RESUMO
Chemotherapy extravasation is a rare but severe cutaneous complication associated with administration of intravenous chemotherapy. Extravasation causes serious disability and diminishes the quality of life in patients with cancer undergoing antineoplastic therapy. Treatment of chemotherapy extravasation is not standardized. We report a patient with paclitaxel extravasation who was successfully treated with corticosteroids.
Assuntos
Antineoplásicos Fitogênicos , Paclitaxel , Humanos , Paclitaxel/efeitos adversos , Antineoplásicos Fitogênicos/efeitos adversos , Qualidade de Vida , Extravasamento de Materiais Terapêuticos e Diagnósticos , PeleAssuntos
Infecções por Vírus Epstein-Barr , Linfoma Cutâneo de Células T , Neoplasias Cutâneas , Infecções por Vírus Epstein-Barr/patologia , Humanos , Células Matadoras Naturais/patologia , Linfoma Cutâneo de Células T/diagnóstico , Linfoma Cutâneo de Células T/patologia , Neoplasias Cutâneas/patologia , ÚlceraAssuntos
Neoplasias da Mama/complicações , Esclerodermia Localizada/classificação , Biomarcadores/análise , Biomarcadores/sangue , Neoplasias da Mama/diagnóstico , Tratamento Farmacológico/métodos , Feminino , Fator de Transcrição GATA3/análise , Fator de Transcrição GATA3/sangue , Humanos , Queratina-7/análise , Queratina-7/sangue , Pessoa de Meia-Idade , Cuidados Paliativos/métodos , Esclerodermia Localizada/etiologiaRESUMO
Skin manifestations of sarcoidosis occur in up to 30% of cases, and may be the sentinel sign of the disease, with the skin being sometimes exclusively affected. While this may facilitate an early dermatologic diagnosis, heterogeneity in the cutaneous morphologies of sarcoidosis complicates recognition and affirms its reputation as a "great imitator". Here, we present a case of a verrucous version of sarcoidosis that may be misdiagnosed because it can mimic other inflammatory and neoplastic skin disorders. Although it is a rare variant, its presence should alert clinicians to the likelihood of systemic involvement of cutaneous sarcoidosis.
Assuntos
Sarcoidose/diagnóstico , Dermatopatias/diagnóstico , Diagnóstico Diferencial , Erros de Diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Sarcoidose/patologia , Dermatopatias/patologiaAssuntos
Doença de Bowen/diagnóstico , Doenças da Unha/diagnóstico , Unhas/diagnóstico por imagem , Neoplasias Cutâneas/diagnóstico , Adulto , Biópsia , Doença de Bowen/patologia , Doença de Bowen/cirurgia , Dermoscopia , Humanos , Masculino , Doenças da Unha/patologia , Doenças da Unha/cirurgia , Unhas/patologia , Pele/diagnóstico por imagem , Pele/patologia , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/cirurgia , Resultado do TratamentoAssuntos
Pustulose Exantematosa Aguda Generalizada/diagnóstico , Pustulose Exantematosa Aguda Generalizada/etiologia , Antifúngicos/efeitos adversos , Terbinafina/efeitos adversos , Adulto , Dermatomicoses/tratamento farmacológico , Feminino , Humanos , Luz , Pele/patologia , Pele/efeitos da radiaçãoRESUMO
Maffucci syndrome is a rare nonhereditary disorder comprising of lymphovascular malformations and multiple enchondromas, which may be associated with several internal malignancies. This report describes a new association of Maffucci syndrome with pedal synovial sarcoma. Our case is also remarkable as lymphangioma circumscriptum is the sole lymphovascular component, which has been rarely reported. The aim of this report is to generate awareness about this rare condition and also highlight the importance of screening for malignancies in this disorder.
