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    [Epicutaneous patch testing in delayed drug hypersensitivity reactions induced by antiepileptic drugs].
    Therapie 2017 Mar 25. Epub 2017 Mar 25.
    Centre régional de pharmacovigilance de Sfax, faculté de médecine de Sfax, avenue Majida-Boulila, 3029 Sfax, Tunisie.
    Introduction: Antiepileptic drugs are widely used and are associated with numerous side effects including skin eruptions. Epicutaneous tests have been used with variable success in skin drug reactions. The purpose of this study was to evaluate the profitability of epicutaneous tests in delayed hypersensitivity reactions induced by antiepileptic drugs. Read More

    Minocycline-Induced Hyperpigmentation in a Patient Treated with Erlotinib for Non-Small Cell Lung Adenocarcinoma.
    Case Rep Oncol 2017 Jan-Apr;10(1):156-160. Epub 2017 Feb 15.
    Walter Reed National Military Medical Center, Bethesda, MD, USA.
    Introduction: While epidermal growth factor receptor (EGFR) inhibitors have improved progression-free survival in patients with non-small cell lung cancer (NSCLC), one of the most common adverse effects is papulopustular skin eruption, which is frequently severe enough to be treated with oral minocycline or doxycycline.

    Case: We present a case of an 87-year-old man who developed a severe papulopustular skin eruption secondary to erlotinib therapy for NSCLC. Control of the eruption with 100 mg of minocycline twice daily for 8 months eventually led to blue-gray skin hyperpigmentation. Read More

    Viral exanthems: An update on laboratory testing of the adult patient.
    J Am Acad Dermatol 2017 Mar 26;76(3):538-550. Epub 2016 Oct 26.
    Division of Dermatology, Department of Internal Medicine, Ohio State University Comprehensive Cancer Center, Columbus, Ohio. Electronic address:
    Although classic viral exanthems of childhood are well described, they are rarely differentiated in adults. Laboratory techniques for viral identification have advanced without substantial literature to suggest how a dermatologist ought to conduct a cost-effective and diagnostic viral panel. Certain clinical features such as petechiae, vesicles, and dusky macular or morbilliform exanthems point strongly toward a viral exanthem. Read More

    Fever in Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in Pediatric Cases: Laboratory Work-up and Antibiotic Therapy.
    Pediatr Infect Dis J 2017 May;36(5):513-515
    From the Department of Dermatology, Dokumentationszentrum schwerer Hautreaktionen (dZh), Medical Center-University of Freiburg, Hauptstrasse 7, 79104 Freiburg, Germany.
    Fever is a symptom that often accompanies skin eruptions, especially in children. It can be a sign of an infectious condition presenting with exanthems or it may precede an exanthematous eruption. Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe reactions affecting skin and mucosa with blisters and erosions. Read More

    Treatment of Human Scabies with Oral Ivermectin. Eczematous Eruptions as a New Non-Reported Adverse Event.
    Actas Dermosifiliogr 2017 Apr 3. Epub 2017 Apr 3.
    Department of Dermatology, Hospital Universitario La Princesa, Spain.
    Background: Oral ivermectin is an alternative therapy for human scabies infection due to its ease of administration and good safety profile. However, there is no definitive consensus on the optimal dosing regimen.

    Objective: To describe the treatment of human scabies with different dosages of oral ivermectin and the possible adverse events. Read More

    [Toxic epidermal necrolysis (Lyell syndrome), a lifethreatening emergency of introgenic origin].
    Rev Med Liege 2016 Oct;71(10):435-439
    Service de Dermatologie, CHU de Liège, site du Sart Tilman, Liège, Belgique.
    Cutaneous drug eruptions are frequently encoun¬tered. Their putative diagnosis is based on a set of imputability arguments. The histopathological aspect is often suggestive of the dermatosis nature, and varies according to the type of drug reaction. Read More

    Non-immediate Cutaneous Reactions to Beta-Lactams: Approach to Diagnosis.
    Curr Allergy Asthma Rep 2017 Apr;17(4):23
    Allergy Unit, Presidio Columbus, Via G. Moscati, 31, 00168, Rome, Italy.
    Non-immediate cutaneous reactions (i.e., occurring at least 1 h after the initial drug administration), particularly maculopapular exanthemas and urticarial eruptions, are common during beta-lactam treatments. Read More

