RESUMO
Acrokeratosis paraneoplastica (Basex syndrome) is a rare paraneoplastic condition hallmarked by psoriasiform lesion development on acral surfaces, most often related to an underlying squamous cell carcinoma. Patients may also present with nail plate changes. Successful management of this condition can be accomplished by treating the underlying malignancy.
Assuntos
Carcinoma de Células Escamosas , Neoplasias Pulmonares , Doenças da Unha , Síndromes Paraneoplásicas , Neoplasias Cutâneas , Humanos , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/patologia , Síndromes Paraneoplásicas/diagnóstico , Síndromes Paraneoplásicas/patologia , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/patologia , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/complicações , Doenças da Unha/patologia , Doenças da Unha/diagnóstico , Doenças da Unha/etiologia , Masculino , Idoso , Pessoa de Meia-Idade , Carcinoma Basocelular , HipotricoseAssuntos
Hidroxicloroquina , Nivolumabe , Doenças do Pênis , Humanos , Masculino , Nivolumabe/efeitos adversos , Hidroxicloroquina/efeitos adversos , Doenças do Pênis/induzido quimicamente , Doenças do Pênis/tratamento farmacológico , Doenças do Pênis/patologia , Úlcera Cutânea/induzido quimicamente , Úlcera Cutânea/patologia , Erupções Liquenoides/induzido quimicamente , Erupções Liquenoides/patologia , Toxidermias/etiologia , Toxidermias/patologia , Idoso , Antineoplásicos Imunológicos/efeitos adversosRESUMO
Squamous cell carcinoma (SCC) is a known sequela of chronic inflammatory conditions of the skin. Labial discoid lupus erythema-tosus (DLE), oral lichen planus (OLP), and lichen sclerosus have a relatively short lag time from dermatosis onset to manifestation of malignancy; cutaneous DLE, hypertrophic lichen planus, chronic wounds, hidradenitis suppurativa (HS), and necrobiosis lipoidica can be present for decades before an associated malignancy is observed. Vigilant monitoring is essential for orolabial DLE, chronic HS, and chronic wounds because malignancies in these settings are particularly aggressive and often fatal. We summarize what is known about the nature and demographics of SCC arising within chronic inflammatory dermatoses, emphasizing lag time from dermatosis diagnosis to malignancy onset of common inflammatory conditions.
Assuntos
Carcinoma de Células Escamosas , Hidradenite Supurativa , Líquen Plano , Humanos , Carcinoma de Células Escamosas/diagnóstico , Líquen Plano/patologia , Doença Crônica , Progressão da Doença , Hidradenite Supurativa/complicaçõesRESUMO
Hydroxychloroquine (HCQ) is an immunomodulator used in dermatology and rheumatology. Side effects may be observed on routine monitoring studies before they become clinically apparent. The goal of this retrospective chart review was to assess laboratory abnormalities in dermatologic and rheumatologic patients taking HCQ. Medical records of patients prescribed HCQ were retrospectively reviewed. Demographics, reported side effects, and parameters on baseline and follow-up complete blood count (CBC) and comprehensive metabolic panel (CMP) were recorded and graded. Laboratory abnormalities were considered severe if they were grade 3 or greater according to Common Terminology Criteria for Adverse Events v3.0 and persistent if they continued beyond subsequent laboratory testing. Of 646 eligible charts, 289 had monitoring studies for review. There were 35 severe (grade 3 or 4, 35/289; 12%) adverse events that developed, as noted on CBC or CMP. Of these 35 severe adverse events, 25 self-corrected on subsequent testing, and 10 (10/289, 3%) across 9 patients were persistent, including glomerular filtration rate, alanine transferase, alkaline phosphatase, glucose, hemoglobin and lymphopenia abnormalities. Of these 10 abnormalities, 7/10 (70%) were unlikely due to hydroxychloroquine use according to the calculated Naranjo score for each patient. Severe laboratory abnormalities while taking hydroxychloroquine are rare, even in a population with a high rate of comorbidities. Among the abnormalities observed, the majority of them (70%) were likely due to disease progression or a medication other than hydroxychloroquine. CBC and CMP monitoring for the reason of observing abnormalities while on HCQ should be at the discretion of the prescribing physician.