RESUMO
Nabumetone is a nonsteroidal anti-inflammatory drug, which has only rarely been associated with photosensitivity. We report a case of bullous lesions arising over photoexposed areas in a patient treated with nabumetone.
Assuntos
Anti-Inflamatórios não Esteroides/efeitos adversos , Butanonas/efeitos adversos , Porfirias/induzido quimicamente , Biópsia , Feminino , Humanos , Pessoa de Meia-Idade , Nabumetona , Transtornos de Fotossensibilidade/induzido quimicamente , Transtornos de Fotossensibilidade/patologia , Porfirias/patologiaRESUMO
BACKGROUND: Early studies using HIV protease inhibitors (PI) showed regression of Kaposi's sarcoma (KS) lesions in some patients. OBJECTIVE: Our purpose was to determine prospectively the influence of PI on HIV-related KS. METHODS: KS lesions of nine patients with progressive cutaneous disease were prospectively evaluated clinically and by means of epiluminescence microscopy before and during PI therapy. HIV viremia and CD4 cell count were measured in parallel. RESULTS: All patients experienced reduction or initial stabilization of KS lesions during the first 4 to 8 weeks of HIV-1 PI therapy. After a median follow-up of 7 months and according to AIDS Clinical Trials Groups criteria, six patients had a partial response, two showed stable disease, and in one noncompliant patient KS progressed, requiring chemotherapy. With epiluminescence microscopy, a reduction in skin surface alterations, lesional size, and color intensity was demonstrated in six of nine patients. PI induced a median decrease in viremia of 1.66 log and a median increase in the CD4 count of 49 cells/mm3. CONCLUSION: In this series, HIV PI therapy reduced or stabilized KS. The efficacy of HIV-1 PI in KS may result from the improvement in cellular immunity. These results suggest the use of PI in AIDS-related KS regardless of the level of CD4 lymphocyte count and HIV viremia.
Assuntos
Infecções por HIV/tratamento farmacológico , Inibidores da Protease de HIV/uso terapêutico , Sarcoma de Kaposi/prevenção & controle , Neoplasias Cutâneas/prevenção & controle , Contagem de Linfócito CD4 , Seguimentos , Infecções por HIV/complicações , Infecções por HIV/imunologia , HIV-1/isolamento & purificação , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estudos Prospectivos , Sarcoma de Kaposi/etiologia , Sarcoma de Kaposi/imunologia , Neoplasias Cutâneas/etiologia , Neoplasias Cutâneas/imunologia , Fatores de TempoRESUMO
We report the case of a 17-year-old girl with a constitutional chromosome anomaly (ring chromosome 7), associated with multiple pigmented skin lesions, who developed malignant melanoma. Eight other cases of ring chromosome 7 are described in the literature; all present vascular or pigmented skin lesions, but our patient was the first to develop a malignant tumor. Genetic studies in malignant melanoma are discussed, as well as the possible link between a constitutional anomaly of chromosome 7 and the occurrence of malignant melanoma. This association is possibly not fortuitous, particularly since most ring chromosome 7 patients reported to date have pigmented skin lesions.
Assuntos
Cromossomos Humanos Par 7 , Melanoma/patologia , Neoplasias Primárias Múltiplas/patologia , Nevo Pigmentado/congênito , Cromossomos em Anel , Neoplasias Cutâneas/patologia , Adolescente , Síndrome do Nevo Displásico/genética , Síndrome do Nevo Displásico/patologia , Feminino , Humanos , Melanoma/genética , Neoplasias Primárias Múltiplas/genética , Nevo Pigmentado/genética , Nevo Pigmentado/patologia , Neoplasias Cutâneas/genéticaRESUMO
All 9 cases of ring chromosome 7 syndrome already identified had skin lesions: 7 had vascular lesions, 5 showed large pigmented congenital nevi, 3 had café-au-lait spots and in 1 case there were achromic spots on the trunk. One girl developed malignant melanoma at the age of 17 years. It appears that in patients presenting with growth retardation and pigmented skin lesions, with or without mental retardation, a cytogenetic study is indicated to search for ring chromosome 7, which is probably more frequent than suggested by the literature.
