ABSTRACT
Our pharmacologic armamentarium is expanding at a tremendous pace, and requires that we as clinicians maintain a certain level of knowledge of the drugs that we use, as well as their metabolism, and how they may function, both positively and negatively, in a given patient. Certain drugs, such as the angiotensin-converting enzyme inhibitors, interfere with the natural deactivation of certain vasoactive substances normally present in the body. Since many of these systems are functionally interrelated (eg, angiotensin-converting enzyme and kininase II), we may see cutaneous side effects when these drugs are administered. Enalapril is an angiotensin-converting enzyme inhibitor that promoted a cutaneous eruption in a patient with renal failure secondary to diabetes. We suspect that our patient's vasculitis and maculopapular erythema is included in a large number of polymorphic eruptions that can be seen with angiotensin-converting enzyme inhibitors, and review the operative pathogenetic mechanism. Many of these side effects are dose related, and can be controlled or eliminated by lowering the dosage of angiotensin-converting enzyme inhibitor, depending upon the clinical circumstances.
Subject(s)
Drug Eruptions/pathology , Enalapril/adverse effects , Erythema/chemically induced , Vasculitis/chemically induced , Adult , Drug Eruptions/etiology , Erythema/pathology , Female , Humans , Skin/blood supply , Skin/pathology , Vasculitis/pathologySubject(s)
Scleredema Adultorum , Adolescent , Adult , Age Factors , Animals , Chemical Phenomena , Chemistry , Child , Child, Preschool , Diagnosis, Differential , Female , Humans , Infant , Infant, Newborn , Male , Mice , Middle Aged , Prognosis , Scleredema Adultorum/diagnosis , Scleredema Adultorum/etiology , Scleredema Adultorum/pathology , Scleredema Adultorum/therapy , Sex Factors , Skin/pathology , Skin Diseases/diagnosis , Staining and LabelingABSTRACT
We report a case of hyalinosis cutis et mucosae, a rare disorder of hyalin deposition in skin and mucous membranes, in a 27-year-old male, whose coefficient of inbreeding was 0-0106 due to seven common ancestors, including an aunt of an early American president, in the eight preceding generations.
