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  • 1 Semmelweis Egyetem, Budapest, Mária u. 41., 1085
  • 2 Semmelweis Egyetem, Budapest
  • 3 Semmelweis Egyetem, Budapest
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Absztrakt:

A nemszteroid gyulladáscsökkentők (NSAID-ok) lokális és szisztémás formában történő alkalmazása egyre elterjedtebbé vált, az ezzel kapcsolatos adverz reakciók gyakoriak. A szerzők egy 49 éves férfi beteg esetét ismertetik, aki lábszárak fájdalma miatt etofenamáttartalmú lokális készítményt alkalmazott, majd az alkalmazás helyén, UV-expozíciót követően, haemorrhagiás, atípusos, kontaktdermatitisnek megfelelő bőrtünetek jelentek meg. Tüneteinek rapid terjedése miatt sürgősségi fekvőbeteg-ellátásra szorult. Fizikális vizsgálata során az etofenamátexpozíció helyén, mindkét lábszáron, valamint azon túlmenően a karokon, valamint a törzsön és az arcon bevérzett, konfluáló, erythemás seropapulákat és maculákat láttunk, melyek mellett testszerte és a buccalis nyálkahártyán petechiák voltak megfigyelhetők. A nagy kiterjedésű és aspecifikus bőrtünetek, a fizikális vizsgálattal észlelt splenomegalia, valamint a perifériás vérképeltérés miatt indított onkohematológiai kivizsgálás során hajas sejtes leukaemia diagnózisa igazolódott. Epicutan tesztelés (ET) során az etofenamáttartalmú gélre adott, erősen pozitív reakció mellett fakátrány-, propilén-glikol-, propolisz-, ’fragrance mix I’, metilizotiazolinon-, benzoesav- és perubalzsam-poliszenzibilizáció volt verifikálható. Az etofenamát hatóanyaggal elvégzett lymphocytatranszformációs teszt (LTT) és CD69-expresszió-vizsgálat negatív eredményt adott. Orv Hetil. 2020; 161(38): 1646–1651.

  • 1

    Temesvári E. Eczema. In: Kárpáti S, Gyulai R, Kemény L, et al. (eds.) Dermatology and venereology. [Ekzemák. In: Kárpáti S, Gyulai R, Kemény L, et al. (szerk.) Bőrgyógyászat és venerológia.] Medicina Könyvkiadó, Budapest, 2020; pp. 271–290. [Hungarian]

  • 2

    Jones R, Horn HM. Identifying the causes of contact dermatitis. Practitioner 2014; 258: 27–31.

  • 3

    Subiabre-Ferrer D, Esteve-Martinez A, Blasco-Encinas R, et al. European photopatch test baseline series: a 3-year experience. Contact Dermatitis 2019; 80: 5–8.

  • 4

    Huber M. Experiences with a new percutaneously effective antirheumatic preparation. [Erfahrungen mit einem neuen perkutan wirksamen Antirheumatikum.] Fortschr Med. 1977; 95: 2209–2210. [German]

  • 5

    Vanhee J, Gevers D, Dooms-Goossens A. Contact dermatitis from an antirheumatic gel containing etofenamate. Contact Dermatitis 1981; 7: 50–51.

  • 6

    Balato N, Lembo G, Cantelli V, et al. Allergic dermatitis from etofenamate. Contact Dermatitis 1984; 11: 190.

  • 7

    Chu CY, Chen YL, Lin LJ, et al. Allergic contact dermatitis from etofenamate without cross sensitization to other anthranilic acid derivatives. Dermatology 2003; 206: 341–342.

  • 8

    Nakamura H, Motoyoshi S, Ishii K, et al. The mode of anti-inflammatory action of a topical non-steroidal anti-inflammatory drug, etofenamate. Nihon Yakurigaku Zasshi 1987; 89: 15–24. [Japanese]

  • 9

    Goday Buján JJ, Pérez Varela L, Piñeyro Molina F, et al. Allergic and photoallergic contact dermatitis from etofenamate: study of 14 cases. Contact Dermatitis 2009; 61: 118–120.

  • 10

    Ozlu E, Baykan A, Ertas R, et al. Case report: Nicolau syndrome due to etofenamate injection. [Version 1; peer review: 2 approved] F1000Research 2017; 6: 867.

  • 11

    Dadaci M, Altuntas Z, Ince B, et al. Nicolau syndrome after intramuscular injection of non-steroidal anti-inflammatory drugs (NSAID). Bosn J Basic Med Sci. 2015; 15: 57–60.

  • 12

    Orbak Z, Yildirim ZK, Sepetci O, et al. Adverse reaction of topical etofenamate: petechial eruption. West Indian Med J. 2012; 61: 767–769.

  • 13

    Alcántara Villar M, Pagan JA, Palacios L, et al. Allergic contact dermatitis to etofenamate. Cross-reaction to other nonsteroidal anti-inflammatory drugs. Contact Dermatitis 2008; 58: 118–119.

  • 14

    Kerr A, Becher G, Ibbotson S, et al. Action spectrum for etofenamate photoallergic contact dermatitis. Contact Dermatitis 2011; 65: 117–118.

  • 15

    Spiewak R. The frequency and causes of photoallergic contact dermatitis among dermatology outpatients. Acta Dermatovenerol Croat. 2013; 21: 230–235.

  • 16

    Golcuk Y, Oray D, Atilla OD, et al. Etofenamate associated with Lyell syndrome: a case report. Clin Toxicol (Phila). 2010; 48: 471–472.

