Asunto(s)
Antitusígenos/efectos adversos , Dextrometorfano/efectos adversos , Erupciones por Medicamentos/etiología , Erupciones por Medicamentos/inmunología , Analgésicos Opioides/uso terapéutico , Erupciones por Medicamentos/patología , Tolerancia a Medicamentos , Humanos , Masculino , Persona de Mediana EdadAsunto(s)
Humanos , Masculino , Persona de Mediana Edad , Dextrometorfano/efectos adversos , Dextrometorfano/inmunología , Hipersensibilidad a las Drogas/complicaciones , Hipersensibilidad a las Drogas/diagnóstico , Hipersensibilidad a las Drogas/tratamiento farmacológico , Receptores Opioides/uso terapéutico , Meperidina/uso terapéutico , Morfina/uso terapéutico , Fentanilo/uso terapéutico , Codeína/uso terapéutico , Hipersensibilidad a las Drogas/inmunología , Hipersensibilidad a las Drogas/fisiopatologíaAsunto(s)
Resinas Acrílicas/efectos adversos , Prótesis Dental/efectos adversos , Dermatitis Alérgica por Contacto/diagnóstico , Estomatitis Subprotética/diagnóstico , Anciano , Dermatitis Alérgica por Contacto/etiología , Dermatitis Alérgica por Contacto/patología , Diagnóstico Diferencial , Femenino , Humanos , Pruebas del Parche , Estomatitis Subprotética/inducido químicamente , Estomatitis Subprotética/patologíaRESUMEN
Skin necrosis from intravenous infiltration of soft tissue is a rare but potentially devastating complication of intravenous therapy. Vinca alkaloids are among the intravenous drugs with the highest destructive power. We report two cases of skin necrosis from accidental extravasation of vinorelbine, a semisynthetic analogue of vinblastine, rarely described as being responsible for this event. Histopathologic study showed separation of the dermis from necrotic epidermis, associated with cytologic atypia, in both patients, and focal necrosis of eccrine glands in one of them. We consider that intravenous infusions of vinorelbine should be performed using the preventive measures and care applied for other chemotherapeutic agents with high potential for induction of skin necrosis due to extravasation.
Asunto(s)
Antineoplásicos Fitogénicos/efectos adversos , Infusiones Intravenosas/efectos adversos , Piel/efectos de los fármacos , Vinblastina/análogos & derivados , Vinblastina/efectos adversos , Anciano , Neoplasias de la Mama/patología , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Extravasación de Materiales Terapéuticos y Diagnósticos , Femenino , Antebrazo , Humanos , Neoplasias Pulmonares/tratamiento farmacológico , Neoplasias Pulmonares/secundario , Masculino , Persona de Mediana Edad , Necrosis , Vinblastina/administración & dosificación , VinorelbinaRESUMEN
We report a patient who presented with an intensely pruritic rash, with hyperpigmentation of the whole back and multiple hyperpigmented and hyperkeratotic papules over his forearms and lower extremities. Histologically, he showed deposits of amyloid that reacted positively with monoclonal antibodies against cytokeratins. The lesions were resistant to antihistamines and corticosteroids. Treatment with oral acitretin was started and great improvement of the lesion was noted; the patient became asymptomatic. We review the literature on the effect of retinoids in cutaneous amyloidosis.