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1.
Dermatol Clin ; 37(4): 537-544, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31466593

RESUMO

It is important to recognize paraneoplastic dermatoses because they allow the practitioner to begin an early, directed workup to detect an underlying malignant neoplasm. In this review, several paraneoplastic dermatoses are outlined using existing data to detail each one's association with underlying malignancy, demographics, prognosis, and treatment considerations.


Assuntos
Neoplasias/diagnóstico , Síndromes Paraneoplásicas/diagnóstico , Dermatopatias/diagnóstico , Dermatologia , Dermatomiosite/diagnóstico , Dermatomiosite/etiologia , Neoplasias Gastrointestinais/complicações , Neoplasias Gastrointestinais/diagnóstico , Neoplasias Hematológicas/complicações , Neoplasias Hematológicas/diagnóstico , Humanos , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/diagnóstico , Neoplasias/complicações , Síndrome POEMS/diagnóstico , Síndromes Paraneoplásicas/etiologia , Dermatopatias/etiologia , Síndrome de Sweet/diagnóstico , Síndrome de Sweet/etiologia
2.
BMJ Case Rep ; 12(4)2019 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-30940664

RESUMO

During the follow-up of a woman treated by radiotherapy for an in situ carcinoma of her left breast, radio-induced skin lesions were diagnosed. They appeared not to be simple radiodermatitis but radio-induced Sweet syndrome. Discussions were led on the benefit of completing the last session of radiotherapy for such a low-grade malignancy while considering the risk of complication from radio-induced disease. General and local corticotherapy rapidly eradicated the fever and asthenia, while the skin lesions disappeared gradually. Moreover, biological improvement was noticed. The presented features of Sweet syndrome are almost similar in their initial phase to the radiodermatitis that is seen in common medical conditions.


Assuntos
Radioterapia Adjuvante/efeitos adversos , Síndrome de Sweet/etiologia , Idoso , Carcinoma de Mama in situ/radioterapia , Neoplasias da Mama/radioterapia , Diagnóstico Diferencial , Feminino , Humanos , Síndrome de Sweet/tratamento farmacológico , Síndrome de Sweet/patologia
6.
J Cutan Pathol ; 46(7): 520-527, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30734344

RESUMO

Pseudocarcinomatous (pseudoepitheliomatous) hyperplasia represents reactive epidermal change mimicking squamous cell carcinoma (SCC), owing to a variety of inflammatory and neoplastic phenomena, including deep fungal infections, CD30-positive lymphomas, and others. We report a case of Sweet syndrome (SS) arising in a patient with acute myelogenous leukemia, with persistent orolabial involvement which mimicked SCC both clinically and microscopically, but resolved entirely with adequate corticosteroid treatment. Clinicians should be aware that neutrophilic dermatoses such as SS and pyoderma gangrenosum may rarely exhibit pseudocarcinomatous epidermal changes similar to those seen in soft tissue infections and other inflammatory dermatoses.


Assuntos
Corticosteroides/administração & dosagem , Leucemia Mieloide Aguda , Neoplasias Cutâneas , Síndrome de Sweet , Feminino , Humanos , Leucemia Mieloide Aguda/tratamento farmacológico , Leucemia Mieloide Aguda/metabolismo , Leucemia Mieloide Aguda/patologia , Pessoa de Meia-Idade , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/patologia , Síndrome de Sweet/tratamento farmacológico , Síndrome de Sweet/etiologia , Síndrome de Sweet/metabolismo , Síndrome de Sweet/patologia
7.
Rinsho Shinkeigaku ; 59(1): 1-12, 2019 Jan 30.
Artigo em Japonês | MEDLINE | ID: mdl-30606996

RESUMO

Behçet disease, and its related disorder Sweet disease, are multisystem inflammatory conditions characterized by muco-cutaneous symptoms. When neuropsychiatric symptoms appear, the two conditions are referred to as neuro-Behçet disease and neuro-Sweet disease. While diagnosing these conditions according to their diagnostic criteria, muco-cutaneous symptoms must be observed; however, neuropsychiatric symptoms may precede muco-cutaneous symptoms. In these conditions the dysregulation of cytokines, following the onset of oral muco-cutaneous bacterial infection, may induce an abnormal chemotaxis of neutrophils causing ectopic encephalitis and meningitis. Thus, an initial treatment targeting neutrophils should be considered based on the diagnosis of neuro-neutrophilic disease when symptoms indicating neutrophil hyperactivity are observed, even without muco-cutaneous symptoms. In addition to human leukocyte antigen-B51 and -A26, genome-wide association analyses have identified new susceptibility loci on the genes of various immunological factors in Behçet disease. These findings may help elucidate disease pathogenesis and assist the development of diagnostic modalities and therapeutic agents for neuro-neutrophilic disease.


