RESUMO
Multiple cutaneous side effects have been reported with the use of immunotherapies including programmed cell death protein 1 inhibitors. We report 2 patients who presented with papillary dermal elastolysis presenting as multiple, skin-colored, wrinkled papules and atrophic macules following an inflammatory eruption in the setting of combination chemotherapy with nivolumab and cabiralizumab. These two cases highlight a novel finding, elastolysis in the setting of chemotherapy with nivolumab and cabiralizumab.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Toxidermias , Pigmentação da Pele/efeitos dos fármacos , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Neoplasias Ósseas/tratamento farmacológico , Neoplasias Ósseas/metabolismo , Neoplasias Ósseas/patologia , Derme/metabolismo , Derme/patologia , Toxidermias/metabolismo , Toxidermias/patologia , Feminino , Humanos , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/metabolismo , Neoplasias Pulmonares/patologia , Pessoa de Meia-Idade , Metástase Neoplásica , Nivolumabe/administração & dosagem , Nivolumabe/efeitos adversos , Osteossarcoma/tratamento farmacológico , Osteossarcoma/metabolismo , Osteossarcoma/patologiaAssuntos
Clobetasol/administração & dosagem , Eosinofilia , Hidroxizina/administração & dosagem , Isotretinoína/administração & dosagem , Pitiríase Rubra Pilar , Psoríase/diagnóstico , Pele/patologia , Ureia/administração & dosagem , Fármacos Dermatológicos/administração & dosagem , Diagnóstico Diferencial , Eosinofilia/complicações , Eosinofilia/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Pitiríase Rubra Pilar/sangue , Pitiríase Rubra Pilar/complicações , Pitiríase Rubra Pilar/diagnóstico , Pitiríase Rubra Pilar/patologia , Índice de Gravidade de Doença , Resultado do TratamentoAssuntos
Dermatoses do Pé/microbiologia , Infecções por Bactérias Gram-Positivas/microbiologia , Infecções por HIV/complicações , HIV , Dor/etiologia , Dermatopatias Bacterianas/microbiologia , Pele/microbiologia , Biópsia , Diagnóstico Diferencial , Dermatoses do Pé/complicações , Bactérias Gram-Positivas/isolamento & purificação , Infecções por Bactérias Gram-Positivas/complicações , Infecções por Bactérias Gram-Positivas/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Pele/patologia , Dermatopatias Bacterianas/complicações , Dermatopatias Bacterianas/diagnósticoRESUMO
INTRODUCTION: Venous thromboembolism may recur in up to 30% of patients with a spontaneous venous thromboembolism after a standard course of anticoagulation. Identification of patients at risk for recurrent venous thromboembolism would facilitate decisions concerning the duration of anticoagulant therapy. OBJECTIVES: In this exploratory study, we investigated whether whole blood gene expression data could distinguish subjects with single venous thromboembolism from subjects with recurrent venous thromboembolism. METHODS: 40 adults with venous thromboembolism (23 with single event and 17 with recurrent events) on warfarin were recruited. Individuals with antiphospholipid syndrome or cancer were excluded. Plasma and serum samples were collected for biomarker testing, and PAXgene tubes were used to collect whole blood RNA samples. RESULTS: D-dimer levels were significantly higher in patients with recurrent venous thromboembolism, but P-selectin and thrombin-antithrombin complex levels were similar in the two groups. Comparison of gene expression data from the two groups provided us with a 50 gene probe model that distinguished these two groups with good receiver operating curve characteristics (AUC 0.75). This model includes genes involved in mRNA splicing and platelet aggregation. Pathway analysis between subjects with single and recurrent venous thromboembolism revealed that the Akt pathway was up-regulated in the recurrent venous thromboembolism group compared to the single venous thromboembolism group. CONCLUSIONS: In this exploratory study, gene expression profiles of whole blood appear to be a useful strategy to distinguish subjects with single venous thromboembolism from those with recurrent venous thromboembolism. Prospective studies with additional patients are needed to validate these results.
