RESUMO
Biologic agents are regarded as an effective treatment for a variety of autoimmune diseases. These drugs have an acceptable safety and tolerability profile, although an increasing number of autoimmune conditions have been reported with their use. Additionally, a variety of cutaneous diseases have been associated with their use. Here we report our experience of adverse cutaneous events with the use of biologic agents. An alternative explanation for patients presenting with adverse cutaneous events including drug interactions must be carefully investigated.
Assuntos
Anticorpos Monoclonais Humanizados/efeitos adversos , Antirreumáticos/efeitos adversos , Certolizumab Pegol/efeitos adversos , Eritema/induzido quimicamente , Etanercepte/efeitos adversos , Psoríase/induzido quimicamente , Vasculite Leucocitoclástica Cutânea/induzido quimicamente , Adulto , Idoso , Artrite Psoriásica/tratamento farmacológico , Artrite Reumatoide/tratamento farmacológico , Eritema/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neutrófilos/patologia , Psoríase/patologia , Arterite de Takayasu/tratamento farmacológico , Vasculite Leucocitoclástica Cutânea/patologiaRESUMO
The panniculitides are a complex dermatologic entity for both dermatologists and dermatopathologists. Panniculitis is an inflammation of the subcutaneous adipose tissue and can be associated with systemic diseases. We present a case of cold panniculitis, a form of traumatic panniculitis, in a 37-year-old woman that was caused by a cold therapy unit. Our patient did not develop lesions until 10 days following initiation of therapy, which is a unique presentation of cold panniculitis, as lesions usually develop 1 to 3 days after cold exposure.
Assuntos
Crioterapia/efeitos adversos , Paniculite/diagnóstico , Adulto , Biópsia , Diagnóstico Diferencial , Feminino , HumanosRESUMO
Granulomatous dermatitis (GD) is known to occur following varicella-zoster virus (VZV) infection. Lesions may appear at varying times after the acute eruption in both immunosuppressed and immunocompetent hosts. The etiology of GD is unclear, and findings of VZV in the lesions often are inconsistent. We describe 2 immunocompromised patients who presented with GD following VZV infection; their lesions were examined for the presence of VZV. We also review the literature on postzoster GD.
Assuntos
Dermatite/etiologia , Granuloma/etiologia , Herpes Zoster/complicações , Herpesvirus Humano 3/isolamento & purificação , Idoso , Dermatite/patologia , Dermatite/virologia , Feminino , Granuloma/patologia , Granuloma/virologia , Humanos , Hospedeiro Imunocomprometido , Masculino , Pessoa de Meia-Idade , Fatores de TempoRESUMO
Granulomatous cutaneous reactions are well described in association with T-cell non-Hodgkin lymphoma and Hodgkin lymphoma, but are rarely seen in association with B-cell non-Hodgkin lymphoma or leukemia. We report a case of a 65-year-old woman with B-cell chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) who presented with multiple, tender, firm pink papules on the face, upper trunk and upper extremities 6 years after diagnosis of CLL. Biopsy revealed both palisading granulomatous dermatitis consistent with actinic granuloma and a dense perivascular lymphocytic infiltrate consistent with the patient's known history of leukemia. This is an unusual manifestation of cutaneous B-cell CLL that is rarely seen.
Assuntos
Neoplasias Faciais/patologia , Granuloma/patologia , Leucemia Linfocítica Crônica de Células B/patologia , Neoplasias Cutâneas/patologia , Idoso , Dermatite/patologia , Feminino , HumanosAssuntos
Porocarcinoma Écrino/etiologia , Doença Enxerto-Hospedeiro/terapia , Infecções por Papillomavirus/complicações , Neoplasias das Glândulas Sudoríparas/etiologia , Porocarcinoma Écrino/virologia , Doença Enxerto-Hospedeiro/etiologia , Humanos , Terapia de Imunossupressão/efeitos adversos , Terapia de Imunossupressão/métodos , Imunossupressores/efeitos adversos , Imunossupressores/uso terapêutico , Linfoma de Célula do Manto/terapia , Masculino , Pessoa de Meia-Idade , Transplante de Células-Tronco/métodos , Neoplasias das Glândulas Sudoríparas/virologiaRESUMO
We report a primary inoculation fungal infection in a 76-year-old man with acute myeloid leukemia. The patient presented with a painful red plaque located where he routinely wore a ruby ring. Histopathology revealed multiple branching septate hyphae. Cultures confirmed Fusarium and Candida parapsilosis infection. A short discussion of these organisms follows.
