Abstrakt
We present the case of a 38-year-old man. In 2006, a superficial spreading melanoma of Breslow 0.8 mm on the left part of the neck in this patient was excised.
The sentinel lymph node was not affected. In 2011, sonography revealed an enlarged nodule in the regional cervical lymph nodes.
The neck dissection showed 1+-6 lymph node macrometastases. Since 1998, the patient was abusing drugs, injecting methamphetamine intravenously.
It is a powerful central nervous system stimulant, with the immediate consequences of addiction. In the Czech Republic, according to authorities and statistics, the substance called "crystal meth" is used by 0.7% of the population, of which at least 30.000 have serious addiction problems (Csémy, Kubicka, & Nociar, 2002; Mravcik, Strada, Reimer, & Schulte, 2014).
The patient underwent a series of drug rehabilitation therapies and since 2011 he was enrolled in a drug addiction detoxification maintenance program. A hepatitis C infection genotype 3 was diagnosed in this patient in 2004.
After the treatment with PEG-IFN and Ribavirin a sustained virological response with undetectable serum HCV RNA was achieved. He experienced hepatitis C reactivation in 2005.
The normalization of aspartate aminotransferase and alanine aminotransferase could be reached, while gamma glutamyltransferase (GMT) remained elevated. During the treatment a maculopapular rash and arthralgia in different joints, mainly in the hands, knees, and ankles appeared.
Both of the symptoms were probably adverse events of dabrafenib.