Assuntos
Síndrome de Behçet/etiologia , Encefalite/etiologia , Meningite/etiologia , Doenças do Sistema Nervoso/etiologia , Síndrome de Sweet/etiologia , Síndrome de Behçet/diagnóstico , Síndrome de Behçet/terapia , Citocinas , Diagnóstico Diferencial , Encefalite/diagnóstico , Encefalite/terapia , Estudo de Associação Genômica Ampla , Antígeno HLA-B51 , Humanos , Meningite/diagnóstico , Meningite/terapia , Doenças do Sistema Nervoso/diagnóstico , Doenças do Sistema Nervoso/terapia , Neutrófilos , Síndrome de Sweet/diagnóstico , Síndrome de Sweet/terapia
11.
Artigo em Inglês | MEDLINE | ID: mdl-30244270

RESUMO

Crohn's disease is a chronic inflammatory bowel disease. The disease is characterized by acute exacerbations with diarrhea, abdominal pain, fever, anorexia, intestinal bleeding, and weight loss. Immune-mediated diseases that are frequently associated with Crohn's disease include arthritis, ankylosing spondylitis, sacroiliitis, episcleritis, uveitis, and skin lesions, such as erythema nodosum and pyoderma gangrenosum. The authors present the case of a 22-year-old female patient that was admitted to their hospital due to diarrhea, fever, arthralgias, and diffuse erythematous papules and plaques with vesicles and pustules affecting the patient's face, lips, arms, trunk, and legs. Six months prior to onset, the patient was diagnosed with terminal ileitis and Crohn's disease of the sigmoid colon. Treatment with mesalazine and budesonide had been introduced. In the diagnostic procedure, a skin biopsy was taken from the patient. Histology confirmed dense infiltration of neutrophilic polymorphonuclear leukocytes, or Sweet's syndrome. This condition is a rare manifestation of chronic inflammatory bowel diseases such as Crohn's disease and ulcerative colitis. This syndrome is thought to be a hypersensitivity reaction and may be associated with various inflammatory, infectious, or neoplastic diseases. The patient was treated with high doses of methylprednisolone (60 mg IV), which resulted in rapid improvement of Crohn's disease and skin lesions.


Assuntos
Doença de Crohn/complicações , Síndrome de Sweet/tratamento farmacológico , Síndrome de Sweet/etiologia , Doença de Crohn/tratamento farmacológico , Feminino , Glucocorticoides/uso terapêutico , Humanos , Metilprednisolona/uso terapêutico , Resultado do Tratamento , Adulto Jovem
12.
J Am Acad Dermatol ; 79(6): 987-1006, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29653210

RESUMO

Neutrophilic dermatoses are a heterogeneous group of inflammatory skin disorders that present with unique clinical features but are unified by the presence of a sterile, predominantly neutrophilic infiltrate on histopathology. The morphology of cutaneous lesions associated with these disorders is heterogeneous, which renders diagnosis challenging. Moreover, a thorough evaluation is required to exclude diseases that mimic these disorders and to diagnose potential associated infectious, inflammatory, and neoplastic processes. While some neutrophilic dermatoses may resolve spontaneously, most require treatment to achieve remission. Delays in diagnosis and treatment can lead to significant patient morbidity and even mortality. Therapeutic modalities range from systemic corticosteroids to novel biologic agents, and the treatment literature is rapidly expanding. The first article in this continuing medical education series explores the pathogenesis of neutrophilic dermatoses and reviews the epidemiology, clinical and histopathologic features, diagnosis, and management of Sweet syndrome, neutrophilic eccrine hidradenitis, and Behçet disease.


