Dermatologic therapy
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Dermatologic therapy · Sep 2019
Review Case ReportsUrticarial rash, fever, and arthritis: A case of refractory Adult-onset Still's disease with good response to tocilizumab.
Adult-onset Still's disease (AOSD) is a rare, systemic inflammatory disorder of not completely understood etiology. Aberrant activation of the innate immune system and overproduction of several pro-inflammatory mediators are considered a critical component in disease pathogenesis. AOSD still poses a challenge due to the broad range of differential diagnoses and no specific biomarkers. ⋯ Finally, after several unsuccessful attempts to achieve disease control with traditional DMAR's administration of Tocilizumab (TCZ), a humanized anti-IL-6 receptor antagonist resulted in substantial disease improvement. Since skin manifestations are a common feature of AOSD, it should be among differential diagnoses in patients with skin lesions and constitutional symptoms. Biologic agents represent a significant therapeutic advance in patients with AOSD refractory to conventional therapy.
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Dermatologic therapy · Jul 2019
Review Case ReportsRapid remission of Stevens-Johnson syndrome by combination therapy using etanercept and intravenous immunoglobulin and a review of the literature.
Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) are spectrum of rare, acute, and life-threatening delayed-type drug hypersensitivity reactions that are associated with high mortality rates. However, no therapeutic standard has been proposed for SJS/TEN. Here, we report a case of a patient diagnosed with Stevens-Johnson syndrome whose disease progression was halted by a single dose of etanercept and was treated successfully. In addition, we reviewed the literature reporting patients with SJS/TEN treated with similar regimens.
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Dermatologic therapy · May 2019
Letter Case ReportsUse of low-dose naltrexone in the treatment of severe Hailey-Hailey disease: One case report.
Hailey-Hailey disease (HHD) or chronic benign familial pemphigus is an autosomal dominant genodermatosis with complete penetrance characterized by painful vesicles, erosions, and macerated intertriginous skin. We present a 66-year-old woman with a personal 35-year history of pruritic recurrent vesicles and erosions in both axillae and inguinal folds. HHD was confirmed by cutaneous biopsy. ⋯ Paradoxically, at low doses, the partial binding to those receptors leads to a homeostatic increase of opioid receptors and an upregulation of endogenous opioids. Low-dose naltrexone (LDN) may also exert an anti-inflammatory action through its antagonist effect on toll-like receptor 4 found on macrophages. We consider that LDN is an effective and safe alternative for the HHD, representing an important progress in the management of this disease with limited therapeutic options.
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Dermatologic therapy · Mar 2019
Case ReportsDevelopment of herpes zoster during infliximab treatment for pediatric generalized pustular psoriasis: A case report.
The present authors report a 12-year-old Chinese child with generalized pustular psoriasis who was responded well to infliximab, but an adverse effect of herpes zoster occurred after the first infusion soon. The antiviral treatment was effective and no recurrence or flaring was observed after half-year of follow-up. This case reminds us to highlight the risk of viral infection during biological treatment on patients with psoriasis or autoimmune disease.