Adverse reactions to gefitinib (Iressa®): Revealing sycosis‐ and pyoderma gangrenosum‐like lesions

Sagara, Rei; Kitami, Amane; Nakada, Tokio; Iijima, Masafumi

doi:10.1111/j.1365-4632.2006.02749.x

Cited by 22 publications

(15 citation statements)

References 5 publications

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“…Drug-induced PG can be triggered by agents, such as granulocyte-macrophage colony-stimulating factor, interferon, propylthiouracil, 71 pegfilgrastim (a granulocyte-stimulating factor), 72 gefitinib (an inhibitor of epidermal growth factor receptor), 73 and recently tumor necrosis factor alpha (TNF-a) antagonists.…”

Section: Pyoderma Gangrenosummentioning

confidence: 99%

Cutaneous Manifestations in Patients With Inflammatory Bowel Diseases

Marzano

Borghi

Stadnicki

et al. 2014

Inflammatory Bowel Diseases

116

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The skin is one of the most common extraintestinal organ system affected in patients with inflammatory bowel disease (IBD), including both Crohn's disease and ulcerative colitis. The skin manifestations associated with IBD are polymorphic and can be classified into 4 categories according to their pathophysiology: (1) specific, (2) reactive, (3) associated, and (4) induced by IBD treatment. Cutaneous manifestations are regarded as specific if they share with IBD the same granulomatous histopathological pattern: perianal or metastatic Crohn's disease (commonly presenting with abscesses, fistulas or hidradenitis suppurativa-like features) is the prototype of this setting. Reactive cutaneous manifestations are different from IBD in the histopathology but have close physiopathological links: pyoderma gangrenosum, a neutrophil-mediated autoinflammatory skin disease typically manifesting as painful ulcers, is the paradigm of this group. Among the cutaneous diseases associated with IBD, the most commonly seen are erythema nodosum, a form of panniculitis most commonly involving bilateral pretibial areas, and psoriasis, a T helper 1/T helper 17-mediated erythematous squamous inflammatory disease. Finally, the number of cutaneous adverse reactions because of IBD therapies is progressively increasing. The most frequent drug-induced cutaneous manifestations are psoriasis-like, eczema-like, and lichenoid eruptions, as well as cutaneous lupus erythematosus for biologics, and nonmelanoma skin cancer, mainly basal cell and squamous cell carcinomas for thiopurines.

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Section: Pyoderma Gangrenosummentioning

confidence: 99%

Cutaneous Manifestations in Patients With Inflammatory Bowel Diseases

Marzano

Borghi

Stadnicki

et al. 2014

Inflammatory Bowel Diseases

116

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“…Recent examples of drug-induced PG include compounds such as propylthiouracil [31], pegfilgastrim – a granulocyte-stimulating factor [32], and gefinib – an inhibitor of epidermal growth factor receptor [33]. …”

Section: Clinical Presentationmentioning

confidence: 99%

Pyoderma gangrenosum – a review

Wollina

2007

Orphanet J Rare Dis

237

246

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Pyoderma gangrenosum (PG) is a rare noninfectious neutrophilic dermatosis. Clinically it starts with sterile pustules that rapidly progress and turn into painful ulcers of variable depth and size with undermined violaceous borders. The legs are most commonly affected but other parts of the skin and mucous membranes may also be involved. Course can be mild or malignant, chronic or relapsing with remarkable morbidity. In many cases PG is associated with an underlying disease, most commonly inflammatory bowel disease, rheumatic or haematological disease and malignancy. Diagnosis of PG is based on history of an underlying disease, typical clinical presentation, histopathology, and exclusion of other diseases that would lead to a similar appearance. The peak of incidence occurs between the ages of 20 to 50 years with women being more often affected than men. Aetiology has not been clearly determined yet.The treatment of PG is a challenge. Randomized, double-blinded prospective multicenter trials for PG are not available. The best documented treatments are systemic corticosteroids and ciclosporin A. Combinations of steroids with cytotoxic drugs are used in resistant cases. The combination of steroids with sulfa drugs or immunosuppressants has been used as steroid-sparing modalities. Antitumor necrosis alpha therapy in Crohn's disease showed a rapid response of PG. Skin transplants and the application of bioengineered skin is useful in selected cases as a complement to the immunosuppressive treatment. Topical therapy with modern wound dressings is useful to minimize pain and the risk of secondary infections. Despite recent advances in therapy, the prognosis of PG remains unpredictable.

