ABSTRACT
A very rare case of etanercept-induced Wegener's granulomatosis in a patient with long-standing rheumatoid arthritis is reported. A thorough critical analysis on Wegener's granulomatosis pathogenetic mechanisms is done. The peculiarities of etanercept pharmacodynamic features are also presented together with some suggestions of possible induction pathways.
Subject(s)
Antirheumatic Agents/adverse effects , Arthritis, Rheumatoid/drug therapy , Granulomatosis with Polyangiitis/chemically induced , Immunoglobulin G/adverse effects , Etanercept , Female , Granulomatosis with Polyangiitis/diagnosis , Humans , Middle Aged , Receptors, Tumor Necrosis Factor , Tumor Necrosis Factor-alpha/antagonists & inhibitorsABSTRACT
Leukotrienes are potent proinflammatory mediators derived from arachidonic acid through the 5-lipoxygenase pathway. Experimental data suggest a role for cysteinyl leukotrienes in the pathogenesis of atopy giving a rationale for its use in asthma, allergic rhinitis, and chronic urticaria management. A few clinical observations and small trials suggest that montelukast may be used in an adjunctive manner as an effective therapeutic option for all age categories affected by moderate-to-severe atopic dermatitis. Our own observations proved that montelukast as a prospective corticosteroid-sparing option in the complex therapeutic strategy of corticosteroid-dependent atopic dermatitis patients, even in the severe erythrodermic cases.
Subject(s)
Acetates/therapeutic use , Dermatitis, Atopic/drug therapy , Leukotriene Antagonists/therapeutic use , Quinolines/therapeutic use , Adult , Asthma/drug therapy , Cyclopropanes , Eosinophilia/drug therapy , Exudates and Transudates/drug effects , Female , Humans , Immunoglobulin E/blood , Male , Methylprednisolone/therapeutic use , Randomized Controlled Trials as Topic , Receptors, Leukotriene/metabolism , Rhinitis/drug therapy , Sulfides , Treatment Outcome , Young AdultABSTRACT
Disabling pansclerotic morphea of childhood (DPMC) is an aggressive form of cutaneous scleroderma that involves all layers of the skin, extending through the dermis and subcutaneous tissues to involve muscle, tendon, and even bone. As DPMC is extremely rare, its association with skin squamous cell carcinoma (SCC) is rarer still. To our knowledge there are only two cases of SCC in patients with DPMC that developed within areas of chronic skin ulceration. We report the first case of lower lip squamous cell carcinoma arising in a young woman with DPMC and discuss the carcinogenic pathway that may have led to its occurrence.
Subject(s)
Carcinoma, Squamous Cell/pathology , Lip Neoplasms/pathology , Scleroderma, Systemic/pathology , Skin/pathology , Carcinoma, Squamous Cell/etiology , Carcinoma, Squamous Cell/radiotherapy , Female , Humans , Lip Neoplasms/etiology , Lip Neoplasms/radiotherapy , Scleroderma, Systemic/complications , Severity of Illness Index , Ulcer/etiology , Ulcer/pathology , Ultraviolet Rays/adverse effects , Young AdultABSTRACT
A 62 years old patient presented with rapidly progressive mycosis fungoides. Lesions of the face, head, trunk and limbs exhibited numerous vesicles and erosions. Histopathology showed marked spongiosis and intraepidermal blisters, as well as invasion of the epidermis by atypical lymphocytes, which was confirmed by immunohistochemistry. The vesicular variant of mycosis fungoides is rare and associated with a poor prognosis.