Assuntos
Encondromatose/complicações , Encondromatose/diagnóstico , Sarcoma Sinovial/complicações , Sarcoma Sinovial/diagnóstico , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
We propose to study the epidemiological aspects of North African psoriasis and determine the cardiovascular comorbidities and addictive behaviors associated with psoriasis. This is a North African case-control study which was conducted over a five year period (October 2008 through August 2013), involving 671 psoriatic patients and 1,242 controls identified in various Algerian, Tunisian and Moroccan university hospitals. For each patient, epidemiological characteristic, addictive behaviors, and cardiovascular pathologies associated with psoriasis were noted. Six hundred and seventy one psoriasis patients and 1,242 controls were included in this study. The average age was 47.24 years and the M/F sex-ratio was 1.11 (354 men and 317 women). Statistical analysis showed that psoriasis patients were more likely to develop addictive behaviors than controls (smoking p<10-5 and alcohol consumption: p < 10-5), together with dyslipidemia (30.1% of patients p < 10-5), obesity (23.8% of patients p < 10-4), hypertension (22.3% of patients p < 10-5), diabetes (21.7% of occurrences p < 10-5) and metabolic syndrome (37.4% of patients p<10-5). The relative risk for developing psoriasis was 1.9 in hypertensive patients, 1.7 in diabetic patients, 3.9 in dyslipidemic patients, 1.8 in obese patients, 2.6 in those with metabolic syndrome, 2.1 in smokers and 2.8 in alcoholics. Our work confirms the high incidence of addictive behaviors and of cardiovascular and metabolic comorbidities during the North-African psoriasis, hence the need for a multidisciplinary comprehensive care based on a guideline suited to the characteristics of North-African psoriatic patients.
Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Doenças Cardiovasculares/epidemiologia , Psoríase/epidemiologia , Fumar/epidemiologia , Argélia/epidemiologia , Comportamento Aditivo/epidemiologia , Estudos de Casos e Controles , Feminino , Hospitais Universitários , Humanos , Masculino , Síndrome Metabólica/epidemiologia , Pessoa de Meia-Idade , Marrocos/epidemiologia , Tunísia/epidemiologiaAssuntos
Antígenos Ly/genética , Ceratodermia Palmar e Plantar/diagnóstico , Melanoma Amelanótico/diagnóstico , Neoplasias Cutâneas/diagnóstico , Ativador de Plasminogênio Tipo Uroquinase/genética , Idoso , Humanos , Ceratodermia Palmar e Plantar/complicações , Ceratodermia Palmar e Plantar/genética , Masculino , Melanoma Amelanótico/etiologia , Melanoma Amelanótico/patologia , Neoplasias Cutâneas/etiologia , Neoplasias Cutâneas/patologiaAssuntos
Nevo , Poroceratose , Poroma , Neoplasias Cutâneas , Neoplasias das Glândulas Sudoríparas , Braço/patologia , Pré-Escolar , Face/patologia , Feminino , Humanos , Tronco/patologiaRESUMO
Cicatricial Pemphigoid is a subepithelial bullous dermatosis which essentially involves the mucous membranes with cicatricial evolution We report the case of a 66-year old patient hospitalized with erosive gingivitis associated with dysphagia, dyspnea and blurred vision. Dermatologic examination showed erosive lesions involving the palate and the pharynx. Ophthalmologic examination showed symblepharons, ectropion and bilateral cataract. Gingival biopsy revealed a necrotic detachment of the buccal epithelium. Direct immunofluorescence showed linear IgA deposit at the dermo-epidermal junction. Indirect immunofluorescence test was negative. The diagnosis of cicatricial pemphigoid was confirmed. Esophagogastroduodenoscopy objectified double stenosis of the esophagus. Nasopharyngeal and bronchial endoscopy showed ulceration of the epiglottis, hypopharynx, pharynx and bronchial tree. The patient was treated with Solumedrol bolus corresponding to 0.5mg/kg/day prednisone associated with 100mg/day disulone. The patient showed a favorable early clinical outcome complicated because of the aggravation of dysphagia and esophageal stenosis after 2 months. Our case study is singular due to the occurrence of a cicatricial pemphigoid in a male patient with a serious clinical picture due to lesions extending to conjunctival, oral, nasal, esophageal and bronchial mucous membranes associated with direct immunofluorescence only showing IgA deposit.
