RESUMO
Nilotinib es un inhibidor altamente selectivo de BCR-ABL tirosina kinasa usado para el tratamiento de Leucemia mieloide crónica. Las reacciones cutáneas fueron uno de los efectos adversos no hematológicos más frecuentemente reportados en relación al uso de esta droga. El presente artículo documenta el caso una paciente femenina de 17 años de edad diagnosticada con Leucemia mieloide crónica que había estado en tratamiento con Nilotinib por 5 meses desarrollando una reacción tipo queratosis pilar. La paciente fue tratada con medidas generales, Urea 15% y antihistamínicos, con cese del prurito. Es importante reconocer las reacciones cutáneas asociadas al uso de Nilotinib para así otorgar alivio oportuno de los síntomas con el fin de lograr una mejor adherencia al tratamiento de la Leucemia mieloide crónica y mejorar la calidad de vida del paciente.
Nilotinib is a highly selective inhibitor of BCR-ABL tyrosine kinase. It is used as a treatment for chronic myelogenous leukemia (CML). Cutaneous reactions are one of the most common non-hematologic reported adverse effects. The present article documents the case of a 17-year-old female patient diagnosed with CML. She was treated with nilotinib for 5 months and developed a keratosis pilaris-like reaction. The patient was treated with general measures, topical 15%-urea and antihistamines with improvement and cessation of pruritus. It is imperative to recognize the cutaneous adverse effects associated with the use of new oncologic treatments such as nilotinib.
Assuntos
Humanos , Feminino , Adolescente , Pirimidinas/efeitos adversos , Leucemia Mielogênica Crônica BCR-ABL Positiva/tratamento farmacológico , Ceratose/induzido quimicamente , Pirimidinas/uso terapêutico , ToxidermiasRESUMO
A 42-year-old man presented with a six-month history of a slowly-enlarging ulcer on his right sole, a 30-year history of altered pigmentation of the trunk and extremities, and hyperkeratotic papules of the palms and soles. Histopathologic examination showed an invasive squamous-cell carcinoma of the right sole and hyperkeratosis with keratinocyte atypia of the left finger and left lateral foot. The clinical and histopathologic findings are consistent with chronic arsenicism, which most commonly occurs in the setting of drinking contaminated water or after occupational exposure. Evaluation should include a physical examination, basic laboratory work-up, and measurement of a 24-hour urine arsenic concentration. Vigilant surveillance for the development of cutaneous malignancies is required. Oral retinoids may be helpful in reducing hyperkeratosis secondary to chronic arsenicism.
Assuntos
Arsenicais/efeitos adversos , Carcinoma de Células Escamosas/diagnóstico , Dermatoses do Pé/induzido quimicamente , Doenças do Pé/diagnóstico , Úlcera do Pé/etiologia , Dermatoses da Mão/induzido quimicamente , Hiperpigmentação/induzido quimicamente , Ceratose/induzido quimicamente , Poluentes Químicos da Água/efeitos adversos , Adulto , Carcinoma de Células Escamosas/induzido quimicamente , Carcinoma de Células Escamosas/patologia , Equador/etnologia , Epiderme/patologia , Dermatoses do Pé/patologia , Doenças do Pé/induzido quimicamente , Doenças do Pé/patologia , Dermatoses da Mão/patologia , Humanos , Hiperpigmentação/patologia , Hiperplasia , Queratinócitos/patologia , Ceratose/patologia , Masculino , Abastecimento de Água/análiseAssuntos
Acantose Nigricans/patologia , Toxidermias/diagnóstico , Insulina/efeitos adversos , Lipodistrofia/patologia , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diagnóstico Diferencial , Toxidermias/tratamento farmacológico , Feminino , Humanos , Hiperpigmentação/induzido quimicamente , Hiperpigmentação/diagnóstico , Hipoglicemiantes/efeitos adversos , Ceratose/induzido quimicamente , Ceratose/diagnóstico , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Arsenic (As) is a well-recognized poison. Exposure may be of an acute nature, leading to high concentrations and acute arsenic poisoning. Chronic exposure may lead to benign skin changes, skin cancer, and internal malignancy. OBJECTIVE: Our purpose was to study the nature, incidence, and sequelae of skin disorders in a group of Argentinean patients suffering from chronic arsenicism due to the intake of contaminated well water. METHODS: All patients who presented with chronic arsenicism at the Dermatology Department of Hospital Posadas (Buenos Aires, Argentina) during a 10-year period (1988-1998) were included in this study. The patient group compromised 9 women and 14 men, the age range was 37-72 years. Diagnosis was based on the clinical triad (keratoderma, leucoderma and epiteliomatosis). We performed clinical, laboratory, and histopathologic studies to confirm diagnosis. We screened for possible internal diseases. RESULTS: All patients included in this study had cutaneous lesions associated with long-term arsenic exposure. The mean age of the patients was 58.2 years. The estimated mean time of the beginning of the lesions was of 3.7 years. All patients were Argentinean from endemic areas of our country where the arsenic levels are higher than those accepted by the World Health Organization. CONCLUSION: This study allows us to conclude that the relationship between arsenic and cancer is frequent and it describes the principal characteristics of this entity in our group of patients.
Assuntos
Intoxicação por Arsênico/complicações , Carcinoma Basocelular/induzido quimicamente , Neoplasias Cutâneas/induzido quimicamente , Poluentes Químicos da Água/efeitos adversos , Abastecimento de Água , Carcinoma de Células Escamosas/induzido quimicamente , Feminino , Humanos , Ceratose/induzido quimicamente , Masculino , Pessoa de Meia-IdadeRESUMO
This study examines the effects of xerostomia on the development of mucosal changes proceeding carcinoma in rats painted orally with 4-nitroquinoline N-oxide (4NQO). Sialoadenectomy enhanced the incidence of focal acantholytic dyskeratosis (FAD) on the palate and tongue of rats painted on the palate with 0.5% 4NQO three times weekly. At one month, no changes were observed. After two months of painting with 4NQO, sialoadenectomized rats, but not controls, had FAD. After three months, FAD was seen in both test and control groups, but the incidence of FAD was higher in the test group and seen more on the palate than on the tongue of xerostomic animals. Neither test nor control animals developed carcinoma within this study period.
Assuntos
Acantólise/etiologia , Ceratose/etiologia , Lesões Pré-Cancerosas/etiologia , Xerostomia/complicações , 4-Nitroquinolina-1-Óxido , Acantólise/induzido quimicamente , Acantólise/patologia , Animais , Carcinógenos , Ceratose/induzido quimicamente , Ceratose/patologia , Palato/efeitos dos fármacos , Palato/patologia , Lesões Pré-Cancerosas/induzido quimicamente , Ratos , Ratos Wistar , Ductos Salivares/fisiologia , Língua/efeitos dos fármacos , Língua/patologiaRESUMO
Dermatological toxicity has been reported following initiation of therapy with minoxidil, but no cases have been reported following prolonged use. We report the emergence of an erythematous weeping rash with impending exfoliation three years after the initiation of minoxidil therapy. Minoxidil was withdrawn and the patient responded to therapy with topical corticosteroids. Following minor surgery, the patient was inadvertently rechallenged with minoxidil. Within 24 hours of exposure bullous lesions reappeared in the extremities which again resolved with topical corticosteroids. Dermatological lesions observed on this patient were similar to those reported following acute minoxidil exposure and strongly implicate chronic minoxidil therapy.