Hand-Foot Syndrome is a rare adverse reaction to bleomycin-etoposide-cisplatin chemotherapy, characterized by acral skin desquamation, hyperpigmentation, and swelling involving the hands and feet. We report the case of a 32 years old Asian female, diagnosed with right-sided Stage-IV dysgerminoma, who developed cutaneous symptoms following the second cycle of chemotherapy. She presented with hyperpigmentation, swelling, and desquamation affecting both hands and feet. After consultation with the dermatology department, she was diagnosed with chemotherapy-induced skin toxicity. Bleomycin, along with other cytotoxic agents, was discontinued. Initiation of topical betamethasone therapy resulted in significant clinical improvement over the following weeks. One month after starting the treatment, her feet had healed completely, while her hands continued to improve in the recovery phase with ongoing supportive care. This case highlights a rare dermatologic complication of bleomycin-etoposide-cisplatin therapy, emphasizing the need for further exploration into its prevention and effective treatment strategies.

Staphylococcal scalded skin syndrome (SSSS) is a rare, toxin-mediated skin disorder of childhood, caused by the exfoliative toxins ETA and ETB released by Staphylococcus aureus. We report on a 4-year-old boy who presented with a 5-day history of painful, progressive blistering of the face, trunk and anogenital region. Clinical examination revealed widespread erythema with coarse lamellar desquamation, flaccid blisters and a positive Nikolsky sign; the mucous membranes were spared, an important feature distinguishing SSSS from toxic epidermal necrolysis and Stevens-Johnson syndrome. Under parenteral flucloxacillin and clindamycin combined with antiseptic wound care and supportive treatment, the skin healed completely within 1 week. Because delayed treatment can substantially increase mortality, prompt recognition of SSSS and the immediate initiation of empirical antibiotic therapy are decisive for prognosis.

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe T-cell-mediated adverse cutaneous reaction characterized by rash, fever, and visceral involvement following prolonged drug use. It is rarely induced by proton pump inhibitors, with no prior reports documenting pharmacist-identified pantoprazole-related DRESS syndrome and subsequent intervention. A female in her early 60s (Han Chinese ethnicity) was admitted to the intensive care unit of Xiangtan Central Hospital (Xiangtan, China) in mid-2024 for thoracoabdominal pain caused by a fall, and pantoprazole was initiated for stress ulcer prophylaxis on the hospital day 2. Twenty-six days after pantoprazole initiation, the patient developed diffuse macular erythema with desquamation, and her eosinophil percentage increased from 0.5% to 7.8% after 2 days of rash onset. The clinical pharmacist initially suspected meropenem hypersensitivity and recommended discontinuation of this agent; however, 5 days after the onset of rash, leucopenia was observed with the eosinophil percentage peaking at 18.4%, and subsequent discontinuation of pantoprazole resulted in defervescence within 48 h, gradual resolution of the rash, and normalization of blood counts within approximately 10 days of drug cessation. Despite the complex pathophysiology and diagnostic challenges associated with DRESS syndrome, the pharmacist's identification of the suspected drug and targeted intervention achieved favorable outcomes, providing clinical reference for further research on DRESS syndrome.

This paper reports a case of insect bite dermatitis treated with fire dragon cupping. The patient presented with patchy circular erythema on the lateral aspects of both lower extremities, predominantly from the lateral aspect of the right thigh to the buttock. Slight desquamation was observed at the center of the local erythema, accompanied by swelling,induration, tenderness, increased skin temperature, and intolerable itching and burning pain. The treatment principle was to remove the pathogenic factors and detoxify, promote blood circulation and resolve erythema. Fire dragon cupping was administered once every 3 days, twice a week. After the first treatment, the patient's skin itching and burning pain were significantly relieved, erythema on both lower extremities subsided, hyperpigmentation was observed, and skin temperature returned to normal. The scores of skin symptom scale, visual analogue scale (VAS) for itching and dermatology life quality index (DLQI) were all improved. Two treatments were given, and the patient achieved near-complete resolution on day 11 of treatment, with partial residual hyperpigmentation. No recurrence was reported at 1-month follow-up.

