Magalys Vitiello

University of Miami Hospital

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Francisco A. Kerdel

Florida Academic Dermatology Center

Adriana Abuchar

University of Miami Hospital

Begoña Echeverría

Nova Southeastern University

Paolo Romanelli

University of Miami

Luis Dehesa

California State University, Fresno

Michael L. Shelling

University of Miami

Emma Lanuti

University of Miami

P. Valerón‐Almazán

Hospital Universitario de Gran Canaria Doctor Negrín

Maria A. Miteva

Inserm

Annika Grant

University of Miami Hospital

Cooperative Institutions

University of Miami

University of Miami Hospital

Fundación Instituto Valenciano de Oncología

Florida Academic Dermatology Center

University Dermatology

Hospital Infantil Universitario Niño Jesús

American Academy of Dermatology

In-Q-Tel

Advanced Dermatology

Spanish Academy of Dermatology and Venereology

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Erythema Multiforme Major Associated with CMV Infection in an Immunocompetent Patient

Journal of Cutaneous Medicine and Surgery (2011)

Magalys Vitiello Begoña Echeverría George W. Elgart Francisco A. Kerdel

Background: Cytomegalovirus (CMV) infection usually remains asymptomatic in immunocompetent adults, and few cases of complicated disease in nonimmunosuppressed patients have been reported. Erythema multiforme (EM), an acute and self-limiting skin eruption characterized by a typical targetoid lesion that may also affect the mucosa, is a hypersensitivity reaction that usually occurs after herpes simplex virus infection or use of certain drugs and resolves without complications in healthy individuals. To our knowledge, CMV infection has been associated with EM in only six patients. Objective: We present a case of an EM caused by CMV infection in a 35-year-old nonimmunosuppressed patient who was successfully treated with ganciclovir. Conclusion: Our report, like other similar reports found in the literature, suggests that CMV can trigger EM in apparently healthy individuals. Intravenous ganciclovir appears to be a good treatment option in these cases.

Cytomegalovirus

Erythema multiforme

Erythema

10.2310/7750.2011.10020

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Citations (6)

An Update on the Treatment of the Cutaneous Manifestations of Systemic Sclerosis: The Dermatologist's Point of View.

PubMed (2012)

Magalys Vitiello Adriana Abuchar Néstor Santana Luis Dehesa Francisco A. Kerdel

Systemic sclerosis is a connective tissue disorder that affects multiple organs. Although the initial symptoms of the disease are vascular, skin involvement is almost universally present in patients with systemic sclerosis. The presence of Raynaud's phenomenon, progressive thickening of the skin, digital ulcers, and calcinosis all correlate proportionally with disease severity. Since no treatment is available to completely prevent the natural course of the disease, emphasis is often placed on managing symptoms and complications. In this review, the authors focus on the management of each one of the skin manifestations seen in systemic sclerosis, as the dermatologist may facilitate the early recognition and treatment of these complications.

Scleroderma (fungus)

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Citations (28)

Ustekinumab: when everything else fails?

International Journal of Dermatology (2011)

Magalys Vitiello Annika Grant Francisco A. Kerdel

Miami

10.1111/j.1365-4632.2010.04766.x

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Citations (6)

The use of cyclosporine in dermatology.

PubMed (2012)

Luis Dehesa Adriana Abuchar A. Nuño‐González Magalys Vitiello Francisco A. Kerdel

Cyclosporine is an immunosuppressive drug that acts selectively on T-cells by inhibiting calcineurin phosphorylase. It has been used in dermatology since its approval for US Food and Drug Administration in 1997 for the use in psoriasis. While indicated only for the treatment of moderate to severe psoriasis, cyclosporine has also been used as an off-label drug for the treatment of various inflammatory skin conditions, including atopic dermatitis, blistering disorders, and connective tissue diseases. In this article, we review the use of cyclosporine in dermatology.

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An unusual case of cutaneous hyaline-vascular castleman’s disease with multicentric involvement and systemic symptoms

International Journal of Dermatology (2011)

Vanessa Cárdenas Magalys Vitiello Mariya Miteva Masahiro Amano Paolo Romanelli

Miami

Miller

10.1111/j.1365-4632.2009.04442.x

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Sister Mary joseph nodule as a presenting sign of pancreatobiliary adenocarcinoma.