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“…Dans le PG atypique, les maladies associées sont plus souvent des maladies lymphoprolifératives que des maladies intestinales inflammatoires chroniques. Un PG peut apparaître après la prise de médicaments : par exemple, des cas de PG ont été rapportés récemment après la prise de propylthiouracil [41], de pegfilgastrim [92], de gefinib [72] ou de sunitinib [36].…”

Section: Associations Fréquentesunclassified

Pyoderma gangrenosum (1^èrepartie) : mise au point

Chariatte

Lysitsa

Lombardi³

et al. 2011

Med Buccale Chir Buccale

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(Reçu le 18 janvier 2011, accepté le 8 mars 2011)Mots clés : pyoderma gangrenosum / dermatoses neutrophiliques / pathologies associées Résumé -Le pyoderma gangrenosum (PG) est une affection rare, se traduisant par une ou plusieurs ulcération(s) aseptique(s), à fond purulent, à bords surélevés et sous-minés, ayant une extension rapide et une évolution chronique. Il existe plusieurs formes cliniques mais l'aspect fait souvent évoquer une infection subaiguë ou chronique ; la recherche initiale de germes est toujours négative mais il y a souvent une surinfection. Le PG qui est rattaché aux dermatoses neutrophiliques est souvent associé à des pathologies spécifiques et il évolue en général parallèlement à l'affection associée. La prise en charge du PG commence donc par le traitement de cette dernière. Pour le PG lui-même, de nombreux traitements ont été proposés mais les corticoïdes et la ciclosporine constituent en général le traitement de première intention.Key words: pyoderma gangrenosum / neutrophilic dermatoses / associated pathologies Abstract -Pyoderma gangrenosum. Part I: literature review. Pyoderma gangrenosum (PG) is a rare non infectious neutrophilic dermatosis, characterized by one or many sterile painful ulcer(s), with a purulent base, raised and undermined edges; it has a rapid extension and a chronic evolution. There are several clinical forms, but the appearance is often suggestive of a subacute or a chronic infection; the initial search for microorganisms is always negative but secondary infection occurs frequently. PG is often associated with specific diseases and it generally evolves in parallel to the associated condition. Management of PG therefore begins by treating the underlying disorder. For the PG itself, many treatments have been proposed, but corticosteroids and cyclosporine are the first-line treatment.Le pyoderma gangrenosum (PG) est une affection rare qui se traduit cliniquement par une ou plusieurs ulcérations douloureuses ayant une bordure inflammatoire avec des clapiers purulents. Leur extension est rapide et leur évolution chronique. Le PG est maintenant rattaché aux dermatoses neutrophiliques.La description princeps a été réalisée par Louis Brocq en 1908 sous le terme de « phagédénisme géométrique ». Le terme phagédénisme (φάγειν, manger ;άδην, abondamment) a été proposé pour décrire des ulcérations qui ont tendance à s'étendre en surface et en profondeur [48]. En 1930, Brunsting, Goeckermann et O'Leary lui donnèrent son appellation actuelle. Ils décrivirent des ulcérations nécrotiques, extensives, douloureuses, à bords bleutés et sous-minés, entourées d'une aréole érythémateuse chez 5 patients, dont 4 étaient atteints d'une rectocolite ulcéreuse [13]. Ils pensaient que cette pathologie était liée à une infection. Des études ultérieures ont élargi le concept clinique du PG et identifié d'autres maladies associées. Dans la plupart des cas, le PG est associé avec une maladie intestinale inflammatoire

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Adverse reactions to gefitinib (Iressa®): Revealing sycosis‐ and pyoderma gangrenosum‐like lesions

Cited by 22 publications

References 5 publications

Cutaneous Manifestations in Patients With Inflammatory Bowel Diseases

Cutaneous Manifestations in Patients With Inflammatory Bowel Diseases

Pyoderma gangrenosum – a review

Pyoderma gangrenosum (1^èrepartie) : mise au point

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Adverse reactions to gefitinib (Iressa®): Revealing sycosis‐ and pyoderma gangrenosum‐like lesions

Cited by 22 publications

References 5 publications

Cutaneous Manifestations in Patients With Inflammatory Bowel Diseases

Cutaneous Manifestations in Patients With Inflammatory Bowel Diseases

Pyoderma gangrenosum – a review

Pyoderma gangrenosum (1èrepartie) : mise au point

Contact Info

Product

Resources

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Pyoderma gangrenosum (1^èrepartie) : mise au point