trimethoprim--sulfamethoxazole-drug-combination and Skin-Neoplasms

The anti-cancer impact of an allergic reaction is strongly linked to immunity enhancement. Trimethoprim-sulfamethoxazole (TMP-SMX), an antibiotic, has potential immunomodulatory effects, but has side effects such as allergies. Thus far, the effects and underlying mechanisms of TMP-SMX in melanoma have not been clarified. This study examined the potential roles of TMP-SMX in melanoma skin cancer using an immunodeficient mouse model. TMP-SMX significantly improved the survival rate and reduced the tumor weight and growth and vascular endothelial growth factor levels in melanoma skin cancer of immunodeficient mice. In the forced swimming test, TMP-SMX significantly reduced immobility time compared to the melanoma skin cancer of immunodeficient mice, indicating improved immunity. TMP-SMX significantly increased infiltration of mast cells and release of allergy-related mediators (IgE, histamine, interleukin (IL)-4, IL-5, IL-13, and IL-33) and immune-enhancing mediators (tumor necrosis factor-α, IL-2, IL-6, and IL-12). In addition, the administration of TMP-SMX significantly increased the caspase-3, 8, and 9 activities. Furthermore, mice given TMP-SMX showed no adverse reactions according to the blood biochemical parameters. TMP-SMX significantly inhibits the growth of melanoma skin cancer by triggering an allergic reaction and promotingimmunity. Hence, we propose that TMP-SMX may be used as an immune booster in cancer chemotherapy.

Topics: Animals; Hypersensitivity; Melanoma; Melanoma, Cutaneous Malignant; Mice; Skin Neoplasms; Trimethoprim, Sulfamethoxazole Drug Combination; Vascular Endothelial Growth Factor A

Vemurafenib improves survival of melanoma patients. However, cutaneous side-effects commonly occur in them. Nivolumab and ipilimumab are monoclonal antibodies against programmed death 1 and cytotoxic T-lymphocyte-associated antigen 4, both of which regulate excessive T-cell activation. Although these agents induce antitumor immunity against melanoma, the modified immune condition may result in an unexpected adverse reaction which has not been observed previously. Herein, we report a case who manifested severe erythema multiforme-like eruption with mucosal involvement associated with vemurafenib following nivolumab. The patient also subsequently suffered from ipilimumab-induced interstitial pneumonia with refractory course. Such a case has never been reported. This case suggested that dermatologists should pay special attention to unexpected adverse events of these drugs, and carefully observe cutaneous and respiratory status of patients during the treatment of melanoma.

Topics: Adult; Antibodies, Monoclonal; Antineoplastic Agents, Immunological; Biopsy; Chemotherapy, Adjuvant; CTLA-4 Antigen; Drug Eruptions; Drug Resistance; Erythema Multiforme; Fever; Glucocorticoids; Humans; Indoles; Ipilimumab; Lung Diseases, Interstitial; Lymphatic Metastasis; Male; Melanoma; Mutation; Neoplasm Recurrence, Local; Nivolumab; Parotid Neoplasms; Programmed Cell Death 1 Receptor; Proto-Oncogene Proteins B-raf; Pulse Therapy, Drug; Skin Neoplasms; Sulfonamides; Tomography, X-Ray Computed; Trimethoprim, Sulfamethoxazole Drug Combination; Vemurafenib; Withholding Treatment

We report a case of cutaneous Stenotrophomonas maltophilia infection which presented with clinical and histopathological findings that mimicked a gamma/delta (γδ) T-cell lymphoma. In this case, tissue culture of the biopsy specimen was key to determining the diagnosis and allowing appropriate treatment with oral trimethoprim-sulfamethoxazole and topical silvadene. A prompt complete resolution of lesions was observed following antibiotic treatment, with no recurrence of disease over the last 5 years, supporting an infectious rather than malignant etiology. In our patient, radiation therapy was indicated based on the misdiagnosis of γδ T-cell lymphoma, which was supported both clinically and histopathologically. However, tissue culture in this case avoided unnecessary radiation exposure and highlights the role of tissue culture in the evaluation of the biopsy of an undiagnosed cutaneous lesion.

Topics: Aged, 80 and over; Anti-Bacterial Agents; Gram-Negative Bacterial Infections; Humans; Lymphoma, T-Cell, Cutaneous; Male; Skin Neoplasms; Stenotrophomonas maltophilia; Trimethoprim, Sulfamethoxazole Drug Combination

A captive 33-year-old male white rhinoceros with seasonal dermatitis was diagnosed with a malignant squamous cell carcinoma on the right flank. Staphylococcus aureus was cultured from the skin lesions. No fungal or yeast was isolated. The dermatitis was treated with a combination of oral antibiotics (trimethoprim-sulphadiazine) and topically with weekly chlorhexidine washes and a mixture of a zinc oxide, balsam peru and bismuth oxide cream. Under azaperone and butorphanol anaesthesia, the skin tumour was surgically removed. The tumour was excised with wide margins and allowed to heal by secondary intention as primary wound closure was not possible. A post-mortem performed 2 years later for an unrelated condition revealed no metastases or recurrence of the skin tumour. It was presumed that chronic irritation or trauma may have contributed to the development of the skin tumour. This is the first detailed report of the successful treatment of a squamous cell carcinoma not associated with the horn in a rhinoceros.

Topics: Administration, Oral; Animals; Anti-Bacterial Agents; Carcinoma, Squamous Cell; Diagnosis, Differential; Male; Perissodactyla; Skin Neoplasms; Staphylococcal Skin Infections; Trimethoprim, Sulfamethoxazole Drug Combination