deviation; categorical variables as counts and percentages. Incidence rates and 95% confidence intervals were calculated using EPIDAT 4.2, based on the European standard population. Municipal population data were obtained from the SADEI website. Results: A total of 7477 BCC, 2689 SCC, and 585 melanoma cases were identified. Over the study period, BCC cases increased by 50%, SCC by 80%, and melanoma by 159%. Among melanoma cases, 89% were diagnosed by dermatologists, 60% were women, 33.1% were melanoma in situ, and 73.3% were superficial spreading melanomas. Age-standardized melanoma incidence rose from 8.85/100,000 in 2014 to 18.50 in 2023. Conclusions: Skin cancer incidence, especially melanoma, has risen markedly in Asturias, with more in situ cases suggesting improved early detection. The 2020 decline reflects COVID-19′s impact on access to care, underscoring the need for sustained prevention and screening efforts.