ABSTRACT
INTRODUCCIÓN: La eritrodermia es un síndrome inflamatorio cutáneo infrecuente caracterizado por compromiso eritematoso generalizado y descamación, de más del 90% de superficie cutánea total. OBJETIVO: Caracterizar clínica e histopatológicamente a los pacientes con eritrodermia en un hospital universitario chileno. METODOLOGÍA: Estudio retrospectivo, realizado en el Hospital Clínico Universidad de Chile, basado en revisión de fichas clínicas e informes histopatológicos de pacientes con eritrodermia, entre 2005 y 2018. Se evaluó edad, sexo y variables clínicas (co-morbilidades, síntomas, días de evolución, ingreso hospitalario, informe histopatológico, diagnóstico y evolución). RESULTADOS: Total de 28 pacientes, 18 hombres (64%), edad promedio 59 años. Causa más frecuente de eritrodermia fue dermatosis pre-exis-tentes, con 15 casos (54%), que incluyen: psoriasis 9 (32%), dermatitis de contacto 3 (11%), PRP 2 (7%), dermatitis atópica 1 (4%). A estas le siguen: reacción adversa medicamentosa 6 (21%), idiopática 6 (21%) y Síndrome de Sezary 1 (4%). CONCLUSIÓN: El presente estudio corresponde a la primera serie de eritrodermias realizada en Chile. Destacan las dermatosis preexistentes como la principal causa, lo que se correlaciona con la literatura.
INTRODUCTION: Erythroderma is an infrequent cutaneous inflammatory disorder characterized by generalized erythematous compromise and desquamation, of more than 90% of total cutaneous surface. OBJECTIVE: Clinical and histopathological cha-racterization of patients with erythroderma in a Chilean university hospital. METHODOLOGY: Retrospective study, performed at the University of Chile Clinical Hospital, based on review of clinical records and histopatho-logical reports of patients with erythroderma, between 2005 and 2018. Age, sex and clinical variables were evaluated (co-morbidities, symp-toms, days of evolution, hospital admission, histopathological report, diagnosis and evolu-tion). RESULTS: A total of 28 patients, 18 were men (64%), average age 59 years. Most frequent cause of erythroderma was pre-existing dermatosis, with 13 cases (52%), which included: psoriasis 9 (32%), contact dermatitis 3 (11%), PRP 2 (7%), atopic dermatitis 1 (4%). These are followed by adverse drug eruption 6 (21%), idiopathic 6 (21%) and Sezary syndrome 1 (4%). CONCLUSION: The present study corresponds to the first series of erythrodermas performed in Chile. The pre-existing dermatoses were the main cause of erythroderma, which coincides with other reports.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Dermatitis, Exfoliative/etiology , Dermatitis, Exfoliative/pathology , Dermatitis, Exfoliative/epidemiology , Psoriasis/complications , Psoriasis/epidemiology , Clinical Evolution , Chile , Cross-Sectional Studies , Retrospective Studies , Drug Eruptions/complications , Drug Eruptions/epidemiology , Dermatitis, Atopic/complications , Dermatitis, Atopic/epidemiology , Dermatitis, Contact/complications , Dermatitis, Contact/epidemiologyABSTRACT
There are several common mucocutaneous adverse effects related to chemotherapy, either by direct cytotoxic action or by hypersensitivity to the drugs. The authors report inflammation in multiple seborrheic keratoses after chemotherapy with gemcitabine in a patient under treatment for pancreatic cancer. Moreover, they discuss the relative benignity of this event and warn about the need to correctly identify systemic chemotherapy-induced skin adverse effects.
Subject(s)
Antimetabolites, Antineoplastic/adverse effects , Deoxycytidine/analogs & derivatives , Drug Eruptions/complications , Drug Eruptions/etiology , Keratosis, Seborrheic/chemically induced , Keratosis, Seborrheic/complications , Deoxycytidine/adverse effects , Female , Humans , Middle Aged , GemcitabineABSTRACT
São diversos e comuns os efeitos mucocutâneos dos quimioterápicos, alguns por ação citotóxica, outros por hipersensibilidade ao fármaco. Os autores relatam a ocorrência de inflamação em múltiplas queratoses seborreicas pré-existentes, após terapia citorredutora com gencitabina, em paciente sob tratamento para neoplasia de pâncreas. Discutem, ainda, a benignidade do evento e alertam para a necessidade de adequada identificação dos efeitos cutâneos decorrentes da quimioterapia sistêmica.