  • 17

    Roelandts R. The diagnosis of photosensitivity. Arch Dermatol. 2000; 136: 1152–1157.

  • 18

    Espasandín-Arias M, Vázquez-Osorio I, Salgado-Boquete L, et al. Prolonged localized photosensitivity following allergic and photo-aggravated contact dermatitis from etofenamate. Photodermatol Photoimmunol Photomed. 2014; 30: 340–342.

  • 19

    Drago S, Imboden R, Schlatter P, et al. Pharmacokinetics of transdermal etofenamate and diclofenac in healthy volunteers. Basic Clin Pharmacol Toxicol. 2017; 121: 423–429.

  • 20

    Montoro J, Rodriguez-Serna M, Liñana JJ, et al. Photoallergic contact dermatitis due to flufenamic acid and etofenamate. Contact Dermatitis 1997; 37: 139–140.

  • 21

    Roldán-Marín R, de-la-Barreda Becerril F. Petechial and purpuric eruption induced by lidocaine/prilocaine cream: a rare side effect. J Drugs Dermatol. 2009; 8: 287–288.

  • 22

    Mayorga C, Ebo DG, Lang DM, et al. Controversies in drug allergy: in vitro testing. J Allergy Clin Immunol. 2019; 143: 56–65.

  • 23

    Pichler WJ, Tilch J. The lymphocyte transformation test in the diagnosis of drug hypersensitivity. Allergy 2004; 59: 809–820.

  • 24

    Mayorga C, Doña I, Perez-Inestrosa E, et al. The value of in vitro tests to diminish drug challenges. Int J Mol Sci. 2017; 18: 1222.

  • 25

    Phillips EJ, Sullivan JR, Knowles SR, et al. Utility of patch testing in patients with hypersensitivity syndromes associated with abacavir. AIDS 2002; 16: 2223–2225.

  • 26

    Popple A, Williams J, Maxwell G, et al. The lymphocyte transformation test in allergic contact dermatitis: New opportunities. J Immunotoxicol. 2016; 13: 84–91.

  • 27

    Greenberger PA. Drug allergy. Allergy Asthma Proc. 2019; 40: 474–479.

  • 28

    Shadman M, White E, De Roos AJ, et al. Associations between allergies and risk of hematologic malignancies: results from the VITamins and lifestyle cohort study. Am J Hematol. 2013; 88: 1050–1054.

  • 29

    Ganzel C, Gatt ME, Maly A, et al. High incidence of skin rash in patients with hairy cell leukemia treated with cladribine. Leuk Lymphoma 2012; 53: 1169–1173.

  • 30

    Sabattini E, Bacci F, Sagramoso C, et al. WHO classification of tumours of haematopoietic and lymphoid tissues in 2008: an overview. Pathologica 2010; 102: 83–87.

  • 31

    Sluga R, Tersmette M, Sohne M. Hairy cell leukemia presenting with ecthyma gangrenosum – a case report. BMC Infect Dis. 2019; 19: 85.

  • 32

    Clore LS Jr, Stafford CT. Chronic urticaria as a presenting sign of hairy cell leukemia. Allergy Asthma Proc. 1999; 20: 51–55.

  • 33

    Fank H, Caers J, Lambert M, et al. Schnitzler syndrome associated with hairy cell leukemia presenting with chronic urticaria and arthralgias. JAAD Case Rep. 2018; 4: 386–389.

  • 34

    Colović N, Perunicić M, Jurisić V, et al. Specific skin lesions in hairy cell leukemia at presentation: case report and review of literature. Med Oncol. 2010; 27: 559–561.

  • 35

    Gisser SD. Acute febrile neutrophilic dermatosis (Sweet’s syndrome) in a patient with hairy-cell leukemia. Am J Dermatopathol. 1983; 5: 283–288.

  • 36

    Broccoli A, Gandolfi L, Pellegrini C, et al. Leukocytoclastic vasculitis associated with hairy cell leukemia at diagnosis: a case report and review of the literature. Tumori 2016; 102(Suppl 2): 124–127.

  • 37

    Jain A, Lad D, Prakash G, et al. Bullous pyoderma gangrenosum associated with hairy cell leukemia and its complete response to cladribine therapy. Indian J Hematol Blood Transfus. 2017; 33: 273–275.

  • 38

    Fino P, Fioramonti P, Onesti MG, et al. Skin metastasis in patient with hairy cell leukemia: case report and review of literature. In Vivo 2012; 26: 311–314.

  • 39

    Raanani P, Thaler M, Keller N, et al. Skin lesions in a patient with hairy cell leukaemia. Postgrad Med J. 1997; 73: 375–377.

  • 40

    Arai E, Ikeda S, Itoh S, et al. Specific skin lesions as the presenting symptom of hairy cell leukemia. Am J Clin Pathol. 1988; 90: 459–464.

  • 41

    Zák P, Chrobák L, Podzimek K, et al. An unusual course in hairy-cell leukemia with marked abdominal lymphadenopathy, leukemic infiltration of the cornea and skin changes. [Neobvyklý průbĕh leukémie s vlasatými bunkami s výraznou abdominální lymfadenopatií, leukemickými infiltraty ocní rohovky a kozními zmĕnami.] Vnitr Lek. 1996; 42: 463–466. [Czech]

  • 42

    Wang RF, Kuehn GJ, Andritsos LA, et al. Cutaneous adverse events associated with purine analogs in the treatment of hairy cell leukemia. Int J Dermatol. 2019; 58: e109–e110.