scholarly journals Serpentine supravenous hyperpigmentation – A rare cutaneous manifestation in non-neoplastic conditions

2019 ◽  
Vol 1 ◽  
pp. 97-100
Author(s):  
Divya Somasekharan ◽  
Beena Narayanan
Keyword(s):  
Chemotherapeutic Agents ◽  
Cutaneous Manifestation ◽  
Morphological Pattern ◽  
History Of

Serpentine erythematous or hyperpigmented streaks along with the superficial venous network usually occur as a distinctive eruption after infusion of several chemotherapeutic agents. This morphological pattern has been described under various terms such as “persistent supravenous erythematous eruption,” “persistent serpentine supravenous hyperpigmented eruption,” or “persistent serpentine supravenous hyperpigmentation (SSH). We describe four patients with no history of malignancy or treatment for malignancy who developed SSH.

scholarly journals Chronic inflammatory demyelinating polyradiculoneuropathy induced by paclitaxel

2021 ◽  
Author(s):  
Isabella Sabião Borges ◽  
João Victor Aguiar Moreira ◽  
Eustaquio Costa Damasceno Junior ◽  
Alencar Pereira dos Santos ◽  
Gabriela Tomás Alves ◽  
...  
Keyword(s):  
Peripheral Neuropathy ◽  
Glial Cells ◽  
Conduction Block ◽  
Chemotherapeutic Agents ◽  
Chronic Inflammatory Demyelinating Polyradiculoneuropathy ◽  
Microtubule Stabilization ◽  
Progressive Muscle Weakness ◽  
History Of ◽  
Secondary Demyelination ◽  
Distal Axonal Degeneration

Background: Peripheral neuropathies in cancer are most often due to neurotoxic chemotherapeutic agents. Approximately 30% of patients receiving neurotoxic chemotherapy (CTX) will suffer from chemotherapy-induced peripheral neuropathy (CIPN). Paclitaxel is an extremely effective chemotherapeutic agent for the treatment of breast, ovarian, and lung cancer. However, paclitaxel-induced peripheral neuropathy occurs in 59-87% of patients who receive this drug. Paclitaxel is an anti-tubulin drug that causes microtubule stabilization, resulting in distal axonal degeneration, secondary demyelination and nerve fiber loss. Case: We present a case of a 68-year-old female patient with history of breast cancer who presented sensorial ataxia and progressive muscle weakness two months after starting CTX with paclitaxel. The physical examination showed tetraparesis with proximal predominance, areflexia, severe hypopalesthesia and postural instability. Electroneuromyography showed the existence of asymmetric demyelinating polyradiculoneuropathy, with conduction block and temporal dispersion in practically all evaluated nerves. The cerebrospinal fluid confirmed the albumin-cytological dissociation. Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) was confirmed and patient underwent monthly treatment with methylprednisolone with good response. Discussion: Evidences has implicated neuroinflammation in the development of PIPN. While most CTX drugs do not cross the blood-brain-barrier, they readily penetrate the blood-nerve-barrier and bind to and accumulate in dorsal root ganglia and peripheral axons. CTX can induce neuroinflammation through activation of immune and immune- like glial cells. In fact, immune cells (e.g., macrophages, lymphocytes) and glial cells (e.g., Schwann cells) in the peripheral nervous system play important role in the induction and maintenance of neuropathy. Conclusion: CIDP should be included in the spectrum of CIPN.

