Cargando…
Panniculite au cours d'un traitement d'une dermatomyosite par du méthotrexate
Panniculitis is a rare cutaneous manifestation of dermatomyositis (DM). The appearance of panniculitis during treatment with methotrexate (MTX) is exceptional and has only been described in 3 cases. We report a case of a 50-year-old woman suffering from DM since 1997 who was treated with corticoster...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The African Field Epidemiology Network
2016
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4885717/ https://www.ncbi.nlm.nih.gov/pubmed/27279974 http://dx.doi.org/10.11604/pamj.2016.23.149.8950 |
_version_ | 1782434551310581760 |
---|---|
author | Belfeki, Nabil Khanfir, Monia Smiti Ghorbel, Imed Ben Said, Fatma Houman, Mohamed Habib |
author_facet | Belfeki, Nabil Khanfir, Monia Smiti Ghorbel, Imed Ben Said, Fatma Houman, Mohamed Habib |
author_sort | Belfeki, Nabil |
collection | PubMed |
description | Panniculitis is a rare cutaneous manifestation of dermatomyositis (DM). The appearance of panniculitis during treatment with methotrexate (MTX) is exceptional and has only been described in 3 cases. We report a case of a 50-year-old woman suffering from DM since 1997 who was treated with corticosteroids showing favorable clinical and biological evolution. When a relapse occurred 2 years later, she was treated with higher-dose of corticosteroids in combination with a 7,5 mg weekly dose of methotrexate. The evolution was rapidly favorable. Eighteen months later, the patient had multiple subcutaneous nodules on limbs and buttocks. Anatomopathological examination showed panniculitis. There was no evidence supporting progression in DM. Prednisone dose was increased to 0.5 mg/kg/day, always in combination with MTX, without any clear signs of improvement. MTX treatment was stopped and the cutaneous lesions completely disappeared in 2 months without any relapse. This objective response lasted for 42 months. Our observation is particular given the occurrence of panniculitis in a patient undergoing treatment for dermatomyositis with methotrexate and illustrates the difficulties in the diagnosis. This entity must be known despite its exceptional nature since cutting off MTX treatment generally induces the disappearance of subcutaneous nodules. |
format | Online Article Text |
id | pubmed-4885717 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | The African Field Epidemiology Network |
record_format | MEDLINE/PubMed |
spelling | pubmed-48857172016-06-08 Panniculite au cours d'un traitement d'une dermatomyosite par du méthotrexate Belfeki, Nabil Khanfir, Monia Smiti Ghorbel, Imed Ben Said, Fatma Houman, Mohamed Habib Pan Afr Med J Case Report Panniculitis is a rare cutaneous manifestation of dermatomyositis (DM). The appearance of panniculitis during treatment with methotrexate (MTX) is exceptional and has only been described in 3 cases. We report a case of a 50-year-old woman suffering from DM since 1997 who was treated with corticosteroids showing favorable clinical and biological evolution. When a relapse occurred 2 years later, she was treated with higher-dose of corticosteroids in combination with a 7,5 mg weekly dose of methotrexate. The evolution was rapidly favorable. Eighteen months later, the patient had multiple subcutaneous nodules on limbs and buttocks. Anatomopathological examination showed panniculitis. There was no evidence supporting progression in DM. Prednisone dose was increased to 0.5 mg/kg/day, always in combination with MTX, without any clear signs of improvement. MTX treatment was stopped and the cutaneous lesions completely disappeared in 2 months without any relapse. This objective response lasted for 42 months. Our observation is particular given the occurrence of panniculitis in a patient undergoing treatment for dermatomyositis with methotrexate and illustrates the difficulties in the diagnosis. This entity must be known despite its exceptional nature since cutting off MTX treatment generally induces the disappearance of subcutaneous nodules. The African Field Epidemiology Network 2016-03-31 /pmc/articles/PMC4885717/ /pubmed/27279974 http://dx.doi.org/10.11604/pamj.2016.23.149.8950 Text en © Nabil Belfeki et al. http://creativecommons.org/licenses/by/2.0/ The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Belfeki, Nabil Khanfir, Monia Smiti Ghorbel, Imed Ben Said, Fatma Houman, Mohamed Habib Panniculite au cours d'un traitement d'une dermatomyosite par du méthotrexate |
title | Panniculite au cours d'un traitement d'une dermatomyosite par du méthotrexate |
title_full | Panniculite au cours d'un traitement d'une dermatomyosite par du méthotrexate |
title_fullStr | Panniculite au cours d'un traitement d'une dermatomyosite par du méthotrexate |
title_full_unstemmed | Panniculite au cours d'un traitement d'une dermatomyosite par du méthotrexate |
title_short | Panniculite au cours d'un traitement d'une dermatomyosite par du méthotrexate |
title_sort | panniculite au cours d'un traitement d'une dermatomyosite par du méthotrexate |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4885717/ https://www.ncbi.nlm.nih.gov/pubmed/27279974 http://dx.doi.org/10.11604/pamj.2016.23.149.8950 |
work_keys_str_mv | AT belfekinabil panniculiteaucoursduntraitementdunedermatomyositepardumethotrexate AT khanfirmoniasmiti panniculiteaucoursduntraitementdunedermatomyositepardumethotrexate AT ghorbelimedben panniculiteaucoursduntraitementdunedermatomyositepardumethotrexate AT saidfatma panniculiteaucoursduntraitementdunedermatomyositepardumethotrexate AT houmanmohamedhabib panniculiteaucoursduntraitementdunedermatomyositepardumethotrexate |