Melanoma-associated retinopathy treated with ipilimumab therapy.

Melanoma-associated retinopathy (MAR) is a rare autoimmune syndrome in patients with melanoma characterized by visual disorders. MAR is induced by the degeneration of bipolar cells of the retina and the presence of serum autoantibodies against retina proteins. Ipilimumab, an anti-cytotoxic T lymphocyte-associated antigen 4 antibody, improves survival in previously treated patients with metastatic melanoma, but is responsible for a spectrum of immune-related adverse events. Administration of ipilimumab to patients with autoimmune diseases (such as MAR or vitiligo) is actually not recommended. We report a patient presenting with MAR occurring during a melanoma relapse. Surgery and chemotherapy had no effect on visual acuity and melanoma increased. In the absence of alternative antitumoral treatment, we focused on the vital prognosis and treated the patient with ipilimumab. Two years after the treatment the patient is free from new metastasis but has presented with exacerbation of vitiligo and MAR. In the very rare case of melanoma with autoimmune disease without a therapy option, ipilimumab could be discussed, taking into account the fact that it can be effective on tumor burden but can also increase autoimmunity.

Fumagillin-induced aseptic meningoencephalitis in a kidney transplant recipient with microsporidiosis.

Microsporidiosis is an opportunistic infection in organ transplant recipients and patients with other cellular immunodeficiency. Fumagillin is an effective treatment against Enterocytozoon bieneusi, one of the two main species causing the microsporidiosis involved in human diseases. We report the first case, to our knowledge, of a probable drug-induced aseptic meningoencephalitis, after administration of fumagillin in a kidney transplant recipient with microsporidiosis.

[Pyoderma gangrenosum, subcorneal pustular dermatosis and aseptic spleen abscess: "a neutrophilic disease"]. / Association pyoderma gangrenosum, pustulose sous-cornée et abcès aseptiques spléniques: "une maladie neutrophilique".

Neutrophilic diseases may have various clinical presentations but share common histopathological manifestations with an aseptic infiltrate of polymorphonuclears neutrophils. The association with various diseases is frequent and must be systematically discussed. We report a patient who presented three different synchronous clinical manifestations of neutrophilic disease: pyoderma gangrenosum, subcorneal pustular dermatosis and aseptic spleen abscesses.