Assuntos
Betacoronavirus/imunologia , Infecções por Coronavirus/epidemiologia , Penfigoide Bolhoso/imunologia , Pênfigo/imunologia , Pneumonia Viral/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus/patogenicidade , COVID-19 , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Feminino , Higiene das Mãos , Humanos , Imunossupressores/efeitos adversos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias , Penfigoide Bolhoso/complicações , Penfigoide Bolhoso/tratamento farmacológico , Pênfigo/complicações , Pênfigo/tratamento farmacológico , Pneumonia Viral/imunologia , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Fatores de Risco , SARS-CoV-2 , Fatores de Tempo , Adulto JovemAssuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Dermatite Atópica/tratamento farmacológico , Subunidade alfa de Receptor de Interleucina-4/imunologia , Adulto , Anticorpos Monoclonais Humanizados/imunologia , Feminino , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Adulto JovemRESUMO
Drug-induced lupus erythematosus (DILE) is defined as an entity characterized by clinical manifestations and immunopathological serum findings similar to those of idiopathic lupus but which is temporally related to continuous drug exposure and resolves after discontinuation of the offending drug. Similar to idiopathic lupus, DILE can be divided into systemic lupus erythematosus (SLE), subacute cutaneous lupus erythematosus (SCLE) and chronic cutaneous lupus erythematosus (CCLE). Based on the literature review and retrospective analysis of our case series, we focused on the dermatological aspects of DILE. The cutaneous features of drug-induced SLE are protean, including particularly purpura, erythema nodosum and photosensitivity as well as the skin lesions characterizing both urticarial and necrotizing vasculitis. The typical laboratory profile of systemic DILE consists of positive antinuclear antibodies (ANA) and antihistone antibodies, the latter being regarded as the serum marker of this subset. The drugs most frequently implicated in the development of systemic DILE are hydralazine, procainamide, isoniazid and minocycline. Drug-induced SCLE usually presents with annular polycyclic or papulosquamous cutaneous manifestations as in the idiopathic form, but blisters or targetoid lesions mimicking erythema multiforme cannot rarely be associated. The clinical presentation is often generalized, with involvement of the lower legs that are usually spared in idiopathic SCLE. ANA and anti-Ro/SSA antibodies are usually present, whereas antihistone antibodies are uncommonly found. Drugs associated with SCLE include particularly calcium channel blockers, angiotensin-converting enzyme inhibitors, thiazide diuretics, terbinafine and the recently reported tumour necrosis factor (TNF)-alpha antagonists. Drug-induced CCLE is very rarely described in the literature and usually refers to fluorouracile agents or TNF-alpha antagonists. The picture is characterized by the occurrence of classic discoid lesions, but aspects of lupus tumidus can occasionally develop. ANA are demonstrated in around two-thirds of the cases. Management of DILE is based on the withdrawal of the offending drug. Topical and/or systemic corticosteroids and other immunosuppressive agents should be reserved for resistant cases.
Assuntos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Lúpus Eritematoso Cutâneo , Lúpus Eritematoso Discoide , Lúpus Eritematoso Sistêmico , Antiarrítmicos/efeitos adversos , Antibacterianos/efeitos adversos , Anti-Hipertensivos/efeitos adversos , Antituberculosos/efeitos adversos , Autoanticorpos/imunologia , Humanos , Hidralazina/efeitos adversos , Isoniazida/efeitos adversos , Lúpus Eritematoso Cutâneo/induzido quimicamente , Lúpus Eritematoso Cutâneo/imunologia , Lúpus Eritematoso Cutâneo/patologia , Lúpus Eritematoso Discoide/induzido quimicamente , Lúpus Eritematoso Discoide/imunologia , Lúpus Eritematoso Discoide/patologia , Lúpus Eritematoso Sistêmico/induzido quimicamente , Lúpus Eritematoso Sistêmico/imunologia , Lúpus Eritematoso Sistêmico/patologia , Minociclina/efeitos adversos , Procainamida/efeitos adversos , Dermatopatias/induzido quimicamente , Dermatopatias/imunologia , Dermatopatias/patologiaAssuntos
Linfoma de Células B/microbiologia , Linfoma Cutâneo de Células T/microbiologia , Psitacose/complicações , Neoplasias Cutâneas/microbiologia , Chlamydophila psittaci/genética , DNA Bacteriano/isolamento & purificação , Humanos , Reação em Cadeia da Polimerase Multiplex , Estudos RetrospectivosAssuntos
Cromossomos Humanos Par 5/genética , Granuloma/genética , Linfoma Cutâneo de Células T/genética , Neoplasias Cutâneas/genética , Adulto , Biópsia , Deleção de Genes , Rearranjo Gênico do Linfócito T , Genótipo , Granuloma/imunologia , Granuloma/patologia , Humanos , Linfoma Cutâneo de Células T/imunologia , Linfoma Cutâneo de Células T/patologia , Masculino , Músculos/patologia , Neoplasias Cutâneas/imunologia , Neoplasias Cutâneas/patologia , Tela Subcutânea/patologia , Linfócitos T/imunologiaAssuntos
Adjuvantes Imunológicos/efeitos adversos , Aminoquinolinas/efeitos adversos , Toxidermias/etiologia , Exantema/induzido quimicamente , Toxidermias/patologia , Exantema/patologia , Humanos , Imiquimode , Hospedeiro Imunocomprometido , Masculino , Pessoa de Meia-Idade , Penfigoide Bolhoso/tratamento farmacológicoRESUMO
We describe a male patient with rosacea who had a 2-year history of persistent bilateral oedema of the eyelids, leading to an elephantoid condition with blepharoptosis. An upper eyelid blepharoplasty was performed, but swelling progressively recurred over a few months. Based on the case history, clinical appearance and histological findings, rosaceous lymphoedema was considered to be the diagnosis. The latter is a bilateral, solid oedema of the mid-third of the face, regarded as a rare complication of rosacea. It is thought to occur as a result of chronic inflammation and lymphatic stasis, but its exact aethiopathogenesis remains elusive. Predominant eyelid involvement, causing severe visual impairment as in our patient, is unique.