RESUMEN
Abstract Cutaneous tuberculosis is a rare extrapulmonary manifestation of tuberculosis which, like disseminated tuberculosis, commonly occurs in immunocompromised patients. Poncet reactive arthritis is a seronegative arthritis affecting patients with extrapulmonary tuberculosis, which is uncommon even in endemic countries. We report a previously healthy 23-year-old male patient with watery diarrhea associated with erythematous ulcers on the lower limbs and oligoarthritis of the hands. Histopathological examination of the skin showed epithelioid granulomatous process with palisade granulomas and central caseous necrosis. AFB screening by Ziehl-Neelsen staining showed intact bacilli, the culture was positive for Mycobacterium tuberculosis, and colonoscopy revealed multiple shallow ulcers. Disseminated tuberculosis associated with reactive Poncet arthritis was diagnosed, with an improvement of the clinical and skin condition after appropriate treatment.
Asunto(s)
Humanos , Masculino , Adulto Joven , Tuberculosis Cutánea/inmunología , Tuberculosis Cutánea/patología , Huésped Inmunocomprometido , Artritis Reactiva/inmunología , Inmunocompetencia , Pirazinamida/uso terapéutico , Rifampin/uso terapéutico , Úlcera Cutánea/inmunología , Úlcera Cutánea/patología , Úlcera Cutánea/tratamiento farmacológico , Tuberculosis Cutánea/tratamiento farmacológico , Resultado del Tratamiento , Etambutol/uso terapéutico , Isoniazida/uso terapéutico , Mycobacterium tuberculosis/aislamiento & purificación , Antituberculosos/uso terapéuticoRESUMEN
Everolimus, a mammalian target of rapamycin inhibitor, is an emerging drug, which is being increasingly applied in oncology and solid organ transplantation. Oral ulcers are a frequent side effect associated with this immunosupressor. We report the case of a renal transplant recipient who developed disfiguring oral and perianal ulcers secondary to everolimus's toxicity. This is probably the first report of perianal involvement. Dermatologists need to be aware of the potential mucocutaneous adverse effects related to these new drugs that are becoming evermore common in our clinical practice.
.Asunto(s)
Adulto , Femenino , Humanos , Enfermedades del Ano/inducido químicamente , Everolimus/efectos adversos , Inmunosupresores/efectos adversos , Trasplante de Riñón/efectos adversos , Úlcera Cutánea/inducido químicamente , Estomatitis/inducido químicamente , Enfermedades del Ano/patología , Inmunocompetencia/inmunología , Boca/patología , Úlcera Cutánea/inmunología , Úlcera Cutánea/patología , Estomatitis/inmunología , Estomatitis/patología , Serina-Treonina Quinasas TOR/antagonistas & inhibidoresRESUMEN
Malignant syphilis is an uncommon manifestation of secondary syphilis, in which necrotic lesions may be associated with systemic signs and symptoms. Generally it occurs in an immunosuppressed patient, mainly HIV-infected, but might be observed on those who have normal immune response. Since there is an exponential increase in the number of syphilis cases, more diagnoses of malignant syphilis must be expected. We report a case in an immunocompetent female patient.