RESUMO
IMPORTANCE: Dermatologists are using an increasing range of immunomodulatory therapies to treat an expanding number of skin diseases. Complications of therapy are broad and include infection. Cytomegalovirus (CMV) retinitis has not been reported in association with dermatologic disease. OBSERVATIONS: We report two cases of CMV retinitis associated with immunosuppression for eczema and pemphigus vulgaris. In both cases, patients were receiving corticosteroid and a second-line immunosuppressive agent (cyclosporine or mycophenolate mofetil). Disease presented in both patients with painless visual loss. CONCLUSIONS AND RELEVANCE: Patients receiving immunosuppressive therapy should be monitored for blurred vision, floaters, or visual loss and referred for urgent assessment to ensure accurate diagnosis and prompt treatment of possible CMV retinitis.
Assuntos
Cegueira/etiologia , Retinite por Citomegalovirus/etiologia , Terapia de Imunossupressão/efeitos adversos , Imunossupressores/efeitos adversos , Doenças Raras/virologia , Idoso , Idoso de 80 Anos ou mais , Ciclosporina/efeitos adversos , Eczema/tratamento farmacológico , Glucocorticoides/efeitos adversos , Humanos , Masculino , Ácido Micofenólico/efeitos adversos , Ácido Micofenólico/análogos & derivados , Pênfigo/tratamento farmacológico , Prednisolona/efeitos adversosRESUMO
Erythroderma-induced cardiogenic shock is a rare but known manifestation of erythrodermic psoriasis. Erythrodermic psoriasis is an aggressive form of the disease and can be precipitated by numerous factors including stress to the body. In this article we present a case of persistent severe vasodilatation after coronary artery bypass surgery that required prolonged epinephrine administration. This was caused by a flareup of erythrodermic psoriasis that was previously only controlled by methotrexate. This drug was omitted in the perioperative phase. Vasodilatation disappeared after treatment was reinstituted.
