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2.
Lupus ; 28(14): 1716-1721, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31674268

RESUMO

Rowell syndrome (RS) is a rare disease characterized by the association of systemic lupus erythematosus (SLE) or cutaneous lupus with lesions similar to erythema multiforme and the presence of autoantibodies including ANA, SSA, SSB, or rheumatoid factor. Due to the low incidence of this disease, the epidemiology of RS is not clear. So far there are 95 cases reported in the literature; of these, only seven cases are pediatric patients. Macrophage activation syndrome (MAS) is an increasingly recognized complication of SLE, although its true prevalence in childhood is still unknown. We describe a unique pediatric patient with RS who developed MAS.


Assuntos
Eritema Multiforme/diagnóstico , Lúpus Eritematoso Sistêmico/diagnóstico , Síndrome de Ativação Macrofágica/etiologia , Pele/patologia , Criança , Diagnóstico Diferencial , Eritema Multiforme/patologia , Humanos , Lúpus Eritematoso Sistêmico/patologia , Masculino
4.
Dermatol Ther ; 32(5): e13066, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31414706

RESUMO

Herpes simplex virus (HSV)-associated erythema multiforme (HAEM) is an acute and self-limiting mucocutaneous hypersensitivity reaction triggered by herpes virus infections. We reported a patient with HAEM after hematopoietic stem cell transplantation (HSCT). A 55-year-old man received HSCT 7 months ago. He suffered from chronic graft versus host disease 4 months after HSCT and was treated with prednisone and tacrolimus. One week ago, he developed generalized macules with leukopenia. Dermatological examination revealed multiple iris-like erythemas on his trunk and extremities. The skin lesions and leukopenia resolved upon anti-HSV treatment.


Assuntos
Eritema Multiforme/virologia , Famciclovir/administração & dosagem , Doença Enxerto-Hospedeiro/terapia , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Herpes Simples/patologia , Simplexvirus/isolamento & purificação , Biópsia por Agulha , Eritema Multiforme/tratamento farmacológico , Eritema Multiforme/patologia , Seguimentos , Doença Enxerto-Hospedeiro/diagnóstico , Herpes Simples/etiologia , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Síndromes Mielodisplásicas/patologia , Síndromes Mielodisplásicas/terapia , Medição de Risco , Simplexvirus/efeitos dos fármacos , Fatores de Tempo , Resultado do Tratamento
5.
J Nepal Health Res Counc ; 17(1): 119-121, 2019 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-31110391

RESUMO

Porphyria cutaneatarda, is the most common type of porphyria.It is characterized by defective uroporphyrinogen III decarboxylase enzyme.It presents with erosion, bulla with milia formation and sometimes with hypertrichosis and abnormal pigmentation mostly on the photo-exposed sites. A urine fluorescence of coral red color helps in the diagnosis. Here, we present a rare case of porphyria cutanea tarda in a 15 years old male who presented with multiple targetoid plaques. Keywords: Erythema-multiforme; porphyria cutanea tarda; targetoid.


Assuntos
Eritema Multiforme/diagnóstico , Porfiria Cutânea Tardia/diagnóstico , Adolescente , Diagnóstico Diferencial , Eritema Multiforme/patologia , Humanos , Masculino , Porfiria Cutânea Tardia/patologia , Pele/patologia
6.
Clin Dermatol ; 37(2): 148-158, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30981295

RESUMO

We have explored the rash that appears as target lesions, with the central and dominant diseases belonging to the Stevens-Johnson syndrome/toxic epidermal necrolysis group. After presenting the clinical patterns of an individual target lesion and classifying them into different types of lesions, the contribution has been organized with groups characterized by such specific findings according to the type of lesion: flat or raised, typical or atypical, presence or absence of fever, presence or absence of mucosal ulcerations, presence or absence of arthralgias, and/or internal organ involvement. Other specific features, such as histologic appearance, immunofluorescence findings, and laboratory changes, are considered. We provide clinicians with an algorithmic, systematic, and logical approach to diagnose the condition of the patients who present with targetoid lesions, and enable them to differentiate between those with serious systemic and life-threatening diseases from others with ordinary skin ailments.


Assuntos
Eritema Multiforme/complicações , Eritema Multiforme/diagnóstico , Exantema/diagnóstico , Exantema/etiologia , Pele/patologia , Síndrome de Stevens-Johnson/complicações , Síndrome de Stevens-Johnson/diagnóstico , Artralgia , Diagnóstico Diferencial , Eritema Multiforme/patologia , Exantema/patologia , Feminino , Febre , Imunofluorescência , Doença Enxerto-Hospedeiro/complicações , Doença Enxerto-Hospedeiro/diagnóstico , Doença Enxerto-Hospedeiro/patologia , Humanos , Masculino , Síndrome de Linfonodos Mucocutâneos/complicações , Síndrome de Linfonodos Mucocutâneos/diagnóstico , Síndrome de Linfonodos Mucocutâneos/patologia , Membrana Mucosa , Penfigoide Bolhoso/complicações , Penfigoide Bolhoso/diagnóstico , Penfigoide Bolhoso/patologia , Gravidez , Complicações na Gravidez , Choque Séptico/complicações , Choque Séptico/diagnóstico , Choque Séptico/patologia , Síndrome de Stevens-Johnson/patologia , Sífilis/complicações , Sífilis/diagnóstico , Sífilis/patologia , Úlcera , Urticária/complicações , Urticária/diagnóstico , Urticária/patologia
7.
Am J Dermatopathol ; 41(4): 273-280, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30211734

