RESUMEN
Two Caucasian carriers for chronic granulomatous disease (CGD) developed cutaneous lupus erythematosus (LE) with clinically and morphologically characteristic appearance for chronic discoid lupus erythematosus (DLE) and lupus erythematosus tumidus (LET). Direct immunofluorescent examinations and ANA titers were positive in both young women. No systemic involvement due to the ACR criteria was evident. Their sons suffered from X-linked cytochrome-b negative CGD. The diagnosis of CGD was based on measurement of oxidative burst activity by nitroblue tetrazolium (NBT) slide test and by flow cytometry using dihydrorhodamine 123 (DHR). The absence of cytochrome b558 in neutrophilic granulocytes was confirmed photometrically and by flow cytometry using the 7D5 monoclonal antibody against cytochrome b. We report for the first time the association of the photosensitive LE subtype LET and the X-linked CGD carrier state. Tissue damage by UV radiation and a reduced antimicrobial capacity may lead to recurrent immune stimulation and may together with genetic predisposition explain the occurrence of cutaneous LE in female carriers of CGD.
Asunto(s)
Dermatosis Facial/complicaciones , Dermatosis Facial/genética , Enfermedad Granulomatosa Crónica/complicaciones , Enfermedad Granulomatosa Crónica/genética , Lupus Eritematoso Discoide/complicaciones , Adulto , Dermatosis Facial/patología , Femenino , Predisposición Genética a la Enfermedad , Enfermedad Granulomatosa Crónica/patología , Heterocigoto , Humanos , Lupus Eritematoso Discoide/genéticaRESUMEN
Acne fulminans e uma forma particularmente severa de acne que acomete pacientes jovens e que, por seu quadro clinico-laboratorial, pode ser separada dos outros tipos Sao apresentados onze pacientes com esta doenca. Alem dos aspectos diagnosticos e clinicos, e discutido, com especial atencao, o tratamento com o acido 13-cis-retinoico (isotretinoina, RO 4-3780, Accutane: EUA, Roaccutan: Europa) que apresentou em todos os pacientes uma melhora substancial