Tinea pedis (athlete's foot) is a superficial fungal skin infection caused by dermatophytes, most commonly the anthropophilic dermatophyte Trichophyton rubrum. Clinically, it is characterized mainly by scaling, erythema, and fissure formation, and it may present in three primary forms: interdigital, plantar, and vesiculobullous. The infection is often accompanied by mild pruritus; when fissures develop, burning and pain may also occur. Maceration, fissures, and desquamation of the stratum corneum in the interdigital spaces may serve as entry points for β-haemolytic streptococci, thereby increasing the risk of erysipelas. Another complication is the potential spread of infection to the nails, hands, groin, or other body sites. Tinea pedis is primarily indicated for topical antifungal therapy. Over-the-counter antifungal agents include imidazoles, allylamines, thiocarbamates, and undecylenic acid derivatives. Based on an analysis of clinical studies, their efficacy and duration of treatment have been compared.

Desquamating or blistering skin conditions may be referred to burns and plastic surgeons owing to the morphological similarity to burn injuries, given an increasing shortage of dermatology inpatient beds within the context of NHS care. Desquamating skin conditions, similar to burn injuries, carry the potential to be severe, debilitating and potentially fatal; however, they present more complexity owing to their underlying aetiologies. These conditions may present with similar physiological challenges, dressing requirements and need for extensive multidisciplinary input as burn injuries, and there is an increasing demand for burns and plastic surgery involvement in their management. In this review, the following blistering skin diseases (BSDs) are discussed: Bullous erythema multiforme, Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TENS), pyoderma gangrenosum, impetigo, Staphylococcal scalded skin syndrome, erythroderma, pemphigus vulgaris (PV), bullous lupus, pemphigus paraneoplastica, acute generalised exanthematous pustulosis (AGEP), dermatitis artefacta, linear IgA bullous dermatosis and adverse drug reaction. All patients should undergo a thorough head to toe skin examination, including the mucous membranes, their current and recent medications should be reviewed, and considered for discontinuation if clinically safe. A full panel of blood investigations, including an auto-antibody screen, should be performed to identify the underlying cause and multiorgan disfunction. A single investigation of the greatest diagnostic value is an incision or punch biopsy, which should be sent for histology and immunofluorescence analyses. Antimicrobials and steroids should be initiated by dermatology after review. General care of these patients includes treatment of the underlying cause, management of acute deterioration and symptoms, and appropriate wound care.

Topical corticosteroid withdrawal (TCSW) can occur after prolonged topical corticosteroid (TCS) use. Despite the effectiveness of TCS in treating dermatological conditions, the phenomenon of steroid phobia has been gaining attention on social media platforms. This has contributed to increased anxiety among patients and potentially influenced their treatment adherence. This review aims to update the findings of two studies by investigating the latest research on TCSW. A systematic search was conducted in Ovid MEDLINE, PubMed, and the Cochrane Library from October 2020 to June 2024. Seven studies were included in the analysis, including five case reports, one case series, and one qualitative cross-sectional survey, reflecting the limited and descriptive nature of the currently available evidence on TCSW. TCSW appears to predominantly occur in adult women (90%) using TCS for atopic dermatitis (99.5%), mostly on the face (90%). Common symptoms include burning (89.8%), itching (85.6%), and skin hypersensitivity (82.3%), with erythema (89.6%) and desquamation (88.7%). TCSW appears to occur more commonly in women using high-potency TCS on the face long-term. Inconsistent diagnostic criteria, variable definitions, and the primarily descriptive nature of the currently available evidence complicate accurate diagnosis and treatment of TCSW. Increased awareness, education, and research on standardized criteria and management strategies are essential.