title: Reactive neutrophilic dermatoses associated with nontuberculous mycobacterial infection in adult-onset immunodeficiency syndrome responded well to acitretin: four cases report.
abstract: BACKGROUND
  Recent articles have suggested an adult-onset immunodeficiency syndrome that was described in HIV-uninfected adults with disseminated non-tuberculous mycobacterial infection and/or another opportunistic infection with concomitant reactive dermatoses. Few studies reported the drugs used to treat these reactive neutrophilic dermatoses including systemic steroid, etretinate, clofazimine, colchicine, and dapsone. This study aims to report the efficacy of acitretin for the treatment of this condition.
  
  
  METHODS
  Four HIV-uninfected patients with disseminated non-tuberculous mycobacterial infection and the reactive dermatoses from department of internal medicine, Maharaj Nakorn Chiang Mai Hospital between 2008 through 2011 were observed in the clinical presentation and course of disease including treatment and response.
  
  
  RESULTS
  All patients had at least one episode of reactive dermatoses with variable presentations comprising Sweet's syndrome with pustules, pustular vasculitis-like lesions, or generalized pustular lesions. Acitretin was prescribed to treat these reactive neutrophilic dermatoses. It showed a good response without side effects.
  
  
  CONCLUSIONS
  Acitretin, a second-generation retinoid, can be used for the treatment of reactive pustular lesions in the syndrome of adult-onset immunodeficiency due to its good response, being well tolerated, and without immunosuppression.
authors: Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. schiewch@med.cmu.ac.th
authors: Siri
authors: S
authors: Chiewchanvit
authors: Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
authors: Mati
authors: M
authors: Chuamanochan
authors: Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
authors: Pongsak
authors: P
authors: Mahanupab
authors: Central Diagnostic Laboratory, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
authors: Vilai
authors: V
authors: Baosoung
mesh_terms: D017255:Acitretin / Q000627:therapeutic use*; D017074:Common Variable Immunodeficiency / Q000188:drug therapy* / Q000276:immunology; D005260:Female; D006801:Humans; D007641:Keratolytic Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000188:drug therapy* / Q000276:immunology; D016463:Sweet Syndrome / Q000188:drug therapy* / Q000276:immunology
chemical_list: D007641:Keratolytic Agents; D017255:Acitretin