1/11. acute generalized exanthematous pustulosis induced by chromium picolinate.A case of acute generalized exanthematous pustulosis (AGEP) due to chromium picolinate is described. This supplemental form of chromium has received a great deal of interest recently because of its possible beneficial effects on both muscle strength and body composition. There have been no previous reports to our knowledge of adverse cutaneous reactions to this agent. Various aspects of AGEP are reviewed.- - - - - - - - - - ranking = 1keywords = muscle (Clic here for more details about this article) |
2/11. A woman with leg cramps and rash.A 68-year-old woman presented with generalized weakness and a rash on her lower extremities. The weakness began one week earlier, shortly after treatment for leg cramps and two days before the rash appeared. She had also had blood-streaked sputum a few days before admission. There was no history of bleeding diathesis, nose bleeding, hematuria, vasculitis, muscle or joint aches, cinchonism, or exposure to tuberculosis. She denied fever, chills, night sweats, leg pain or swelling, chest pain, or abdominal pain.- - - - - - - - - - ranking = 1keywords = muscle (Clic here for more details about this article) |
3/11. dermatomyositis-like eruption after long-term hydroxyurea therapy for polycythemia vera.hydroxyurea (HU) is an antitumor agent used to treat chronic myeloproliferative disorders. HU is usually well tolerated, but several cutaneous changes have been reported during long-term HU therapy. Although the occurrence of dermatomyositis-like changes during long-term HU therapy are well known, they are rarely described in patents with polycythemia vera. We report a 69 year-old-male with polycythemia vera who developed a dermatomyositis-like eruption on his face and dorsum of the hands following long-term HU therapy. Despite the cutaneous features, there were no clinical signs of muscular involvement, and muscle specific enzymes were within normal ranges. After interruption of HU administration, the skin lesions disappeared within two months. The improvement following withdrawal of HU implicated this drug as a possible etiological factor in the development of cutaneous features of dermatomyositis in our patient.- - - - - - - - - - ranking = 1keywords = muscle (Clic here for more details about this article) |
4/11. Drug-induced rash with eosinophilia and systemic symptoms syndrome with bupropion administration.BACKGROUND: Sustained-release bupropion is commonly used for the symptomatic relief of depressive illness and as an adjuvant in smoking cessation therapy. OBJECTIVE: To report a case of bupropion-induced drug rash with eosinophilia and systemic symptoms syndrome, including acute hepatitis, obstructive lung disease, and myositis. methods: After the patient discontinued use of bupropion, serologic tests, muscle biopsies, pulmonary function tests, a chest x-ray examination, venous Doppler ultrasounds, and an electrocardiogram were performed. RESULTS: On discontinuation of bupropion and prolonged systemic corticosteroid therapy, there was complete resolution of symptoms. CONCLUSIONS: To our knowledge, this is the first reported case of drug rash with eosinophilia and systemic symptoms syndrome induced by bupropion therapy. We report this case to notify clinicians of the potential serious multisystem complications that can occur with sustained-release bupropion therapy.- - - - - - - - - - ranking = 1keywords = muscle (Clic here for more details about this article) |
5/11. Extramedullary acute myeloid leukemia (granulocytic sarcoma) with arm paresis, maculopapular exanthema and organ involvement.Granulocytic sarcoma (extramedullary myelosarcoma, chloroma) is a rare extramedullary myeloid tumor which can occur at any anatomical site as isolated finding or associated with acute myelogenous leukemia (AML) or myelodysplastic syndrome (MDS). In this case, we describe a 71-year-old man who presented with incomplete paresis of the left arm, periorbital swelling, a maculopapular exanthema and organ involvement including testis and stomach. The tumors responded to combination chemotherapy and the patient fully recovered. However, after five months the patient relapsed and died quickly. This case confirms the importance of including granulocytic sarcoma in the differential diagnoses of a variety of diseases. In AML, the presence of granulocytic sarcoma is associated with worse overall survival. When diagnosed, it should be treated with intensive chemotherapy as soon as possible.- - - - - - - - - - ranking = 1121.9855686159keywords = paresis (Clic here for more details about this article) |
