RESUMEN
Kaposi sarcoma (KS) is a malignant proliferation of endothelial cells within the skin. The clinical presentation is characterized by clusters of violaceous macules and papules that often appear on the distal extremities or trunk with or without oral mucosal involvement. Mucocutaneous lesions are present at onset of diagnosis in a minority of cases. The lesions can evolve to include the mucous membranes of the gastric mucosa and the lungs. We present a unique case of KS in a 45-year-old, asymptomatic, human immunodeficiency virus (HIV)-positive man with mucocutaneous involvement to highlight the importance of recognizing KS in immunocompromised patients.
Asunto(s)
Seropositividad para VIH/diagnóstico , Sarcoma de Kaposi/diagnóstico , Neoplasias Cutáneas/diagnóstico , Biopsia con Aguja , VIH/aislamiento & purificación , Humanos , Extremidad Inferior/patología , Masculino , Sarcoma de Kaposi/etiología , Sarcoma de Kaposi/virología , Neoplasias Cutáneas/etiología , Neoplasias Cutáneas/virologíaRESUMEN
Ruxolitinib, a small molecule JAK-1/2 inhibitor, was approved by the U.S. Food and Drug Administration (FDA) in November 2011, as the first therapeutic for the treatment of intermediate and high-risk myelofibrosis. The Janus kinase/signal transducers and activators of transcription (JAK/STAT) pathway is one of the most well-studied intracellular signaling networks. Recent advances in our understanding of the complexities of signal activation and regulation of gene expression has provided opportunities for targeted therapeutic interventions. Although numerous inhibitors of the JAK/STAT pathway are currently being evaluated in clinical trials, ruxolitinib represents the first FDA approved in-class JAK inhibitor. We report a drug eruption associated with ruxolitinib.
Asunto(s)
Erupciones por Medicamentos/etiología , Eritema/inducido químicamente , Quinasas Janus/antagonistas & inhibidores , Mielofibrosis Primaria/tratamiento farmacológico , Pirazoles/efectos adversos , Erupciones por Medicamentos/patología , Eritema/patología , Humanos , Masculino , Persona de Mediana Edad , Nitrilos , PirimidinasRESUMEN
Although acanthosis nigricans (AN) may be associated with internal malignancies, a benign form is more common, and a subset of these is drug-induced. In this case, a solitary, hyperpigmented, acanthotic plaque developed on the right abdomen after daily, same-site injections of insulin over a six-month period. The lesion completely resolved eight months after insulin injections were rotated to other locations. Acanthosis nigricans recurred, however, at the original location two months after the patient resumed serial same-site insulin injections, against medical advice. This provides direct evidence that localized hyperinsulinism is causally related to AN through its effect on insulin-like growth factor receptors.