Background. Dermatomyositis is a rare inflammatory dermatosis for which an iatrogenic origin has been described in very few cases. We report a case of dermatomyositis occurring after fluvastatin intake. Case report. A...Background. Dermatomyositis is a rare inflammatory dermatosis for which an iatrogenic origin has been described in very few cases. We report a case of dermatomyositis occurring after fluvastatin intake. Case report. A 76-year-old male patient sought medical attention for a photodistributed rash and considerable muscular weakness present for one month. Two months earlier, fluvastatin had been introduced following the discovery of dyslipidemia. Serum creatine phosphokinase levels were elevated. Histological examination of a muscle biopsy was consistent with a diagnosis of dermatomyositis. Investigation for neoplasia and associated autoimmune disease proved negative. All clinical and laboratory abnormalities diminished spontaneously without recourse to corticosteroids with in one month of the final intake of fluvastatin. After a follow-up period of three years, no recurrence was observed and no signs of neoplasia or connectivitis were found. Discussion. Iatrogenic dermatomyositis has only been reported in rare cases. Certain drugs have been incriminated, notably D-penicillamine. Six cases of drug-induced dermatomyositis have been described with statins: simvastatin, atorvastatin, pravastatin and lovastatin. Of these cases, only one resolved spontaneously after withdrawal of the drug alone without use of corticosteroids. Our case concerns intake of fluvastatin, an HMG-CoA reductase inhibitor with rare though well-known muscular side effects: elevated serum CPK, myalgia and rhabdomyolysis. Six cases of polymyositis have also been reported. Ours is the first case of dermatomyositis described with this category of statins. It is also the second reported case showing improvement after withdrawal of the lipid-lowering agent and without corticosteroids. Thus in cases of dermatomyositis, this iatrogenic picture should be sought routinely.展开更多
Background. Neutrophilic eccrine hidradenitis occurs mostly in patients receiving chemotherapy for acute myeloblastic leukemia, rarely in healthy patients. Histopathologic pattern is characteristic and includes select...Background. Neutrophilic eccrine hidradenitis occurs mostly in patients receiving chemotherapy for acute myeloblastic leukemia, rarely in healthy patients. Histopathologic pattern is characteristic and includes selective necrosis of the eccrine glands with a local neutrophilic infiltrate. Case report. We report the case of a 41 year- old woman with no medical past history who developed during 2 years successive papulous skin eruptions. The latter always resolved spontaneously. Skin biopsy led to the diagnosis showing typical features of neutrophilic eccrine hidradenitis. Discussion. Our case is original because the neutrophilic eccrine hidradenitis had occured in a healthy woman. Neither malignant hematologic disease nor visceral cancer was disclosed in this patient in the following 31 months.展开更多
文摘Background. Dermatomyositis is a rare inflammatory dermatosis for which an iatrogenic origin has been described in very few cases. We report a case of dermatomyositis occurring after fluvastatin intake. Case report. A 76-year-old male patient sought medical attention for a photodistributed rash and considerable muscular weakness present for one month. Two months earlier, fluvastatin had been introduced following the discovery of dyslipidemia. Serum creatine phosphokinase levels were elevated. Histological examination of a muscle biopsy was consistent with a diagnosis of dermatomyositis. Investigation for neoplasia and associated autoimmune disease proved negative. All clinical and laboratory abnormalities diminished spontaneously without recourse to corticosteroids with in one month of the final intake of fluvastatin. After a follow-up period of three years, no recurrence was observed and no signs of neoplasia or connectivitis were found. Discussion. Iatrogenic dermatomyositis has only been reported in rare cases. Certain drugs have been incriminated, notably D-penicillamine. Six cases of drug-induced dermatomyositis have been described with statins: simvastatin, atorvastatin, pravastatin and lovastatin. Of these cases, only one resolved spontaneously after withdrawal of the drug alone without use of corticosteroids. Our case concerns intake of fluvastatin, an HMG-CoA reductase inhibitor with rare though well-known muscular side effects: elevated serum CPK, myalgia and rhabdomyolysis. Six cases of polymyositis have also been reported. Ours is the first case of dermatomyositis described with this category of statins. It is also the second reported case showing improvement after withdrawal of the lipid-lowering agent and without corticosteroids. Thus in cases of dermatomyositis, this iatrogenic picture should be sought routinely.
文摘Background. Neutrophilic eccrine hidradenitis occurs mostly in patients receiving chemotherapy for acute myeloblastic leukemia, rarely in healthy patients. Histopathologic pattern is characteristic and includes selective necrosis of the eccrine glands with a local neutrophilic infiltrate. Case report. We report the case of a 41 year- old woman with no medical past history who developed during 2 years successive papulous skin eruptions. The latter always resolved spontaneously. Skin biopsy led to the diagnosis showing typical features of neutrophilic eccrine hidradenitis. Discussion. Our case is original because the neutrophilic eccrine hidradenitis had occured in a healthy woman. Neither malignant hematologic disease nor visceral cancer was disclosed in this patient in the following 31 months.
