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Balighi K, Ghiasi M, Aryanian Z, Nikyar Z, Hatami P. Kaposi's sarcoma in a patient with pemphigus vulgaris mimicking exacerbation of pemphigus. Cancer Rep (Hoboken) 2023; 6:e1815. [PMID: 37002662 PMCID: PMC10172168 DOI: 10.1002/cnr2.1815] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 03/14/2023] [Accepted: 03/17/2023] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND Kaposi's sarcoma (KS) is a rare multifocal angiogenic tumor often seen in immunocompromised setting such as acquired immunodeficiency syndrome (AIDS) or organ transplantation recipients. Pemphigus vulgaris (PV) is a rare blistering disorder with mucocutaneous involvement for which immunosuppressive therapy has long been the core of treatment. Iatrogenic form of KS has been reported infrequently in pemphigus patients as a result of long-term immunosuppressive therapy. CASE We describe a 39-year-old male patient with confirmed diagnosis of PV who developed KS after receiving immunosuppressive agents for his pemphigus. KS was initially localized to the oral cavity with features mimicking exacerbation of his pemphigus. CONCLUSION This interesting case of KS suggests that dermatologists visiting patients with pemphigus with discomfort in the oral cavity should have a high degree of awareness and consider other differential diagnoses along with merely an exacerbation of PV.
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Affiliation(s)
- Kamran Balighi
- Autoimmune Bullous Diseases Research Center Tehran University of Medical Sciences 1199663911 Tehran Iran
- Department of Dermatology, School of Medicine, Razi Hospital Tehran University of Medical Sciences 1199663911 Tehran Iran
| | - Maryam Ghiasi
- Autoimmune Bullous Diseases Research Center Tehran University of Medical Sciences 1199663911 Tehran Iran
- Department of Dermatology, School of Medicine, Razi Hospital Tehran University of Medical Sciences 1199663911 Tehran Iran
| | - Zeinab Aryanian
- Autoimmune Bullous Diseases Research Center Tehran University of Medical Sciences 1199663911 Tehran Iran
- Department of Dermatology, School of Medicine, Razi Hospital Tehran University of Medical Sciences 1199663911 Tehran Iran
- Department of Dermatology Babol University of Medical Sciences 47176_47745 Babol Iran
| | - Zahra Nikyar
- Department of Dermatology, School of Medicine, Pediatric Dermatology Fellowship, Razi Hospital Tehran University of Medical Sciences 1199663911 Tehran Iran
| | - Parvaneh Hatami
- Autoimmune Bullous Diseases Research Center Tehran University of Medical Sciences 1199663911 Tehran Iran
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Glowacka P, Rudnicka L, Warszawik-Hendzel O, Sikora M, Goldust M, Gajda P, Stochmal A, Blicharz L, Rakowska A, Olszewska M. The Antiviral Properties of Cyclosporine. Focus on Coronavirus, Hepatitis C Virus, Influenza Virus, and Human Immunodeficiency Virus Infections. BIOLOGY 2020; 9:biology9080192. [PMID: 32731331 PMCID: PMC7463439 DOI: 10.3390/biology9080192] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 07/21/2020] [Accepted: 07/23/2020] [Indexed: 12/13/2022]
Abstract
This review updates current knowledge regarding the risk of viral infections, including COVID-19, in patients treated with cyclosporine. We also shortly refer to bacterial infections and parasitic infestations in patients treated with cyclosporin. Cyclosporine is an immunosuppressive drug, which is widely used in medicine, including in the treatment of autoimmune skin diseases in dermatology, rheumatology, ophthalmology and nephrology, and in organ transplantation. A usual concern associated with immunosuppressive treatment is the potential risk of infections. Interestingly, several data indicate a relatively low risk of infections, especially viral infections, in patients receiving cyclosporine. It was shown that cyclosporine exerts an inhibitory effect on the replication of some viruses, or may have a potentially beneficial effect on the disease course in infections. These include hepatitis C, influenza virus, rotavirus, human immunodeficiency virus and coronavirus infections. Available data indicate that cyclosporine may have a beneficial effect on COVID-19, which is caused by the coronavirus SARS-COV2.
