A 59-year-old male presented with 1 month of progressive dyspnea, 30-lb weight loss, and skin changes on the digits of the hands. In the 4 weeks prior to admission, he was admitted and treated twice for pneumonia at another hospital and received intravenous (IV) vancomycin, ceftriaxone, and azithromycin for a total of 10 days. After admission, he underwent computed tomography imaging of chest, which revealed findings suggestive of interstitial lung disease but given the fact that infection was not ruled out, empiric antibiotics were initiated. The skin lesions on the fingers were felt to be consistent with Gottron's papules, and his overall constellation of findings were felt to be consistent with dermatomyositis (DM). Over the following 3 days, he developed diffuse, violaceous skin lesions, elevation of liver transaminases, and severe thrombocytopenia. The skin lesions progressed to epidermal necrosis. He developed erosions of the oral mucosa and scrotum. Before skin biopsy results were finalized, IV immunoglobulin and IV dexamethasone were started empirically for suspected DM and immune-mediated thrombocytopenia. His laboratory abnormalities normalized within a week. Biopsy results of the skin were consistent with Stevens-Johnson syndrome (SJS). Autoantibody test for anti-MDA5 were positive, confirming a diagnosis of anti-MDA5 associated DM. Subsequent development of SJS was likely due to antibiotic exposure in the preceding month. Simultaneous development of anti-MDA5 DM and SJS raises the question of a link between the 2 conditions. To our knowledge, this is the first reported association of these 2 conditions reported in the literature.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7350393PMC
http://dx.doi.org/10.1177/2324709620940496DOI Listing

Publication Analysis

Top Keywords

skin lesions
16
felt consistent
8
skin
7
anti-mda-5 dermatomyositis
4
dermatomyositis development
4
development drug-mediated
4
drug-mediated necrolytic
4
necrolytic skin
4
lesions
4
lesions 59-year-old
4

Similar Publications

After the global impact of the COVID-19 pandemic, concerns over virus transmission have risen. A state of health emergency was declared in 2022 due to Clade 2 of the monkeypox (MPOX) virus. In August 2024, another emergency was declared by the World Health Organization (WHO) because of the widespread Clade 1b, which caused a more severe and lethal disease.

View Article and Find Full Text PDF

Phyllodes tumor is a type of fibroepithelial neoplasm involving the breast. This tumor is rarely reported in adolescents and the elderly and has a peak incidence in middle-aged women. Histologically, phyllodes tumors are classified as benign, borderline, or malignant.

View Article and Find Full Text PDF

Membranoproliferative glomerulonephritis (MPGN) has previously been used as an umbrella term to describe a spectrum of hypocomplementemic glomerular diseases, which are rare causes of end stage kidney disease (ESKD). We present a 22-year-old man with a well-established medical history who had been complaining of 4 days of frothy dark urine, bilateral lower limb swelling, and puffiness on his face. For a month before his presentation, he had many bilateral skin lesions on his lower limbs that were leaking pus.

View Article and Find Full Text PDF

To determine the frequency of confirmed Lyme neuroborreliosis (LNB) cases in adult patients with three different clinical presentations consistent with early LNB. Data were obtained through routine health care at the UMC Ljubljana, Slovenia from 2005-2022, using clinical pathways. The patients were classified into three groups: i) radicular pain of new onset (N = 332); or ii) involvement of cranial nerve(s) but without radicular pain (N = 997); or iii) erythema migrans (EM) skin lesion(s) in conjunction with symptoms suggestive of nervous system involvement but without either cranial nerve palsy or radicular pain (N = 240).

View Article and Find Full Text PDF

While the genetic paradigm of cancer etiology has proven powerful, it remains incomplete as evidenced by the widening spectrum of non-cancer cell-autonomous "hallmarks" of cancer. Studies have demonstrated the commonplace presence of high oncogenic mutational burdens in homeostatically-stable epithelia. Hence, the presence of driver mutations alone does not result in cancer.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!