Ravindranath Brahmadeo Chavan; Vasudha A Belgaumkar; Nitika Deshmukh; Balakrishna Nikam; Vijay Deepak Joshi
Abstract
Proliferating trichilemmal tumors are rare, generally solitary, benign tumors arising from the hair’s outer root sheath with trichilemmal keratinization. These tumors are predominantly found on the head, neck, and face of elderly females; the inguinal region is a highly unusual site of involvement. ...
Read More
Proliferating trichilemmal tumors are rare, generally solitary, benign tumors arising from the hair’s outer root sheath with trichilemmal keratinization. These tumors are predominantly found on the head, neck, and face of elderly females; the inguinal region is a highly unusual site of involvement. Malignant change in this tumor is rare, histologically mimicking squamous cell carcinoma. Metastatic malignant proliferating trichilemmal tumor requires a high index of suspicion for diagnosis and accurate histopathological reporting for timely intervention. Here, we report the case of a 65-yearold man presenting with nodular-ulcerative lesions in the groin, clinically confused with hidradenitis suppurativa and histologically with squamous cell carcinoma. He was finally diagnosed with an inoperable metastatic stage of malignant proliferating trichilemmal tumor and was treated with palliative care. This case highlights the innocuous clinical appearance of such lesions that might delay the management of this fulminant tumor.
Anil Prakash Gosavi; Ravindranath Brahmadeo Chavan; Rahul Narendra Jaiswal; Vijay Deepak Joshi
Abstract
Methotrexate, an anti-psoriatic drug possessing immunoregulatory, antiproliferative, and anti-inflammatory properties,acts by blocking deoxyribonucleic acid and ribonucleic acid synthesis. It acts especially on rapidly dividing bone marrow cells and proliferating epithelia and mucosae. The toxicity of ...
Read More
Methotrexate, an anti-psoriatic drug possessing immunoregulatory, antiproliferative, and anti-inflammatory properties,acts by blocking deoxyribonucleic acid and ribonucleic acid synthesis. It acts especially on rapidly dividing bone marrow cells and proliferating epithelia and mucosae. The toxicity of this double-edged sword occurs due to accidental excessive intake or daily dosing instead of weekly dosing. We report the case of a 31-year-old male with acute methotrexate toxicity presenting with ulcerations over pre-existing psoriatic plaques with foci of bleeding. Oral mucosal involvement in the form of buccal and palatal ulceration was present in the setting of sepsis, pancytopenia, and acute kidney injury. It is worth emphasizing the role of adequate prescription guidelines, patient education, stringent monitoring, early recognition of tell-tale signs of toxicity, timely leucovorin rescue, and the need for strict enforcement of regulations regarding the over-the-counter availability of such drugs, especially in developing countries.
