RESUMO
A very rare case of etanercept-induced Wegener's granulomatosis in a patient with long-standing rheumatoid arthritis is reported. A thorough critical analysis on Wegener's granulomatosis pathogenetic mechanisms is done. The peculiarities of etanercept pharmacodynamic features are also presented together with some suggestions of possible induction pathways.
Assuntos
Antirreumáticos/efeitos adversos , Artrite Reumatoide/tratamento farmacológico , Granulomatose com Poliangiite/induzido quimicamente , Imunoglobulina G/efeitos adversos , Etanercepte , Feminino , Granulomatose com Poliangiite/diagnóstico , Humanos , Pessoa de Meia-Idade , Receptores do Fator de Necrose Tumoral , Fator de Necrose Tumoral alfa/antagonistas & inibidoresRESUMO
Leukotrienes are potent proinflammatory mediators derived from arachidonic acid through the 5-lipoxygenase pathway. Experimental data suggest a role for cysteinyl leukotrienes in the pathogenesis of atopy giving a rationale for its use in asthma, allergic rhinitis, and chronic urticaria management. A few clinical observations and small trials suggest that montelukast may be used in an adjunctive manner as an effective therapeutic option for all age categories affected by moderate-to-severe atopic dermatitis. Our own observations proved that montelukast as a prospective corticosteroid-sparing option in the complex therapeutic strategy of corticosteroid-dependent atopic dermatitis patients, even in the severe erythrodermic cases.
Assuntos
Acetatos/uso terapêutico , Dermatite Atópica/tratamento farmacológico , Antagonistas de Leucotrienos/uso terapêutico , Quinolinas/uso terapêutico , Adulto , Asma/tratamento farmacológico , Ciclopropanos , Eosinofilia/tratamento farmacológico , Exsudatos e Transudatos/efeitos dos fármacos , Feminino , Humanos , Imunoglobulina E/sangue , Masculino , Metilprednisolona/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto , Receptores de Leucotrienos/metabolismo , Rinite/tratamento farmacológico , Sulfetos , Resultado do Tratamento , Adulto JovemRESUMO
Disabling pansclerotic morphea of childhood (DPMC) is an aggressive form of cutaneous scleroderma that involves all layers of the skin, extending through the dermis and subcutaneous tissues to involve muscle, tendon, and even bone. As DPMC is extremely rare, its association with skin squamous cell carcinoma (SCC) is rarer still. To our knowledge there are only two cases of SCC in patients with DPMC that developed within areas of chronic skin ulceration. We report the first case of lower lip squamous cell carcinoma arising in a young woman with DPMC and discuss the carcinogenic pathway that may have led to its occurrence.
Assuntos
Carcinoma de Células Escamosas/patologia , Neoplasias Labiais/patologia , Escleroderma Sistêmico/patologia , Pele/patologia , Carcinoma de Células Escamosas/etiologia , Carcinoma de Células Escamosas/radioterapia , Feminino , Humanos , Neoplasias Labiais/etiologia , Neoplasias Labiais/radioterapia , Escleroderma Sistêmico/complicações , Índice de Gravidade de Doença , Úlcera/etiologia , Úlcera/patologia , Raios Ultravioleta/efeitos adversos , Adulto JovemAssuntos
Eritema/etiologia , Glucagonoma/diagnóstico , Neoplasias Pancreáticas/diagnóstico , Síndromes Paraneoplásicas/diagnóstico , Eritema/diagnóstico , Feminino , Glucagonoma/complicações , Humanos , Pessoa de Meia-Idade , Neoplasias Pancreáticas/complicações , Síndromes Paraneoplásicas/patologiaRESUMO
A 62 years old patient presented with rapidly progressive mycosis fungoides. Lesions of the face, head, trunk and limbs exhibited numerous vesicles and erosions. Histopathology showed marked spongiosis and intraepidermal blisters, as well as invasion of the epidermis by atypical lymphocytes, which was confirmed by immunohistochemistry. The vesicular variant of mycosis fungoides is rare and associated with a poor prognosis.
