1/26. hypersensitivity syndrome caused by amitriptyline administration.Adverse cutaneous manifestations are among the most common side effects associated with psychotropic drugs. skin reactions due to amitriptyline (a tricyclic antidepressant agent) include rashes and hypersensitivity reactions (for example, urticaria and photosensitivity) as well as hyperpigmentation. hypersensitivity syndrome is a specific severe idiosyncratic reaction causing skin, liver, joint, and haematological abnormalities, which usually resolve after the discontinuation of the implicated drug. A case of a 24 year old woman who experienced hypersensitivity syndrome three weeks after the initiation of amitriptyline is reported.- - - - - - - - - - ranking = 1keywords = hyperpigmentation (Clic here for more details about this article) |
2/26. Fixed drug eruptions to human immunodeficiency virus-1 protease inhibitor.Despite numerous drug interactions that occur with human immunodeficiency virus-1 protease inhibitors, there are relatively few drug reactions. We present two patients receiving saquinavir who developed fixed drug reactions. Both reactions cleared while patients received a therapeutic dose of the medication, and in one patient a flare was seen when the patient later stopped and then restarted the medication. Although fixed drug reactions are relatively inconsequential, it is important to know that these eruptions may clear when the patient is given uninterrupted therapy of a human immunodeficiency virus-1 protease inhibitor, with only post-inflammatory hyperpigmentation.- - - - - - - - - - ranking = 1keywords = hyperpigmentation (Clic here for more details about this article) |
3/26. Persistent serpentine supravenous hyperpigmented eruption as an adverse reaction to chemotherapy combining actinomycin and vincristine.A 15-year-old boy experienced a macular serpentine erythematous eruption that subsided with a persistent hyperpigmentation overlying the superficial venous network of the left forearm. This reaction occurred at the injection site of a chemotherapy regimen that combined actinomycin and vincristine a few hours after the first course. After a single injection of actinomycin in the right arm, a similar reaction occurred, implicating it as the responsible agent. A skin biopsy specimen demonstrated a cell-poor interface tissue reaction associated with an eccrine neutrophilic hidradenitis. To our knowledge, this is the first case of persistent supravenous serpentine hyperpigmented eruption reported in a child treated with this particular drug combination.- - - - - - - - - - ranking = 1keywords = hyperpigmentation (Clic here for more details about this article) |
4/26. diltiazem-associated photodistributed hyperpigmentation: a review of 4 cases.BACKGROUND: diltiazem hydrochloride is a widely used calcium channel blocking agent. While a few cases of diltiazem-associated photosensitivity have been reported, no cases of photodistributed hyperpigmentation are known. observation: Four cases of photodistributed hyperpigmentation associated with the long-acting formulation of diltiazem hydrochloride (Cardizem CD) are presented. All patients were African American women, with a mean age of 62 years. The mean duration of diltiazem administration prior to the development of hyperpigmentation was 8 months. The hyperpigmentation was slate-gray and reticulated. Phototesting during diltiazem therapy revealed a decreased minimal erythema dose to UV-A in 1 patient. Histopathologic examination showed lichenoid dermatitis with prominent pigmentary incontinence. Electron microscopic examination of the tissue revealed multiple melanosome complexes. Discontinuation of diltiazem therapy resulted in the gradual resolution of the hyperpigmentation. CONCLUSIONS: Long-term administration of diltiazem may be associated with characteristic reticulated, slate-gray hyperpigmentation on sun-exposed areas. Discontinuation of the therapy results in resolution of the eruption.- - - - - - - - - - ranking = 10keywords = hyperpigmentation (Clic here for more details about this article) |
5/26. Periungal hyperpigmentation induced by cisplatin.A number of anticancer drugs are known to produce pigmentary changes affecting the skin or nails. Among them, cisplatin (cis-diamminedichloroplatinum)-induced hyperpigmentation has been described previously in only two cases. We describe an unusual case with hyperpigmentation confined to periungal areas of the hands and feet after treatment with cisplatin.- - - - - - - - - - ranking = 6keywords = hyperpigmentation (Clic here for more details about this article) |