    Cutaneous Manifestations of Diabetes Mellitus: A Review.
    Am J Clin Dermatol 2017 Apr 3. Epub 2017 Apr 3.
    Department of Dermatology, University Hospital Jena, Erfurter Straße 35, 07740, Jena, Germany.
    Diabetes mellitus is a widespread endocrine disease with severe impact on health systems worldwide. Increased serum glucose causes damage to a wide range of cell types, including endothelial cells, neurons, and renal cells, but also keratinocytes and fibroblasts. Skin disorders can be found in about one third of all people with diabetes and frequently occur before the diagnosis, thus playing an important role in the initial recognition of underlying disease. Read More

    Syphilis: Re-emergence of an old foe.
    Microb Cell 2016 Jun 27;3(9):363-370. Epub 2016 Jun 27.
    Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7435.
    Syphilis is caused by infection with Treponema pallidum subsp. pallidum, a not-yet-cultivable spiral-shaped bacterium that is usually transmitted by sexual contact with an infected partner or by an infected pregnant woman to her fetus. There is no vaccine to prevent syphilis. Read More

    Pharmacologic Impact (aka "Breaking Bad") of Medications on Wound Healing and Wound Development: A Literature-based Overview.
    Ostomy Wound Manage 2017 Mar;63(3):18-35
    School of Nursing-Camden, Rutgers University, Camden, NJ.
    Patients with wounds often are provided pharmacologic interventions for their wounds as well as for their acute or chronic illnesses. Drugs can promote wound healing or substantively hinder it; some medications cause wound or skin reactions. A comprehensive review of extant literature was conducted to examine the impact of drug therapy on wound healing and skin health. Read More

    Generalized bullous fixed drug eruption treated with cyclosporine.
    Dermatol Online J 2017 Feb 15;23(2). Epub 2017 Feb 15.
    Department of Dermatology, University of Texas Southwestern Medical Center.
    Fixed drug eruptions (FDE) comprise 10 percent of alladverse cutaneous drug reactions and generalizedbullous fixed drug eruptions (GBFDE) are a raresubset of FDEs. We present a patient with severeGBFDE caused by ibuprofen successfully treated withcyclosporine. Further work is needed to determine ifcyclosporine can be an effective therapy for GBFDE. Read More

    Capecitabine-induced lichenoid drug eruption: a case report.
    Dermatol Online J 2017 Feb 15;23(2). Epub 2017 Feb 15.
    Richard L. Roudebush VA Medical Center, Indianapolis, Indiana.
    Capecitabine is a 5-fluorouracil basedchemotherapeutic drug widely used in the treatmentof solid tumors, especially colorectal and breast. Someof the most common side effects of capecitabine arecutaneous in nature, including hand-foot syndrome(palmar-plantar erythrodysesthesia). Several reports inthe literature link capecitabine use with photosensitivelichenoid eruptions. Read More

    Certolizumab-induced guttate psoriasiform dermatitis.
    Dermatol Online J 2017 Jan 15;23(1). Epub 2017 Jan 15.
    Division of Dermatology, University of Kansas Medical Center, Kansas City.
    Certolizumab is a TNF inhibitor that has showngreat efficacy in chronic inflammatory diseases. Wereport a patient exhibiting a novel adverse effect ofcertolizumab: drug-induced guttate psoriasiformeruption. A review of the mechanism of psoriasiformdrug eruptions is also included. Read More

    Difficult clinical management of antituberculosis DRESS syndrome complicated by MRSA infection: A case report.
    Medicine (Baltimore) 2017 Mar;96(11):e6346
    Department of Dermatology, Allergy and Clinical Immunology Centre, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
    Rationale: Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe drug-induced hypersensitivity reaction characterized by skin rash, fever, blood abnormalities, and multiple organ involvement. The diagnosis of DRESS syndrome is often delayed because of its variable presentation. Prompt withdrawal of the culprit drug is the definitive treatment. Read More

