Asunto(s)
Adalimumab , Síndrome de Behçet , Hidradenitis , Humanos , Adalimumab/uso terapéutico , Adalimumab/efectos adversos , Síndrome de Behçet/tratamiento farmacológico , Síndrome de Behçet/diagnóstico , Síndrome de Behçet/complicaciones , Hidradenitis/inducido químicamente , Hidradenitis/tratamiento farmacológico , Hidradenitis/patología , Masculino , Antiinflamatorios/uso terapéutico , Adulto , Femenino , Neutrófilos/patologíaRESUMEN
INTRODUCTION: Although many individual cases and small series of toxic erythema of chemotherapy (TEC) have been described, the full spectrum of findings is not well understood. OBJECTIVE: To provide a comprehensive review of the clinical and histopathologic features of TEC with an emphasis on novel histopathologic findings. METHODS: We searched our electronic medical record for "toxic erythema of chemotherapy" or "neutrophilic eccrine hidradenitis." Fifty-six cases meeting clinical and histopathologic criteria were identified. The electronic medical record and accompanying hematoxylin and eosin-stained slides were retrospectively reviewed. RESULTS: The clinical findings were heterogeneous but included classic presentations such as intertriginous eruptions (34%) and acral erythema (25%). The most common histopathologic features were apoptotic keratinocytes (95%), basal vacuolar change (91%), and epithelial dysmaturation (79%). Eccrine squamous syringometaplasia was seen in over half of the cases (33/56; 59%), whereas neutrophilic eccrine hidradenitis was uncommon (16%). Interestingly, many cases showed prominent interstitial histiocytes (55%). Other novel findings included irregular orthohyperkeratosis (23%), irregular epidermal hyperplasia (14%), and acantholysis (9%). LIMITATIONS: As a retrospective study, it is subject to information bias. CONCLUSION: This is the largest reported series of TEC. In addition to confirming previously reported features, we identify novel histopathologic findings to add to the spectrum of TEC.
Asunto(s)
Antineoplásicos , Erupciones por Medicamentos , Eritema , Humanos , Estudios Retrospectivos , Femenino , Persona de Mediana Edad , Masculino , Erupciones por Medicamentos/patología , Erupciones por Medicamentos/etiología , Anciano , Adulto , Antineoplásicos/efectos adversos , Eritema/inducido químicamente , Eritema/patología , Adulto Joven , Hidradenitis/inducido químicamente , Hidradenitis/patología , Anciano de 80 o más AñosAsunto(s)
Antineoplásicos Fitogénicos/farmacología , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Proteína Reguladora de Apoptosis Similar a CASP8 y FADD/análisis , Hidradenitis/inducido químicamente , Homoharringtonina/farmacología , Leucemia Mieloide Aguda/tratamiento farmacológico , Proteínas de Neoplasias/análisis , Inhibidores de Proteínas Quinasas/farmacología , Antineoplásicos Fitogénicos/administración & dosificación , Antineoplásicos Fitogénicos/efectos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Apoptosis , Proteína Reguladora de Apoptosis Similar a CASP8 y FADD/biosíntesis , Proteína Reguladora de Apoptosis Similar a CASP8 y FADD/genética , Ciclofosfamida/administración & dosificación , Citarabina/administración & dosificación , Daunorrubicina/administración & dosificación , Regulación hacia Abajo , Erupciones por Medicamentos/etiología , Hidradenitis/patología , Homoharringtonina/administración & dosificación , Homoharringtonina/efectos adversos , Humanos , Incidencia , Mercaptopurina/administración & dosificación , Proteína 1 de la Secuencia de Leucemia de Células Mieloides/análisis , Proteínas de Neoplasias/biosíntesis , Proteínas de Neoplasias/genética , Neutrófilos , Inhibidores de Proteínas Quinasas/administración & dosificación , Inhibidores de Proteínas Quinasas/efectos adversos , Glándulas Sudoríparas/química , Glándulas Sudoríparas/efectos de los fármacos , Glándulas Sudoríparas/patologíaAsunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Hidradenitis/inducido químicamente , Adulto , Citarabina/administración & dosificación , Citarabina/efectos adversos , Daunorrubicina/administración & dosificación , Daunorrubicina/efectos adversos , Femenino , Hidradenitis/diagnóstico , Hidradenitis/patología , Humanos , Leucemia Monocítica Aguda/tratamiento farmacológico , Estaurosporina/administración & dosificación , Estaurosporina/análogos & derivadosAsunto(s)
Síndrome Coronario Agudo/tratamiento farmacológico , Erupciones por Medicamentos/patología , Mano/patología , Hidradenitis/inducido químicamente , Inhibidores de Agregación Plaquetaria/efectos adversos , Ticagrelor/efectos adversos , Anciano , Clopidogrel/uso terapéutico , Erupciones por Medicamentos/tratamiento farmacológico , Humanos , Masculino , Inhibidores de Agregación Plaquetaria/uso terapéutico , Ticagrelor/uso terapéutico , Resultado del TratamientoRESUMEN
