An update on the treatment of cutaneous tumours

Cutaneous tumours continue to present a significant clinical challenge in equine practice. There are a large number of treatment options and selecting the appropriate modality requires careful consideration of a number of factors. While sarcoids are the most commonly diagnosed cutaneous tumour, their clinical appearance can have considerable overlap with other types of lesion, so biopsy should be performed where the diagnosis is uncertain. New treatment options for sarcoids include electrosurgery, electrochemotherapy and novel intralesional treatments. Melanomas still have relatively limited treatment options beyond surgical resection, but there are now limited data to support the use of a xenogenic DNA vaccination protocol. Squamous cell carcinomas are generally best treated via surgical excision, but a novel intralesional treatment may prove to be a useful option for further treatment.

Amentoflavone as an Ally in the Treatment of Cutaneous Leishmaniasis: Analysis of Its Antioxidant/Prooxidant Mechanisms

Treatment of leishmaniasis is a challenging subject. Although available, chemotherapy is limited, presenting toxicity and adverse effects. New drugs with antileishmanial activity are being investigated, such as antiparasitic compounds derived from plants. In this work, we investigated the antileishmanial activity of the biflavonoid amentoflavone on the protozoan Leishmania amazonensis. Although the antileishmanial activity of amentoflavone has already been reported in vitro, the mechanisms involved in the parasite death, as well as its action in vivo, remain unknown. Amentoflavone demonstrated activity on intracellular amastigotes in macrophages obtained from BALB/c mice (IC50 2.3 ± 0.93 μM). No cytotoxicity was observed and the selectivity index was estimated as greater than 10. Using BALB/c mice infected with L. amazonensis we verified the effect of an intralesional treatment with amentoflavone (0.05 mg/kg/dose, in a total of 5 doses every 4 days). Parasite quantification demonstrated that amentoflavone reduced the parasite load in treated footpads (46.3% reduction by limiting dilution assay and 56.5% reduction by Real Time Polymerase Chain Reaction). Amentoflavone decreased the nitric oxide production in peritoneal macrophages obtained from treated animals. The treatment also increased the expression of ferritin and decreased iNOS expression at the site of infection. Furthemore, it increased the production of ROS in peritoneal macrophages infected in vitro. The increase of ROS in vitro, associated with the reduction of NO and iNOS expression in vivo, points to the antioxidant/prooxidant potential of amentoflavone, which may play an important role in the balance between inflammatory and anti-inflammatory patterns at the infection site. Taken together these results suggest that amentoflavone has the potential to be used in the treatment of cutaneous leishmaniasis, working as an ally in the control and development of the lesion.

Intralesional measles, mumps, and rubella vaccine for the treatment of recalcitrant warts: A case series and review of literature

Objectives: To document the response of recalcitrant warts to intralesional measles, mumps, and rubella (MMR) vaccine. Materials and Methods: This case series reports the treatment response to intralesional MMR vaccine observed in 11 patients who attended the dermatology outpatient department with recalcitrant warts of more than 1 year duration. Only the largest wart was treated in each case. The intralesional treatment was repeated at an interval of 2 weeks. Results: Nine patients (81.9%) showed complete response to treatment. One patient did not return for treatment after two sessions (9.1%). One showed incomplete treatment response (9.1%). The adverse reactions noted among the 11 patients were pain (3/11, 27.3%) and secondary bacterial infection (1/11, 9.1%). Limitations: Results are based on a case series of 11 patients. Conclusion: Intralesional MMR vaccine was found effective and safe in the management of recalcitrant warts.