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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...

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Autores principales: Belfeki, Nabil, Khanfir, Monia Smiti, Ghorbel, Imed Ben, Said, Fatma, Houman, Mohamed Habib
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
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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.
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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
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