RESUMO
UNLABELLED: A 4-month-old boy was diagnosed with Kawasaki disease. The ordinary treatments with intravenous gammaglobulin and metylpredonisolone were not effective. Infliximab (5 mg/kg) was administrated on 13th day of illness which led to defeverscence and improvement of clinical manifestations. On 23 days of illness, however, desquamative papules and plaques developed on both the extensor surfaces of the forearms and legs. In addition, typical subungual desquamations of fingers and toes followed crusted hyperkeratosis which resembled supprative acrodermatitis. Skin biopsy from the forearm showed inflammatory dyskeratosis with marked hyperkeratosis, epithelial parakeratotsis, loss of granular layer and dominant infiltration of CD8 + T-cells. Local treatment of steroid followed improvement of skin lesions within a few weeks. CONCLUSION: Although previous reports described the beneficial effects of infliximab in patients with Kawasaki disease, it is possible that the administration of infliximab modify psoriasiform skin lesion associated with Kawasaki disease.
Assuntos
Acrodermatite/etiologia , Anticorpos Monoclonais/efeitos adversos , Síndrome de Linfonodos Mucocutâneos/tratamento farmacológico , Psoríase/etiologia , Acrodermatite/diagnóstico , Antebraço/patologia , Humanos , Lactente , Infliximab , Masculino , Síndrome de Linfonodos Mucocutâneos/complicações , Psoríase/diagnósticoAssuntos
Pênfigo/etiologia , Neoplasias Gástricas/complicações , Idoso , Diagnóstico Diferencial , Evolução Fatal , Gastroscopia , Humanos , Masculino , Doenças da Boca/etiologia , Doenças da Boca/patologia , Pênfigo/patologia , Escroto/patologia , Neoplasias Gástricas/diagnóstico , Doenças da Língua/etiologia , Doenças da Língua/patologiaRESUMO
A 41-year-old Japanese woman came to our clinic complaining of multiple edematous erythemas on the trunk and legs. The eruptions recurred periodically in association with the menstrual cycle. She had received oral progesterone therapy between 24 and 34 years of age. There were no abnormal values found in the routine and hormonal examinations, including progesterone and estrogen levels in serum and urine. After an intradermal skin test with progesterone, she had no reaction after 20 minutes but a positive reaction after 48 hours.