Assuntos
Dapsona/administração & dosagem , Imunoglobulina A/imunologia , Hemissuccinato de Metilprednisolona/administração & dosagem , Penfigoide Mucomembranoso Benigno/fisiopatologia , Idoso , Transtornos de Deglutição/etiologia , Endoscopia do Sistema Digestório , Estenose Esofágica/etiologia , Técnica Direta de Fluorescência para Anticorpo , Humanos , Masculino , Penfigoide Mucomembranoso Benigno/diagnóstico , Penfigoide Mucomembranoso Benigno/imunologiaRESUMO
Clinical manifestation, etiology and outcome of leukocytoclastic vasculitis are little studied. The aim of our study was to examine epidemiological, clinical etiological, and evolutionary characteristics of this entity. We conducted a cross-sectional data collection from medical records of 85 patients with leukocytoclastic vasculitis in the Department of Dermatology at the Farhat Hached University Hospital, Sousse between January 2000 and December 2013. Epidemiological, clinical, paraclinical, etiological data sheets had been completed for each patient. The average age of patients was 47.65 years, ranging between 10 and 78 years. Fifty-three women and 32 men were registered (sex ratio = 0.6). Cutaneous manifestations were dominated by vascular purpura (88.2%). The most common causes of leukocytoclastic vasculitis were systemic diseases (51%), infection (20%) and neutrophilic dermatoses (14.5%). Other causes were drugs (9.1%) and hematologic malignancies (5.4%). The cause of leukocytoclastic vasculitis was not detected in 30 patients (35, 3%). Two predictive factors associated with the acute outcome were retained: the presence of a recent infection (p= 0.014) and drug intake before the rash (p= 0.013). Chronic evolution was positively correlated with antinuclear antibodies (p= 0.009) and cryoglobulinemia (p=0.025). Our study highlights the multitude of causes of leukocytoclastic vasculitis. The search for an underlying disease is an imperative in order to ensure better therapeutic management.
Assuntos
Anticorpos Antinucleares/análise , Crioglobulinemia/epidemiologia , Vasculite por IgA/etiologia , Vasculite Leucocitoclástica Cutânea/fisiopatologia , Adolescente , Adulto , Idoso , Criança , Estudos Transversais , Crioglobulinemia/etiologia , Feminino , Hospitais Universitários , Humanos , Vasculite por IgA/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Vasculite Leucocitoclástica Cutânea/epidemiologia , Vasculite Leucocitoclástica Cutânea/etiologia , Adulto JovemAssuntos
Antineoplásicos/efeitos adversos , Carcinoma de Células Escamosas/induzido quimicamente , Hidroxiureia/efeitos adversos , Ceratose Actínica/induzido quimicamente , Neoplasias Cutâneas/induzido quimicamente , Humanos , Masculino , Pessoa de Meia-Idade , Policitemia Vera/tratamento farmacológicoRESUMO
Sweet's syndrome has been reported in association with inflammatory diseases such as Crohn's disease. It has also been reported in association with several drugs. Here, we report a rare case of Sweet's syndrome induced by azathioprine in a patient with Crohn's disease.
Assuntos
Anti-Inflamatórios/efeitos adversos , Azatioprina/efeitos adversos , Doença de Crohn/tratamento farmacológico , Fármacos Gastrointestinais/efeitos adversos , Pele/efeitos dos fármacos , Síndrome de Sweet/induzido quimicamente , Biópsia , Doença de Crohn/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Indução de Remissão , Pele/patologia , Síndrome de Sweet/diagnósticoRESUMO
BACKGROUND: Hemophagocytic lymphohistiocytosis (HLH) is a rare condition of chaotic uncontrolled immune system stimulation and not fully understood pathophysiology. Most reported cases of hemophagocytic syndrome in patients with mycobacterial infections have been associated with Mycobacterium tuberculosis. As far as we could ascertain, to date, no established HLH case complicating leprosy has been published in the medical literature. CASE REPORT: We describe here a new case of Hansen's disease in a 58-year-old Tunisian man with an unusual complicated clinical course documented as hemophagocytic syndrome. Cutaneous and neurological involvements were the main clinical signs of Hansen's disease. Histological findings suggested the diagnosis of leprosy and were somewhat more characteristic of the lepromatous leprosy type. While on antileprosy treatment, he developed unexplained persistent fever, organomegaly, bicytopenia, and elevated rate of inflammatory markers with bone marrow aspirate showing large macrophages with increased phagocytosis of mature and immature blood elements, typical features of hemophagocytic syndrome. CONCLUSION: A high index of suspicion is essential for prompt diagnosis of hemophagocytic syndrome in the setting of disseminated infection such as leprosy.