RESUMO
IMPORTANCE: Wells syndrome (WS) (eosinophilic cellulitis) is an uncommon eosinophilic dermatitis that has been rarely described in association with, but distinct from, hypereosinophilic syndrome (HES). OBSERVATIONS: We report a case of an eosinophilic dermatosis with flame figures in association with idiopathic HES, manifested by inflammatory myocarditis, asthma, and peripheral blood eosinophilia. CONCLUSIONS AND RELEVANCE: The diagnoses of WS and HES, rather than being distinct findings, may represent 2 entities on a spectrum of hypereosinophilic diseases. The diagnosis of WS should be made with caution and should prompt a thorough investigation that includes a work-up for a systemic eosinophilic disorder.
Assuntos
Celulite (Flegmão)/complicações , Celulite (Flegmão)/patologia , Doença de Charcot-Marie-Tooth/epidemiologia , Eosinofilia/complicações , Eosinofilia/patologia , Síndrome Hipereosinofílica/complicações , Síndrome Hipereosinofílica/patologia , Adulto , Asma/epidemiologia , Celulite (Flegmão)/fisiopatologia , Comorbidade , Eosinofilia/fisiopatologia , Feminino , Humanos , Síndrome Hipereosinofílica/fisiopatologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologiaAssuntos
Fármacos Dermatológicos/uso terapêutico , Acessibilidade aos Serviços de Saúde , Uso Off-Label/legislação & jurisprudência , Dermatopatias/tratamento farmacológico , United States Food and Drug Administration/legislação & jurisprudência , Adulto , Criança , Dermatologia , Aprovação de Drogas/legislação & jurisprudência , Feminino , Humanos , Masculino , Avaliação das Necessidades , Dermatopatias/patologia , Estados UnidosAssuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/terapia , Cavidade Pleural/patologia , Neoplasias Pleurais/patologia , Neoplasias Pleurais/terapia , Idoso , Carboplatina/administração & dosagem , Desbridamento , Empiema/cirurgia , Feminino , Fluoruracila/administração & dosagem , Humanos , Invasividade Neoplásica , Paclitaxel/administração & dosagem , ToracostomiaRESUMO
BACKGROUND: Cutaneous reactions to drugs are among the most common clinical manifestations of adverse drug events (ADEs); however, data on outpatient cutaneous adverse drug events (CADEs) are limited. PURPOSE: To provide national estimates of outpatient CADEs and determine their most frequent causes. METHODS: Outpatient CADEs recorded in the National Ambulatory Medical Care Survey (NAMCS) and the National Hospital Ambulatory Medical Care Survey (NHAMCS) between 1995 and 2005 were analyzed. The national incidence of outpatient CADEs in those seeking medical attention in the United States was estimated, and the common medication classes implicated with CADEs were identified. RESULTS: There were a mean annual total of 635,982 CADE-related visits, resulting in an annual incidence of 2.26 CADEs per 1,000 persons. Patients took an average of 2.2 medications in addition to the one causing the CADE. The incidence of CADEs increased with age, with a peak in the age group from 70 to 79 years. The medications most frequently causing a CADE were antimicrobial agents. Dermatitis and urticaria were the two main types of skin reactions reported. CONCLUSIONS: CADEs occur less frequently in outpatients than in inpatients and result in few hospital admissions. Physicians must be particularly cognizant of the occurrence of CADEs when prescribing antimicrobial agents.