RESUMO

BACKGROUND: Hand-foot-mouth disease (HFMD) is a common contagious viral infection usually affecting infants and children. Recently, literature on HFMD in adults is increasing. It has been reported that adults often present with unusual exanthems with similarities to erythema multiforme (EM). No study has so far compared the histologic features of HFMD with those of EM. METHODS: Histopathologic features in 7 biopsies of 6 adult patients with HFMD are compared with biopsies from 9 patients with EM to identify the best criteria for differentiation. RESULTS: HFMD and EM both have a perivascular lymphocytic infiltrate together with epidermal necrosis, spongiosis, ballooning, and reticular alteration. However, large numbers of neutrophils in parakeratosis (P < 0.05), in the viable epidermis (P < 001), or neutrophils forming intraepidermal collections (P < 0.05) are significantly more common in HFMD. In HFMD, necrotic keratinocytes are emphasized in the upper third of the epidermis (P < 0.05), whereas the lower third is typically involved more in EM. Neutrophils are significantly more common and more numerous in the dermal infiltrate of HFMD compared with EM (P < 0.01) Extravasated erythrocytes in the epidermis are more common and more numerous in HFMD (P < 0.05). CONCLUSIONS: Lesions of EM and HFMD can be differentiated based on the amount of neutrophils in the epidermis and in the dermal infiltrate, which are significantly more numerous in HFMD. In addition, necrosis is emphasized in the upper part of the epidermis in HFMD and in the lower part of it in EM.


Assuntos
Eritema Multiforme/diagnóstico , Eritema Multiforme/patologia , Doença de Mão, Pé e Boca/diagnóstico , Doença de Mão, Pé e Boca/patologia , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Estudos Retrospectivos
9.
J Am Acad Dermatol ; 79(1): 110-117, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29559400

RESUMO

BACKGROUND: Mycoplasma pneumoniae infection has been documented in erythema multiforme (EM) and Stevens-Johnson syndrome-toxic epidermal necrosis (SJS-TEN). Clinical aspects of M pneumoniae-related EM have been poorly described in the literature. OBJECTIVE: To highlight differences between M pneumoniae EM and non-M pneumoniae EM. METHODS: This single-center, retrospective cohort study included all patients admitted to our dermatology department for EM during 2000-2015. We compared epidemiologic, clinical, and histologic data and follow-up for M pneumoniae EM and non-M pneumoniae EM cases. RESULTS: Thirty-three patients with M pneumoniae EM were compared with 100 patients with non-M pneumoniae EM. Disease onset in winter was more frequent with M pneumoniae EM (P = .003). Acrally distributed lesions (32% vs 88%, P < .0001) and typical targets (45% vs 74%, P = .01) were less common in M pneumoniae EM than non-M pneumoniae EM. Multiple (≥2) mucousal membrane involvement was more frequent in M pneumoniae EM than non-M pneumoniae EM (97% vs 60%; P < .0001), as were mucosal and respiratory tract sequelae (P < .05). The mean hospital stay was longer with M pneumoniae EM patients: 9.5 days versus 5.1 days (P = .0002). A TEN-like pattern was observed in all 14 (100%) M pneumoniae EM skin biopsies versus 10 of 27 (48%) non-M pneumoniae EM biopsies (P < .001). LIMITATIONS: The retrospective design. CONCLUSION: M pneumoniae EM has a distinctive presentation compared with non-M pneumoniae EM, with more diffuse and atypical targets, more mucositis and respiratory tract sequelae. Histologic data show a TEN-like pattern in all M pneumoniae EM skin samples.


Assuntos
Eritema Multiforme/microbiologia , Eritema Multiforme/patologia , Mycoplasma pneumoniae/patogenicidade , Pneumonia por Mycoplasma/epidemiologia , Pneumonia por Mycoplasma/patologia , Centros Médicos Acadêmicos , Adulto , Fatores Etários , Biópsia por Agulha , Estudos de Coortes , Eritema Multiforme/epidemiologia , Feminino , França , Humanos , Imuno-Histoquímica , Incidência , Masculino , Pessoa de Meia-Idade , Mucosite/epidemiologia , Mucosite/microbiologia , Mucosite/patologia , Pneumonia por Mycoplasma/fisiopatologia , Prognóstico , Valores de Referência , Estudos Retrospectivos , Medição de Risco , Índice de Gravidade de Doença , Fatores Sexuais
11.
J Cutan Med Surg ; 22(4): 427-430, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29463113

RESUMO

BACKGROUND: Erythema multiforme (EM) is a mucocutaneous disease most often associated with preceding herpes simplex virus or Mycoplasma pneumoniae infection. It is characterized by targetoid lesions occurring on the limbs and head and neck. Mucosal involvement can be extensive. OBJECTIVE: We report a case of lip adhesion as a complication of EM in a child who required corrective surgery and review similar oral commissure complications. METHODS: We completed a review of the literature for similar cases using PubMed and Medline. CONCLUSIONS AND RELEVANCE: We present the youngest report of lip adhesion due to striking mucositis related to EM. Sequelae of erythema multiforme can be significant, in our case requiring surgery. Meticulous oral hygiene should be encouraged when mucosal lesions are identified.


