ABSTRACT
A 66-year-old man was treated for chronic active hepatitis C with 3 MU of recombinant interferon alfa-2a three times weekly. Nine months before interferon therapy, a mild lichen planus had been diagnosed, which exacerbated within 4 weeks of treatment to a generalized erosive lichen planus. After 8 weeks, interferon therapy was stopped because local measures did not improve skin lesions. Otherwise, the patient tolerated interferon therapy well, and the initially 20-fold elevated aminotransferase levels returned to normal. Four weeks after discontinuation of interferon therapy, nearly all mucosal and skin lesions had disappeared. But 8 weeks after the discontinuation, aminotransferase levels again rose to 10 times the normal range. Treating physicians should know that a preexisting lichen planus will potentially exacerbate as a side effect of interferon alfa-2a therapy of a chronic hepatitis. However, because this is the first report on this association, further observations are needed to decide the clinical relevance.
Subject(s)
Hepatitis C/therapy , Hepatitis, Chronic/therapy , Interferon-alpha/adverse effects , Lichen Planus/pathology , Aged , Humans , Interferon alpha-2 , Male , Mouth Diseases/pathology , Recombinant ProteinsABSTRACT
The aims of this study were (a) to examine the association of skin tags and colonic polyps and (b) to identify factors influencing skin tags. Therefore, a consecutive series of 157 medical ward patients with gastrointestinal symptoms who underwent colonoscopy underwent dermatological examination. Skin tags were found in 52% of these patients regardless of sex. (a) There was a statistically significant association between skin tags and colonic polyps (P = 0.33). This association, however, was based solely on an age effect. (b) Influencing factors were weight and age for the number of skin tags and the interaction between sex and the concentration of triglycerides for their size. At any given triglyceride concentration, men had larger skin tags.
Subject(s)
Colonic Neoplasms/diagnosis , Colonic Polyps/diagnosis , Fibroma/diagnosis , Neoplasms, Multiple Primary/diagnosis , Skin Neoplasms/diagnosis , Aged , Cholesterol/blood , Female , Humans , Male , Middle Aged , Regression Analysis , Risk Factors , Triglycerides/bloodABSTRACT
To test the association between skin tags and colorectal polyps, 157 consecutive patients (60 men and 97 women, mean age 61.2 [17-92] years) who during their hospitalization had a coloscopy for gastro-enterological indications, underwent independently medical and dermatological examinations. 61 patients (38%) had colorectal polyps, 83 (53%) skin tags; 39 had both (24.8%). Thus the probability of having colorectal polyps was significantly higher for a person with than without skin tags (P = 0.033). But this relationship was entirely age-dependent. Discriminant analysis indicated that in addition to age (F = 15.1) the presence of skin tags (F = 1.2) was only a small additional factor in the recognition of those with colorectal polyps. Skin tags are thus of little help in the diagnosis of polyps in elderly patients.
Subject(s)
Aging/pathology , Colonic Polyps/epidemiology , Fibroma/epidemiology , Neoplasms, Multiple Primary/epidemiology , Skin Neoplasms/epidemiology , Adenocarcinoma/diagnosis , Adenocarcinoma/epidemiology , Adenoma/diagnosis , Adenoma/epidemiology , Aged , Carcinoma/diagnosis , Carcinoma/epidemiology , Colonic Neoplasms/diagnosis , Colonic Neoplasms/epidemiology , Colonic Polyps/diagnosis , Colonoscopy , Discriminant Analysis , Female , Fibroma/diagnosis , Humans , Male , Middle Aged , Neoplasms, Multiple Primary/diagnosis , Pigmentation Disorders/diagnosis , Pigmentation Disorders/epidemiology , Skin Neoplasms/diagnosisABSTRACT
To find common factors for colonic-neoplasias and skin-tags, 157 inpatients, who consecutively had a coloscopy because of intestinal complaints, were intensively examined dermatologically. Regression-analyses showed that the number of colonic polyps were age- (p = 3 x 10(-8)) and sex-dependent (1.9 x 10(-2)) and skin-tags had no influence on the number of colonic polyps. The size of colonic polyps also showed a clear age dependency (p = 3 x 10(-8)). The number of skin-tags were dependent on weight (p = 9 x 10(-3)) and age (p = 1.3 x 10(-2)), its size on the interaction of sex and triglyceride-levels (p = 3 x 10(-8)). Discriminant-analyses identified the following factors as important: age and triglyceride-concentration to recognize a patient with colonic polyps; age, positive Haemoccult-test and number of skin-tags to recognize a patient with tubulovillous adenomas or colonic carcinomas. The essential common factor of colonic polyps and skin-tags was the age. For the recognition of a patient with colonic polyps the age was the most essential factor, skin-tags, on the contrary, were unimportant. The association between colonic polyps and skin-tags therefore was merely an effect of age.
Subject(s)
Colonic Neoplasms/etiology , Colonic Polyps/etiology , Fibroma/etiology , Neoplasms, Multiple Primary/etiology , Paraneoplastic Syndromes/etiology , Skin Neoplasms/etiology , Age Factors , Cholesterol/blood , Female , Humans , Male , Middle Aged , Occult Blood , Risk Factors , Triglycerides/bloodABSTRACT
A 52-year-old man, known to be alcohol dependent, was admitted to hospital because of intense drowsiness. He had previously drunk over 100 g alcohol daily, but for the last 2 days "not a drop". Serum sodium concentration was 103 mmol/l, serum osmolarity was low (216 mosmol/l) and urine osmolarity remarkably high (373 mosmol/l). These abnormalities, taken in conjunction with his normal water balance (absence of obvious edema or dehydration), suggested the diagnosis of inappropriate secretion of antidiuretic hormone (ADH), and this was confirmed by a water loading test. Exclusion of the recognized causes of inappropriate ADH secretion left alcohol withdrawal as the only tenable explanation. The reabsorption of water which it induced was the cause of the patient's hyponatraemia and drowsiness. Restriction of fluid intake to 500 ml daily with continued total abstinence from alcohol led to rapid recovery. The discovery of hyponatraemia in an alcoholic in a state of normal water balance should rouse suspicion of inappropriate ADH secretion.
