Methotrexate
- PDF / 170,281 Bytes
- 1 Pages / 595.245 x 841.846 pts (A4) Page_size
- 78 Downloads / 208 Views
1
Methotrexate Localised cutaneous ulcerative nodular amyloidosis: case report A 73-year-old woman developed localised cutaneous ulcerative nodular amyloidosis during treatment with methotrexate for seronegative arthritis. The woman presented with painful ulcerated nodules on the lower limbs at the age of 73 years; the nodules had been slowly progressing over a period of 7 months. She had been receiving methotrexate [route and dosage not stated] for 2 years for seronegative arthritis. Medical history included pulmonary embolism and an aortic valve replacement. At the current presentation, amyloid deposits of the amyloid lightchain present deep in the dermis and subcutaneous fat were observed on skin biopsy. Monoclonal plasma cells were observed around the blood vessels, and monotypic kappa light-chain restriction was noted. Immunochemistry failed to show underlying cutaneous lymphoma. Elevated levels of serum light κ-chains and troponins were noted. She showed an ulcerated form of primary cutaneous nodular amyloidosis [time to reaction onset not stated]. Due to the deep lesions, conventional skin directed therapies were not considered, and surgical excision could not be performed due to the widespread lesions. The treatment with methotrexate was discontinued; however, the lesions continued to progress. The woman was then treated with prednisone and cyclophosphamide. Over 12 months, the ulcers healed slowly. She remained to be disease free as noted during a follow-up after 1 year. Author comment: "The main objective of this article is to present and discuss a case of localized ulcerative nodular amyloidosis with deep involvement". "In this case, methotrexate might have also been involved in the ulceration process." Fernandes C, et al. Localized ulcerative nodular amyloidosis presenting as ulcerative panniculitis, an unusual clinical manifestation: A case report. SAGE Open Medical Case Reports 7: 1-3, 2019. Available from: URL: http:// 803442948 doi.org/10.1177/2050313X19890755 - Canada
0114-9954/20/1785-0001/$14.95 Adis © 2020 Springer Nature Switzerland AG. All rights reserved
Reactions 4 Jan 2020 No. 1785
Data Loading...