6/26. Peculiar unilateral fixed drug eruption of the breast.BACKGROUND: Fixed drug eruption (FDE) is a common cutaneous disorder which develops within hours of taking the offending drug and recurs at the same site with subsequent exposure to the same drug. Non-steroidal anti-inflammatory drugs (NSAIDs) are common offending drugs. methods: A 14-year-old girl initially presented with a 1-year history of a recurrent reddish-brown plaque around her right areola. The lesion became pruritic and raised during menses, and subsided during the remainder of her menstrual cycle with the exception of persistent residual hyperpigmentation. The patient had a pattern of naproxen use during menses for dysmenorrhea. RESULTS: The skin biopsy specimen revealed focal bullae formation and scattered necrotic keratinocytes in epidermis, hydropic degeneration of the basal cell layer, pigmentary incontinence and a perivascular infiltrate composed of lymphocytes and eosinophils. These changes confirmed the diagnosis of fixed drug eruption. CONCLUSION: Fixed drug eruption to nonsteroidal anti-inflammatory drugs is common. However, FDE due to naproxen, one of the NSAIDs, is rarely reported. We describe an unusual case of FDE, which recurred at each menses.- - - - - - - - - - ranking = 1keywords = hyperpigmentation (Clic here for more details about this article) |
7/26. Multiple eruptive dermatofibromas in patients with systemic lupus erythematosus treated with prednisone.Solitary dermatofibromas are a common occurrence, especially on the lower limbs of young women, while multiple dermatofibromas (MDF) are rare, accounting for less than 0.3% of all dermatofibromas and may suddenly develop in immunosuppressed patients. We report a patient with systemic lupus erythematosus (SLE) who developed MDF while she was taking oral prednisone. A 46-year-old woman presented in 1989 complaining of photosensitivity, arthralgias, fatigue, malaise and dyspepsia. The patient denied fever, Raynaud's phenomenon, oral ulcer and hair loss. On examination she presented a typical SLE malar rash. Erythrocyte sedimentation rate (ESR) was elevated (54 mm/h). Speckle patterned IgG/IgM antinuclear antibodies were present at 1/1280 titer. antibodies anti Ro/SSA were detected by counterimmunelectrophoresis up to 1/8 titer. Other laboratory findings were negative or within normal limits. Systemic lupus erythematosus was diagnosed and the patient given 50 mg/day prednisone. After a few months, both clinical symptoms and immunologic parameters improved. Eighteen months later, prednisone was replaced by 500 mg/day hydroxychloroquine. In 1994, she presented again with malar rash, arthralgias and facial hyperpigmentation. prednisone 15 mg/day was reintroduced and hydroxychloroquine stopped being a possible cause of the facial hyperpigmented macules. In 1996, while she was taking 5 mg/day prednisone, several nodules developed on her limbs within a few months. On examination we observed 16 firm, slightly elevated 3-15-mm wide brown nodules on her arms, legs and trunk. A biopsy specimen of a lesion of the trunk revealed an epidermal seborrheic-keratosis-like hyperplasia with dermal fibrosis and fibroblastic proliferation (Fig. 1). Dermatofibroma was diagnosed.- - - - - - - - - - ranking = 1keywords = hyperpigmentation (Clic here for more details about this article) |
8/26. hydroxyurea-induced dermatomyositis-like eruption.hydroxyurea is a cytotoxic chemotherapeutic agent used for myelodysplasia. The adverse cutaneous effects due to hydroxyurea include leg ulcers, hyperpigmentation of the skin and nails, a lichen planus-like eruption, lupus erythematosus, and a dermatomyositis-like eruption. We present a case of hydroxyurea-induced dermatomyositis-like eruption and review the features of this entity as previously reported.- - - - - - - - - - ranking = 1keywords = hyperpigmentation (Clic here for more details about this article) |
9/26. hyperpigmentation during interferon-alpha therapy for chronic hepatitis c virus infection.Many types of skin disorders concomitantly occur with hepatitis c virus infection. These skin lesions may be induced or worsened during antiviral therapy with interferon-alpha (IFN). To our knowledge, hyperpigmentation of the skin--and especially of the tongue--has not been reported so far. We describe two dark-skinned patients who developed hyperpigmented skin and tongue lesions during combination therapy with IFN and ribavirin. Immunohistochemical analysis of tongue biopsies confirmed the suspicion of melanin deposits in these areas of hyperpigmentation. We hypothesize that during interferon therapy, melanocytes may produce more melanin pigment in the presence of alpha-melanocyte stimulating hormone and sufficient amounts of tyrosine, leading to melanin deposits and clinical hyperpigmentation.- - - - - - - - - - ranking = 3keywords = hyperpigmentation (Clic here for more details about this article) |
10/26. Morbilliform drug reaction with histologic features of pustular dermatosis associated with bryostatin-1.Bryostatin-1 is a new chemotherapeutic agent that inhibits protein kinase c. The most common side effect and the dose limiting toxicity is myalgia. The cutaneous side effects reported during the phase I and II trials were alopecia, mucositis, nonspecific "rash," "bronzing," and hyperpigmentation in sun exposed areas. No specific acute drug eruptions have been reported. We present the first reported case of a morbilliform drug eruption with histologic features of intraepidermal and subcorneal spongiotic pustules containing eosinophils secondary to bryostatin-1.- - - - - - - - - - ranking = 1keywords = hyperpigmentation (Clic here for more details about this article) |
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