Acute development of multiple keratoacanthomas and squamous cell carcinomas after treatment with infliximab.

Infliximab, a chimeric mouse-human monoclonal antibody, blocks the action of tumor necrosis factor-alpha and is a highly effective treatment for several inflammatory disorders, including inflammatory bowel disease and rheumatoid arthritis. Although safety data are encouraging, immunosuppressive sequelae may result. We report the acute development of multiple squamous cell carcinomas and keratoacanthomas in a patient receiving infliximab for rheumatoid arthritis.

Endoscopic retrograde cholangiopancreatography findings of a gallbladder filling defect caused by sludge.

Ultrasound of the abdomen has described intraluminal gallbladder masses or stones without acoustic shadowing which have been termed "sludge balls." This finding has not been previously reported via its x-ray appearance at endoscopic retrograde cholangiopancreatography. This case reports this finding at endoscopic retrograde cholangiopancreatography and emphasizes that it is in the spectrum between suprasaturated bile and choledocholithiasis.