RESUMO
We report the case of an 8-year-old boy who was taking amantadine off label for multiple childhood neurobehavioral disorders and subsequently developed livedo reticularis. Although this side effect is well-described in adult patients taking amantadine for Parkinson disease, it is now being seen in children as the off-label use of amantadine is expanded to this population.
Assuntos
Amantadina/uso terapêutico , Fármacos do Sistema Nervoso Central/uso terapêutico , Livedo Reticular/induzido quimicamente , Transtornos do Neurodesenvolvimento/tratamento farmacológico , Uso Off-Label , Criança , Toxidermias/etiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Humanos , MasculinoAssuntos
Adjuvantes Imunológicos/efeitos adversos , Ácido Hialurônico/efeitos adversos , Livedo Reticular/induzido quimicamente , Livedo Reticular/diagnóstico , Adjuvantes Imunológicos/administração & dosagem , Idoso , Humanos , Ácido Hialurônico/administração & dosagem , Injeções Intra-Articulares/efeitos adversos , Masculino , Pessoa de Meia-IdadeAssuntos
Antibacterianos/efeitos adversos , Livedo Reticular/induzido quimicamente , Minociclina/efeitos adversos , Poliarterite Nodosa/induzido quimicamente , Adulto , Feminino , Humanos , Livedo Reticular/tratamento farmacológico , Livedo Reticular/patologia , Pessoa de Meia-Idade , Poliarterite Nodosa/tratamento farmacológico , Poliarterite Nodosa/patologia , Rosácea/tratamento farmacológicoAssuntos
Livedo Reticular/induzido quimicamente , Livedo Reticular/fisiopatologia , Norepinefrina/efeitos adversos , Idoso , Humanos , Hipotensão/tratamento farmacológico , Perna (Membro)/fisiopatologia , Masculino , Norepinefrina/administração & dosagem , Norepinefrina/uso terapêutico , Pele/fisiopatologia , Hemorragia Subaracnóidea/tratamento farmacológicoRESUMO
Although livedo reticularis is a known adverse effect of amantadine, only limited studies have addressed this association. Livedo racemosa in contrast to livedo reticularis is characterized by a striking violaceous netlike pattern of the skin similar to livedo reticularis with a different histopathology and morphology (irregular, broken circular segments). In this case report, we present 2 cases of livedo racemosa and edema of lower extremities following amantadine treatment. The cutaneous biopsies in both cases showed intraluminal thrombi in subcutaneous blood vessels without evidence of vasculitis, which is consistent with livedo racemosa.
Assuntos
Amantadina/efeitos adversos , Antiparkinsonianos/efeitos adversos , Toxidermias/etiologia , Livedo Reticular/induzido quimicamente , Feminino , Humanos , Perna (Membro) , Masculino , Pessoa de Meia-IdadeRESUMO
Livedo reticularis is a spastic-anatomical condition of the small vessels which translates morphologically by a reticular pattern, interspersing cyanosis, pallor and erythema. The same can be congenital or acquired. Among the acquired, we highlight the physiological livedo reticularis and the idiopathic livedo by vasospasm; the latter configures the most common cause. The drug-induced type is less common. The drugs amantadine and norepinephrine are often implicated. Cyanosis is usually reversible if the causative factor is removed, however, with chronicity, the vessels may become permanently dilated and telangiectatic. We report a case of a patient diagnosed with Parkinson's disease with chronic livedo reticularis associated with the use of amantadine and improvement after discontinuation of the drug.
Assuntos
Amantadina/efeitos adversos , Antiparkinsonianos/efeitos adversos , Livedo Reticular/induzido quimicamente , Idoso , Humanos , Livedo Reticular/patologia , Masculino , Doença de Parkinson/tratamento farmacológico , Pele/irrigação sanguínea , Pele/patologiaRESUMO
AbstractLivedo reticularis is a spastic-anatomical condition of the small vessels which translates morphologically by a reticular pattern, interspersing cyanosis, pallor and erythema. The same can be congenital or acquired. Among the acquired, we highlight the physiological livedo reticularis and the idiopathic livedo by vasospasm; the latter configures the most common cause. The drug-induced type is less common. The drugs amantadine and norepinephrine are often implicated. Cyanosis is usually reversible if the causative factor is removed, however, with chronicity, the vessels may become permanently dilated and telangiectatic. We report a case of a patient diagnosed with Parkinson's disease with chronic livedo reticularis associated with the use of amantadine and improvement after discontinuation of the drug.
