RESUMEN
Dupilumab is a humanized monoclonal antibody against the interleukin (IL)-4 receptor alpha chain that inhibits IL-4 and IL-13 signalling. It is one of the systemic treatments for patients with moderate-to-severe atopic dermatitis (AD), which provides favourable safety and efficacy. We report a case of psoriasis-like eruption induced by dupilumab as an adverse effect in a patient with AD, immediately remitted after switching to baricitinib, which inhibits JAK1/2. Moreover, the atopic skin lesion also simultaneously went into remission upon baricitinib treatment. Baricitinib could be a favourable option for patients with AD who develop dupilumab-induced psoriasis-like eruption.
RESUMEN
Angioedema is a variant of urticaria that causes deep dermal and subcutaneous swelling. It frequently is a unilateral reaction and usually lasts for several hours but may persist for several days. We report 2 cases of angioedema that involved the right upper and lower eyelids and was associated with congestion of the right bulbar conjunctiva; the symptoms started approximately 1 to 2 hours after taking loxoprofen sodium. All of the symptoms subsided after oral corticosteroid therapy. In both cases, an oral challenge test with 60 mg of loxoprofen sodium (contained in a tablet) caused swelling of the right upper eyelid within several hours, followed by swelling of the right bulbar conjunctiva. We believe the drug reaction in both patients is angioedema.
Asunto(s)
Angioedema/inducido químicamente , Antiinflamatorios no Esteroideos/efectos adversos , Enfermedades de la Conjuntiva/inducido químicamente , Enfermedades de los Párpados/inducido químicamente , Fenilpropionatos/efectos adversos , Adulto , Femenino , HumanosAsunto(s)
Proteínas de Homeodominio/genética , Mutación , Síndrome de la Uña-Rótula/genética , Factores de Transcripción/genética , Preescolar , Familia , Femenino , Proteínas de Homeodominio/metabolismo , Humanos , Proteínas con Homeodominio LIM , Síndrome de la Uña-Rótula/patología , Uñas/patología , Factores de Transcripción/metabolismoRESUMEN
We report the case of a Japanese patient with PCWH, a neurological variant of Waardenburg type 4. Direct sequencing of the genomic DNA obtained from peripheral leukocytes revealed the p.Q377X nonsense mutation in the SOX10 gene. The patient had mottled hypopigmented macules on the trunk since birth; such macules have not been described previously. The so-called "white forelock", a triangular or diamond shaped leukoderma on the forehead, was absent. We also reviewed and summarized the outcomes of 23 patients with Waardenburg syndrome type 4, PCWH and Yemenite deaf-blind hypopigmentation syndrome, in which SOX10 mutations were identified. Among them, 17 cases were reported to have hypopigmented skin macule(s). The five patients who had the white forelock had PCWH with severe neurological complications. Paradoxically, two cases had hyperpigmented spots. Heterochromia of the iris was reported in four patients.