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Chighizola CB, Suardi I, Marino A, Gattinara M, Costi S, Cattaneo A, Gerosa M, Caporali R. Belimumab-induced periungual pyogenic granulomas: A case report. Lupus 2024; 33:1017-1021. [PMID: 38860334 DOI: 10.1177/09612033241260180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
Pyogenic granuloma (PG) is a benign vascular neoformation, presenting as a painful red nodule on the skin, mucosa or nail apparatus. It is usually related to local complications such as bleedings and superinfections. The etiology of PG remains still unclear, and several triggers can lead to its formation. In case of multiple lesions, systemic conditions and drugs remain the main causes. Antineoplastic treatments, retinoids, antiretrovirals, hormones and anticonvulsants are frequently implicated in PG formation. In literature, PG has been rarely described in the course of biological treatment due to rheumatological disease. The present case report describes the development of polydactolous PGs in a 21-year-old woman with juvenile systemic lupus erythematosus (jSLE) during treatment with belimumab, a monoclonal antibody directed against BlyS. The clinical presentation, in particular the timing and the multiplicity of the lesions, and the improvement after belimumab discontinuation allowed us to consider PG as drug-induced. This case highlights the importance of considering PG as a potential complication of rheumatologic treatments.
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Affiliation(s)
- Cecilia Beatrice Chighizola
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Department of Rheumatology and Medical Sciences, Pediatric Rheumatology Unit, ASST Pini-CTO, Milan, Italy
| | - Ilaria Suardi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Department of Rheumatology and Medical Sciences, Pediatric Rheumatology Unit, ASST Pini-CTO, Milan, Italy
- Department of Rheumatology and Medical Sciences, Clinical Rheumatology Unit, ASST Pini-CTO, Milan, Italy
| | - Achille Marino
- Department of Rheumatology and Medical Sciences, Pediatric Rheumatology Unit, ASST Pini-CTO, Milan, Italy
| | - Maurizio Gattinara
- Department of Rheumatology and Medical Sciences, Pediatric Rheumatology Unit, ASST Pini-CTO, Milan, Italy
| | - Stefania Costi
- Department of Rheumatology and Medical Sciences, Pediatric Rheumatology Unit, ASST Pini-CTO, Milan, Italy
| | - Angelo Cattaneo
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Maria Gerosa
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Department of Rheumatology and Medical Sciences, Clinical Rheumatology Unit, ASST Pini-CTO, Milan, Italy
| | - Roberto Caporali
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Department of Rheumatology and Medical Sciences, Pediatric Rheumatology Unit, ASST Pini-CTO, Milan, Italy
- Department of Rheumatology and Medical Sciences, Clinical Rheumatology Unit, ASST Pini-CTO, Milan, Italy
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Salah H, Duran J, Russell MA, Gru AA. Apocrine Hidrocystoma of the Nail: A Unique Case. Am J Dermatopathol 2024; 46:433-435. [PMID: 38648032 DOI: 10.1097/dad.0000000000002729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
ABSTRACT Apocrine hidrocystomas are benign, cystic neoplastic lesions resulting from the apocrine secretory component of the sweat gland. They most commonly occur on the head and neck, with predilection to the periorbital area. Less frequent sites include the axilla, nipple, external auditory canal, foreskin, conjunctiva, lower lip, and fingers, among others. The authors report a unique case of a nail bed hidrocystoma in a 55-year-old woman, a site not previously described.
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Affiliation(s)
- Haneen Salah
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX
| | - Juanita Duran
- Division of Dermatopathology, Department of Pathology, University of Virginia, Charlottesville, VA
| | - Mark A Russell
- Department of Dermatology, University of Virginia, Charlottesville, VA; and
| | - Alejandro A Gru
- Department of Dermatology, Columbia University, New York, NY
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Hwang JK, Lipner SR. Blue Nail Discoloration: Literature Review and Diagnostic Algorithms. Am J Clin Dermatol 2023; 24:419-441. [PMID: 36971947 DOI: 10.1007/s40257-023-00768-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2023] [Indexed: 03/29/2023]
Abstract
Blue nail discoloration is a distinctive clinical presentation, and diagnosis is challenging given the broad differential diagnosis. A comprehensive review of the literature describing blue discoloration of one or multiple nails was performed using the PubMed, Embase, Scopus, and Web of Science databases. A total of 245 publications were included and grouped based on involvement of a single nail (monodactylic) or multiple nails (polydactylic). Monodactylic blue discoloration was associated with tumors or benign nevi, most commonly glomus tumors, followed by blue nevi and less commonly melanomas. Polydactylic blue discoloration was frequently associated with medications (such as minocycline, zidovudine, and hydroxyurea), toxic and exogenous exposures (such as silver), and other medical conditions (such as HIV/AIDS and systemic lupus erythematous). Patients presenting with blue nail discoloration warrant a thorough history, physical examination, and workup to rule out malignancy, systemic disease, or toxic exposure. We present diagnostic algorithms for monodactylic and polydactylic blue nail discoloration to guide workup and treatment plans.
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