There are several common mucocutaneous adverse effects related to chemotherapy, either by direct cytotoxic action or by hypersensitivity to the drugs. The authors report inflammation in multiple seborrheic keratoses after chemotherapy with gemcitabine in a patient under treatment for pancreatic cancer. Moreover, they discuss the relative benignity of this event and warn about the need to correctly identify systemic chemotherapy-induced skin adverse effects.
Subject(s)
Female , Humans , Middle Aged , Antimetabolites, Antineoplastic/adverse effects , Deoxycytidine/analogs & derivatives , Drug Eruptions/complications , Drug Eruptions/etiology , Keratosis, Seborrheic/chemically induced , Keratosis, Seborrheic/complications , Deoxycytidine/adverse effectsABSTRACT
Levamisole is an antihelmintic drug that stimulates antibodies formation increasing both T response, and neutrophilic response, and quimiotaxis. It is used in dermatology for the treatment of plane warts, erythema multiforme, aphtous ulcers and, with prednisone, in lichen planus. With prolonged use this drug has been implicated in adverse dermatological reactions as lichenoid eruptions, ulcers and vasculitis. We present a 9-years old girl who developed a cutaneous eruption and a reverse leucoencephalopathy with a short treatment but high doses of the drug.
Subject(s)
Drug Eruptions/complications , Drug Eruptions/etiology , Levamisole/adverse effects , Posterior Leukoencephalopathy Syndrome/chemically induced , Posterior Leukoencephalopathy Syndrome/complications , Child , Female , Humans , Skin Diseases/drug therapy , Warts/drug therapyABSTRACT
Skin necrosis and priapism are unusual complications of warfarin therapy. We report a teenager with warfarin-associated skin necrosis and priapism who was subsequently found to be a compound heterozygote for protein C deficiency and a heterozygote for the factor V Leiden mutation.
Subject(s)
Anticoagulants/adverse effects , Drug Eruptions/etiology , Priapism/chemically induced , Warfarin/adverse effects , Adolescent , Drug Eruptions/complications , Drug Eruptions/pathology , Factor V/genetics , Humans , Male , Necrosis , Priapism/complications , Protein C Deficiency/complications , Thrombophilia/geneticsABSTRACT
Se comunican los resultados de un estudio efectuado para determinar la frecuencia de farmacodermias en pacientes dermatológicos en un hospital general. La incidencia fue del 2.16 por ciento. Los cuadros clínicos más frecuentes fueron exantemas y eritema pigmentado fijo tanto en adultos como en niños. Los antiinflamatorios no esterioides causaron 37 por ciento de las reacciones en adultos, y metamizol y sulfas fueron los medicamentos más frecuentemente implicados en niños
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Adolescent , Adult , Middle Aged , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Dipyrone/adverse effects , Drug Eruptions/complications , Drug Eruptions/diagnosis , Health Services/statistics & numerical data , Sulfasalazine/adverse effectsABSTRACT
Enfermedades reumáticas, vasculares, por depósito, metabólicas, endocrinas, cardiopulmonares, renales, neurocutáneas, psicocutáneas. Aparato digestivo y alteraciones nutricionales. Embarazo. Manifestaciones cutáneas de la inmunosupresión. Farmacodermias. Dermatosis paraneoplásicas. Prurito. Otras enfermedades sistémicas con repercusión en la piel
Subject(s)
Humans , Pregnancy , Dermatology , Medical Illustration , Skin Manifestations , Amyloidosis/complications , Angiodysplasia/complications , Colitis, Ulcerative/complications , Cryoglobulinemia/complications , Dermatomyositis/complications , Diabetes Mellitus/complications , Celiac Disease/complications , Metabolic Diseases/complications , Nutritional and Metabolic Diseases/complications , Rheumatic Diseases/complications , Vascular Diseases/complications , Collagen Diseases/complications , Digestive System Diseases/complications , Endocrine System Diseases/complications , Drug Eruptions/complications , Glucagonoma/complications , Gout/complications , Histiocytosis/complications , Immunocompromised Host/complications , Immunosuppression Therapy/complications , Renal Insufficiency, Chronic/complications , Lupus Erythematosus, Systemic/complications , Neoplasms/complications , Panniculitis/complications , Polycythemia Vera/complications , Pruritus/complications , Pseudoxanthoma Elasticum/complications , Purpura/complications , Sarcoidosis/complications , Malingering/complications , Acquired Immunodeficiency Syndrome/complications , Sweet Syndrome/complications , Paraneoplastic Syndromes/complications , Malabsorption Syndromes/complications , Kidney Transplantation/complications , Vasculitis/complicationsABSTRACT
