scholarly journals Mucocutaneous Ulcerations and Pancytopenia due to Methotrexate Overdose

2016 ◽  
Vol 8 (3) ◽  
pp. 287-293 ◽  
Author(s):  
Katharina Knoll ◽  
Florian Anzengruber ◽  
Antonio Cozzio ◽  
Lars E. French ◽  
Carla Murer ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Early Stage ◽  
Skin Lesions ◽  
Bone Marrow Suppression ◽  
Cutaneous Lesions ◽  
Neoplastic Diseases ◽  
Immune Mediated

Methotrexate (MTX) is an antifolic drug used in the treatment of immune-mediated and neoplastic diseases. Initiation or dosage changes in MTX therapy can cause mucositis and bone marrow suppression. Skin lesions due to acute MTX toxicity are rare, but they serve as a herald for later-onset pancytopenia. Therefore, identification of those cutaneous lesions might help to initiate rescue strategies at an early stage. Here we describe a case with mucocutaneous ulcerations and pancytopenia due to overdosed MTX.

scholarly journals Extensive Lepromatous Lymphadenitis Preceding Lesions on the Face and Earlobes: An Unusual Presentation of Leprosy in Singapore

2018 ◽  
Vol 10 (1) ◽  
pp. 35-40
Author(s):  
Shi Yao Sam Yang ◽  
Wai Mun Sean Leong ◽  
Cruz Maria Teresa Kasunuran ◽  
Jing Xiang Huang ◽  
Sue-Ann Ju Ee Ho ◽  
...  
Keyword(s):  
Early Stage ◽  
Developed Countries ◽  
Skin Lesions ◽  
The Body ◽  
The Other ◽  
Cutaneous Lesions ◽  
Poor Countries ◽  
Geographical Regions ◽  
Resource Poor ◽  
The Face

Leprosy is also known as Hansen disease, as in some countries the diagnosis of leprosy carries a negative stigma and patients fear being shunned as outcasts. Presently, leprosy is primarily limited to specific geographical regions in resource-poor countries. As a result, there is increased difficulty for the younger generation of physicians today to correctly identify leprosy due to a lack of exposure and a low-index of suspicion, particularly in developed countries. In this case, the indurated lesions over the face demonstrated a preference for the outer lateral aspects over the maxillary areas, the nose bridge, and the pinna of the ears consistent with the organism’s preference for cooler regions of the body. This was also evident in the other skin lesions affecting the more acral regions of the limbs in the early stage of disease progression. There is a need to keep this infective condition as an alternate diagnosis to all unusual cutaneous lesions.

scholarly journals A Case of Plasmacytoid Dendritic Cell Leukemia

2013 ◽  
Vol 59 (2) ◽  
pp. 111-114
Author(s):  
Judit Beáta Köpeczi ◽  
I Benedek ◽  
Erzsébet Benedek ◽  
Enikő Kakucs ◽  
Aliz Tunyogi ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Dendritic Cell ◽  
Plasmacytoid Dendritic Cell ◽  
Initial Response ◽  
Skin Lesions ◽  
High Rate ◽  
Response To Treatment ◽  
Cell Leukemia ◽  
Cutaneous Lesions ◽  
Hla Dr

AbstractIntroduction: Plasmacytoid dendritic cell leukemia is a rare subtype of acute leukemia, which has recently been established as a distinct pathologic entity that typically follows a highly aggressive clinical course in adults. The aim of this report is to present a case of plasmacytoid dendritic cell leukemia due to its rarity and difficulty to recognize and diagnose it.Case report: We present a case of a 67 year-old man who presented multiple subcutaneous lesions on his face, neck, chest and upper extremities with reddish-brown, brown colour. In the bone marrow aspirate 83% of the blast cells were found. Immunophenotypically the blasts were positive for CD4, CD56, CD123 (high intensity), CD36, CD22, CD10 (10.42%), CD33, HLA-DR, CD7 (9.24%), CD38 (34.8%) and negative for CD13, CD64, CD14, CD16, CD15, CD11b, CD11c, CD3, CD5, CD2, CD8, CD19, CD20, CD34. The skin biopsy showed lymphohistiocytoid infiltration in the dermis. The patient was diagnosed with acute plasmacytoid dendritic cell leukemia and received polychemotherapy with rapid response of skin lesions and blastic infiltration of the bone marrow. After 3 courses of polychemotherapy the cutaneous lesions reappeared and multiplied. The blast infiltration in the bone marrow increased to 70%. A more aggressive polychemotherapy regimen was administered, but the patient presented serious complications (febrile neutropenia) and died in septic shock 8 months after the initiation of treatment.Conclusions: Immunophenotyping of blasts cells is indispensable in the diagnosis of plasmacytoid dendritic cell leukemia. The CD4+, CD56+, lin-, CD123 ++high, CD11c-, CD36+, HLA-DR+, CD34-, CD45+ low profile is highly suggestive for pDCL. The outcome of plasmacytoid dendritic cell leukemia is poor. Despite the high rate of initial response to treatment, early relapses occur and the patients die of disease progression.