Assuntos
Candida/isolamento & purificação , Candidíase Cutânea/diagnóstico , Dermatomicoses/diagnóstico , Fusarium/isolamento & purificação , Joias/efeitos adversos , Úlcera Cutânea/diagnóstico , Nucleotídeos de Adenina/uso terapêutico , Idoso , Antineoplásicos/uso terapêutico , Arabinonucleosídeos/uso terapêutico , Candidíase Cutânea/tratamento farmacológico , Candidíase Cutânea/patologia , Clofarabina , Citarabina/uso terapêutico , Fármacos Dermatológicos/uso terapêutico , Dermatomicoses/tratamento farmacológico , Dermatomicoses/patologia , Humanos , Hospedeiro Imunocomprometido , Itraconazol/uso terapêutico , Leucemia Mieloide Aguda/tratamento farmacológico , Masculino , Pirimidinas/uso terapêutico , Úlcera Cutânea/microbiologia , Úlcera Cutânea/patologia , Resultado do Tratamento , Triazóis/uso terapêutico , VoriconazolRESUMO
Epidermodysplasia verruciformis (EV) has several clinical presentations and has been reported in various states of immune deregulation. We report the unique presentation of this disease as a pigmented periungual macule in a patient with a previous history of immune deregulation related to cutaneous lymphoma. A literature review did not reveal any previous reports of EV in patients with cutaneous T-cell lymphoma.
Assuntos
Epidermodisplasia Verruciforme/diagnóstico , Linfoma Cutâneo de Células T/complicações , Transtornos da Pigmentação/diagnóstico , Neoplasias Cutâneas/complicações , Idoso , Epidermodisplasia Verruciforme/etiologia , Epidermodisplasia Verruciforme/patologia , Epidermodisplasia Verruciforme/cirurgia , Epidermodisplasia Verruciforme/virologia , Feminino , Humanos , Linfoma Cutâneo de Células T/tratamento farmacológico , Linfoma Cutâneo de Células T/radioterapia , Linfoma Cutâneo de Células T/virologia , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/diagnóstico , Transtornos da Pigmentação/patologia , Transtornos da Pigmentação/cirurgia , Transtornos da Pigmentação/virologia , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/radioterapia , Neoplasias Cutâneas/virologia , Resultado do TratamentoRESUMO
Onycholemmal carcinoma is believed to be of trichilemmal origin, and shows differentiation similar to that found in the trichilemmal portion of the hair follicle. Less then 3 cases are currently in the English literature. All reported cases presented in elderly patients and were without recurrence after amputation. Clinical presentation has been varied and can be very subtle. As with most nail tumors, pain is not a common feature. The diagnosis is based on the histology showing an infiltrative growth of atypical keratinocytes, one or more foci of abrupt keratinization, and usually also keratinous cysts devoid of a granular layer. When a cystic component and clear cells predominate, the subtype description of malignant proliferating onycholemmal cyst has been applied. No standard treatment option or follow up has been established.
Assuntos
Carcinoma de Células Escamosas/diagnóstico , Doenças da Unha/diagnóstico , Neoplasias Cutâneas/diagnóstico , Idoso , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Diagnóstico Diferencial , Feminino , Humanos , Doenças da Unha/patologia , Doenças da Unha/cirurgia , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/cirurgiaRESUMO
BACKGROUND: The histologic diagnosis of atypical fibroxanthoma (AFX) can sometimes be challenging. No specific marker exists to confirm the diagnosis other than excluding other entities. CD163 has been shown to have great specificity for tumors of monocyte/histiocyte lineage. In this study, we evaluated the diagnostic utility of CD163 in diagnosing AFX and in identifying skin lesions with histiocytic/dendritic derivation. METHODS: A total of 157 cases, including 14 AFXs, 5 spindle cell squamous cell carcinomas (SCCs), and 7 spindle cell/desmoplastic melanomas, along with other cutaneous spindle cell and histiocytic/fibrohistiocytic lesions, were stained with CD163. RESULTS: CD163 was expressed in 11 of 14 (79%) AFXs, with moderate to strong intensity. No staining was observed in cases of spindle cell SCC (0/5) and dermatofibrosarcoma protuberans (0/10). Rare spindle cell/desmoplastic melanomas (2/7) and cutaneous leiomyosarcomas (1/5) demonstrated positive staining. CD163 reactivity was seen in 24 of 29 of benign fibrous histiocytomas (BFHs), including 8 of 8 cellular fibrous histiocytomas and 6 of 9 epithelioid cell histiocytomas. The majority of cutaneous histiocytic lesions, including juvenile xanthogranuloma, Langerhans cell histiocytosis and Rosai-Dorfman disease, were positive for CD163. CONCLUSION: CD163 is a useful adjunct in distinguishing AFX from other malignant cutaneous spindle cell tumors and offers improved specificity in identifying cutaneous histiocytic/dendritic lesions.