Subject(s)
Androstadienes/adverse effects , Bronchodilator Agents/adverse effects , Dermatitis, Perioral/chemically induced , Epilepsies, Myoclonic/diagnosis , Epilepsies, Myoclonic/etiology , Epilepsies, Myoclonic/genetics , Failure to Thrive/etiology , Failure to Thrive/genetics , Status Epilepticus/etiology , Alleles , Androstadienes/administration & dosage , Asthma/drug therapy , Bronchodilator Agents/administration & dosage , Child, Preschool , Chromosomes, Human, Pair 7/genetics , DNA Mutational Analysis , Dermatitis, Perioral/diagnosis , Exocrine Pancreatic Insufficiency/diagnosis , Exocrine Pancreatic Insufficiency/genetics , Female , Fluticasone , Humans , Infant , Male , Metered Dose Inhalers , NAV1.1 Voltage-Gated Sodium Channel/genetics , SyndromeABSTRACT
BACKGROUND: Acute febrile neutrophilic dermatosis, or Sweet syndrome (SS), is a condition that is presumed to be triggered by infectious disease agents. We report a case of SS associated with human granulocytic anaplasmosis (HGA), which is of interest because Anaplasma phagocytophilum infects, multiplies in, and disrupts the function of neutrophils, the key infiltrating cell in SS. OBSERVATIONS: A patient with initial dermatologic manifestations of SS who did not respond to standard SS treatment was suspected to have concurrent HGA with the demonstration of leukopenia, thrombocytopenia, and elevated hepatic transaminase levels. The HGA diagnosis was established when morulae in neutrophils were observed on a peripheral blood smear, a finding confirmed by both serologic examination and polymerase chain reaction on the skin biopsy specimen used to establish the SS diagnosis. CONCLUSION: The significant involvement of neutrophils with both SS and HGA warrants a broader search for additional cases that may further define whether pathogenetic linkages could exist.
Subject(s)
Anaplasma phagocytophilum/isolation & purification , Anaplasmosis/complications , Sweet Syndrome/complications , Sweet Syndrome/pathology , Anaplasmosis/diagnosis , Anaplasmosis/drug therapy , Biopsy, Needle , Female , Follow-Up Studies , Humans , Immunohistochemistry , Middle Aged , Prednisolone/therapeutic use , Risk Assessment , Severity of Illness Index , Sweet Syndrome/drug therapy , Treatment OutcomeABSTRACT
Chemotherapeutic agents are known to cause a myriad of cutaneous side effects that the dermatologist is often called upon to identify and treat. The taxoid drug paclitaxel is commonly used in oncology. To date, there have been few adverse dermatologic effects reported secondary to paclitaxel use. This is in contrast to the related drug docetaxel. We report a case in which paclitaxel caused onycholysis and nail loss in a patient being treated for lung cancer. To our knowledge, this finding has not previously been reported in the American dermatologic literature, though it has been reported in association with docetaxel use. It is important for clinicians to recognize that onycholysis can be associated with paclitaxel. Prompt recognition may prevent the unnecessary use of antibiotics or antifungal medications. Discontinuation of paclitaxel chemotherapy generally is not required, and regrowth of nails can be expected following completion of therapy.