scholarly journals Acute Methotrexate Toxicity: A Fatal Condition in Two Cases of Psoriasis

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Pankti Jariwala ◽  
Vinay Kumar ◽  
Khyati Kothari ◽  
Sejal Thakkar ◽  
Dipak Dayabhai Umrigar
Keyword(s):  
Bone Marrow ◽  
Drug Interactions ◽  
Creatinine Level ◽  
Joint Pain ◽  
Low Dose ◽  
Skin Lesions ◽  
Bone Marrow Suppression ◽  
Intermittent Treatment ◽  
Self Medication ◽  
Dose Methotrexate

We describe two fatal cases of low dose methotrexate (MTX) toxicity in patients with psoriasis, emphasizing the factors that exacerbate MTX toxicity. The first patient was a 50-year-old male of psoriasis on intermittent treatment with MTX. After a treatment-free period of six months, he had self-medication of MTX along with analgesic for joint pain for one week which followed ulceration of the lesions, bone marrow suppression, and eventually death. The second patient was a 37-year-old male of psoriasis, who has taken MTX one week earlier without prior investigations. He had painful ulcerated skin lesions and bone marrow suppression. On investigations, he showed high creatinine level and atrophied, nonfunctioning right kidney on ultrasonography. In spite of dialysis, he succumbed to death. MTX is safe and effective if monitored properly, but inadvertent use may lead to even death also. Prior workup and proper counseling regarding the drug interactions as well as self-medication should be enforced.

scholarly journals Mixed Phenotype Acute Leukemia Presenting as Leukemia Cutis

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Geetha Narayanan ◽  
M. T. Sugeeth ◽  
Lali V. Soman
Keyword(s):  
Bone Marrow ◽  
Acute Leukemia ◽  
Bone Marrow Aspiration ◽  
Skin Lesions ◽  
The Body ◽  
Leukemic Cells ◽  
Monocytic Differentiation ◽  
Cutaneous Lesions ◽  
Congenital Leukemia ◽  
Leukemia Cutis

Leukemia cutis (LC) is defined as infiltration of the skin by leukemic cells resulting in clinically recognizable cutaneous lesions. It is common in congenital leukemia and acute myeloid leukemia. However, LC has rarely been reported with mixed phenotypic acute leukemia (MPAL). We report the case of a lady who presented with erythematous papular and nodular lesions all over the body. Skin biopsy showed leukemic infiltration and bone marrow aspiration showed MPAL of the T/myeloid with monocytic differentiation lineage. This is the first report of an adult patient with MPAL of the T/myeloid with monocytic differentiation type presenting with leukemia cutis. She was started on chemotherapy with Hyper-CVAD. There is complete resolution of the skin lesions and she has achieved bone marrow remission after the first cycle of chemotherapy.

scholarly journals Feminization and severe pancytopenia caused by testicular neoplasia in a cryptorchid dog

2016 ◽  
Vol 85 (4) ◽  
pp. 197-205 ◽  
Author(s):  
D. Paepe ◽  
L. Hebbelinck ◽  
A. Kitshoff ◽  
S. Vandenabeele
Keyword(s):  
Bone Marrow ◽  
Early Stage ◽  
Fatal Outcome ◽  
Clinical Signs ◽  
Testicular Tumor ◽  
Bone Marrow Suppression ◽  
Blood Levels ◽  
Intact Male ◽  
Initial Improvement ◽  
Severe Pancytopenia