Assuntos
Idoso , Humanos , Masculino , Amantadina/efeitos adversos , Antiparkinsonianos/efeitos adversos , Livedo Reticular/induzido quimicamente , Livedo Reticular/patologia , Doença de Parkinson/tratamento farmacológico , Pele/irrigação sanguínea , Pele/patologiaRESUMO
Dapsone is a drug commonly used in the treatment of various dermatological diseases. Here, we report the case of a 45-year-old female prescribed dapsone for chronic urticaria after which she developed extensive livedo reticularis in the limbs, abdomen, and trunk. The use of dapsone may be associated with a plethora of adverse effects including rash but livedo reticularis has been very rarely reported. Emphasis should be laid on the possible drug etiology in any patient who develops new signs and symptoms while on medications, even if it may not be supported by enough literature.
Assuntos
Anti-Infecciosos/efeitos adversos , Dapsona/efeitos adversos , Livedo Reticular/induzido quimicamente , Urticária/tratamento farmacológico , Anti-Infecciosos/administração & dosagem , Anti-Infecciosos/uso terapêutico , Doença Crônica , Dapsona/administração & dosagem , Dapsona/uso terapêutico , Feminino , Humanos , Livedo Reticular/diagnóstico , Pessoa de Meia-IdadeAssuntos
Amantadina/efeitos adversos , Livedo Reticular/induzido quimicamente , Doença de Parkinson/tratamento farmacológico , Idoso , Antiparkinsonianos/uso terapêutico , Carbidopa/uso terapêutico , Quimioterapia Combinada , Feminino , Humanos , Indanos/uso terapêutico , Levodopa/uso terapêutico , Doença de Parkinson/complicaçõesRESUMO
A 31-year-old woman with MS developed livedo reticularis and secondary Raynaud phenomenon 2.5 years after introduction of interferon beta-1b. The symptoms disappeared after withdrawal of the drug. Livedo reticularis and Raynaud phenomenon as well as pulmonary arterial hypertension, venous sinus thrombosis, pulmonary embolism and renal thrombotic microangiopathy have all been described in association with interferon beta therapy. These complications strongly suggest that type I interferons have vasoconstrictive and procoagulant effects with potentially serious systemic complications.
Assuntos
Interferon beta/efeitos adversos , Livedo Reticular/induzido quimicamente , Esclerose Múltipla/tratamento farmacológico , Doença de Raynaud/induzido quimicamente , Adulto , Feminino , Humanos , Interferon beta-1b , Livedo Reticular/diagnóstico , Livedo Reticular/patologia , Doença de Raynaud/diagnóstico , Resultado do TratamentoRESUMO
This is a case report of a 69-year-old female with Parkinson's disease who developed an asymptomatic eruption on her legs bilaterally. Clinical and histologic examination was consistent with livedo reticularis, which was temporally associated with initiation of rasagiline. The pathogenesis of livedo reticularis is discussed along with the possible mechanisms for both rasagiline and amantidine causing drug-induced livedo reticularis in patients.
Assuntos
Indanos/efeitos adversos , Perna (Membro)/patologia , Livedo Reticular/induzido quimicamente , Livedo Reticular/diagnóstico , Idoso , Feminino , Humanos , Doença de Parkinson/diagnóstico , Doença de Parkinson/tratamento farmacológicoRESUMO
We report the case of a 58-year-old white female with Parkinson's disease. She evolved to an extensive livedo reticularis in the limbs and abdomen after commencing treatment with amantadine. We discuss the diagnostic approach to livedo reticularis and its differential diagnoses, emphasizing that the drug etiology must be considered when investigating livedo reticularis.
