Assuntos
Doença Enxerto-Hospedeiro/etiologia , Dermatopatias/etiologia , Transplante de Células-Tronco/efeitos adversos , Doença Aguda , Criança , Feminino , Doença Enxerto-Hospedeiro/patologia , Humanos , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapia , Dermatopatias/patologia , Estrias de Distensão/patologia , Transplante Homólogo/efeitos adversosRESUMO
La criptococosis cutánea es una micosis propia de pacientes inmunodeprimidos, sobre todo aquellos con infección por el virusde la inmunodeficiencia humana (VIH). Sin embargo, existen casos infrecuentes de criptococosis cutánea en pacientes inmunocompetentes, que suelen simular otras dermatosis, lo que retrasa su diagnóstico y tratamiento. Presentamos el caso de un varón pluripatológico de 79 años, con úlceras dolorosas en dorso de mano derecha que no respondían a tratamientos tópicos. A través del estudio histopatológico y micológico se alcanzó el diagnóstico de criptococosis cutánea primaria, lográndose la remisión de las lesiones tras 6 meses de tratamiento con fluconazol.
Assuntos
Criptococose/patologia , Dermatomicoses/patologia , Dermatoses da Mão/patologia , Imunocompetência , Idoso , Antifúngicos/uso terapêutico , Criptococose/diagnóstico , Criptococose/tratamento farmacológico , Dermatomicoses/diagnóstico , Dermatomicoses/tratamento farmacológico , Fluconazol/uso terapêutico , Dermatoses da Mão/diagnóstico , Dermatoses da Mão/tratamento farmacológico , Humanos , Masculino , Pele/patologiaRESUMO
Vemurafenib has proved to be useful in the treatment of patients with unresectable or metastatic melanoma harboring the BRAF-V600E mutation, with better rates of overall and progression-free survival than previous treatments. Adverse cutaneous effects, such as alopecia, pruritus, photosensitivity reactions, verrucous keratosis, keratoacanthomas, or squamous cell carcinomas, have been described. Thirty cases of vemurafenib-associated panniculitis are available in the literature with variable clinical relevance. Only 9 of them exhibited definitive evidence of neutrophilic panniculitis. They all consist of multiple lesions, usually located in the lower limbs. Histopathologically, they have been described as predominantly neutrophilic, lymphocytic, or mixed, more commonly with lobular location. We report an additional case of neutrophilic panniculitis in a 45-year-old woman treated with vemurafenib for metastatic melanoma, presenting as a single lesion on his right leg. The lesion resolved spontaneously and did not need treatment reduction. The presentation of this condition with a single lesion is particularly challenging. Recognition of this association is important given the increasing use of vemurafenib and the potential implications of treatment withdrawal.