This case study describes a 37-year-old Caucasian male with pruritic papules and plaques-some with central erosion-on the arms, neck, and trunk that appeared after chemotherapy with FOLFOX (folinic acid, fluorouacil, and oxiliplatin) for colon cancer. A histological examination showed features of neutrophilic eccrine hidradenitis. To the best of our knowledge, this is the first reported case of neutrophilic eccrine hidradenitis due to FOLFOX.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias del Colon/tratamiento farmacológico , Hidradenitis/inducido químicamente , Hidradenitis/diagnóstico , Adulto , Fluorouracilo/uso terapéutico , Hidradenitis/terapia , Humanos , Leucovorina/uso terapéutico , Masculino , Compuestos Organoplatinos/uso terapéuticoAsunto(s)
Antineoplásicos Inmunológicos/efectos adversos , Erupciones por Medicamentos/etiología , Hidradenitis/inducido químicamente , Liquen Plano/inducido químicamente , Nivolumab/efectos adversos , Administración Cutánea , Anciano , Erupciones por Medicamentos/diagnóstico , Erupciones por Medicamentos/tratamiento farmacológico , Glucocorticoides/uso terapéutico , Hidradenitis/diagnóstico , Hidradenitis/tratamiento farmacológico , Hidradenitis/patología , Humanos , Liquen Plano/diagnóstico , Liquen Plano/tratamiento farmacológico , Liquen Plano/patología , Neoplasias Pulmonares/tratamiento farmacológico , Masculino , Glándulas Sudoríparas/patologíaRESUMEN
Neutrophilic eccrine hidradenitis (NEH) is a rare neutrophilic dermatosis, first described in patients undergoing chemotherapy for a malignant haemopathy. It has polymorphous clinical features and the association of both clinical and histological features is necessary to make a diagnosis. We report the first two cases of NEH in patients treated with a BRAF inhibitor (BRAFi), either dabrafenib or vemurafenib, for a stage IV metastatic melanoma. Disseminated erythematous plaques associated with fever and polyarthralgia occurred early after the initiation of treatment and were badly tolerated. Histological analyses confirmed the diagnosis of NEH. Symptoms disappeared a few days after the cessation of treatment and introduction of topical steroids. The replacement of one BRAFi with another is a therapeutic alternative as it is not necessarily associated with a relapse of NEH. NEH can be added to the spectrum of neutrophilic dermatoses induced by BRAFis. It occurs earlier (3-4 days) than previously described drug-induced NEH (9-12 days) and may be an earlier stage of eccrine squamous syringometaplasia, which has already been reported in the context of BRAFi-treated patients.
Asunto(s)
Antineoplásicos/efectos adversos , Erupciones por Medicamentos/etiología , Hidradenitis/inducido químicamente , Imidazoles/efectos adversos , Indoles/efectos adversos , Oximas/efectos adversos , Sulfonamidas/efectos adversos , Adulto , Femenino , Humanos , Masculino , Melanoma/tratamiento farmacológico , Neoplasias Cutáneas/tratamiento farmacológico , Vemurafenib , Adulto JovenAsunto(s)
Fármacos Anti-VIH/efectos adversos , Emtricitabina/efectos adversos , Hidradenitis/inducido químicamente , Raltegravir Potásico/efectos adversos , Tenofovir/efectos adversos , Terapia Antirretroviral Altamente Activa/efectos adversos , Quimioterapia Combinada , Femenino , Hidradenitis/diagnóstico , Hidradenitis/patología , Humanos , Persona de Mediana EdadAsunto(s)
Azatioprina/efectos adversos , Hipersensibilidad a las Drogas/complicaciones , Hidradenitis/inducido químicamente , Inmunosupresores/efectos adversos , Enfermedad de Crohn/tratamiento farmacológico , Diagnóstico Diferencial , Humanos , Leucemia Mieloide Aguda/tratamiento farmacológico , Síndrome de Sweet/diagnósticoAsunto(s)
Antibióticos Antineoplásicos/efectos adversos , Antimetabolitos Antineoplásicos/efectos adversos , Citarabina/efectos adversos , Daunorrubicina/efectos adversos , Hidradenitis/inducido químicamente , Enfermedades de la Vulva/inducido químicamente , Femenino , Hidradenitis/patología , Humanos , Persona de Mediana Edad , Enfermedades de la Vulva/patologíaRESUMEN
BACKGROUND: Neutrophilic eccrine hidradenitis (NEH) is a form of neutrophilic dermatitis characterized by tender erythematous and painful papules involving the trunk, extremities and face. The generalized form is associated with malignant hemopathies. The palmoplantar form occurs in children without any context of malignancy. Histology shows a neutrophilic infiltrate surrounding and infiltrating the eccrine glands associated with vacuolar degeneration and necrosis of the epithelial secretory portion. PATIENTS AND METHODS: We report the case of a 4-year-old girl with palmoplantar HEN progressing to the generalized form while in remission from acute lymphoblastic leukemia. DISCUSSION: Progression of HEN from the palmoplantar form to the generalized form has never been published previously in the literature.