Pilot study of Scrambler therapy for the treatment of chemotherapy-induced peripheral neuropathy.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 9075-9075 ◽  
Author(s):  
Deirdre R. Pachman ◽  
Breanna M. Linquist ◽  
Debra L. Barton ◽  
Kelliann C. Fee-Schroeder ◽  
Thomas J. Smith ◽  
...  
Keyword(s):  
Peripheral Neuropathy ◽  
Pilot Trial ◽  
Chemotherapeutic Agents ◽  
Controlled Clinical Trial ◽  
Effective Interventions ◽  
Days Of Therapy ◽  
Patient Reported ◽  
History Of ◽  
Scrambler Therapy ◽  
Ecog Ps

9075 Background: Chemotherapy-induced peripheral neuropathy (CIPN), a common dose-limiting side effect of chemotherapy, remains without known effective interventions. Preliminary data support that Scrambler therapy, a device which treats pain via non-invasive cutaneous electrostimulation, is beneficial for the treatment of CIPN. This pilot trial was performed to investigate the effect of Scrambler therapy for the treatment of CIPN. Methods: Eligible patients included those age ≥18 years, ECOG PS ≤2, life expectancy ≥3 months, with pain or CIPN symptoms of ≥1 month duration and tingling or pain ≥4/10 during the prior week. Patients were treated with Scrambler therapy to the affected area for up to 10 daily 30 minute sessions. Symptoms were monitored daily during therapy using a questionnaire to measure symptoms of neuropathy with a numerical analogue scale. Results: We report on the first 11 CIPN patients, enrolled between 7/18/2011 and 12/12/2011, 3 men and 8 women; mean age 57 years. Patients had history of exposure to various chemotherapeutic agents and the majority had symptoms >2 years. The table portrays data at baseline, at the end of the 10 planned days of therapy, and the percent changes from baseline to the end of treatment, regarding patient reported pain, tingling, and numbness over the preceding 24 hours. There were no adverse events. Persistent benefit out to 5 weeks was seen in some patients; maturing data will be available by May 2012. Descriptive summary statistics formed the basis of data analysis. Further patients are being entered on this trial. Conclusions: Scrambler therapy appears to be beneficial in the treatment of CIPN. A prospective placebo-controlled clinical trial should be performed to confirm these preliminary findings. [Table: see text]

Palliation of ulcerative breast lesions with radiation.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 199-199
Author(s):  
Prashant Vempati ◽  
Miriam Knoll ◽  
Kavita Vyas Dharmarajan ◽  
Sheryl Green ◽  
Amy Tiersten ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Lesion ◽  
Radiation Treatment ◽  
Academic Medical Center ◽  
Previous History ◽  
Chemotherapeutic Agents ◽  
Breast Lesions ◽  
Median Dose ◽  
History Of ◽  
The Mean

199 Background: Patients with advanced breast cancer may experience ulcerative breast lesions. Breast cancer with ulcerative lesions has been shown to severely affect a patient’s quality of life (QoL). The role of palliative radiation therapy (RT) in the management of ulcerative breast lesions needs to be further explored. Methods: IRB-approval was obtained to retrospectively review the radiation treatment records for all patients who underwent palliative RT for breast cancer at our urban academic medical center. A total of 13 patients were identified, and we herein report their demographics, treatment characteristics, and clinical outcomes. Results: The mean age of the patients receiving palliative RT for ulcerative breast cancer was 64 years. All patients had stage IV disease when they were evaluated for RT. All patients received prior systemic chemotherapy with a mean of four chemotherapeutic agents, the most common of which was Capecitabine. The mean radiation dose received for palliative RT was 27.54 Gy in 11 fractions with a median dose of 30 Gy in 15 fractions. Six (46%) of the patients received prior RT to the same breast, with a median dose of 59.5 Gy in 31 fractions. Among these six patients, the average interval between initial RT and ulcerative breast lesion was 69.5 months. The median overall survival in all patients since ulcerative breast lesion was 5 months and the mean survival did not differ between patients with previous history of RT and RT-naïve patients (4.50 vs. 4.57; p = 0.95). Six out of the 9 (69%) patients who received ≥ 30 Gy reported clinical improvement, whereas none of the 4 patients who received < 30 Gy reported any benefit. There were no radiation-associated toxicities reported by patients. Conclusions: These data suggest that palliative RT ( ≥ 30 Gy) is an efficacious treatment for ulcerative breast cancer with minimal toxicity. Prior RT should not be a contraindication as patients with previous history of RT have similar outcomes compared to RT-naïve patients.

