Segmental vitiligo after infliximab use for rheumatoid arthritis - A case\nreport
A forty-six-year old female patient, of mixed race, diabetic, with rheumatoid arthritis\nfor seven years. Denies personal or familial history of vitiligo. She mentioned the\nonset of achromic macules six months ago, initially on the left hand, which progressed\nin the craniocaudal direction involving all the left hemithorax and upper left limb.\nShe was using infliximab every eight weeks for eight months.\nShe was also using propranolol 20mg/day, metformin 850mg/day and glibenclamide\n5mg/day.\nFor this cutaneous state she had used topical 10% phenylalanine, clobetasol 0.025%, 2%\nvitamin E and Polipodium leucotomos 240 mg/day orally for 30 days, at\nanother service, with no improvement.\nAt the dermatological examination achromic macules were observed on the left upper limb\nand left hemithorax, which under Wood's light presented nacreous white coloration ().\nThere were no abnormalities detected in the remainder of the physical exam.\nAmong the laboratory exams she presented hemogram, biochemistry and thyroid hormones\nwithout changes, serologies for HIV, hepatitis and syphilis negative and one ANF 1: 640\nof mixed pattern, nuclear dense fine speckled and cytoplasmic dotted reticular, with\nnative anti-DNA autoantibodies, anti Jo, anticardiolipin, anti-centromere, anti Sm, anti\nRo, anti La, anti TPO negative.