Apremilast in the Treatment of Ulcerations in Possible Non-uremic Calciphylaxis. Case report

Česká verzia

Authors: H. Kristlová ^1,3; J. Bočková ¹; J. Horažďovský ¹; M. Kadlecová ¹; H. Kořínková ¹; A. Rosolová ¹; M. Pešková ²; M. Rendlová ³
Authors place of work: Kožní oddělení, Nemocnice České Budějovice, primář MUDr. Jiří Horažďovský, Ph. D. ¹; Interní oddělení, Nemocnice České Budějovice, primář MUDr. Marie Pešková ²; Dermatovenerologie Rendlová s. r. o., České Budějovice ³
Published in the journal: Čes-slov Derm, 96, 2021, No. 3, p. 142-148
Category: Case interpretation

Summary

The authors report a case of a 55-year-old woman, who has been developing deep ulcers on the trunk and limbs for 5 years. They were based on non-uremic calciphylaxis and extended to the total area of 988 cm². Treatment with corticosteroids and azathioprine was not successful, the administration of apremilast led to healing of 97% of the ulcers. Apremilast could represent a new alternative in the treatment of this disease.

Keywords:

pyoderma gangrenosum – non-uremic calciphylaxis – immunosuppression – apremilast

Zdroje

1. AL KHAFAJI, A. O A., TAHA, M., MALIK, S. Fatal Case of Non-Uremic Calciphylaxis: A Case Report and Literature review. American Journal of Case Report, 2018, 19, p. 804–807

2. BAJAJ, R., COURBEBAISSE, M., KROSHINSKY, D. et al. Calciphylaxis in patients with normal renal func-tion, a case series and systematic review. Mayo Clinic Proc, 2018, 93(9), p. 1202–1212

3. BISSONETTE, C., KAUZMEN, A., MAINVILLE, G. N. Oral Pyoderma Gangrenosum – Diagnosis, Treat-ment and Challenges: A Systematic Review. Head and Neck Pathol, 2017, 11, p. 427–441.

4. BRENT, M. C., LOGAN, T. W., DANN, F. J. Apremilast for the Treatment of Psoriatic Arthritis. Dermatology Online Journal, 2017, 23(2), p. 1–11.

5. CHANG, J. Calciphylaxis: Diagnosis, Pathogenesis and Treatment. Advances in skin and wound care, 2019, p. 205–214.

6. COURRI, C. E. et al. Monckeberg´s sclerosis – is the artery the only target of calcification? Case report. Cardiovascular Disorder, 2005, Free PMC Article.

7. DEEPAK, B., MEENAKSHI, U. M., DERICK, J. et al. Calciphylaxis and its diagnosis: A review. Journal of Family Medicine and Primary Care, 2019, 8(9), p. 2763–2767.

8. DUSILOVA SULKOVA, S. Cinacalceti hydrochlori-dum. Remedia 3/2005 Lékové profily, p. 235–245.

9. GARCÍA-LOZANO, J. A., OCAMPO-CANDIANI, J., MARTÍNEZ-CABRIALES, S. A. et al. An Update on Calciphylaxis. Am J Clin Dermatol, 2018, 19, p. 599–608.

10. HORAKOVA, M., POCK, L., BURES, I. et al. Kalcifylaxe s kožními ulceracemi – popis případu. Čes-slov derm, 2012, 87(3), p. 81–124.

11. JEONG, S. HANEOL, DOMINGUEZ, R., ARTURO Calciphylaxis: Controversies in Pathogenesis, Diagnosis and Treatment. The American Journal of the Medical Sciences, 2016, 351(2), p. 217–227.

12. KEATING, G. M. Apremilast: A Reiew in Psoriasis and Psoriatic Arthritis. Drugs, 2017, 77, p. 459–472.

13. KOVACEVICOVA, M., SVESTKOVA, S. Retikulární exantémy – patofyziologie, etiopatogeneze, klasifikace. Čes-slov Derm, 2012, 87(6), p. 211–219.

14. LAIRD, M. E., TONG, L. X., LO, SICCO, K. I. et al. Novel use of apremilast for adjunctive treatment of recalcitrant pyoderma gangrenosum. JAAD Case Rep., 2017, 14, 3(3), p. 228–229. doi: 10.1016/j.jdcr.2017.02.019. PMID: 28443317; PMCID: PMC539 4202.

15. PENG, T., ZHUO, L., WANG, Y. et al. Systematic review of sodium thiosulfate in treating calciphylaxis in chronic kidney disease patients. Nephrology, 2018, 23, p. 669–675.

16. MALONEY, N. J., ZHAO, J., TEGTMEYER. K. et al. Off-label studies on apremilast in dermatology: a review. Journal of Dermatological Treatment [online]. 2020, 31(2), p. 131–140 [cit. 2021-02-18]. ISSN 0954-6634.

17. SAGAR, U., NIGWEKAR, RAVI THADHANI Calciphylaxis (calcific uremic arteriolopathy). UpToDate, 2020, p. 1–37.

18. SARI, D. N., SUKMAWATI, L. I., FITRIANI, T. Off-Label Use of Apremilast For Autoimmune Skin Disor-ders Treatment. International Journal of Advances in Science Engineering and Technology [online], 2017, 5(4), 28 [cit. 2021-02-18]. ISSN 2321-9009. Dostupné z www: http://www.iraj.in/journal/journal_file/journal_pdf/6-413-151495881525-28.pdf.

19. SEETHAPATHY, H., BRANDENBURG, V. M., SINHA, S. et al. Review: update on the management of calciphylaxis. QJM An International Journal of Medicine, 2019, p. 29–34.

20. SEETHAPATHY, H., NOUREDDINE, L. Calciphylaxis: Approach to Diagnosis and Management. Advanced Chronic Kidney Disease, 2019, 26(6), p. 484–490.

21. SELYE, H., GENTILE, G., PRIORESCHI, P. Cutaneous molt induced by calciphylaxis in the rat. Science, 1961, 134(3493), p. 1876–1877.

22. VERNERO, M., RIBALDONE, D. G., CARITI, C. et al. Dual-targeted therapy with apremilast and vedolizumab in pyoderma gangrenosum associated with Crohn‘s disease. J Dermatol., 2020, 47(6), p. e216–e217. doi: 10.1111/1346-8138.15283.

23. WANG, Y. A., LI G., JUN M., WANG L. Systematic review of sodium thiosulfate in treating calciphylaxis in chronic kidney disease patients. Nephrology, 2017, p. 669–673

24. WEENING, R. H., SEWELL, L. D., DAVIS, M. D. et al. Calciphylaxis: natural history, risk factor analysis, and outcome. Journal of American Academy of Dermatology, 2007, 56(4), p. 569–579.

25. WOLLINA, U. Emerging treatments for pyoderma gangrenosum. Expert Opinion on Orphan Drugs [online] [cit. 2021-02-18], 2017, 5(10), p. 827–832. ISSN 2167-8707.