RESUMO
Several studies report the usefulness of different biological therapies in the management of a difficult-to-treat pathology such as hidradenitis suppurativa (HS). However, there are little data on this, which shows the great difficulty in the management of this disease. We will report herein our experience of the treatment of four complex cases of HS. We will also review previous cases published in the literature in order to further assess the results obtained with different biological drugs in terms of efficacy and safety. We conclude that, in the near future, biological therapy could become an essential tool in the management of cases of HS who have not previously responded to classical treatment.
Assuntos
Anti-Inflamatórios não Esteroides/uso terapêutico , Anticorpos Monoclonais Humanizados/uso terapêutico , Terapia Biológica , Fármacos Dermatológicos/uso terapêutico , Hidradenite Supurativa/tratamento farmacológico , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Adalimumab , Adulto , Anti-Inflamatórios não Esteroides/administração & dosagem , Anticorpos Monoclonais/uso terapêutico , Anticorpos Monoclonais Humanizados/administração & dosagem , Fármacos Dermatológicos/administração & dosagem , Etanercepte , Feminino , Hidradenite Supurativa/cirurgia , Humanos , Imunoglobulina G/uso terapêutico , Infliximab , Masculino , Pessoa de Meia-Idade , Receptores do Fator de Necrose Tumoral/uso terapêutico , Retratamento , Falha de Tratamento , Adulto JovemRESUMO
El síndrome de DRESS es una toxicodermia grave caracterizada por exantema, fiebre, adenopatías, alteraciones hematológicas (eosinofilia, linfocitos atípicos) y afectación de órganos internos. Los anticonvulsivantes aromáticos y las sulfonamidas son los fármacos que con mayor frecuencia se asocian a esta entidad clínica. El diagnóstico se establece por la exposición al fármaco, los hallazgos clínicos y de laboratorio y el diagnóstico diferencial con otras enfermedades. El manejo terapéutico incluye la rápida retirada del fármaco responsable, el tratamiento de soporte y la prevención de la sepsis. El uso de corticoesteroides sistémicos resulta controvertido. Presentamos un caso de síndrome de DRESS por sulfonamidas con grave afectación multiorgánica. Con la corticoterapia sistémica se obtuvo una importante mejoría clínica y analítica, por lo que recomendamos su uso cuando existe afectación importante de órganos internos
DRESS síndrome is a severe drug reaction characterised by rash, fever, lymph nodes enlargement, hematologic abnormalities (eosinophilia, atipical lymphocytes) and internal organ involvement. Aromatic anticonvulsivants and sulphonamides are the most common drugs associated with this clinical entity. The diagnosis is established by the drug exposition, the clinical and laboratory features and the differential diagnosis with another diseases. The therapeutic management includes the prompt withdrawal of the offending drug, the supportive therapy and the prevention of sepsis. The use of systemic corticosteroids remains controversial. We repport a sulphonamides DRESS syndrome with severe multiorganic involvement. Clinical and analytic improvement has been obtained after systemic corticotherapy. We suggest their use when internal organs are severely affected