    Adult-onset Still's disease with atypical cutaneous manifestations.
    Medicine (Baltimore) 2017 Mar;96(11):e6318
    aDepartment of Rheumatology bDepartment of Dermatology, Hospital Universitario de Bellvitge-IDIBELL, Barcelona, Spain.
    The diagnosis of adult-onset Still's disease (AOSD) can be very difficult. There are no specific tests available, and diagnosis is usually based on a symptom complex and the well-described typical evanescent rash seen in the majority of patients. However, in recent years, other atypical cutaneous manifestations of AOSD have been reported. Read More

    A Case of Cycloserine-Induced Lichenoid Drug Eruption Supported by the Lymphocyte Transformation Test.
    Allergy Asthma Immunol Res 2017 May;9(3):281-284
    Department of Internal Medicine, Kangwon National University Hospital, Chuncheon, Korea.
    Lichenoid drug eruption (LDE) is a rare form of delayed-type drug eruption. Among anti-tuberculosis (Tb) agents, cycloserine (CS) has been reported as a rare cause of LDE. Positive results on the lymphocyte transformation test (LTT) have not been reported in patients with LDE. Read More

    Human Leukocyte Antigen Class I Genes Associated With Stevens-Johnson Syndrome and Severe Ocular Complications Following Use of Cold Medicine in a Brazilian Population.
    JAMA Ophthalmol 2017 Apr;135(4):355-360
    Department of Frontier Medical Science and Technology for Ophthalmology, Kyoto, Prefectural University of Medicine, Kyoto, Japan.
    Importance: Describing the association with human leukocyte antigen (HLA) alleles could facilitate the understanding of increased risk factors for development of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) in patients with severe ocular complications (SOCs).

    Objective: To investigate the association between HLA class I genes and cold medicine (CM)-associated SJS/TEN with SOCs.

    Design, Setting, And Participants: This case-control study was conducted between February 8, 2013, and August 29, 2014. Read More

    The role of dermatopathology in inpatient care.
    Semin Cutan Med Surg 2017 Mar;36(1):17-22
    Department of Dermatology, University of Minnesota Medical Center, Minneapolis, Minnesota, USA.
    Skin biopsy remains one of the most important tools in the evaluation of dermatologic disease in hospitalized patients and is diagnostic for many common inpatient dermatoses, including various drug eruptions and cutaneous infections. The dermatopathology team thus plays a crucial role in the care of many of these patients and can add significant value through timely and precise diagnoses. Here, we review the unique challenges of dermatopathology in hospital-based medicine, discuss approaches to timely care, and examine effective clinicopathologic correlation in this setting. Read More

    Antithyroid arthritis syndrome.
    BMJ Case Rep 2017 Feb 27;2017. Epub 2017 Feb 27.
    Department of Endocrinology, Cooper University Hospital, Camden, New Jersey, USA.
    Antithyroid arthritis syndrome is a constellation of symptoms of myalgia, arthralgia, arthritis, fever and rash associated with the use of antithyroid medications. We report a case of a patient with severe hyperthyroidism likely secondary to Graves' disease who presented with the abovementioned symptoms after being treated with methimazole (antithyroid medication). Our aim is to increase awareness regarding this uncommon but disabilitating and life-threatening adverse effect of antithyroid medications among clinicians. Read More

    The Impact of Early Dermatologic Events in the Survival of Patients with Hepatocellular Carcinoma Treated with Sorafenib.
    Ann Hepatol 2017 March-April;16(2):263-268
    Irmandade Santa Casa de Misericórdia de Porto Alegre Hospital, Department of Hepatology, Federal University of Health Sciences of Porto Alegre, Brazil.
    Background And Aims: The presence of dermatologic reaction as an adverse event to sorafenib treatment in patients with unresectable hepatocellular carcinoma has been indicated as a prognostic factor for survival in a recent prospective analysis. To date, this is the only clinical predictor of treatment response, which can be evaluated earlier in the treatment and, therefore, contribute to a better and more individualized patient management.