Enfermedades reumáticas, vasculares, por depósito, metabólicas, endocrinas, cardiopulmonares, renales, neurocutáneas, psicocutáneas. Aparato digestivo y alteraciones nutricionales. Embarazo. Manifestaciones cutáneas de la inmunosupresión. Farmacodermias. Dermatosis paraneoplásicas. Prurito. Otras enfermedades sistémicas con repercusión en la piel
Subject(s)
Humans , Pregnancy , Dermatology , Skin Manifestations , Medical Illustration , Vascular Diseases/complications , Rheumatic Diseases/complications , Metabolic Diseases/complications , Digestive System Diseases/complications , Nutritional and Metabolic Diseases/complications , Acquired Immunodeficiency Syndrome/complications , Paraneoplastic Syndromes/complications , Pruritus/complications , Drug Eruptions/complications , Sarcoidosis/complications , Histiocytosis/complications , Sweet Syndrome/complications , Polycythemia Vera/complications , Endocrine System Diseases/complications , Purpura/complications , Vasculitis/complications , Diabetes Mellitus/complications , Neoplasms/complications , Renal Insufficiency, Chronic/complications , Kidney Transplantation/complications , Celiac Disease/complications , Malabsorption Syndromes/complications , Angiodysplasia/complications , Amyloidosis/complications , Gout/complications , Collagen Diseases/complications , Colitis, Ulcerative/complications , Glucagonoma/complications , Malingering/complications , Cryoglobulinemia/complications , Pseudoxanthoma Elasticum/complications , Immunosuppression Therapy/complications , Immunocompromised Host/complications , Panniculitis/complications , Lupus Erythematosus, Systemic/complications , Dermatomyositis/complications , /complicationsABSTRACT
Säo relatados quatro casos de necrose tecidual após injeçäo intramuscular do antiinflamatório diclofenaco de sódio (Voltarem). A primeira paciente desenvolveu pequena lesäo necrótica na nádega esquerda, que acometia pele, tecido subcutâneo e pequena porçäo do músculo glúteo máximo. A evoluçäo foi benigna. A 2ª paciente desenvolveu necrose da regiäo deltóidea direita, que também acometia pele, tecido subcutâneo e pequena porçäo do músculo deltóide. A evoluçäo também foi benigna, mas a cicatriz resultante do processo era extensa e inestética. O 3ª pacientes desenvolveu extensa necrose da regiäo deltóidea direita, com acometimento da pele, tecido subcutâneo e músculo, resultando em déficit motor (abduçäo, retro e anteversäo) permanente do membro superior direito. A 4ª paciente desenvolveu necrose musculocutânea na regiäo deltóidea D (com predomínio cutâneo e subcutâneo), que resultou em cicatriz inestética e discreto déficit motor (abduçäo). O mecanismo etiopatogênico da necrose parece estar relacionado a processo embólico, angioespasmo e trombose ou, mais provavelmente, a uma interaçäo destes mecanismos. Alguns autores acreditam num mecanismo imunoalérgico. Säo discutidos cuidados a serem tomados para evitar este tipo de acidente, assim como medidas terapêuticas a serem adotadas caso o acidente venha a ocorrer
Subject(s)
Adult , Middle Aged , Humans , Male , Female , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Drug Eruptions/complications , Embolism/complications , Thrombosis/complications , Injections, IntramuscularABSTRACT
Neste trabalho levantou-se 14,561 prontuários dos pacientes do Serviço de Dermatologia do Centro Médico da Faculdade de Medicina de Santo Amaro, no período de janeiro de 1980 a maio de 1989. Realizou-se levantamento epidemiológico, apresentaçöes clínicas mais freqüentes e as principais drogas envolvidas. Foram diagnósticados 166 casos de farmacodermias
Subject(s)
Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Humans , Male , Female , Drug Eruptions/complications , Skin Diseases/drug therapy , Retrospective StudiesABSTRACT
La mortalidad de la necrosis epidérmica tóxica es sumamente alta en la forma grave; en el presete trabajo se informa de once casos que fueron corroborados por cuadro clínico y biopsia de piel, cuya etiología en el 91 por ciento fueron medicamentos, y que categorizando al paciente con esta enfermedad, fueron tratados en la unidad de cuidados intensivos con heparina y dipiridamol y tuvieron una sobrevida del 100 por ciento.