A case of lichen ruber planus in a patient with familial multiple sclerosis.

Multiple sclerosis and lichen ruber planus are clinically and histologically distinct complex disorders of putative autoimmune aetiology that are fairly commonly observed in isolation but rarely found in combination. Only two previous reports have described lichen skin disorders in association with multiple sclerosis. The present report describes the case of a 51-year-old Caucasian woman exhibiting both familial multiple sclerosis and lichen ruber planus. This combination may have occurred by chance or it might imply that these disorders share common mechanisms in their pathogenesis.

Sildenafil induced choreoathetosis in men with Parkinson's disease.

OBJECTIVE: The present report describes a case of choreoathetotic movements which were most probably induced by sildenafil in a patient with Parkinson's disease (PD) treated with levodopa/carbidopa (LD/CD). CASE SUMMARY: A 56-year-old retired man was admitted to hospital because of bizarre, involuntary movements and anxiety. Before admission he had taken sildenafil 100 mg. He had a previous history of PD for 5 years and during the last 3 years he was stable with long-acting LD/CD and selegiline. He is in Stage 2 according to Hoehn and Yahr Staging of PD. The patient did not have any problems with erectile function and he took sildenafil 50 minutes after the last daily dose of LD/CD. The patient was discharged from the hospital 12 hours after the admittance without any symptoms of choreoathetosis. CONCLUSION: Choreoathetotic dyskinesia is an adverse effect which was provoked by sildenafil administration (drug abuse) in a previously stabile responder to LD therapy, but probably had a lower threshold for dyskinesia. Predisposition for this pharmacokinetic interaction could be a short time interval between LD and sildenafil applied in high dosage.