Assuntos
Síndrome de Behçet , Hidradenite , Síndrome de Sweet , Corticosteroides/uso terapêutico , Antineoplásicos/efeitos adversos , Doenças Autoimunes/complicações , Síndrome de Behçet/diagnóstico , Síndrome de Behçet/epidemiologia , Síndrome de Behçet/etiologia , Síndrome de Behçet/patologia , Quimiotaxia de Leucócito , Citocinas/fisiologia , Derme/imunologia , Derme/patologia , Diagnóstico Diferencial , Erupção por Droga/etiologia , Epiderme/imunologia , Epiderme/patologia , Grupos Étnicos/genética , Predisposição Genética para Doença , Hidradenite/diagnóstico , Hidradenite/epidemiologia , Hidradenite/etiologia , Hidradenite/patologia , Humanos , Imunidade Inata , Imunossupressores/uso terapêutico , Inflamação , Neoplasias/complicações , Neutrófilos/imunologia , Neutrófilos/patologia , Síndrome de Sweet/diagnóstico , Síndrome de Sweet/epidemiologia , Síndrome de Sweet/etiologia , Síndrome de Sweet/patologia , Vasculite/etiologia
13.
Chin Clin Oncol ; 7(1): 11, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29486570

RESUMO

Sweet syndrome is a neutrophilic infiltration of the papillary dermis, which may be associated with the presence of unknown malignancies, either haematological or solid tumours, in 1 out of 5 cases, being considered then as a paraneoplastic syndrome. We present the case of a male with a locally advanced gastric cancer whose final diagnosis was led by the prior debut of Sweet syndrome not explained by other causes.


Assuntos
Neoplasias Gástricas/diagnóstico , Síndrome de Sweet/etiologia , Idoso , Humanos , Masculino , Neoplasias Gástricas/patologia , Síndrome de Sweet/patologia
15.
Indian J Tuberc ; 65(1): 87-90, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29332658

RESUMO

Sweet's syndrome is a skin manifestation of various systemic infections, drugs, malignancies and autoimmune disorders. There are very few case reports describing the relationship between Sweet's syndrome and non-tubercular mycobacterium infection. Further development of Sweet's syndrome secondary to mycobacterium tuberculosis (active pulmonary tuberculosis) is extremely uncommon and this is the second well established case reported from India. Here we report a forty eight year old man who presented with multiple erythematous and tender plaques over neck, palms and sides of soles. He also had high grade fever, headache, myalgias, cough, chest pain and difficulty in breathing. With clinical possibilities of (1) Sweet's syndrome with pulmonary involvement and (2) Sweet's syndrome secondary to pulmonary infection, we send the skin biopsy for histopathological examination and also advised routine laboratory plus imaging investigations to find out the underlying cause. Clinical and lab parameters together with the biopsy report fulfilled the diagnostic criteria for Sweet's syndrome. Further chest X-ray findings, demonstration of acid fast bacilli of mycobacterium tuberculosis on sputum smear microscopy and MGIT report confirmed the diagnosis of pulmonary tuberculosis. Patient was put on colchicine and standard anti-tubercular drugs. Significant improvement was noticed in skin lesions within five days of treatment and no recurrence has been seen for the past six months.


Assuntos
Mycobacterium tuberculosis/isolamento & purificação , Síndrome de Sweet/etiologia , Tuberculose Pulmonar/complicações , Biópsia , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia Torácica , Doenças Raras , Recidiva , Síndrome de Sweet/diagnóstico , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/microbiologia
18.
J Hand Surg Am ; 43(4): 389.e1-389.e6, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-28935337

RESUMO

Sweet syndrome, or acute febrile neutrophilic dermatosis, is a systemic disease process mainly characterized by hyperpyrexia and skin lesions. A newly described entity, necrotizing Sweet syndrome, is a severe and locally aggressive dermatological condition that clinically and histopathologically resembles a necrotizing soft tissue infection. It is characterized by pathergy, a nonspecific inflammatory response to cutaneous trauma resulting in a propagation of the disease. In contrast to a necrotizing infection, this condition responds to systemic steroids. A high clinical suspicion is required in order to distinguish a necrotizing polymicrobial infection from noninfectious necrotizing Sweet syndrome. We present a case following elective hand surgery.


Assuntos
Necrose/etiologia , Necrose/terapia , Complicações Pós-Operatórias , Síndrome de Sweet/etiologia , Síndrome de Sweet/terapia , Extremidade Superior/cirurgia , Derme Acelular , Tecido Adiposo/patologia , Tecido Adiposo/cirurgia , Antibacterianos/uso terapêutico , Colchicina/uso terapêutico , Desbridamento , Contratura de Dupuytren/cirurgia , Procedimentos Cirúrgicos Eletivos , Fasciotomia , Glucocorticoides/uso terapêutico , Humanos , Proteína Antagonista do Receptor de Interleucina 1/uso terapêutico , Masculino , Metilprednisolona/uso terapêutico , Pessoa de Meia-Idade , Retalhos Cirúrgicos , Síndrome de Sweet/diagnóstico , Extremidade Superior/patologia
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