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Journal of Pharmacology and Therapeutic Research
Volume 1 Issue 1 Clinical Pharmacy 2017
Notes:
Page 48
December 07-09, 2017 | Rome, Italy
7th World Congress on
Clinical Pharmacy and Pharmacy Practice
Skin hyperpigmentation associated with
melanocyte activation and inflammatory
process following intravenous polymyxin B
treatment
Patricia Moriel, Karen Prado Herzer Mattos, Cintra, Isabela Romão
Gouvêa, Leonardo Ávila Ferreira and Paulo Eduardo Neves Ferreira
Velho
University of Campinas, Brazil
Polymyxins were widely used until the 1960s; however,
they fell into disfavor owing to their toxicity. The
subsequent growth of infections caused by multidrug
resistant Gram-negative bacteria led to renewed use
of this class of antimicrobials in clinical practice, owing
to their low rate of bacterial resistance. Acquired skin
hyperpigmentation following intravenous polymyxin B
treatment has been previously reported, but little is known
about its pathogenesis, clinical course, and treatment.
We studied the clinical, dermatoscopic, histologic, and
immunohistochemical skin properties of three patients
who presented with this disorder. We concluded that
hyperpigmentation due to intravenous polymyxin B
treatment is associated with an inflammatory process
and subsequent melanocyte activation. Since polymyxin
B causes the release of histamine, which is known for
its melanogenic effect, it is possible that skin darkening
is associated with this inflammatory mediator. Histologic
and immunohistochemical findings showed an abundant
melanocyte-pigmented dendritic network. Langerhans
cells hyperplasia and dermal IL-6 overexpression were
also found, presumably for an inflammatory process due
to polymyxin B use. IL-6 could act as a proinflammatory
factor and an inhibitor of exacerbated melanogenesis, as
previously described. These clinical and dermatoscopic
findings contributed to a better understanding of how the
pigmentary reaction manifests. Although the pigmentary
disorder neither influence the outcome of the therapy
nor warrant discontinuation of treatment, it nevertheless
considerably affects the patient’s quality of life
Biography
Patricia Moriel is a Full Professor in the Faculty of Pharmaceutical Science
at State University of Campinas (UNICAMP), Brazil. She is a Leader of the
Clinical Pharmacy Group that is involved in the study of pharmacotherapy, drug
adverse events, pharmacovigilance, pharmacokinetic, pharmacogenomics
influences in adverse events, especially in cancer. She has authored more
than 45 research articles, awards, conferences and the granting of a research
projects. She has been the director of several works of Master in Medical and
Pharmaceutical Science and Doctoral theses.
Patricia Moriel et al., J Pharmacol Ther Res 2017