Asunto(s)
ADN Nucleotidilexotransferasa/metabolismo , Pierna/patología , Linfoma de Células B Grandes Difuso/diagnóstico , Leucemia-Linfoma Linfoblástico de Células Precursoras/diagnóstico , Neoplasias Cutáneas/patología , Anciano de 80 o más Años , Biopsia/métodos , Diagnóstico Diferencial , Femenino , Humanos , Inmunohistoquímica/métodos , Hibridación Fluorescente in Situ/métodos , Linfoma de Células B Grandes Difuso/metabolismo , Linfoma de Células B Grandes Difuso/patología , Linfoma de Células B Grandes Difuso/radioterapia , Cuidados Paliativos , Fenotipo , Leucemia-Linfoma Linfoblástico de Células Precursoras/metabolismo , Leucemia-Linfoma Linfoblástico de Células Precursoras/patología , Leucemia-Linfoma Linfoblástico de Células Precursoras/radioterapia , Neoplasias Cutáneas/metabolismoRESUMEN
Pemphigus foliaceus (PF) is one of the causes of erythroderma; however, to date, there have been relatively few reported cases. We herein describe 6 cases of erythrodermic PF. In all 6 cases, PF was a direct cause of erythroderma because the patients had not undergone any medical treatments and neither had any other skin diseases nor were taking any drugs that typically cause erythroderma. Serum levels of IgE and thymus and activation-regulated chemokine were elevated in 5 of the 6 cases, whereas soluble interleukin-2 receptor and squamous cell carcinoma-related antigen were markedly increased in all cases, suggesting that those markers are strong indicators of skin surface damage. All patients were treated with predonisolon (PSL), of which PSL pulse was added in 4 patients and intravenous immunoglobulin was added in 4 patients. Furthermore, all patients except for one were older adults, among whom 2 cases developed Kaposi's varicelliform eruption, and died, and another 2 patients, respectively, died of gastrointestinal bleeding and sepsis. Kaposi's varicelliform eruption is a complication of erythrodermic PF associated with poor prognosis, and thus caution is necessary when considering the diagnosis. Furthermore, elderly people are more likely to have complications due to PSL, which may result in death. Inappropriate treatment and delay in treatment may cause erythroderma, so early diagnosis and treatment are necessary.
Asunto(s)
Criptococosis/diagnóstico , Dermatomicosis/diagnóstico , Piodermia Gangrenosa/diagnóstico , Úlcera Cutánea/diagnóstico , Piel/microbiología , Anciano , Anciano de 80 o más Años , Antifúngicos/uso terapéutico , Biopsia , Criptococosis/tratamiento farmacológico , Criptococosis/microbiología , Criptococosis/patología , Dermatomicosis/tratamiento farmacológico , Dermatomicosis/microbiología , Dermatomicosis/patología , Diagnóstico Diferencial , Resultado Fatal , Femenino , Humanos , Valor Predictivo de las Pruebas , Piel/efectos de los fármacos , Piel/patología , Úlcera Cutánea/tratamiento farmacológico , Úlcera Cutánea/microbiología , Úlcera Cutánea/patología , Resultado del TratamientoAsunto(s)
Anticuerpos Monoclonales Humanizados , Antineoplásicos Inmunológicos , Neoplasias Hepáticas , Melanoma , Neoplasias Cutáneas , Humanos , Anticuerpos Monoclonales Humanizados/efectos adversos , Anticuerpos Monoclonales Humanizados/uso terapéutico , Melanoma/tratamiento farmacológico , Melanoma/patología , Melanoma/secundario , Neoplasias Cutáneas/tratamiento farmacológico , Neoplasias Cutáneas/patología , Neoplasias Hepáticas/secundario , Neoplasias Hepáticas/tratamiento farmacológico , Antineoplásicos Inmunológicos/efectos adversos , Melanoma Cutáneo Maligno , Masculino , Rotura Espontánea/inducido químicamente , Femenino , Resultado Fatal , Persona de Mediana Edad , AncianoRESUMEN
Lupus alopecia is usually difficult to treat. We report a case of a 40-year-old woman with Sjögren's syndrome and atopic dermatitis who presented with discoid lupus erythematosus on the forearms and lupus erythematosus profundus with alopecia involving the scalp. A biopsy specimen taken from the discoid lupus erythematosus lesion on the forearm further exhibited a xanthomatous reaction, which however was not detected in another specimen from the lupus erythematosus profundus on the scalp. Treatment with oral hydroxychloroquine showed dramatic effects and complete hair regrowth was obtained 3 months later.