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Affiliation(s)
- Paulina Glowacka
- Department of Dermatology, Medical University of Warsaw, 02-008 Warsaw, Poland; (P.G.); (O.W.-H.); (M.S.); (P.G.); (A.S.); (L.B.); (A.R.); (M.O.)
| | - Lidia Rudnicka
- Department of Dermatology, Medical University of Warsaw, 02-008 Warsaw, Poland; (P.G.); (O.W.-H.); (M.S.); (P.G.); (A.S.); (L.B.); (A.R.); (M.O.)
- Correspondence:
| | - Olga Warszawik-Hendzel
- Department of Dermatology, Medical University of Warsaw, 02-008 Warsaw, Poland; (P.G.); (O.W.-H.); (M.S.); (P.G.); (A.S.); (L.B.); (A.R.); (M.O.)
| | - Mariusz Sikora
- Department of Dermatology, Medical University of Warsaw, 02-008 Warsaw, Poland; (P.G.); (O.W.-H.); (M.S.); (P.G.); (A.S.); (L.B.); (A.R.); (M.O.)
| | - Mohamad Goldust
- Department of Dermatology, G. Marconi University of Rome, 00193 Rome, Italy;
- Department of Dermatology, University Medical Center Mainz, 55131 Mainz, Germany
- Department of Dermatology, University Hospital Basel, 4031 Basel, Switzerland
| | - Patrycja Gajda
- Department of Dermatology, Medical University of Warsaw, 02-008 Warsaw, Poland; (P.G.); (O.W.-H.); (M.S.); (P.G.); (A.S.); (L.B.); (A.R.); (M.O.)
| | - Anna Stochmal
- Department of Dermatology, Medical University of Warsaw, 02-008 Warsaw, Poland; (P.G.); (O.W.-H.); (M.S.); (P.G.); (A.S.); (L.B.); (A.R.); (M.O.)
| | - Leszek Blicharz
- Department of Dermatology, Medical University of Warsaw, 02-008 Warsaw, Poland; (P.G.); (O.W.-H.); (M.S.); (P.G.); (A.S.); (L.B.); (A.R.); (M.O.)
| | - Adriana Rakowska
- Department of Dermatology, Medical University of Warsaw, 02-008 Warsaw, Poland; (P.G.); (O.W.-H.); (M.S.); (P.G.); (A.S.); (L.B.); (A.R.); (M.O.)
| | - Malgorzata Olszewska
- Department of Dermatology, Medical University of Warsaw, 02-008 Warsaw, Poland; (P.G.); (O.W.-H.); (M.S.); (P.G.); (A.S.); (L.B.); (A.R.); (M.O.)
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Gambichler T, Susok L. PD-1 blockade for disseminated Kaposi sarcoma in a patient with atopic dermatitis and chronic CD8 lymphopenia. Immunotherapy 2020; 12:451-457. [PMID: 32316815 DOI: 10.2217/imt-2019-0183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
We describe a 53-year-old male patient with a history of long-standing atopic dermatitis (AD) who presented with disseminated Kaposi sarcoma (KS). Although he never had received long-term immunosuppressive treatment for his AD, he had a 16-year history of CD8 lymphopenia. Because of his heavily pretreated progressive KS in lymph nodes and soft tissues, we treated the patient using pembrolizumab 2 mg/kg body weight 3-weekly. On PET-computed tomography 3-months after the initiation of pembrolizumab therapy, a solid treatment response was detected in all tumor sites - 6-months later a mixed response was observed. Pembrolizumab therapy for further 10 months resulted in stable disease. Notably, his AD also improved during the pembrolizumab treatment period. This report highlights a rare association between AD and KS that was complicated by chronic CD8 lymphopenia of unknown origin. Even though our patient was immunocompromised, he showed an overall good response to pembrolizumab treatment.
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Affiliation(s)
- Thilo Gambichler
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - Laura Susok
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
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