Reactive angioendotheliomatosis as a presenting cutaneous manifestation of Hughes syndrome.

BACKGROUND: Antiphospholipid antibody syndrome is an autoimmune disorder associated with pregnancy complications, venous and/or arterial thrombosis and the presence of antiphospholipid antibodies. This syndrome is known to present with various cutaneous features, but association with reactive angioendotheliomatosis has been described rarely in the literature. RESULTS: A woman in her thirties with a past history of three consecutive abortions developed purpuric, ulcerative plaque over the plantar aspect of the foot. Her biopsy showed marked expansion of dermal vasculature due to intravascular cellular proliferation suggestive of reactive angioendotheliomatosis. The intravascular cells stained positive for CD31. Her blood investigations showed positive lupus anticoagulant, antiphospholipid antibodies and anticardiolipin antibodies, leading to a diagnosis of antiphospholipid syndrome also known as Hughes syndrome. CONCLUSION: We suggest that a hypercoagulable state caused the formation of intravascular thrombi leading to reactive angioendotheliomatosis. We report a case of Hughes syndrome with reactive angioendotheliomatosis as the first clinical cutaneous manifestation and treated satisfactorily with anticoagulants and immunomodulators.

Nuevo método espectrofotométrico para la estimación de olmesartán medoxomilo en forma de dosificación comprimido usando la solubilización isotrópica / Novel Spectrophotometric Method for Estimation of Olmesartan Medoxomil from its Tablet Dosage Form Using Hydrotropic Solubilization

Objetivo: La estimación cuantitativa de fármacos poco solubles en agua implica el uso de disolventes orgánicos. En la presente investigación, se emplea la solubilización hidrotrópica para mejorar las solubilidades acuosas fármacos poco solubles en agua como el olmesartán medoxomilo dosificado en comprimido. Material y Métodos: Este método emplea acetato sódico 0,05 M como agente solubilizante hidrotrópico, mostrando el olmesartán medoxomilo una absorbancia máxima a 256 nm. La solución de acetato 0.05 M no muestra ninguna interferencia con la longitud de onda de muestreo. El agente hidrotrópico y los aditivos utilizados en la elaboración de los comprimidos no interfieren en el análisis. Resultados y conclusiones: El fármaco obedece a la Ley de Beer en el intervalo de concentraciones 2-14 mg / ml con un de coeficiente de correlación de 0,9987. El método desarrollado fue validado estadísticamente siguiendo las directrices ICH Q2B (R1). El análisis estadístico demostró que el método era sencillo y rápido para la estimación de olmesartán medoxomilo y se puede utilizar para análisis de rutina de olmesartán medoxomilo en laboratorios de control de calidad (AU)

Aim: Quantitative estimation of poorly water-soluble drugs involves use of organic solvents. In the present investigation, hydrotropic solubilization is employed to enhance the aqueous solubilities of poorly water-soluble drugs like Olmesartan Medoxomil in tablet dosage forms.Material and methods: This method utilizes 0.05 M Sodium acetate solution as hydrotropic solubilizing agent Where Olmesartan Medoxomil shows maximum absorbance at 256 nm. The 0.05 M Sodium acetate solution does not show any interference with the sampling wavelength. The hydrotropic agent and additives used in the manufacture of tablets did not interfere in the analysis. Results and Conclusion: The drug obeys the Beer’s Law in the concentration range 2-14 μg/ml with correlation coefficient value of 0.9987. The developed reliable method was validated statistically following ICH Q2B (R1) guidelines. Statistical analysis proved that the method was simple and rapid for the estimation of Olmesartan Medoxomil and can be used for routine analysis of Olmesartan Medoxomil in quality control laboratories. The ex vivo mucoadhesion time of patches ranged between 109 min (FA10) to 126 min (FB14). The ex vivo mucoadhesive force was in the range of 0.278 to 0.479 Kg.m.s-2. The in vitro drug release studies revealed that formulation FA8 released 84% and FB16 released 99.01% of drug in 140 min (AU)

Cutaneous neonatal lupus erythematosus with unusual features.

A three month-old boy was brought by his mother with complaints of multiple reddish lesions on his trunk and face since birth. The patient had erythematous annular plaques with scaling on his extremities, palms and soles with periorbital erythema and edema giving the characteristic "eye mask" or "owl's eye" appearance. His mother did not have history of any illness. Hemogram, liver and renal function tests were within normal limits. A skin biopsy was suggestive of subacute cutaneous lupus erythematosus. Immunological work-up was positive for antinuclear antibodies (ANA) (1:40) with anti-Ro titers of 3.4 and 3.47 (>1.1 = clinically significant titre) in the mother and child respectively, although negative for anti-La antibodies. The child's electrocardiogram and 2D echocardiography were normal. We are presenting a case of anti-Ro-positive cutaneous lupus erythematosus with an uncommon skin manifestation.