RESUMO
Woringer-Kolopp disease is a localized epidermotropic T cell lymphoma with good prognosis. We describe a 79-year-old man with an erythematous scaly plaque of the foot. Clinical diagnosis of psoriasis, parapsoriasis and fungal infection were proposed. Histopathological and immunohistochemical findings were characteristic of Woringer-Kolopp disease. We observed an immunohistochemical positivity of tumour cells for the anti-CD103 antibody (alphaEB7 integrin) according to the epidermotropism of this localized cutaneous T cell lymphoma.
Assuntos
Linfoma Cutâneo de Células T/patologia , Neoplasias Cutâneas/patologia , Idoso , Biomarcadores Tumorais/análise , Diagnóstico Diferencial , Humanos , Imuno-Histoquímica , Integrinas/análise , MasculinoRESUMO
BACKGROUND: Tramadol chlorhydrate (Topalgic) is a powerful analgesic recently introduced in France where its use has spread rapidly. We report a case where this drug induced a maculopapulous toxic skin reaction with secondary erythrodermia. CASE REPORT: A 47-year-old man was treated for lower back pain with tramadol chlorhydrate (50 mg b.i.d.). Otherwise, he was in good general health and was taking no other medications. Shortly after beginning the treatment, he developed a highly pruriginous maculopapulous eruption involving the entire skin surface, hyperthermia and general degradation. There was no skin exfoliation, mucosal involvement nor nodal enlargement. Tramadol was withdrawn and the patient was given corticosteroid therapy. Secondary erythrodermia developed after termination of the corticosteroids. The lesions regressed after tramadol withdrawal. DISCUSSION: Tramadol-induced skin reactions are uncommon and usually benign. In our case, the delay from onset of tramadol and the development of the maculopapulous eruption was very short (four days). The patient was taking no other medication. We hypothesize that the patient had been sensitized by cross-reaction with another compound and recall the fundamental aspects of tramadol and opiate drugs.