Etanercept-induced Wegener granulomatosis in a patient with rheumatoid arthritis.

A very rare case of etanercept-induced Wegener's granulomatosis in a patient with long-standing rheumatoid arthritis is reported. A thorough critical analysis on Wegener's granulomatosis pathogenetic mechanisms is done. The peculiarities of etanercept pharmacodynamic features are also presented together with some suggestions of possible induction pathways.

Therapeutic Hotline: Cysteinyl leukotriene receptor antagonist montelukast in the treatment of atopic dermatitis.

Leukotrienes are potent proinflammatory mediators derived from arachidonic acid through the 5-lipoxygenase pathway. Experimental data suggest a role for cysteinyl leukotrienes in the pathogenesis of atopy giving a rationale for its use in asthma, allergic rhinitis, and chronic urticaria management. A few clinical observations and small trials suggest that montelukast may be used in an adjunctive manner as an effective therapeutic option for all age categories affected by moderate-to-severe atopic dermatitis.

Lower lip squamous cell carcinoma in disabling pansclerotic morphea of childhood.

Disabling pansclerotic morphea of childhood (DPMC) is an aggressive form of cutaneous scleroderma that involves all layers of the skin, extending through the dermis and subcutaneous tissues to involve muscle, tendon, and even bone. As DPMC is extremely rare, its association with skin squamous cell carcinoma (SCC) is rarer still. To our knowledge there are only two cases of SCC in patients with DPMC that developed within areas of chronic skin ulceration.

Vesicular mycosis fungoides.

A 62 years old patient presented with rapidly progressive mycosis fungoides. Lesions of the face, head, trunk and limbs exhibited numerous vesicles and erosions. Histopathology showed marked spongiosis and intraepidermal blisters, as well as invasion of the epidermis by atypical lymphocytes, which was confirmed by immunohistochemistry.