    Material And Methods: This retrospective study included 127 patients treated with sorafenib under real-life practice conditions in two hepatology reference centers in Brazil. Read More

    Common Skin Conditions in Children: Noninfectious Rashes.
    FP Essent 2017 Feb;453:18-25
    University of North Carolina Chapel Hill School of Medicine Dermatology Residency Program, 410 Market St. Suite 400 CB#7715, Chapel Hill, NC 27516.
    Cutaneous adverse drug reactions are among the most common noninfectious rashes of childhood. Cutaneous adverse drug reactions are classified as morbilliform, urticarial, bullous, pustular, or psoriasiform. Atopic dermatitis is one of the most common inflammatory cutaneous eruptions, and is characterized by pruritus and flexural distribution. Read More

    Metronidazole and Norfloxacin induced Generalized Fixed Drug Eruptions in an adult male patient - A Case Report.
    Curr Drug Saf 2017 Feb 9. Epub 2017 Feb 9.
    Government Medical College and Sir Takhtsinhji General Hospital,India.
    Introduction: Fluoroquinolones are most widely used for empirical treatment of gastrointestinal disease due to emergence of drug resistant strains to other antimicrobials. They are also indulged in cutaneous adverse drug reactions with varying form of severity.

    Case Presentation: A 43 year old male patient developed fixed drug eruptions after administration of tablet norfloxacin and metronidazole for treatment of colicky abdominal pain with diarrhoea. Read More

    Janus kinase inhibitors in dermatology: A systematic review.
    J Am Acad Dermatol 2017 Apr 4;76(4):745-753.e19. Epub 2017 Feb 4.
    Department of Dermatology, Hadassah - Hebrew University Medical Center, Jerusalem, Israel. Electronic address:
    Background: Janus kinase (JAK) inhibitors are emerging as a promising new treatment modality for many inflammatory conditions.

    Objective: Our aim was to systematically review the available data on the use of JAK inhibitors in cutaneous diseases.

    Methods: This is a systematic review of PubMed and ClinicalTrials. Read More

    Risk of cumulative toxicity after complete melanoma response with pembrolizumab.
    BMJ Case Rep 2017 Feb 1;2017. Epub 2017 Feb 1.
    Department of Medical Oncology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
    Pembrolizumab is an approved first-line systemic therapy for unresectable metastatic melanoma. Despite the achievement of complete and durable responses in a small subgroup of patients, it is standard practice that pembrolizumab therapy continues beyond complete response. Nevertheless, the incidence of immune-related toxicities gradually increases with continuing pembrolizumab therapy. Read More

    The metabolism of methazolamide in immortalized human keratinocytes, HaCaT cells.
    Drug Metab Lett 2017 Jan 27. Epub 2017 Jan 27.
    Department of Ophthalmology, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, 3-7-1 Habikino, Habikino-shi Osaka 583-8588, Japan.
    Objective: Drug therapy is occasionally accompanied by an idiosyncratic severe toxicity, which occurs very rarely, but can lead to patient mortality. Methazolamide, an anti-glaucomatous agent, could cause severe skin eruptions called Stevens-Johnson syndrome/toxic epidermal necrolyis (SJS/TEN). Its precise etiology is still uncertain. Read More

    Lichenoid Dermatologic Toxicity From Immune Checkpoint Blockade Therapy: A Detailed Examination of the Clinicopathologic Features.
    Am J Dermatopathol 2017 Feb;39(2):121-129
    *Department of Pathology, Section of Dermatopathology, The University of Texas MD Anderson Cancer Center, Houston, TX; Departments of †Dermatology, and ‡Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.
    Immunotherapy targeting the programmed cell death 1 (PD-1) receptor has demonstrated tremendous promise in the treatment of advanced solid tumors. Dermatologic toxicities, however, are an emerging consequence of this therapy and have been clearly associated with immune checkpoint blockade antibodies. Distinctive clinical and histologic subtypes of dermatologic toxicity secondary to immunotherapy are emerging and include rare autoimmune bullous reactions (eg, bullous pemphigoid) and lichenoid eruptions. Read More

