RESUMO
Cutis laxa is a rare entity characterized clinically by redundant skin that gives an appearance of premature aging. The appearance relates to a loss of elasticity because of the destruction of elastic fibers that affects the skin and other organs. It may be associated with inflammatory conditions or diseases, such as plasma cell dyscrasias. We report the case of a 54-year-old man with acquired cutis laxa, which preceded the development of IgG-lambda monoclonal gammopathy with lambda light chain deposits in the kidney. The patient had a fatal outcome owing to severe and rapidly progressive renal failure. We emphasize the importance of recognizing a plasma cell dyscrasia in a patient with cutis laxa, although this association is rare.
Assuntos
Cútis Laxa/complicações , Cadeias lambda de Imunoglobulina , Paraproteinemias/complicações , Insuficiência Renal/complicações , Amiloidose/diagnóstico , Diagnóstico Diferencial , Evolução Fatal , Humanos , Cadeias lambda de Imunoglobulina/metabolismo , Masculino , Pessoa de Meia-Idade , Paraproteinemias/metabolismo , Insuficiência Renal/metabolismoRESUMO
Bevacizumab is a recombinant humanized monoclonal IgG1 antibody that binds to and inhibits the biologic activity of human vascular endothelial growth factor (VEGF). This antibody, in combination with other antineoplastic agents, is currently used to treat various neoplasms, including colorectal, lung, breast, kidney cancer, and glioblastoma. It is also being used as an off-label intravitreal agent in the treatment of proliferative (neovascular) eye diseases. We report the development of a skin rash with two different patterns in a patient with a hemangiopericytoma of the meninges, a rare aggressive sarcoma, who was treated with repeated intravenous injections of bevacizumab.
Assuntos
Erupções Acneiformes/etiologia , Anticorpos Monoclonais Humanizados/efeitos adversos , Antineoplásicos/uso terapêutico , Neoplasias Ósseas/tratamento farmacológico , Hemangiopericitoma/tratamento farmacológico , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Meníngeas/tratamento farmacológico , Erupções Acneiformes/tratamento farmacológico , Adulto , Antibacterianos/uso terapêutico , Bevacizumab , Neoplasias Ósseas/secundário , Hemangiopericitoma/radioterapia , Hemangiopericitoma/cirurgia , Humanos , Neoplasias Hepáticas/secundário , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/secundário , Masculino , Neoplasias Meníngeas/patologia , Neoplasias Meníngeas/radioterapia , Neoplasias Meníngeas/cirurgia , Neovascularização Patológica/tratamento farmacológico , Resultado do TratamentoRESUMO
Immunocompromised patients are at high risk of developing serious disseminated infections by opportunistic fungi (Aspergillus, Candida, and Fusarium spp), which frequently present as cutaneous lesions, sometimes as a first sign. Prolonged and deep neutropenia, immunodepressive treatments (systemic steroids and chemotherapy) and severe T-cell immunodeficiency are the most important risk factors. We report 2 patients with acute lymphoblastic leukemia, who developed multiple tender erythematous skin lesions on their legs and arms during chemotherapy treatment. Skin biopsies for histology and culture studies established the diagnosis of Fusarium infection. They received treatment with systemic antifungal and granulocyte colony-stimulting factor. The infection responded after recovering from neutropenia. Early diagnosis and treatment is very important to improve the prognosis, because these infections in immunodepressed hosts have a high mortality rate.
Assuntos
Anfotericina B/farmacocinética , Fusariose/imunologia , Hospedeiro Imunocomprometido , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Anfotericina B/administração & dosagem , Antifúngicos/administração & dosagem , Evolução Fatal , Feminino , Fator Estimulador de Colônias de Granulócitos/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Pirimidinas/administração & dosagem , Triazóis/administração & dosagem , Voriconazol , Adulto JovemAssuntos
Perna (Membro)/patologia , Rabdomiossarcoma Alveolar/diagnóstico , Neoplasias Cutâneas/diagnóstico , Biomarcadores Tumorais/análise , Feminino , Humanos , Lactente , Perna (Membro)/cirurgia , Rabdomiossarcoma Alveolar/congênito , Rabdomiossarcoma Alveolar/terapia , Neoplasias Cutâneas/congênito , Neoplasias Cutâneas/terapiaRESUMO
Introduction. Pityriasis lichenoides is a rare, acquired spectrum of skin conditions of an unknown etiology. Case Report. A 28-year-old man presented with recurrent outbreaks of herpes simplex virus associated with the onset of red-to-brown maculopapules located predominantly in trunk in each recurrence. Positive serologies to herpes simplex virus type 2 were detected. Histopathological examination of one of the lesions was consistent with a diagnosis of pityriasis lichenoides chronica. Discussion. Pityriasis lichenoides is a rare cutaneous entity of an unknown cause which includes different clinical presentations. A number of infectious agents have been implicated based on the clustering of multiple outbreaks and elevated serum titers to specific pathogens (human immunodeficiency virus, cytomegalovirus, Epstein-Barr virus, Toxoplasma gondii, and herpes simplex virus). In our patient, resolution of cutaneous lesions coincided with the administration of antiviral drugs and clinical improvement in each genital herpes recurrence. In conclusion, we report a case in which cutaneous lesions of pityriasis lichenoides chronica and a herpes simplex virus-type 2-mediated disease have evolved concomitantly.
Assuntos
Doença de Crohn/fisiopatologia , Fármacos Dermatológicos/uso terapêutico , Rosácea/patologia , Fármacos Dermatológicos/administração & dosagem , Ácido Fusídico/administração & dosagem , Ácido Fusídico/uso terapêutico , Humanos , Isotretinoína/administração & dosagem , Isotretinoína/uso terapêutico , Masculino , Pessoa de Meia-Idade , Prednisona/administração & dosagem , Prednisona/uso terapêutico , Rosácea/diagnóstico , Rosácea/tratamento farmacológicoAssuntos
Doenças do Nervo Trigêmeo/patologia , Nervo Trigêmeo/patologia , Úlcera/patologia , Idoso , Biópsia , Face , Feminino , Seguimentos , HumanosRESUMO
Se comunica un caso de Displasia Ectodérmica Hidrótica en un varón de 24 años, que inició sintomatología a los 3 meses de edad. Presenata alteraciones de las uñas y del cabello, hiperqueratosis palmoplantar y áreas de poiquilodermia en muslos. La sudoración es normal. El patrón dermatoglífico muestra gran desestructuración de las crestas epidérmicas