In this case report, a paraneoplastic syndrome caused by testicular neoplasia in a ten-year-old cryptorchid dog is described. Feminization and pancytopenia were observed, resulting from the testicular neoplastic production of estrogens. A diagnosis of testicular tumor and associated bone marrow suppression was made by ultrasonography and blood examination, with estrogen blood levels being severely elevated. Urinalysis revealed a urinary tract infection. Castration was performed together with a blood transfusion, and antibiotic treatment was started. After an initial improvement, the dog died suddenly after approximately three weeks. In this report, the importance is highlighted of identifying clinical signs associated with feminization in intact male dogs at an early stage, to avoid severe, potentially irreversible, hematological consequences due to bone marrow suppression. Elective orchidectomy of both testes is highly recommended in cryptorchid dogs as neoplastic transformation of the undescended testis may occur, with potentially fatal outcome.

scholarly journals Study on Cutaneous Manifestations of Leukemia and Lymphoma

2015 ◽  
Vol 4 (2) ◽  
pp. 31-34
Author(s):  
Md Abdul Wahab ◽  
AKM Rejaul Haque ◽  
Md Rafiquzzaman Khan ◽  
Biswas Shaheen Hassan ◽  
Md Moksedur Rahman ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Hematologic Malignancies ◽  
Skin Lesions ◽  
Cutaneous Lesions ◽  
Cross Sectional ◽  
Cutaneous Manifestations ◽  
Aleukemic Leukemia Cutis ◽  
Leukemia Cutis ◽  
One Year ◽  
Medical University

Leukemia and Lymphoma can present with various cutaneous manifestations. These include specific cutaneous diseases and non-specific cutaneous lesions. Non-specific skin lesions are more common in patients with Hodgkins diseases. Leukemia cutis (specific skin lesions of Leukemia) most commonly occurs concommitent with or following the diagnosis of leukemia. The skin may also be the site of relapse of Leukemia after chemotherapy. Uncommonly leukemia cutis may be identified while the bone marrow and peripheral blood are normal. Those patients are classified as aleukemic leukemia cutis. The objective of this study is to know the prevalence of skin manifestations of hematologic malignancies and to help the diagnosis and management of hematologic malignancies in some extent. It is a cross sectional observational study in which the skin lesions of the patients in hematologic malignancies who were already diagnosed & hospitalized in the hematology department of Bangabandhu Sheikh Mujib Medical University were evaluated in the period of one year. We found malignant infiltrative lesions & hemorrhagic findings both were predominate in leukemia. Infections were predominant in both Leukemia & Lymphoma. CBMJ 2015 July: Vol. 04 No. 02 P: 31-34

scholarly journals Severe bone marrow suppression due to methotrexate toxicity following aceclofenac-induced acute kidney injury

2018 ◽  
pp. bcr-2018-224722 ◽  
Author(s):  
Robin George Manappallil ◽  
Durga Prasan ◽  
Jayameena Peringat ◽  
Illolil Kuniyil Biju
Keyword(s):  
Bone Marrow ◽  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Bone Marrow Suppression ◽  
Methotrexate Toxicity

scholarly journals Cutaneous manifestations of COVID-19 in Mexican patients: A case series and review of literature

2021 ◽  
Vol 9 ◽  
pp. 2050313X2199719
Author(s):  
Juan Carlos Palomo-Pérez ◽  
Maria Elisa Vega-Memije ◽  
David Aguilar-Blancas ◽  
Erik González-Martínez ◽  
Lucia Rangel-Gamboa
Keyword(s):  
Respiratory Symptoms ◽  
Case Series ◽  
Signs And Symptoms ◽  
Skin Lesions ◽  
World Health ◽  
Medical Community ◽  
Atypical Pneumonia ◽  
Cutaneous Lesions ◽  
Cutaneous Manifestations ◽  
Mexican Patients

China officially recognized atypical pneumonia outbreak in December 2019; on 11 March 2020, the World Health Organization declared COVID-19 as a pandemic that is produced by a new coronavirus, named SARS-CoV-2, of rapid transmissibility, which can be asymptomatic, with mild to severe respiratory symptoms, and with cardiovascular, neurological, gastrointestinal, and cutaneous complications. Considering that the pandemic prolonged more than initially expected was prognostic, it is essential for the medical community to identify the signs and symptoms of COVID-19. Thus, this work’s objectives were to present cases of cutaneous lesions observed in COVID-19 Mexican patients. We register cutaneous lesions in COVID-19 patients referred from internal medicine and otorhinolaryngology services to dermatology. We presented four interesting cases with cutaneous lesions, including exanthema morbilliform, urticaria, chilblains, ecchymosis, and facial edema, and review the available literature. The most frequent cutaneous markers are rash, chilblains, and urticaria. Skin lesions may be the first manifestation of COVID-19, accompany initial respiratory symptoms, or appear during the disease course. Symptoms associated with vascular changes (livedo reticularis and vasculitis) are considered of poor prognosis.

