Improvement of scleromyxedema associated with isotretinoin therapy

Hisler, Barbara M.; Savoy, L. Boyd; Hashimoto, Ken

doi:10.1016/0190-9622(91)70132-l

Cited by 58 publications

(26 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[10][11][12] Scleromyxedema remains a therapeutic challenge. Reported treatments include dermabrasion, 13 psoralen-UV-A, 14 systemic retinoids, 15,16 and corticosteroids. 7,17,18 Other reports of successful treatment include granulocyte colonystimulating factor, 19 plasmapheresis, 20 external beam irradiation, 21 intravenous immunoglobulin, 22 interferon alfa2a, 23 and extracorporal photopheresis.…”

Section: Commentmentioning

confidence: 99%

Thalidomide as a Potential Treatment for Scleromyxedema

Caradonna¹

2004

Arch Dermatol

View full text Add to dashboard Cite

with a 1-year history of skin thickening. The process began on her hands and progressed to involve her arms, face, neck, shoulders, chest, and proximal extremities. Her only systemic complaints were limited mobility of her joints, particularly her hands and wrists. Physical examination findings revealed leonine facies. The skin of the neck, shoulders, and chest exhibited 1-to 2-mm coalescent linear papules. The skin of the hands, forearms, upper arms, and trunk was sclerotic. Skin biopsy results showed marked dermal thickening, displacement of collagen bundles by mucin, and numerous spindled fibroblasts, consistent with scleromyxedema. The results of laboratory tests, including a complete blood cell count, chemistry tests, liver function tests, an antinuclear antibody panel, an extractable nuclear antigen panel, and thyroid function tests, were normal. Immunoglobulins were obtained, and the following levels were revealed: IgM, 92 mg/dL (reference range, 25-210 mg/ dL); IgA, 152 mg/dL (reference range, 40-390 mg/dL); and IgG, 1490 mg/dL (reference range, 525-1650 mg/ dL), with a light chain monoclonal gammopathy. Hematologic evaluations, including serum and urine protein electrophoresis, immunoelectrophoresis, a bone marrow examination, and radiography of the head and chest, produced no evidence of multiple myeloma.Because of significant restriction of joint mobility, the patient underwent treatment with cytotoxic agents. She was initially treated with melphalan, 16 mg/d orally (PO), plus prednisone, 100 mg/d PO, for 4 days at a time in 1-month intervals for 4 cycles from

show abstract

Section: Commentmentioning

confidence: 99%

Thalidomide as a Potential Treatment for Scleromyxedema

Caradonna¹

2004

Arch Dermatol

View full text Add to dashboard Cite

show abstract

“…Reported treatments include systemic retinoids, [17][18][19] corticosteroids (including dexamethasone 20 ), adrenocorticotropic hormone, 12 interferon), 22 2-chlorodeoxyadenosine, 23 granulocyte colony-stimulating factor, 24 thalidomide, 4 plasmapheresis, 25,26 dermabrasion, 27 electron beam radiation, 28 extracorporeal photochemotherapy, 29 and PUVA. 30 Other agents, including melphalan, 31-33 cyclophosphamide, 34 cyclosporine, 35-37 methotrexate, 38,39 and chlorambucil, 40 have been used with some success but are limited by toxicity.…”

Section: Discussionmentioning

confidence: 99%

Combination Oral Prednisone and Intravenous Immunoglobulin in the Treatment of Scleromyxedema

Majeski¹,

Taher²,

Grewal³

et al. 2005

J Cutan Med Surg

View full text Add to dashboard Cite

IVIg is being used for a growing number of inflammatory and immune disorders. It is being increasingly reported as a successful treatment for scleromyxedema. Although our patient succumbed to the disease, combination therapy with prednisone and IVIg provided temporary symptomatic, laboratory, and clinical improvement of the condition. Optimization of this therapeutic strategy is thus indicated for the management of scleromyxedema.

show abstract

“…Retinoidler SM tedavisinde ikinci sırada tercih edilen ilaçlar arasında yer almaktadır. Retinoidlerin etkilerini fibroblast proliferasyonunu inhibe ederek ve müsin oluşumunu engelleyerek gösterdikleri düşünülmektedir 16 . Literatüre baktığımızda SM tedavisinde retinoid kullanımını araştıran yayınlardan çoğu isotretinoin tedavisi ile ilgilidir.…”

Section: Discussionunclassified

“…Literatüre baktığımızda SM tedavisinde retinoid kullanımını araştıran yayınlardan çoğu isotretinoin tedavisi ile ilgilidir. İsotretinoin tedavisi ile bazı olgularda iyi yanıt alınırken, bazılarında ise yanıt alınamamıştır [16][17][18][19] . Biz de hastamızda herhangi bir organ tutulumunun olmaması, monoklonal gamopatinin eşlik etmemesi nedeniyle yan etki profili daha güvenli olan asitretin tedavisini tercih ettik.…”

Section: Discussionunclassified