Drug Resistance in Bacteria: History, Genetics and Biochemistry

1993 ◽  
Vol 21 (1) ◽  
pp. 1-14 ◽  
Author(s):  
S Mitsuhashi
Keyword(s):  
Drug Resistance ◽  
Antimicrobial Chemotherapy ◽  
Therapeutic Agents ◽  
Chemotherapeutic Agents ◽  
Protective Effects ◽  
The Future ◽  
History Of ◽  
Modern Era

The significance of the discovery of prontosil in 1932 as the initiating step in the development of the modern era of antimicrobial chemotherapy is reviewed. The history of the discovery and the development of chemotherapeutic agents, from penicillin in 1929 to present-day antibiotics, are summarized. The various mechanisms by which bacteria are able to overcome the protective effects of these therapeutic agents (from the sulphonamides to the new fluoroquinolones) and develop resistance to them are discussed in detail. Attempts to elucidate the mechanisms by which resistance to chemotherapeutic agents develops are vital to the future of antimicrobial chemotherapy.

scholarly journals Clinical profile of Tinea pseudoimbricata: an observational study from a tertiary care institution in western Maharashtra, India

2020 ◽  
Vol 6 (3) ◽  
pp. 295
Author(s):  
Ajay Kumar ◽  
Kalyani Milind Deshmukh ◽  
M. S. Deora ◽  
Shrea Kapoor ◽  
Shreya R. Deoghare
Keyword(s):  
Tertiary Care ◽  
Topical Steroid ◽  
Case Series ◽  
Clinical Profile ◽  
Fungal Treatment ◽  
Morphological Pattern ◽  
Steroid Abuse ◽  
Inappropriate Use ◽  
History Of ◽  
Anti Fungal

<p class="abstract"><strong>Background:</strong> Topical steroid-modified tinea corporis and tinea cruris is on the rise due to the ease of availability of over-the-counter potent topical corticosteroid preparations and their inappropriate use, alters the true morphology of lesion. As there is paucity of literature about increasing prevalence and varied presentation of this condition, we aimed to study the clinical profile and dermoscopic features of <em>Tinea pseudoimbricata</em> due to topical steroid abuse. We present a case-series of 77 cases of a distinct morphological pattern with central erythematous, scaly, pruritic concentrically spreading plaques with raised and scaly borders known as <em>Tinea pseudoimbricata</em>.</p><p class="abstract"><strong>Methods:</strong> We evaluated 77 clinically diagnosed patients of <em>Tinea pseudoimbricata</em> with positive 10% potassium hydroxide examination and culture. Dermoscopy was performed in all patients. The demographic, clinical, and mycological features of each patient were recorded on a predesigned proforma.<strong></strong></p><p class="abstract"><strong>Results:</strong> There were 52 male and 25 female patients with a mean age of 28.66 and a mean disease duration of 7.6 months. There was a history of application of potent or super-potent topical steroid for varying durations. Culture isolates were <em>Trichophyton rubrum</em> species. Dermoscopic analysis showed features of steroid abuse.</p><p class="abstract"><strong>Conclusions:</strong> Injudicious and inappropriate use of topical steroid causes <em>Tinea pseudoimbricata</em>; a special subset of tinea incognito, which is very common now a days. This should alert the dermatologist about the steroid abuse and requires systemic anti-fungal treatment for prolong time.</p>

Clostridioides difficile-induced diarrhoea following dasatinib therapy

2021 ◽  
Vol 14 (1) ◽  
pp. e239394
Author(s):  
Amlan Kusum Datta ◽  
Partha Debnath ◽  
Uddalak Chakraborty ◽  
Atanu Chandra
Keyword(s):  
Abdominal Pain ◽  
Kinase Inhibitor ◽  
Antibiotic Use ◽  
Chemotherapeutic Agents ◽  
Fluid Retention ◽  
Uneventful Recovery ◽  
Clostridioides Difficile ◽  
History Of ◽  
Etiological Agents ◽  
Oral Metronidazole

