RESUMO
The term cutaneous pseudolymphoma (C-PSL) is defined in the literature as a benign, reactive lymphoproliferation that clinically and/or histopathologically imitates cutaneous lymphoma. The exact etiopathogenesis has not been fully elucidated to date. A distinction is made between primary, idiopathic PSL without an identifiable cause and secondary PSL with a known stimulus. We report the occurrence of pseudolymphoma after treatment with medicinal leeches (hirudotherapy). To the best of our knowledge, a total of only nine cases of cutaneous PSL after hirudotherapy have been reported in the literature to date.
Assuntos
Linfoma não Hodgkin , Pseudolinfoma , Neoplasias Cutâneas , Humanos , Pseudolinfoma/induzido quimicamente , Pseudolinfoma/diagnósticoRESUMO
Pseudolymphoma, also known as Jessner's lymphocytic infiltration, is a benign but usually chronic, T-cell infiltrating disease with erythematous papules and plaques usually seen on the skin of the face, neck, and back. The use of leech therapy also known as hirudotherapy has increased in recent years. Here, we report a 52-year-old male patient who had undergone hirudotherapy in his neck and developed infiltrating plaques after four months. A skin biopsy confirmed the diagnosis of Jessner's lymphocytic infiltration. In parallel with the increasing use of hirudotherapy in recent years, the side-effect reports will likely to increase. Indications and contraindications of hirudotherapy, which is being used officially in hospitals, should be taken into consideration.
Assuntos
Aplicação de Sanguessugas/efeitos adversos , Pseudolinfoma/diagnóstico , Dermatopatias/diagnóstico , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade , Pescoço , Pseudolinfoma/etiologia , Pseudolinfoma/patologia , Dermatopatias/etiologia , Dermatopatias/patologiaRESUMO
Human immunodeficiency virus (HIV) prevalence is increasing worldwide as people on antiretroviral therapy are living longer. These patients are often susceptible to debilitating inflammatory disorders that are frequently refractory to standard treatment. Psoriasis is a systemic inflammatory disorder, associated with both physical and psychological burden, and can be the presenting feature of HIV infection. In this population, psoriasis tends to be more severe, to have atypical presentations and higher failure rates with the usual prescribed treatments. Management of moderate and severe HIV-associated psoriasis is challenging. Systemic conventional and biologic agents may be considered, but patients should be carefully followed up for potential adverse events, like opportunist infections, and regular monitoring of CD4 counts and HIV viral loads.
Assuntos
Infecções por HIV/complicações , Psoríase/complicações , Corticosteroides/uso terapêutico , Terapia Biológica , Contraindicações de Medicamentos , Diagnóstico Diferencial , Gerenciamento Clínico , Humanos , Imunossupressores/efeitos adversos , Imunossupressores/uso terapêutico , Fototerapia , Prevalência , Pseudolinfoma/diagnóstico , Psoríase/epidemiologia , Psoríase/imunologia , Psoríase/terapia , Escabiose/diagnóstico , Sífilis/diagnóstico , Sífilis Cutânea/diagnóstico , Talidomida/análogos & derivados , Talidomida/uso terapêutico , Fator de Necrose Tumoral alfa/antagonistas & inibidoresRESUMO
A 52-year-old Colombian woman, a patient with psoriasis, undergoing phototherapy with (ultraviolet B narrowband) UVBnb, presented with a symptomless solitary diffuse erythaematous plaque on her nose for 3â months. Initially, she was treated with pimecrolimus 1% cream for 8â weeks, which was then combined with metronidazole cream for 4â weeks, with the initial diagnosis of UV-triggered rosacea, without improvement. A punch biopsy was performed and the histology showed a pseudolymphomatous reaction. The diagnosis of nasal pseudolymphoma of borreliosis was confirmed with PCR. The lesion completely resolved following oral doxycycline therapy.