- A breath-taking DRESS due to amoxicillin-clavulanate presenting as polymorphic eruption of the pregnancy. [Journal Article]
- JEJ Eur Acad Dermatol Venereol 2018 Mar 23
- Drug reaction with eosinophilia and systemic symptoms (DRESS) is a delayed-type drug hypersensitivity reaction with potential life-threatening complications. To our knowledge, DRESS has never been de...
Drug reaction with eosinophilia and systemic symptoms (DRESS) is a delayed-type drug hypersensitivity reaction with potential life-threatening complications. To our knowledge, DRESS has never been described in pregnancy. Here, we report on a pregnant woman presenting with erythematous plaques on the abdomen, developing cardiac tamponade due to eosinophilic perimyocarditis and an interstitial pneumonitis five weeks after exposure to amoxicillin-clavulanate. This article is protected by copyright. All rights reserved.
- The Medication Risk of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in Asians: The Major Drug Causality and Comparison to the USA FDA Label. [Journal Article]
- CPClin Pharmacol Ther 2018 Mar 23
- Specific ethnic genetic backgrounds associated with risk of Stevens-Johnson syndrome/toxic epidermal necrolysis(SJS/TEN) especially in Asians. However, there have been no large cohort, multiple-count...
Specific ethnic genetic backgrounds associated with risk of Stevens-Johnson syndrome/toxic epidermal necrolysis(SJS/TEN) especially in Asians. However, there have been no large cohort, multiple-country epidemiological studies of medication risk related to SJS/TEN in Asian populations. Thus, we analyzed the registration databases from multiple Asian countries who were treated during 1998-2017. A total 1028 SJS/TEN cases were identified by ALDEN. Furthermore, those medications labeled by USFDA as carrying a risk of SJS/TEN were also compared to the common causes of SJS/TEN in Asian countries. Oxcarbazepine, sulfasalazine, COX-II inhibitors, and strontium ranelate were identified as new potential causes. In addition to sulfa drugs and beta-lactam antibiotics, quinolones was also a common cause. Only one acetaminophen-induced SJS was identified, while several medications (e.g., oseltamivir, terbinafine, isotretinoin, and sorafenib) labeled as carrying a risk of SJS/TEN by USFDA were not found to have caused any of the cases in the Asian countries investigated in this study. This article is protected by copyright. All rights reserved.
- Case of lamotrigine-induced drug adverse reaction under tocilizumab treatment with clinical and virological features of drug-induced hypersensitivity syndrome. [Journal Article]
- JDJ Dermatol 2018 Mar 22
- The pathological mechanisms and immunological kinetics of drug-induced hypersensitivity syndrome (DIHS), including the relevance of interleukin (IL)-6, remain unclear. We report a case of drug advers...
The pathological mechanisms and immunological kinetics of drug-induced hypersensitivity syndrome (DIHS), including the relevance of interleukin (IL)-6, remain unclear. We report a case of drug adverse reaction that does not fulfill the diagnostic criteria of DIHS but mimics its characteristic features. Because the patient was under anti-IL-6 therapy at the onset, some symptoms typically seen in DIHS were absent, such as fever and leukocyte count abnormalities. However, the characteristic features of DIHS were clearly observed in the subsequent course, including the repeated recurrence of skin rash, prolonged liver dysfunction and reactivation of herpes viruses. This case suggested that IL-6 role at the onset is not a main factor to determine the subsequent pathomechanism of DIHS and attention should be paid to the preceding therapy for achieving accurate diagnosis.
- Low frequency of acetyl salicylic acid hypersensitivity in mastocytosis: the results of a double-blind, placebo-controlled challenge study. [Journal Article]
- AAllergy 2018 Mar 22
- CONCLUSIONS: The frequency of ASA hypersensitivity as determined by a prospective challenge study was 2%, and 4.1% in a retrospective chart review of 191 patients with mastocytosis. NSAIDs can be administered safely to most patients with mastocytosis. Extra caution should be taken in patients with a history of hypersensitivity reactions to other drugs, or traditional risk factors for NSAID hypersensitivity. This article is protected by copyright. All rights reserved.
- [Severe skin reactions due to new medications]. [Review]
- HHautarzt 2018 Mar 22
- Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN) and a specific form of hypersensitivity syndrome which is nowadays called "drug reaction with eosinophilia and systemic symptoms" (DRE...
Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN) and a specific form of hypersensitivity syndrome which is nowadays called "drug reaction with eosinophilia and systemic symptoms" (DRESS) are severe, mainly drug-induced skin reactions. Whereas SJS/TEN is considered one reaction entity of different severity, DRESS has to be distinguished from SJS/TEN but also from other severe exanthems due to multiorgan involvement. Although SJS/TEN is generally referred to as drug reaction, in total only about three quarters of the cases are actually caused by drugs. After the clinical diagnosis is made, identification of the potential inducing factor is most important. In case medications are considered as causal, their withdrawal plays a key role in management. In order to identify and withdraw the inducing agent, a detailed and thorough medication history must be obtained. Agents identified or confirmed as inducers of SJS/TEN by pharmacoepidemiological studies are allopurinol, antibacterial sulfonamides, various antiepileptics, nevirapine and nonsteroidal anti-inflammatory drugs of the oxicam-type. Among drugs inducing DRESS are also various antiepileptics, but in addition allopurinol, sulfonamides and minocycline. Some cases of SJS/TEN and DRESS associated with the use of new medication, including targeted therapies and biologicals, have been observed.
