Patients with systemic lupus erythematosus (SLE)often develop leg ulceration, particularly those with antiphospholipid antibodies or with vasculitis. Pyoderma gangrenosum (PG)is an idiopathic ulcerative neutrophilic d...Patients with systemic lupus erythematosus (SLE)often develop leg ulceration, particularly those with antiphospholipid antibodies or with vasculitis. Pyoderma gangrenosum (PG)is an idiopathic ulcerative neutrophilic dermatosis that is com monly associated with inflammatory bowel disease or seronegative polyarthritis. Although PG-like lesions have been commonly described in patients with the anti phospholipid antibody syndrome, the occurrence of PG as a preceding manifestatio n of SLE has only rarely been reported. We present a patient who developed PG ro ughly 8 years prior to developing SLE.展开更多
Self-resolving Epstein-Barr virus (EBV)-associated lymphomas have become more common with the use of immunosuppressive agents in both transplant patients and patients with connective tissue disorders.Immunosuppressive...Self-resolving Epstein-Barr virus (EBV)-associated lymphomas have become more common with the use of immunosuppressive agents in both transplant patients and patients with connective tissue disorders.Immunosuppressive agents are often used for control of dermatomyositis, but their use has not been linked to subsequent malignancy.We present a 46-year-old woman with dermatomyositis, who developed an EBV-associated B-cell lymphoma of the brain while on oral methotrexate, mycophenolate mofetil and lowdose prednisone.The patients lymphoma gradually resolved “spontaneously”upon discontinuation of the methotrexate and mycophenolate mofetil.The potential for EBV-associated B-cell lymphoma to self-resolve should be recognized by the clinician in order to prevent unnecessary and potentially toxic treatments including radiation therapy or multi-drug chemotherapy.展开更多
Linear IgA bullous dermatosis (LABD) is a rare autoimmune vesiculobullous disorder characterized by variable clinical presentations that may mimic bullous pemphigoid, dermatitis herpetiformis, cicatricial pemphigoid a...Linear IgA bullous dermatosis (LABD) is a rare autoimmune vesiculobullous disorder characterized by variable clinical presentations that may mimic bullous pemphigoid, dermatitis herpetiformis, cicatricial pemphigoid and erythema multi- forme. A few cases of drug-induced LABD that clinically resembled toxic epidermal necrolysis (TEN) have been reported. A subset of patients with LABD have been found to be drug-induced: the most common drug being vancomycin. The diagnosisofLABDisconfirmedbythepresenceofalinearband of IgA along the basement membrane zone on direct immunofluorescence microscopy. We report a case of a 77- year-old man who presented to us with vancomycin-induced LABD that presented clinically as TEN, He had a complete recovery over a 3- week period following discontinuation of the vancomycin and the addition of oral dapsone therapy. It is important to be aware that drug-induced LABD can mimic TEN.展开更多
文摘Patients with systemic lupus erythematosus (SLE)often develop leg ulceration, particularly those with antiphospholipid antibodies or with vasculitis. Pyoderma gangrenosum (PG)is an idiopathic ulcerative neutrophilic dermatosis that is com monly associated with inflammatory bowel disease or seronegative polyarthritis. Although PG-like lesions have been commonly described in patients with the anti phospholipid antibody syndrome, the occurrence of PG as a preceding manifestatio n of SLE has only rarely been reported. We present a patient who developed PG ro ughly 8 years prior to developing SLE.
文摘Self-resolving Epstein-Barr virus (EBV)-associated lymphomas have become more common with the use of immunosuppressive agents in both transplant patients and patients with connective tissue disorders.Immunosuppressive agents are often used for control of dermatomyositis, but their use has not been linked to subsequent malignancy.We present a 46-year-old woman with dermatomyositis, who developed an EBV-associated B-cell lymphoma of the brain while on oral methotrexate, mycophenolate mofetil and lowdose prednisone.The patients lymphoma gradually resolved “spontaneously”upon discontinuation of the methotrexate and mycophenolate mofetil.The potential for EBV-associated B-cell lymphoma to self-resolve should be recognized by the clinician in order to prevent unnecessary and potentially toxic treatments including radiation therapy or multi-drug chemotherapy.
文摘Linear IgA bullous dermatosis (LABD) is a rare autoimmune vesiculobullous disorder characterized by variable clinical presentations that may mimic bullous pemphigoid, dermatitis herpetiformis, cicatricial pemphigoid and erythema multi- forme. A few cases of drug-induced LABD that clinically resembled toxic epidermal necrolysis (TEN) have been reported. A subset of patients with LABD have been found to be drug-induced: the most common drug being vancomycin. The diagnosisofLABDisconfirmedbythepresenceofalinearband of IgA along the basement membrane zone on direct immunofluorescence microscopy. We report a case of a 77- year-old man who presented to us with vancomycin-induced LABD that presented clinically as TEN, He had a complete recovery over a 3- week period following discontinuation of the vancomycin and the addition of oral dapsone therapy. It is important to be aware that drug-induced LABD can mimic TEN.
