RESUMO
A patient with posttransplant cutaneous lymphoma is described. Although most posttransplant lymphomas are of B-cell origin, this patient's lymphoma is a primary cutaneous lymphoma of T-cell origin. Another report exists of the first case of posttransplant primary cutaneous T-cell lymphoma localized to the lower extremities. Our patient's involvement was generalized with tumor nodules on the face and anterior chest. Reduced immune surveillance, chronic antigenic stimulation caused by transplant grafts, and the direct oncogenic effects of immunosuppressive drugs have all been suggested as mechanisms. Prompt recognition of this condition and initiation of appropriate therapy with reduction of high-dose immunosuppression can lead to better patient outcomes.
Assuntos
Terapia de Imunossupressão/efeitos adversos , Transplante de Rim , Linfoma Cutâneo de Células T/etiologia , Complicações Pós-Operatórias/etiologia , Neoplasias Cutâneas/etiologia , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
Two patients with a hypersensitivity vasculitis in association with propylthiouracil (PTU) administration are described. Although both patients presented with a cutaneous eruption, our first patient suffered severe systemic manifestations and the second patient's involvement was primarily limited to the skin. Patients with a vascular hypersensitivity reaction to PTU typically present with constitutional symptoms, acral purpuric skin lesions, and variable involvement of multiple organ systems. The reaction is treated by urgent withdrawal of PTU and implementation of supportive measures and immunosuppressive agents, as necessary. Prompt recognition of this condition and initiation of appropriate therapy lead to complete recovery in most cases.
Assuntos
Antitireóideos/efeitos adversos , Propiltiouracila/efeitos adversos , Vasculite Leucocitoclástica Cutânea/induzido quimicamente , Adolescente , Adulto , Feminino , HumanosAssuntos
Escleroderma Sistêmico/induzido quimicamente , Exposição Ambiental/efeitos adversos , Humanos , Doença Iatrogênica , Exposição Ocupacional/efeitos adversos , Escleroderma Sistêmico/fisiopatologia , Transtornos Relacionados ao Uso de Substâncias/complicações , Transtornos Relacionados ao Uso de Substâncias/patologia , SíndromeRESUMO
The advantages and disadvantages of the immunofluorescence and immunoperoxidase techniques and an introductory description of the major variations of the basic immunoperoxidase method are discussed. The ability to identify intermediate filaments, T and B lymphocyte cell markers, S-100 proteins, myelin basic protein, and carcinoembryonic antigen in tissue sections can assist the dermatopathologist in classifying undifferentiated or histologically similar-appearing tumors. A systematic approach to the diagnosis of a majority of these tumors with the use of immunoenzyme staining is provided.
