ABSTRACT
Granulomatous reactions to tattoo ink have been frequently associated with exogenous pigment, although sometimes they are the manifestation of a cutaneous or an underlying systemic sarcoidosis. We report a case of a patient with a granulomatous reaction to a black tattoo pigment treated with 3% topical allopurinol for 3â months. We observed complete resolution without any side-effects. Examination and follow-up ruled out sarcoidosis. Oral allopurinol has been proven to be effective for the management of granulomatous reactions to tattoos. Based on the significant improvement we have described in our patient, we recommend new studies to reveal all the potential benefits of the topical use of allopurinol for the treatment of granulomatous reactions to tattoo ink.
Subject(s)
Sarcoidosis , Skin Diseases , Tattooing , Humans , Tattooing/adverse effects , Allopurinol/adverse effects , Skin Diseases/diagnosis , Skin , Sarcoidosis/chemically induced , Sarcoidosis/drug therapy , Sarcoidosis/diagnosis , InkABSTRACT
We report a 13-year-old girl with severe pustular psoriasis who had an excellent response to treatment with adalimumab after failure with methotrexate, acitretin, cyclosporin, phototherapy, and biologic drugs including etanercept and infliximab.
Subject(s)
Anti-Inflammatory Agents/therapeutic use , Antibodies, Monoclonal/therapeutic use , Psoriasis/drug therapy , Psoriasis/pathology , Adalimumab , Adolescent , Antibodies, Monoclonal, Humanized , Female , Humans , Severity of Illness Index , Treatment OutcomeSubject(s)
Arthritis, Rheumatoid/complications , Nocardia Infections/diagnosis , Nocardia/isolation & purification , Opportunistic Infections/diagnosis , Skin Diseases, Bacterial/complications , Abdomen , Aged , Anti-Bacterial Agents/therapeutic use , Brain Abscess/etiology , Brain Abscess/microbiology , Consciousness Disorders/etiology , Diabetes Mellitus, Type 2/complications , Fatal Outcome , Humans , Immunocompromised Host , Leg , Male , Nocardia Infections/complications , Nocardia Infections/drug therapy , Opportunistic Infections/drug therapy , Opportunistic Infections/microbiology , Shock, Septic/etiology , Skin Diseases, Bacterial/microbiologySubject(s)
Antibodies, Monoclonal/adverse effects , Exanthema/etiology , Fever/etiology , Tumor Necrosis Factor-alpha/antagonists & inhibitors , Adalimumab , Antibodies, Monoclonal/administration & dosage , Antibodies, Monoclonal/therapeutic use , Antibodies, Monoclonal, Humanized , Etanercept , Exanthema/drug therapy , Female , Fever/drug therapy , Glucocorticoids/therapeutic use , Histamine Antagonists/therapeutic use , Humans , Immunoglobulin G/therapeutic use , Immunosuppressive Agents/therapeutic use , Injections, Subcutaneous , Middle Aged , Psoriasis , Receptors, Tumor Necrosis Factor/therapeutic useABSTRACT
Temozolomide is an oral alkylating agent indicated for the treatment of patients with glioblastoma multiforme concomitantly with radiotherapy and subsequently as monotherapy treatment. We report the case of a patient who developed toxic epidermal necrolysis (TEN) while she was being treated with chemoradiotherapy and several drugs. Cutaneous tests were performed with the drugs involved with negative result. Although the occurrence of TEN contraindicates suspected drug readministration, we based the decision to perform the controlled administration of temozolomide on the following reasons: (1) the poor prognosis of the underlying disease, (2) the lack of therapeutic alternatives, (3) the suspicion that other drugs taken by the patient simultaneously may be responsible (as anticonvulsants and trimethoprim sulfamethoxazole [TMP-SMX]), and (4) temozolomide was the first choice for treating the patient's disease. The administration of a cumulative dose of 60 mg of temozolomide caused a slight skin reaction. Given this result, we conducted controlled administration of other drugs involved. Dexamethasone, codeine, omeprazole and levetiracetam were well tolerated. However, TMP-SMX produced a similar reaction to that caused by temozolomide. In conclusion, we present the first case of TEN induced by temozolomide and TMP-SMX associated with cranial radiotherapy confirmed by controlled administration. Radiotherapy in combination with these drugs could have favored TEN, as some authors have postulated, but we cannot prove this.
ABSTRACT
We describe the case of a 32-year-old male patient who had presented from birth with generalized ichthyosiform dermatosis, palmoplantar keratoderma with constrictive bands around the fingers and keratotic plaques in a linear arrangement, located in the large skin folds. The dermatopathological examination showed orthokeratotic hyperkeratosis and epidermal hyperplasia with hypergranulosis. No other members of the patient's family were affected. With these clinical and histological findings, the diagnosis was keratosis linearis with ichthyosis congenita and sclerosing keratoderma (KLICK syndrome). The patient rejected treatment with oral retinoids and was treated with emollients and 30 % urea creams, with little clinical response.
Subject(s)
Ichthyosis/pathology , Keratosis/pathology , Scleroderma, Localized/pathology , Adult , Humans , Male , SyndromeABSTRACT
Colloid milium is a degenerative process that is characterized clinically by the development of translucent, yellow, 1-2 mm papules located in photoexposed areas. Histologically, deposits of a colloid substance are seen in the papillary dermis. We present two cases of this infrequent pathology in two male patients, who had been subjected to intense sun exposure because of their work. We initiated treatment with photoprotective creams and topical tretinoin, with little clinical improvement.