RESUMO
Toxic epidermal necrolysis is a condition with massive keratinocyte apoptosis, and it is associated with high mortality rates. Fulvestrant, an estrogen receptor antagonist, is indicated in the treatment of estrogen receptor-positive metastatic breast cancer in postmenopausal women. To our knowledge, this is the first described case of toxic epidermal necrolysis due to fulvestrant. A 56-year-old woman received 500 mg of intramuscular fulvestrant monthly for metastatic ductal carcinoma of the breast. Five days after the first dose, the patient presented with a maculopapular rash that evolved to blisters, and a detachment of the epidermis in over 30% of the total body surface area. Histological analysis was compatible with toxic epidermal necrolysis. Fulvestrant was discontinued, topical management and supportive care were initiated.
Assuntos
Antagonistas do Receptor de Estrogênio/efeitos adversos , Fulvestranto/efeitos adversos , Pele/patologia , Síndrome de Stevens-Johnson/etiologia , Neoplasias Encefálicas/tratamento farmacológico , Neoplasias Encefálicas/secundário , Antagonistas do Receptor de Estrogênio/uso terapêutico , Feminino , Fulvestranto/uso terapêutico , Humanos , Pessoa de Meia-Idade , Necrose , Síndrome de Stevens-Johnson/patologiaRESUMO
Abstract Toxic epidermal necrolysis is a condition with massive keratinocyte apoptosis, and it is associated with high mortality rates. Fulvestrant, an estrogen receptor antagonist, is indicated in the treatment of estrogen receptor-positive metastatic breast cancer in postmenopausal women. To our knowledge, this is the first described case of toxic epidermal necrolysis due to fulvestrant. A 56-year-old woman received 500 mg of intramuscular fulvestrant monthly for metastatic ductal carcinoma of the breast. Five days after the first dose, the patient presented with a maculopapular rash that evolved to blisters, and a detachment of the epidermis in over 30% of the total body surface area. Histological analysis was compatible with toxic epidermal necrolysis. Fulvestrant was discontinued, topical management and supportive care were initiated.
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Pele/patologia , Síndrome de Stevens-Johnson/etiologia , Antagonistas do Receptor de Estrogênio/efeitos adversos , Fulvestranto/efeitos adversos , Neoplasias Encefálicas/tratamento farmacológico , Neoplasias Encefálicas/secundário , Síndrome de Stevens-Johnson/patologia , Antagonistas do Receptor de Estrogênio/uso terapêutico , Fulvestranto/uso terapêutico , NecroseRESUMO
Dermatophytosis in infants is rare, especially dermatophytosis of the diaper area. This case report and literature review provides keys to establishing the above diagnosis and discusses the current controversies concerning the use of antifungal drugs in this age group.
Assuntos
Antifúngicos/uso terapêutico , Dermatite das Fraldas/etiologia , Naftalenos/uso terapêutico , Tinha/diagnóstico , Dermatite das Fraldas/tratamento farmacológico , Feminino , Humanos , Lactente , Pele/microbiologia , Terbinafina , Tinha/tratamento farmacológico , Trichophyton/isolamento & purificaçãoRESUMO
BACKGROUND: Screening of skin cancer by teledermatology (TD) has improved the early detection of skin cancer by enhancing access to skin cancer clinics. OBJECTIVE: We sought to analyze how TD-based skin cancer screening has changed the frequency of consultations for benign lesions. PATIENTS AND METHODS: A cross-sectional study including teleconsultations received during a 7-year period was conducted to analyze and compare the trendlines of each lesion type over the study period. Trendlines were analyzed using a linear regression model with the R-squared (R 2) test for goodness of fit. RESULTS: A total of 34,553 teleconsultations were included in the study. Seborrheic keratoses, followed by benign melanocytic lesions, were the most frequent lesions diagnosed. The pick-up rate for malignant lesions was 1:8.6 teleconsultations. Seborrheic keratoses and precancerous lesions showed a positive trendline with good fit to the linear model (R 2 = 0.8 and R 2 = 0.8, respectively). Tis-T1 malignant melanoma (in situ melanoma or melanoma with a Breslow thickness <1 mm) showed an increasing trendline with moderate-to-low fit to the model (R 2 = 0.4). CONCLUSIONS: TD-based screening of skin cancer is associated with an increasing rate of consultations involving seborrheic keratoses, which can be considered a consequence of improved access to dermatologists resulting from TD implementation.