Asunto(s)
Hidradenitis/patología , Huésped Inmunocomprometido , Leucemia-Linfoma Linfoblástico de Células Precursoras , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Biopsia , Preescolar , Diagnóstico Diferencial , Progresión de la Enfermedad , Femenino , Dermatosis del Pie/patología , Dermatosis de la Mano/patología , Hidradenitis/inducido químicamente , Humanos , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamiento farmacológico , Inducción de RemisiónAsunto(s)
Antimetabolitos Antineoplásicos/efectos adversos , Antimetabolitos Antineoplásicos/uso terapéutico , Citarabina/efectos adversos , Citarabina/uso terapéutico , Hidradenitis/inducido químicamente , Leucemia Mieloide Aguda/complicaciones , Leucemia Mieloide Aguda/tratamiento farmacológico , Antiinflamatorios/uso terapéutico , Antiinflamatorios no Esteroideos/uso terapéutico , Femenino , Hidradenitis/patología , Hidradenitis/terapia , Humanos , Persona de Mediana Edad , Infiltración Neutrófila/fisiología , Piel/patologíaRESUMEN
Neutrophilic eccrine hidradenitis (NEH) is a distinctive dermatosis occurring in patients with malignancy or undergoing chemotherapy. This disorder is characterized by a neutrophilic infiltrate around the eccrine glands and secretory coils, and is associated with necrosis. It must be distinguished from infections, drug eruptions, malignancies or other forms of skin diseases. As it is a self-limiting condition, establishing the diagnosis will avoid unnecessary investigations and treatment. Here we report a case of NEH in a 40-year-old woman suspected to be due to carbamazepine.
Asunto(s)
Anticonvulsivantes/efectos adversos , Carbamazepina/efectos adversos , Epilepsia/tratamiento farmacológico , Hidradenitis/inducido químicamente , Adulto , Diagnóstico Diferencial , Femenino , Hidradenitis/patología , HumanosAsunto(s)
Antimetabolitos Antineoplásicos/efectos adversos , Citarabina/efectos adversos , Hidradenitis/inducido químicamente , Antimetabolitos Antineoplásicos/uso terapéutico , Citarabina/uso terapéutico , Glándulas Ecrinas/patología , Femenino , Humanos , Quimioterapia de Inducción , Leucemia Mieloide Aguda/tratamiento farmacológico , Persona de Mediana EdadRESUMEN
Cetuximab is an epidermal growth factor receptor inhibitor used in metastatic colorectal cancer, and head and neck cancers. Several cutaneous side effects due to cetuximab such as acne-like rash, pruritus, dry skin, desquamation, hypertrichosis, and paronychia have been reported so far. A 59-year-old male patient with metastatic colon cancer referred to our outpatient clinic for his lesions on the dorsal surfaces of his hands and wrists, and on thighs developing after the chemotherapy. He was diagnosed as neutrophilic eccrine hydradenitis related to cetuximab in the light of clinical and histopathological findings. According to our knowledge, this is the first reported case of neutrophilic ecrine hydradenitis due to cetuximab.
Asunto(s)
Anticuerpos Monoclonales/efectos adversos , Antineoplásicos/efectos adversos , Hidradenitis/inducido químicamente , Adenocarcinoma/tratamiento farmacológico , Anticuerpos Monoclonales Humanizados , Cetuximab , Neoplasias Colorrectales/tratamiento farmacológico , Hidradenitis/patología , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Neutrophilic eccrine hidradenitis (NEH) was originally described as a distinctive dermatosis occurring in patients undergoing chemotherapy, especially associated with the use of cytarabine in the treatment of acute myelogenous leukemia (AML). This disorder is characterized by a neutrophilic infiltrate around the eccrine glands and coils and is associated with necrosis. However, atypical findings in the histology have been reported. To the best of our knowledge, leukocytoclastic vasculitis has not been described in association with NEH. We hypothesize that a toxic effect of cytarabine may damage the vessel wall to some extent, causing a vasculitic phenomenon.