Browsing by Author "Coelho, S"
Now showing 1 - 6 of 6
Results Per Page
Sort Options
- Epicutaneous patch testing in drug hypersensitivity syndrome (DRESS)Publication . Santiago, F; Gonçalo, Margarida; Vieira, R; Coelho, S; Figueiredo, ABACKGROUND: In some patterns of cutaneous adverse drug reactions, and depending on the culprit drug, patch testing has been helpful in confirming its cause. Its value in Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) has not been established in a large cohort of patients. OBJECTIVE: The aim of the present study is to evaluate the safety and usefulness of patch testing in DRESS. PATIENTS/METHODS: Between January 1998 and December 2008, we studied 56 patients with DRESS induced by antiepileptic agents in 33 patients (59%), allopurinol in 19 (34%) and sulfasalazine, cotrimoxazole, tenoxicam, and amoxicillin in 1 patient each (7%). RESULTS: A positive patch test reaction was observed in 18 patients (32.1%), of which 17 were with antiepileptics and 1 with tenoxicam. In the antiepileptic group, carbamazepine alone was responsible for 13 of 17 positive reactions (76.5%). Patch tests with allopurinol and its metabolite were negative in all cases attributed to this drug. CONCLUSIONS: In this study, patch testing was a safe and useful method in confirming the culprit drug in DRESS induced by antiepileptic drugs, whereas it had no value in DRESS induced by allopurinol. The pathogenesis of DRESS is not yet entirely clarified, but positive patch tests suggest a drug-dependent delayed hypersensitivity mechanism.
- Paraneoplastic pemphigus with clinical features of lichen planus associated with low-grade B cell lymphomaPublication . Coelho, S; Reis, JP; Tellechea, O; Figueiredo, A; Black, MBACKGROUND: Neoplasia-induced lichen planus is described as a cell-mediated reaction to unknown epithelial antigens. Paraneoplastic pemphigus (PNP), characterized by the presence of a specific array of autoantibodies, probably represents a different form of presentation of the same autoimmune syndrome where the mucocutaneous expression depends on the dominant pathologic mechanism. METHODS: The authors report a case of PNP with predominant lichen planus-like lesions and review the relevant literature. We observed a 74-year-old female with vesico-bullous, erosive, target-shaped and flat papular lichenoid lesions on the lower legs, palms and soles, evolving for 3 weeks. Histopathology revealed a lichenoid dermatitis. Direct immunofluorescence showed C3 deposition around keratinocytes and epidermal IgG intranuclear deposition. Indirect immunofluorescence revealed circulating IgG with intercellular staining on rat bladder substrate. Immunoblotting demonstrated bands of 130, 190, 210 and 250 kDa antigens. A pararenal B cell lymphoma was found. RESULTS: Oral corticotherapy with 40 mg prednisolone daily was initiated with a good cutaneous response. Four months later, cyclophosphamide (50 mg/day) was introduced because of a discrete enlargement of the pararenal mass. The patient died on the seventh month of follow up as a result of respiratory insufficiency. CONCLUSION: PNP has different forms of presentation and the lack of a consensus about diagnostic criteria may contribute to underdiagnosed cases. Advances on the knowledge of the sensitivity and specificity of diagnostic criteria have allowed a better accuracy of diagnosis.
- Pioderma Gangrenoso da parede abdominal após cesarianaPublication . Cardoso, JC; Coelho, S; Gonçalo, Margarida; Oliveira, H; Brites, MM; Figueiredo, A
- Síndroma de Sweet associado a doença mieloproliferativaPublication . Coelho, S; Gonçalo, Margarida; Cortesão, E; Leitão, S; Figueiredo, A
- Síndrome de Schnitzler: descrição de 7 casos clínicos e revisão da literaturaPublication . Cravo, M; Gonçalo, Margarida; Vieira, R; Brites, MM; Coelho, S; Figueiredo, A
- Vancomycin-associated linear IgA bullous dermatosis mimicking toxic epidermal necrolysis.Publication . Coelho, S; Tellechea, O; Reis, JP; Mariano, A; Figueiredo, A