PubMed (2012)

Michael L. Shelling Magalys Vitiello Emma Lanuti Senen Rodriguez Francisco A. Kerdel

Sister Mary Joseph nodules represent metastatic cancer of the umbilicus. These malignancies are usually associated with the ovary and gastrointestinal tract. The authors report the case of a Sister Mary Joseph nodule originating from the bifurcation of the common hepatic duct. Umbilical nodules should prompt clinical evaluations, as these tumors are usually associated with poor prognosis.

Sister

Nodule (geology)

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Type I Cryoglobulinemia With a Fatal Outcome

Actas Dermo-Sifiliográficas (2011)

Begoña Echeverría Magalys Vitiello Adriana Abuchar Francisco A. Kerdel

Type I cryoglobulinemia, a condition associated with lymphoproliferative disorders, is caused by monoclonal immunoglobulins that precipitate at low temperatures. It mostly involves the skin and pathology study shows no signs of vasculitis. Management is usually based on immunosuppressive drugs associated with plasmapheresis for severe disease. The use of rituximab has recently been described for resistant cases. We present an unusual case of long-standing type I cryoglobulinemia associated with a monoclonal gammopathy of uncertain significance. The patient developed extremely severe skin lesions with histological signs of vasculitis. The patient died due to the onset of noncutaneous manifestations of the cryoglobulinemia and complications of the immunosuppressive treatment. La crioglobulinemia tipo I es un trastorno producido por inmunoglobulinas monoclonales que precipitan a bajas temperaturas. Se asocia a trastornos linfoproliferativos, su clínica es predominantemente cutánea y la anatomía patológica no muestra fenómenos de vasculitis. En su manejo se emplean habitualmente fármacos inmunosupresores junto con plasmaféresis para los casos graves. Recientemente se ha descrito el uso de rituximab para los casos resistentes. Se presenta un caso poco común de crioglobulinemia tipo I de largo tiempo de evolución asociada a una gammapatía monoclonal de significado incierto. El paciente desarrolló lesiones cutáneas de extrema gravedad con fenómenos de vasculitis en la anatomía patológica, y presentó un desenlace fatal secundariamente a la aparición de manifestaciones extracutáneas de la crioglobulinemia y a las complicaciones del tratamiento inmunosupresor.

10.1016/s1578-2190(11)70787-9

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Fatal cutaneous Strongyloidiasis as a side effect of Pemphigus foliaceus treatment with mycophenolate mofetil.

PubMed (2011)

Magalys Vitiello Michael L. Shelling Ivan D. Camacho Clara Milikowski Francisco A. Kerdel

Strongyloidiasis is caused by the roundworm Strongyloides stercoralis (S. stercoralis). It is uncommon in the Unites States, and most cases are brought by travelers who have visited or lived in South America or Africa. Individuals with an intact immune system may experience mild gastrointestinal symptoms or none at all. In contrast, those with a compromised immune system may develop a rapidly fatal infection, commonly referred to as hyperinfection syndrome or disseminated Strongyloidiasis. We present a 66-year-old inmunocompromised male with Pemphigus Foliaceus who was admitted to the intensive care unit in critical condition and in whom a skin biopsy prove to be the main tool in the diagnosis of Strongyloidiasis.

Strongyloides stercoralis

Strongyloidiasis

Pemphigus foliaceus

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Citations (7)

A Case of Palmoplantar Pustulosis Induced by Certolizumab Pegol: New Anti-TNF-alpha Demonstrates the Same Class Effect.

PubMed (2012)

Michael L. Shelling Magalys Vitiello Emma Lanuti Maria A. Miteva Paolo Romanelli

The development of de novo psoriasis in patients treated with tumor necrosis factor-alpha antagonists is well recognized. The authors hereby report a case of palmplantar pustular psoriasis in a patient with rheumatoid arthritis treated with etanercept. The condition responded to topical steroids but re-occurred upon treating the patient with certolizumab pegol. This strongly suggests that the development of de novo psoriasis is a class effect.

Certolizumab pegol

Palmoplantar pustulosis

Pustular psoriasis

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Citations (13)

Cutaneous sarcoid mimicking tinea imbricata

International Journal of Dermatology (2011)

Rupa Reddy Magalys Vitiello Francisco A. Kerdel

Miami

10.1111/j.1365-4632.2010.04680.x

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Citations (2)