Assuntos
Eritema Multiforme , Lábio , Adolescente , Criança , Eritema Multiforme/patologia , Eritema Multiforme/cirurgia , Feminino , Humanos , Lábio/patologia , Lábio/cirurgia , Masculino , Mycoplasma pneumoniae , Pneumonia por Mycoplasma
16.
Cutis ; 100(1): E8-E11, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28873116

RESUMO

Ever since a rare syndrome of lupus erythematosus (LE) presenting with erythema multiforme (EM)-like lesions was described in 1963, clinicians have questioned the defining characteristics of the so-called Rowell syndrome (RS) in addition to its very existence as a unique pathological entity. In this article, we present a new case of RS and investigate the various components and criteria that have been outlined in the years since this syndrome's original account.


Assuntos
Eritema Multiforme/diagnóstico , Lúpus Eritematoso Sistêmico , Adulto , Azatioprina/administração & dosagem , Diagnóstico Diferencial , Quimioterapia Combinada , Eritema Multiforme/tratamento farmacológico , Eritema Multiforme/patologia , Feminino , Humanos , Imunossupressores/administração & dosagem , Prednisona/administração & dosagem , Síndrome
18.
Actas odontol ; 14(1): 50-56, jul. 2017. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-982602

RESUMO

El Eritema Multiforme (EM) es una reacción poco común, aguda, de piel y mucosa. Es una reacción de hipersensibilidad, caracterizada por erupciones en piel en forma de diana, constituidas por zonas concéntricas de diferente coloración, y lesiones ulcerosas o vesículo-ampollares en mucosa. La enfermedad puede ser desencadenada por infecciones, principalmente por virus del herpes simple (HSV) y Mycoplasma pneumoniae y por ingestión de drogas, siendo las más frecuentes las sulfonamidas y las penicilinas. Se presentan tres casos relacionados a la infección por el virus del herpes simple.


Erythema multiforme (EM) is a condition acute, mucocutaneous, caused by hypersensitivity reaction, characterized by skin eruption (target lesions with concentric zones) and mucous membrane lesions (ulcerous, bullous-vesicular lesions). The disorder can be induced by infections, particularly herpes simplex(VSH) and Mycoplasma pneumoniae, or by drug intake (AINE, sulfonamides, penicillin’s) Three cases related to VHS infection, are presented.


Assuntos
Masculino , Feminino , Humanos , Adolescente , Eritema Multiforme/diagnóstico , Eritema Multiforme/tratamento farmacológico , Eritema Multiforme/etiologia , Eritema Multiforme/patologia , Antivirais/uso terapêutico , Herpes Simples/complicações , Herpes Simples/tratamento farmacológico , Boca/lesões
19.
J Cutan Pathol ; 44(10): 867-873, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28644551

RESUMO

Primary cutaneous aggressive cytotoxic epidermotropic CD8+ T-cell lymphoma is an extremely rare, rapidly progressing, cutaneous lymphoma, with frequent systemic involvement and poor prognosis, that still represents a diagnostic and therapeutic challenge, especially in the early stage. Herein, we report a case of an elderly woman with a fulminant course, who at onset presented with clinical and pathological features mimicking erythema multiforme (EM) and treated with cyclosporine that led to rapid deterioration with fatal outcome 6 months after disease onset. Histopathology showed a lichenoid, epidermotropic and nodular, angiocentric, dermal and subcutaneous infiltrate of sF1, CD8+, CD45RA+ small to medium-sized atypical lymphoid cells, which strongly expressed cytotoxic markers. Monoclonal T-cell-γ receptor was clonally rearranged and array-CGH showed numerous chromosomal imbalances. This case evidences the clinical, pathological and therapeutic challenges involved in this tumor. The first biopsy showed an interface dermatitis-like pattern, revealing the deceptive features that early cutaneous infiltrates of this aggressive lymphoma may have. A high suspicion for aggressive CTCL and a low threshold for repeat biopsies should be maintained when faced with rapidly progressing and/or ulcerative EM-like lesions, especially if immunomodulatory therapy is being considered.


Assuntos
Linfócitos T CD8-Positivos , Eritema Multiforme , Leucemia de Células T , Neoplasias Cutâneas , Idoso , Linfócitos T CD8-Positivos/metabolismo , Linfócitos T CD8-Positivos/patologia , Eritema Multiforme/metabolismo , Eritema Multiforme/patologia , Evolução Fatal , Feminino , Humanos , Leucemia de Células T/metabolismo , Leucemia de Células T/patologia , Neoplasias Cutâneas/metabolismo , Neoplasias Cutâneas/patologia
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