Maladie de Kaposi : un effet secondaire inhabituel des dermocorticoïdes

Boudhir, H.; Mael-Ainin, M.; Senouci, Karima; Hassam, B.; Benzekri, Laïla

doi:10.1016/j.annder.2013.04.078

Cited by 12 publications

(7 citation statements)

References 8 publications

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“…Our study has shown four-fold odds of Kaposi's sarcoma-related mortality in individuals receiving glucocorticoids, after controlling for possible confounding factors. Glucocorticoid therapy has also been clinically associated with development of Kaposi's sarcoma in non-HIV-related diseases such as transplant recipients [ 14 , 15 ]; rheumatic disorders [ 16 , 17 ]; asthma [ 18 ]; lung cancer [ 19 ]; dermatologic diseases [ 20 , 21 ]; atopic dermatitis [ 22 ]; ulcerative colitis [ 23 ]; glomerulonephritis [ 24 , 25 ] and many other clinical conditions of iatrogenic immunosuppression. In most cases, withdrawal of immunosuppressive therapies leads to Kaposi's sarcoma remission, but not in the case of HIV-infected individuals [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Steroids are a risk factor for Kaposi's sarcoma-immune reconstitution inflammatory syndrome and mortality in HIV infection

Fernández-Sánchez

Iglesias

Ablanedo-Terrazas

et al. 2016

Aids

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Objectives:To investigate the association between Kaposi's sarcoma-associated immune reconstitution inflammatory syndrome (KS-IRIS) and mortality, with the use of glucocorticoids in HIV-infected individuals.Design:Case–control study.Methods:We reviewed the medical records of 145 individuals with HIV-associated Kaposi's sarcoma receiving antiretroviral therapy. The association of different variables with KS-IRIS and Kaposi's sarcoma-related mortality was explored by univariate and multivariate analyses. The main exposure of interest was the use of glucocorticoids. We also compared the time to KS-IRIS and the time to death of individuals treated with glucocorticoids vs. those nontreated with glucocorticoids, and the time to death of individuals with KS-IRIS vs. those without KS-IRIS by hazards regression.Results:Sixty of 145 individuals received glucocorticoids (41.4%) for the management or suspicion of Pneumocystis jirovecii pneumonia. Fifty individuals had KS-IRIS (37%). The use of glucocorticoids was more frequent in individuals with KS-IRIS than in those without KS-IRIS (54.9 vs. 36.47%, P = 0.047). Kaposi's sarcoma-related mortality occurred in 17 cases (11.7%), and glucocorticoid use was more frequent in this group (76.47 vs. 36.7%, P = 0.003). Glucocorticoid use was a risk factor for mortality (adjusted odds ratio = 4.719, 95% confidence interval = 1.383–16.103, P = 0.0132), and was associated with shorter periods to KS-IRIS (P = 0.03) and death (P = 0.0073). KS-IRIS was a risk factor for mortality (P = 0.049).Conclusion:In HIV-infected individuals, the use of glucocorticoids is a risk factor for KS-IRIS and Kaposi's sarcoma-associated mortality. In addition, KS-IRIS is a risk factor for mortality. Therefore, glucocorticoid administration in this population requires careful consideration based on individualized risk–benefit analysis.

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Section: Discussionmentioning

confidence: 99%

Steroids are a risk factor for Kaposi's sarcoma-immune reconstitution inflammatory syndrome and mortality in HIV infection

Fernández-Sánchez

Iglesias

Ablanedo-Terrazas

et al. 2016

Aids

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“…Indeed, Boudhir H et al underlined that nodular lesions of Kaposi’s disease appeared during treatment of bullous pemphigoid with topical corticosteroids [5]. …”

mentioning

confidence: 99%

Impetiginized Dyshidrotic Eczema

Tchernev¹,

Zanardelli²,

Voicu³

et al. 2017

Open Access Maced J Med Sci

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A 16 years old female patient, affected by atopic dermatitis and rhinoconjunctivitis allergica since childhood, requested a dermatologic consultation for lesions which had appeared after 3 months of local treatment with clobethasole propionate. The histological analysis confirmed the diagnosis of dyshidrotic eczema and the microbiological smears demonstrated a significant infection with Staphylococcus aureus. The risk of developing corticosteroids’ side-effects depends on the potency of the product, extended period of use and the volume of product applied. Clobetasol propionate is a group I- highly potent corticosteroid, which should be used for a maximum period of 2 weeks. Several authors have found that this agent has cumulative depot effect, persisting in the epidermis for 4 days after only one application. Taking together these observations, sustained by the clinical case presented above, we can conclude that the infectious risks associated with topical corticosteroid treatment must not be neglected, particularly since treated patients are fragile, and frequently have multiple well-known risk factors.

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“…Although SC usage is one of the major causes of iatrogenic KS, there are only three KS cases reported after intraarticular and/or epidural injections of corticosteroids,[233334] and a few cases related to topical use of corticosteroids. [353637] In two reports about KS development in PV patients, the role of TC (ointment/intralesional) was emphasized. [2627] The authors suggested that although both patients were receiving immunosuppressive treatment including SC, local application of corticosteroid might have caused additional decrease in immunity leading to KS development.…”

Section: Discussionmentioning

confidence: 99%

“…[38] Although there is insufficient data regarding the relationship between TC usage and skin cancer (melanoma and nonmelanoma),[39] cases of KS related with TC usage reported in the literature along with our cases might be significant. [2326273334353637].…”

Section: Discussionmentioning

confidence: 99%

The spectrum of underlying causes of iatrogenic Kaposi's sarcoma in a large series: A retrospective study

et al. 2019

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Background:The frequency of clinicoepidemiological variants of Kaposi's sarcoma (KS) differs markedly throughout the world. The iatrogenic variant is mainly associated with the use of immunosuppressive therapy.Aims:We aimed to investigate the distribution of KS variants in our practice and elucidate the underlying causes of iatrogenic KS.Methods:Consecutive KS patients seen in a single tertiary center were grouped according to the tumor variants and iatrogenic KS patients were evaluated about associated conditions.Results:Among 137 patients, classic variant was the most frequent presentation (n = 88), followed by iatrogenic (n = 37) variant. Among the iatrogenic group, ten were transplant recipients. In 16 iatrogenic KS patients, systemic corticosteroid was used, in four for myasthenia gravis (MG) and in three for rheumatoid arthritis. In three patients, KS developed under topical corticosteroid (TC) treatment. Among iatrogenic KS patients, ten of them had a second primary neoplasm and one had congenital immunodeficiency syndrome.Conclusions:Our study revealed one of the highest rates for iatrogenic KS (27%) reported in the literature. Besides well-known causes, relatively frequent association with MG was remarkable. Usage of different forms of TCs was the cause of KS in a few cases.

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Maladie de Kaposi : un effet secondaire inhabituel des dermocorticoïdes

Cited by 12 publications

References 8 publications

Steroids are a risk factor for Kaposi's sarcoma-immune reconstitution inflammatory syndrome and mortality in HIV infection

Steroids are a risk factor for Kaposi's sarcoma-immune reconstitution inflammatory syndrome and mortality in HIV infection

Impetiginized Dyshidrotic Eczema

The spectrum of underlying causes of iatrogenic Kaposi's sarcoma in a large series: A retrospective study

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