scholarly journals Morphologic Features of Cutaneous T-Cell Lymphomas Using Dermoscopy and High Frequency Ultrasound

2020 ◽  
Vol 10 (1) ◽  
pp. 17
Author(s):  
Iris Wohlmuth-Wieser ◽  
Joel M. Ramjist ◽  
Neil Shear ◽  
Raed Alhusayen
Keyword(s):  
T Cell ◽  
High Frequency ◽  
Early Stage ◽  
Skin Lesions ◽  
Diagnostic Tools ◽  
Skin Thickness ◽  
High Frequency Ultrasound ◽  
T Cell Lymphomas ◽  
Standardized Parameters ◽  
Frequency Ultrasound

The diagnosis of cutaneous T-cell lymphomas (CTCL) is frequently delayed by a median of three years and requires the clinical evaluation of an experienced dermatologist and a confirmatory skin biopsy. Dermoscopy and high-frequency ultrasound (HFUS) represent two non-invasive diagnostic tools. While dermoscopy is inexpensive and widely used for the diagnosis of melanoma and non-melanoma skin cancers, HFUS of skin lymphomas represents a novel diagnostic approach that is not yet implemented in the routine dermatologic practice. The aim of our study was to prospectively assess skin lesions of patients with either CTCL patches or plaques with dermoscopy and HFUS and to compare the findings with atopic dermatitis (AD) and psoriasis. Thirteen patients with an established diagnosis of CTCL, psoriasis, or AD were studied: Dermoscopy features including spermatozoa-like structures and the presence of white scales could assist in differentiating between early-stage CTCL and AD. HFUS measurements of the skin thickness indicated increased epidermal-, thickness in CTCL, and psoriasis compared with AD. Our results support the use of dermoscopy as a useful tool to diagnose CTCL. HFUS could augment the dermatologic assessment, but further studies will be needed to define standardized parameters.

scholarly journals Neuropsychiatric, cognitive and sexual impairment in mastocytosis patients

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Fatma Jendoubi ◽  
Maella Severino-Freire ◽  
Mathilde Negretto ◽  
Christophe Arbus ◽  
Carle Paul ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Rating Scale ◽  
Negative Impact ◽  
Diagnostic Delay ◽  
Professional Lives ◽  
Cutaneous Lesions ◽  
Kit Mutation ◽  
Sexual Symptoms ◽  
Organ Systems ◽  
The Impact

Abstract Background Mastocytosis is a rare disease characterised by the accumulation and/or proliferation of abnormal mast cells (MCs) in one or several organs. It may present with a number of different symptoms that involve various organ systems. The current study aims to assess the prevalence of MC mediator-related symptoms in a cohort of mastocytosis patients with a specific focus on neurological, psychiatric, cognitive and sexual symptoms. We also assessed the impact of the disease on patients’ professional lives. Patients were administered a validated multidimensional questionnaire to collect information on patients’ perception of the severity of their symptoms. From the questionnaires we extracted the neurological, cognitive, psychiatric and sexual symptoms and the impact of the disease on patients’ professional lives as well as their grading. The affective status was assessed using the 17-item version of the Hamilton Depression Rating Scale. Results We included 139 patients. Mastocytosis was classified as systemic in 113 patients and cutaneous in 26 patients. The prevalence of MC mediator-related systemic symptoms was as follows: cutaneous (71%), gastro-intestinal (48%), cardio-vascular (36%), musculoskeletal (26.6%), fatigue (24%), urinary (14.4%) and respiratory (10%). Headaches and vertigo were noted in respectively 55% and 32% of patients. Irritability, episodes of memory loss and difficulty concentrating were reported in 54%, 52% and 40% of cases, respectively. Sexual impairment was noted in 24% of patients. No associations were found between neuropsychiatric/cognitive impairment and age, gender, diagnostic delay, disease form, the presence of cutaneous lesions, the level of serum and bone marrow tryptase and the presence of KIT mutation in bone marrow and/or skin. Depression was noted in 49% of patients. One in four patients reported a negative impact of the disease on their professional lives. Conclusion This current study provides some insights regarding symptoms related to mastocytosis and their impact on patients’ professional lives.

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