Dasatinib, an oral tyrosine kinase inhibitor, is approved for therapy of chronic myeloid leukaemia (CML). Common adverse effects of this therapy include myelosuppression, fluid retention and diarrhoea. However, Clostridioides difficile infections (CDIs) in the context of dasatinib therapy, without a history of antecedent antibiotic use, has not been reported previously. We present here a case of a 36-year-old man diagnosed with accelerated phase of CML, who was started on treatment with dasatinib. Two months into therapy, he experienced profuse diarrhoea and abdominal pain. Colonoscopy revealed multiple confluent colonic mucosal ulcerations. Immunoassay study of stool revealed positive C. difficile toxin. The patient was started on oral metronidazole, with discontinuation of all other drugs, including dasatinib. He made a complete uneventful recovery following 2 weeks of antibiotic therapy. Chemotherapeutic agents, such as dasatinib, should be considered as possible etiological agents in the pathogenesis of CDI, even in absence of antibiotic use.

Variable clinical response of hypereosinophilic syndromes (HES) to current therapeutic options

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 16527-16527
Author(s):  
S. Mitra ◽  
P. T. Murphy ◽  
J. R. O’Donnell
Keyword(s):  
Clinical Response ◽  
Interferon Alpha ◽  
Eosinophil Count ◽  
Hypereosinophilic Syndrome ◽  
Case Series ◽  
Chemotherapeutic Agents ◽  
Therapeutic Options ◽  
Treatment Modalities ◽  
High Dose ◽  
History Of

16527 The term Hypereosinophilic syndrome (HES) refers to a heterogeneous group of disorders characterised by marked blood (>1500/cu mm) and tissue eosinophilia resulting in end organ damage.Several visceral complications like cardiomyopathies and cerebrovascular accidents are common. Treatment of HES includes corticosteroids,chemotherapeutic agents (hydroxyurea, cyclophosphamide, vincristine), interferon-alpha. Newer treatment modalities,including tyrosine kinase inhibitors (eg Imatinib) and monoclonal anti IL5 antibodies are now available. We report a case series of patients with HES which demonstrate the variable clinical response to above therapeutic options. Case 1: A 43 year old man who presented with a right lacunar infarct had a eosinophil count of 1200/cu mm. No cause was found. He also had Mitral valve endocarditis. Following initial treatment with Methylprednisolone, the eosinophil count came down to 3500/cu mm, but the eosinophilia persisted. He was given a trial of Imatinib. In 2 months time his eosinophilia resolved. However, he was negative for FILIPI-PDGFRa. Case 2: A 37 year old lady with history of Splenectomy (due to trauma) presented with a eosinophil count of 2660/cu mm. Result of the FILIPI-PDGFRa was equivocal. There was no response to Imatinib. A trial of Prednisolone (1 mg/Kg) was ineffective. She did not respond to Interferon-alpha. However when given a combination of Prednisolone (0.5 mg/kg) and Interferon-alfa, her counts were normal in a month. Case 3: A 63 year old man with history of Atrial Fibrillation had persistent eosinophilia (>1500/cu mm). His serum Tryptase was raised but he was negative for FILIPI-PDGFRa. A trial of Imatinib failed He responded partially to high dose of Hydroxyurea. Prednisolone, Interferon-alpha or a combination of both are future options for him. Case 4: A 80 year old man with background history of Alzheimer’s Disease was found to have persistent unexplained eosinophilia. He had no complains of joint symptoms but his ANF was positive in low titres. A bone marrow showed no evidence of lymphoma or a myeloproliferative disorder. Karyotype was normal. He was given a trial of Hydroxyurea to which he responded in two weeks. Thus, response of HES patients to treatment is variable often unpredictable. No significant financial relationships to disclose.