6/11. A rare complication of generalized edema in juvenile dermatomyositis: a report of one case.Juvenile dermatomyositis (JDM) is a rare autoimmune disease characterized by inflammation of the muscle, connective tissue, skin, gastrointestinal tract and small nerves. Periorbital and facial edema may also be associated. Although localized edema is a common feature of juvenile dermatomyositis, generalized edema has been reported rarely. In this article, we report a 14-year-old boy with juvenile dermatomyositis presenting with generalized edema. Of the diagnostic criteria of JDM, severe symmetric weakness of the proximal musculature, characteristic cutaneous changes, elevated serum muscle enzymes and myopathic electromyographic abnormalities were observed. magnetic resonance imaging (MRI) of the lower extremities and pelvis showed marked diffuse edema in the subcutaneous tissue, muscles and myofascia. We suggest that MRI findings, which are not among the diagnostic criteria, may also be included in the diagnostic criteria of JDM. To the best of our knowledge, this is the 19th case of JDM reported for generalized edema in the English literature.- - - - - - - - - - ranking = 3keywords = muscle (Clic here for more details about this article) |
7/11. Clinical case of the month. 3-year-old boy presenting with a hand rash. Juvenile dermatomyositis.Of the diseases within the spectrum of the juvenile idiopathic inflammatory myopathies, juvenile dermatomyositis (JDM) is the most common. As the name implies, JDM affects the muscles and skin most commonly, but can involve other organ systems as well. Dermatologic manifestations often precede other signs and symptoms by months or even years and frequently are the primary reason the patient seeks medical attention. In the case presented here, a 3-year-old boy initially developed a hand rash that brought him to his primary care physician. By the time muscle weakness had developed, the patient had already been evaluated for dermatomyositis and therapy had been initiated. An understanding of these early clinical findings will enable physicians to make a timely diagnosis and commence therapy promptly in order to prevent life-threatening sequelae of the disease.- - - - - - - - - - ranking = 2keywords = muscle (Clic here for more details about this article) |
8/11. skin rash and muscle weakness.A 48-year-old Hispanic woman came to the clinic as a new patient--her chief complaint was a rash that appeared on her face 3 months before and had recently spread to her chest and hands. It itched occasionally and seemed to worsen after exposure to the sun. She also said that for the last month she had been feeling very weak-she had difficulty rising from a seated position and walking up the stairs to her apartment. She also felt as if her arms were heavy, making it difficult for her to brush and dry her hair in the morning. The patient was otherwise healthy with no known medical conditions, and she was not taking any medications. Her family history was noncontributory. What is your diagnosis? What diagnostic tests would you order for confirmation?- - - - - - - - - - ranking = 4keywords = muscle (Clic here for more details about this article) |
9/11. Improvement in dermatomyositis rash associated with the use of antiestrogen medication.BACKGROUND: dermatomyositis (DM) is an autoimmune disorder that occurs more often in women than men and causes highly symptomatic and inflammatory cutaneous and proximal muscle disease. Corticosteroids have been the treatment of choice for myositis in DM, and antimalarial agents for the skin disease of DM, with methotrexate sodium, azathioprine, mycophenolate mofetil, cyclosporine, and intravenous immunoglobulin used as steroid-sparing agents. Recently, reports supporting a role for anti-tumor necrosis factor alpha (TNF-alpha) therapy in the treatment of DM have emerged. OBSERVATIONS: We describe 2 women who experienced an improvement in their DM-associated skin eruptions while taking antiestrogen medication. The first patient was taking tamoxifen, a selective estrogen receptor modulator that has been found to have anti-TNF-alpha properties. The second was taking anastrozole, an aromatase inhibitor. When tamoxifen therapy was discontinued after 4 years of use in the first patient, her DM rash worsened and remained difficult to control with conventional immunosuppressant medication. CONCLUSIONS: With the limited number of therapies available to manage DM skin eruptions, the discovery of novel agents effective in treating this disease is vital. Using antiestrogen medication in women with DM may result in a significant improvement in their rash, possibly via the inhibition of TNF-alpha production by immune or other cells. Further investigation into the use of antiestrogen therapy in DM is merited to evaluate long-term risks and benefits.- - - - - - - - - - ranking = 1keywords = muscle (Clic here for more details about this article) |
10/11. hypoparathyroidism in a patient presenting with severe myopathy and skin rash. Case report and review of the literature.A 47-year old man with idiopathic hypoparathyroidism (IHP), presented as severe myopathy and skin rash is described. The serum muscle enzymes were increased. After treatment with calcium and vitamin d, the clinical condition improved, the skin rash gradually disappeared, and the muscle enzymes decreased and remained within the normal range thereafter.- - - - - - - - - - ranking = 2keywords = muscle (Clic here for more details about this article) |
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