Assuntos
Amantadina/efeitos adversos , Antiparkinsonianos/efeitos adversos , Livedo Reticular/induzido quimicamente , Doença de Parkinson/tratamento farmacológico , Feminino , Humanos , Pessoa de Meia-IdadeAssuntos
Antibacterianos/efeitos adversos , Toxidermias/etiologia , Toxidermias/patologia , Oxigenoterapia Hiperbárica , Perna (Membro)/patologia , Livedo Reticular/induzido quimicamente , Livedo Reticular/patologia , Penicilina G Benzatina/efeitos adversos , Antibacterianos/administração & dosagem , Pré-Escolar , Humanos , Injeções Intramusculares , Masculino , Necrose/prevenção & controle , Penicilina G Benzatina/administração & dosagem , Síndrome , Fatores de TempoRESUMO
We report the case of a 58-year-old white female with Parkinson's disease. She evolved to an extensive livedo reticularis in the limbs and abdomen after commencing treatment with amantadine. We discuss the diagnostic approach to livedo reticularis and its differential diagnoses, emphasizing that the drug etiology must be considered when investigating livedo reticularis.
Descreve-se caso clínico de paciente feminina adulta, portadora de doença de Parkinson em uso de amantadina que desenvolveu extenso quadro de livedo reticular nos membros e abdome após o início do medicamento. Discutem-se a semiotécnica diagnóstica do livedo reticular e seus diferenciais. Os autores salientam que a etiologia medicamentosa deva ser considerada no diagnóstico dos livedos reticulares.
Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Amantadina/efeitos adversos , Antiparkinsonianos/efeitos adversos , Livedo Reticular/induzido quimicamente , Doença de Parkinson/tratamento farmacológicoRESUMO
Silicone is one of the most widely used filler for facial cosmetic correction and soft tissue augmentation. Although initially it was considered to be a biologically inert material, many local and generalized adverse effects have been reported after silicone usage for cosmetic purposes. We present a previously healthy woman who developed progressive and persistent generalized livedo reticularis after cosmetic surgery for volume augmentation of buttocks. Histopathologic study demonstrated dermal presence of interstitial vacuoles and cystic spaces of different sizes between the collagen bundles, which corresponded to the silicone particles implanted years ago. These vacuoles were clustered around vascular spaces and surrounded by a few foamy macrophages. General examination and laboratory investigations failed to show any evidence of connective tissue disease or other systemic disorder. Therefore, we believe that the silicone implanted may have induced some kind of blood dermal perturbation resulting in the characteristic violet reticular discoloration of livedo reticularis.
Assuntos
Nádegas/cirurgia , Técnicas Cosméticas/efeitos adversos , Livedo Reticular/induzido quimicamente , Próteses e Implantes/efeitos adversos , Géis de Silicone/efeitos adversos , Adulto , Feminino , HumanosAssuntos
Acenocumarol/efeitos adversos , Anticoagulantes/efeitos adversos , Calciofilaxia/induzido quimicamente , Úlcera da Perna/induzido quimicamente , Acenocumarol/uso terapêutico , Idoso de 80 Anos ou mais , Anticoagulantes/uso terapêutico , Asma/complicações , Fibrilação Atrial/complicações , Fibrilação Atrial/tratamento farmacológico , Calciofilaxia/diagnóstico , Cálcio/análise , Complicações do Diabetes , Feminino , Humanos , Hipertensão/complicações , Livedo Reticular/induzido quimicamente , Polimedicação , Trombofilia/tratamento farmacológico , Trombofilia/etiologiaRESUMO
Livedo reticularis (LR) is a "fish-net like" mottling of the skin, and is attributed to a variety of factors. Amantadine, a medication used in Parkinson's disease, has been known to cause LR localized to the lower, and to a rarer extent, the upper extremities. Patient perception of this condition has been severely under-reported and can impact the patient's decision to stop this medication. In this retrospective study, we analyze the perception of five patients presenting with LR and their decision to continue on amantadine. It was seen that patients with the reticularis rash localized in the upper extremities, in addition to the lower extremities, were affected enough to discontinue amantadine despite its useful therapeutic effects. It is imperative that patient perception regarding LR be taken into consideration when initially presented. Furthermore, the decision to change the regiment of amantadine should be individualized according to patient condition and perception of presented rash.