- Risk factors of asthma exacerbation based on asthma severity: a nationwide population-based observational study in South Korea. [Journal Article]
- BOBMJ Open 2018 03 22; 8(3):e020825
- CONCLUSIONS: Different associations between risk factors and asthma exacerbations based on asthma severity suggest that patients with mild asthma require greater attention to their age and comorbidities, whereas those with severe asthma require greater attention to hospitalisation history and drug adherence.
- Genital diseases in the mature woman. [Journal Article]
- CDClin Dermatol 2018 Mar - Apr; 36(2):208-221
- Vulvovaginal conditions are common in mature women. This reflects age-related changes in immunity and skin barrier function of vulvovaginal tissues. Vaginal atrophy is commonly complicated by dryness...
Vulvovaginal conditions are common in mature women. This reflects age-related changes in immunity and skin barrier function of vulvovaginal tissues. Vaginal atrophy is commonly complicated by dryness and inflammation, which makes postmenopausal atrophic vaginitis a virtually ubiquitous condition. The differential of vaginitis includes inflammatory, infectious, and malignant diseases, plus drug hypersensitivity. Atrophic vaginitis is treated with estrogen replacement therapy. Vulvovaginal malignant melanoma occurs predominantly in postmenopausal women and carries a poor prognosis. Similarly, the incidence of vulvovaginal malignancies, such as squamous cell carcinoma and extramammary Paget disease, rises exponentially after 65 years of age. Early diagnosis of these malignancies is of utmost importance. Lichen sclerosus et atrophicus and vulvovaginal candidosis are among the most common postmenopausal vulvovaginal conditions. Lichen sclerosus et atrophicus is associated with significant morbidity, and its management can be challenging. The incidence of vulvovaginal candidosis increases in patients on estrogen replacement therapy.
- Phytochemicals in Skin Cancer Prevention and Treatment: An Updated Review. [Review]
- IJInt J Mol Sci 2018 Mar 22; 19(4)
- Skin is the largest human organ, our protection against various environmental assaults and noxious agents. Accumulation of these stress events may lead to the formation of skin cancers, including bot...
Skin is the largest human organ, our protection against various environmental assaults and noxious agents. Accumulation of these stress events may lead to the formation of skin cancers, including both melanoma and non-melanoma skin cancers. Although modern targeted therapies have ameliorated the management of cutaneous malignancies, a safer, more affordable, and more effective strategy for chemoprevention and treatment is clearly needed for the improvement of skin cancer care. Phytochemicals are biologically active compounds derived from plants and herbal products. These agents appear to be beneficial in the battle against cancer as they exert anti-carcinogenic effects and are widely available, highly tolerated, and cost-effective. Evidence has indicated that the anti-carcinogenic properties of phytochemicals are due to their anti-oxidative, anti-inflammatory, anti-proliferative, and anti-angiogenic effects. In this review, we discuss the preventive potential, therapeutic effects, bioavailability, and structure-activity relationship of these selected phytochemicals for the management of skin cancers. The knowledge compiled here will provide clues for future investigations on novel oncostatic phytochemicals and additional anti-skin cancer mechanisms.
- Ofatumumab for acute treatment and prophylaxis of a patient with multiple relapses of acquired thrombotic thrombocytopenic purpura. [Journal Article]
- JTJ Thromb Thrombolysis 2018 Mar 21
- Acquired thrombotic thrombocytopenic purpura (TTP) is an autoimmune disorder resulting in potentially life-threating systemic thrombotic microangiopathy due to production of antibodies directed again...
Acquired thrombotic thrombocytopenic purpura (TTP) is an autoimmune disorder resulting in potentially life-threating systemic thrombotic microangiopathy due to production of antibodies directed against the von Willebrand factor-cleaving protease ADAMTS13. Typically managed with plasma exchange, glucocorticoids, and the first-generation anti-CD20 monoclonal antibody rituximab, patients with multiple relapses or refractory disease present unique management challenges. We describe a case of a young woman with multiple relapses of TTP despite standard therapy who was treated with ofatumumab, a second-generation anti-CD20 monoclonal antibody, after developing a severe hypersensitivity reaction to rituximab precluding its use. Ofatumumab was effective for the treatment of an acute relapse of TTP in combination with plasmapheresis and as a single-agent for prophylaxis. The patient has had no evidence of relapse 2 years after completion of acute treatment and 1 year after completing prophylactic therapy. Hypersensitivity to ofatumumab did not develop.
New Search Next
- Ultra-short-course booster allergen immunotherapy. [Journal Article]
- IImmunotherapy 2018 Mar 22