scholarly journals Combined Administration of Bisphosphonates, Chemotherapeutic Agents, and/or Targeted Drugs Increases the Risk for Stage 3 Medication-Related Osteonecrosis of the Jaw: A 4-Year Retrospective Study

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Yuqiong Zhou ◽  
Yejia Yu ◽  
Yueqi Shi ◽  
Mengyu Li ◽  
Chi Yang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Immunosuppressive Agents ◽  
Osteonecrosis Of The Jaw ◽  
Chemotherapeutic Agents ◽  
Targeted Drugs ◽  
Advanced Stage ◽  
Medication History ◽  
History Of ◽  
Serological Biomarkers

Objectives. Patients with stage 3 medication-related osteonecrosis of the jaw (MRONJ) suffer from severe complications. Chemotherapeutic agents and targeted drugs are considered to be associated with the development of MRONJ. However, little is known regarding the association of those agents with stage 3 MRONJ. The purpose of this study is to analyze the comprehensive medication history of patients with advanced-stage MRONJ (stage 2 and stage 3) and evaluate the possible risk factors for stage 3 MRONJ. Patients and Methods. Sixty patients with advanced-stage MRONJ were involved in this retrospective study. Patients with developmental maxillofacial anomalies, previous radiation in the head and neck areas, and jaw bone tumors were excluded from the study. All patients were divided into two groups by their MRONJ stage (stage 2 or stage 3). Demographic and clinical characteristics, comprehensive medication data (bisphosphonates, chemotherapeutic agents, targeted drugs, and immunosuppressive agents), and results of serological biomarkers were recorded and compared between two groups. Univariate and multivariate logistic regressions were performed by SPSS 25.0 for evaluating risk factors of stage 3 MRONJ. Results. Our results indicate that chemotherapy ( adjusted   OR = 3.43 ; 95% CI: 1.03 to 11.38), targeted drugs ( adjusted   OR = 3.69 ; 95% CI: 1.06 to 12.80), and maxillary lesions ( adjusted   OR = 4.26 ; 95% CI: 1.19 to 15.23) increase the risk of stage 3 MRONJ. Conclusion. The outcome of this study justifies that chemotherapeutic agents and targeted drugs are probably risk factors for stage 3 MRONJ. In addition, the osteonecrosis in maxilla is more easily to develop into stage 3 MRONJ. Intense clinical observation is recommended in MRONJ patients with maxillary osteonecrosis and in those who concurrently administered bisphosphonates, chemotherapeutic agents, and/or targeted drugs. This trial is registered with ChiCTR2000032428.

scholarly journals Oxaliplatin-Induced Thrombotic Microangiopathy in a Patient with Stage IV Gallbladder Carcinoma: Primary Association or Multiple Hits?

2020 ◽  
Vol 13 (3) ◽  
pp. 1191-1195 ◽  
Author(s):  
María Cynthia Fuentes-Lacouture ◽  
Edgar Camilo Barrera-Garavito
Keyword(s):  
Platelet Activation ◽  
Gallbladder Carcinoma ◽  
Thrombotic Microangiopathy ◽  
Case Reports ◽  
Stage Iv ◽  
Chemotherapeutic Agents ◽  
Thrombotic Microangiopathies ◽  
Vascular Disorders ◽  
History Of ◽  
Secondary Causes

Thrombotic microangiopathies (TMA) include a variety of vascular disorders characterized by the presence of microthrombi, coagulopathy by platelet activation and consumption, and systemic damage. The most frequent secondary causes are infections and some medications. However, the presence of chemotherapeutic agents is not so common, and the induction of TMA by oxaliplatin is poorly understood, with few published case reports. We present the case of a patient with a history of gallbladder carcinoma, in whom findings compatible with TMA were documented, and with a temporal and sole relation to oxaliplatin.

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