Asunto(s)
Abatacept/administración & dosificación , Alopecia Areata/tratamiento farmacológico , Inhibidores de Puntos de Control Inmunológico/administración & dosificación , Abatacept/efectos adversos , Adolescente , Adulto , Anciano , Alopecia Areata/diagnóstico , Alopecia Areata/inmunología , Femenino , Humanos , Inhibidores de Puntos de Control Inmunológico/efectos adversos , Inyecciones Subcutáneas , Masculino , Persona de Mediana Edad , Índice de Severidad de la Enfermedad , Resultado del Tratamiento , Adulto JovenRESUMEN
A 58-year-old woman with a 31-year history of Hailey-Hailey (HH) disease that was refractory to treatment with mycophenolate mofetil, cyclosporine, dapsone, sulfasalazine, topical/oral antibiotics, and topical/oral steroids presented for alternative treatment options. Active erythematous, malodorous, eroded, and crusted plaques were present in the axillae, inframammary region, groin, and back (Figure 1). The patient had an undulant course, with acute exacerbations and partial remissions. During a 3-year period, she was prescribed oral methotrexate at a dose of 10 mg to 15 mg per week with daily oral folic acid (1 mg) supplementation, except on the day she took methotrexate. Oral clarithromycin and prednisone were also used intermittently for antibacterial and anti-inflammatory effects.
Asunto(s)
Fármacos Dermatológicos/efectos adversos , Metotrexato/efectos adversos , Perforación del Tabique Nasal/inducido químicamente , Pénfigo Familiar Benigno/tratamiento farmacológico , Administración Oral , Antibacterianos/uso terapéutico , Claritromicina/uso terapéutico , Femenino , Humanos , Persona de Mediana Edad , Prednisona/uso terapéuticoRESUMEN
Autoimmune blistering disorders are a heterogeneous group of diseases that result from autoantibodies generated against target antigens found in the skin and mucous membranes. This process leads to a variety of disruptions in keratinocyte adhesion and cellular integrity, resulting in fluid accumulation and development of blisters. Physicians should have an appreciation and understanding of autoimmune blistering disorders in the pediatric population when formulating a differential diagnosis of a patient who presents with skin blistering. Early detection and discrimination between the varied autoimmune blistering disorders can change the course of treatment and outcome. Due to the similarity in clinical presentation among different diseases within this category, histopathologic evaluation and, especially, immunofluorescence studies are necessary to establish the definitive diagnosis.