RESUMO
We report the case of a 44-year-old woman with a history of Crohn disease treated with infliximab who presented with erythematous papules and plaques on the upper extremities accompanied by fevers. She was subsequently diagnosed with palisaded neutrophilic and granulomatous dermatitis (PNGD). Whereas immune-complex mediated diseases such as rheumatoid arthritis and systemic lupus erythematosus are most commonly associated, inflammatory bowel disease deserves increased consideration as one of the systemic diseases that can present with PNGD. Additionally, PNGD should remain in the differential diagnosis of cutaneous eruptions that develop in the setting of tumor necrosis factor (TNF) antagonist therapy.
Assuntos
Doença de Crohn/tratamento farmacológico , Dermatite/diagnóstico , Fármacos Gastrointestinais/uso terapêutico , Granuloma/diagnóstico , Infliximab/uso terapêutico , Neutrófilos/patologia , Adulto , Doença de Crohn/imunologia , Dermatite/imunologia , Dermatite/patologia , Feminino , Granuloma/imunologia , Granuloma/patologia , Humanos , Neutrófilos/imunologiaRESUMO
[reaction: see text] Alkyl radical addition reactions to styrene chromium tricarbonyl can be accomplished using alkyl halides and tris(trimethylsilyl)silane in the presence of AIBN in refluxing benzene. The ketyl generated from acetone with SmI2 in THF/HMPA also underwent successful addition. These addition reactions are believed to proceed through intermediates in which the radical is interacting with an adjacent arene chromium tricarbonyl functionality and do not appear to be complicated by polymerization.
