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Severe Sclerodermalike Manifestations of the Eosinophilia-Myalgia Syndrome Despite Concomitant Colchicine Therapy

Severe Sclerodermalike Manifestations of the Eosinophilia-Myalgia Syndrome Despite Concomitant... Abstract To the Editor.— Sclerodermaform infiltration of the skin with morpheaform and hyperpigmented patches is a frequent dermatologic manifestation of the eosinophilia-myalgia syndrome (EMS) related to levotryptophan use.1,2 The prognosis of this syndrome is uncertain, because some cases progress despite discontinuation of levotryptophan use, and no treatment is known to regularly improve its symptoms, especially the dermatologic manifestations. The clinical and histologic sclerodermalike changes of this syndrome could cause dermatologists to test the action of drugs used in the treatment of scleroderma. We report a case of EMS with particularly severe sclerodermatous manifestations despite previous, simultaneous, and subsequent use of colchicine. Report of a Case.— A 66-year-old woman with a history of familial Mediterranean fever treated with colchicine (1 mg/d) was seen in January 1990 with a 6-month history of myalgias and skin symptoms. Pruritus, cutaneous burning sensations, and edematous infiltration of the abdomen and extremities appeared in References 1. Silver RM, Heyes MP, Maize JC, Quearry B, Vionnet-Fuasset M, Sternberg EM. Scleroderma, fasciitis, and eosinophilia associated with the ingestion of tryptophan . N Engl J Med. 1990;322:874-881.Crossref 2. Jaffe I, Kopelman R, Baird R, Grossman M, Hays A. Eosinophilic fasciitis associated with the eosinophilia-myalgia syndrome . Am J Med. 1990;88:542-546.Crossref 3. Housset E. Intérêt de certains dérivés de la colchicine dans le traitement des syndromes sclérodermiques . Ann Dermatol Syphil (Paris) . 1967;94:31-34. 4. Alarcon-Segovia D, Ramos-Niembro F, De Kasep G, et al. Long-term evaluation of colchicine in the treatment of scleroderma . J Rheumatol. 1979;6:705-712. 5. Varga J, Peltonen J, Uitto J, Jimenez S. Development of diffuse fasciitis with eosinophilia during L-tryptophan treatment: demonstration of elevated type I collagen gene expression in affected tissues: a clinicopathologic study of four patients . Ann Intern Med. 1990;112:344-351.Crossref 6. Peltonen J, Kahari L, Jaakkola S, et al. Evaluation of transforming growth factor beta and type I procollagen gene expression in fibrotic skin diseases by in situ hybridization . J Invest Dermatol. 1990;94:365-371.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

Severe Sclerodermalike Manifestations of the Eosinophilia-Myalgia Syndrome Despite Concomitant Colchicine Therapy

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References (6)

Publisher
American Medical Association
Copyright
Copyright © 1991 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.1991.01680100136028
Publisher site
See Article on Publisher Site

Abstract

Abstract To the Editor.— Sclerodermaform infiltration of the skin with morpheaform and hyperpigmented patches is a frequent dermatologic manifestation of the eosinophilia-myalgia syndrome (EMS) related to levotryptophan use.1,2 The prognosis of this syndrome is uncertain, because some cases progress despite discontinuation of levotryptophan use, and no treatment is known to regularly improve its symptoms, especially the dermatologic manifestations. The clinical and histologic sclerodermalike changes of this syndrome could cause dermatologists to test the action of drugs used in the treatment of scleroderma. We report a case of EMS with particularly severe sclerodermatous manifestations despite previous, simultaneous, and subsequent use of colchicine. Report of a Case.— A 66-year-old woman with a history of familial Mediterranean fever treated with colchicine (1 mg/d) was seen in January 1990 with a 6-month history of myalgias and skin symptoms. Pruritus, cutaneous burning sensations, and edematous infiltration of the abdomen and extremities appeared in References 1. Silver RM, Heyes MP, Maize JC, Quearry B, Vionnet-Fuasset M, Sternberg EM. Scleroderma, fasciitis, and eosinophilia associated with the ingestion of tryptophan . N Engl J Med. 1990;322:874-881.Crossref 2. Jaffe I, Kopelman R, Baird R, Grossman M, Hays A. Eosinophilic fasciitis associated with the eosinophilia-myalgia syndrome . Am J Med. 1990;88:542-546.Crossref 3. Housset E. Intérêt de certains dérivés de la colchicine dans le traitement des syndromes sclérodermiques . Ann Dermatol Syphil (Paris) . 1967;94:31-34. 4. Alarcon-Segovia D, Ramos-Niembro F, De Kasep G, et al. Long-term evaluation of colchicine in the treatment of scleroderma . J Rheumatol. 1979;6:705-712. 5. Varga J, Peltonen J, Uitto J, Jimenez S. Development of diffuse fasciitis with eosinophilia during L-tryptophan treatment: demonstration of elevated type I collagen gene expression in affected tissues: a clinicopathologic study of four patients . Ann Intern Med. 1990;112:344-351.Crossref 6. Peltonen J, Kahari L, Jaakkola S, et al. Evaluation of transforming growth factor beta and type I procollagen gene expression in fibrotic skin diseases by in situ hybridization . J Invest Dermatol. 1990;94:365-371.Crossref

Journal

Archives of DermatologyAmerican Medical Association

Published: Nov 1, 1991

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