Assuntos
Anticorpos Monoclonais/uso terapêutico , Imunossupressores/uso terapêutico , Necrobiose Lipoídica/tratamento farmacológico , Pele/efeitos dos fármacos , Adulto , Humanos , Infliximab , Masculino , Necrobiose Lipoídica/diagnóstico , Necrobiose Lipoídica/patologia , Pele/patologia , Resultado do TratamentoAssuntos
Antineoplásicos/administração & dosagem , Eczema/tratamento farmacológico , Dermatoses da Mão/tratamento farmacológico , Tretinoína/administração & dosagem , Administração Oral , Adulto , Alitretinoína , Doença Crônica , Relação Dose-Resposta a Droga , Eczema/diagnóstico , Feminino , Seguimentos , Dermatoses da Mão/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva , Receptores X de Retinoides , Estudos Retrospectivos , Resultado do TratamentoRESUMO
BACKGROUND: A 72-year-old man presented with a Merkel cell carcinoma (MCC) of the left cheek with concomitant nodal spread. A 61-year-old man presented with an MCC of the right thigh with rapid nodal recurrence. INVESTIGATIONS: Skin biopsy samples proved the MCC nature of the neoplasm in both patients. Staging procedure included clinical and radiological investigations. DIAGNOSIS: Advanced stage II MCC. MANAGEMENT: Neoadjuvant cisplatin, etoposide and cyclophosphamide (EPC) regimen led to local control in the first patient and allowed curative surgery associated with adjuvant radiation therapy. Complete remission was maintained for 32 months. The second patient was treated by surgery plus radiation therapy. Nodal and cutaneous recurrences were treated with a neoadjuvant EPC regimen leading to a 5-year complete remission.