    Cutaneous Reactions to Targeted Therapy.
    Am J Dermatopathol 2017 Feb;39(2):67-82
    *Dermatology Resident, University of Pittsburg Medical Center, Pittsburg, PA; Associate Professor, Departments of †Pathology, and ‡Dermatology, Massachusetts General Hospital, Boston, MA; and §Associate Professor, Harvard Medical School, Boston, MA.
    Over the past decade, numerous targeted therapeutic agents have become available for clinical use in the oncologic setting with the hopes of realizing personalized cancer treatment. These agents have achieved great improvements in clinical outcomes for patients suffering from solid and hematologic malignancies. However, adverse cutaneous reactions are among the most common toxicities observed in patients undergoing treatment with a targeted agent and can alter the overall clinical management strategy. Read More

    Rumpel-Leede phenomenon in a patient with adult-onset Still's disease.
    BMJ Case Rep 2017 Jan 27;2017. Epub 2017 Jan 27.
    George Washington University School of Medicine and Health Sciences, Stouffville, Ontario, Canada.
    Rumpel-Leede phenomenon (RLP), also known as acute capillary rupture syndrome (ACRS), is a rare occurrence where distal dermal capillaries rupture in response to a proximal compressive force, such as a blood pressure cuff or tourniquet. This phenomenon has been reported to occur in states of vascular fragility such as long-term steroid use, hypertension or diabetes mellitus. Here, we provide a report of RLP occurring secondary to tourniquet application in a 26-year-old woman with adult-onset Still's disease (AOSD) and a recent drug rash. Read More

    Anticonvulsant hypersensitivity syndrome secondary to carbamazepine.
    Proc (Bayl Univ Med Cent) 2017 Jan;30(1):94-96
    Department of Internal Medicine, Baylor Scott & White Hospital, Temple, Texas.
    Anticonvulsant hypersensitivity syndrome (AHS) is a potentially fatal multiorgan drug reaction that presents with various cutaneous eruptions. There is a genetic predisposition to such reactions. We present a young woman with AHS due to carbamazepine that presented as an atypical erythema multiforme with elevated liver enzymes. Read More

    Nicolau Syndrome.
    Arch Iran Med 2017 Jan;20(1):60-64
    Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
    A 23 year-old man was admitted to the hospital with chief complaints of pain, edema and spasm of the left lower limb, as well as mottling of dorsal and plantar aspects of the foot.  One week before the current admission, he was treated with oral co-amoxiclave and intramuscular penicillin 6.3. Read More

    Management of acute skin toxicity with Hypericum perforatum and neem oil during platinum-based concurrent chemo-radiation in head and neck cancer patients.
    Med Oncol 2017 Feb 18;34(2):30. Epub 2017 Jan 18.
    Department of Oncology, Radiation Oncology, University of Turin, Via Genova 3, 10126, Turin, Italy.
    Acute skin toxicity is a frequent finding during combined radiotherapy and chemotherapy in head and neck cancer patients. Its timely and appropriate management is crucial for both oncological results and patient's global quality of life. We herein report clinical data on the use of Hypericum perforatum and neem oil in the treatment of acute skin toxicity during concurrent chemo-radiation for head and neck cancer. Read More

    Erythema Nodosum Leprosum-Like Lesions Are a Histopathologic Pattern in Whipple's Disease and a Sign of the Immune Reconstitution Inflammatory Syndrome: A Case Series and Review of the Literature.
    Am J Dermatopathol 2017 Apr;39(4):259-266
    *Dermatopathology Duisburg, Duisburg, Germany; †Department of Pathology, APHP Cochin Hospital, University Paris-Descartes, Paris, France; ‡Department of Dermatology, Saint Pierre-Brugmann and Children's University Hospitals, UniversiteLibre de Bruxelles, Brussels, Belgium; and §Divisions of Dermatopathology and Dermatology, Department of Pathology, Albany Medical College, Albany, NY.
    Inflammatory and subcutaneous nodules can arise in treated and untreated cases of Whipple disease (WD). The inflammatory immune reconstitution syndrome describes paradoxical clinical inflammatory worsening of a preexisting condition because of a return of immune function. Clinicopathologic examination of 4 patients with WD who presented with erythema nodosum leprosum (ENL)-like lesions and the findings of a systematic review of this phenomenon revealed that ENL-like lesions occurred in predominantly middle-aged male patients who suffered from WD, mostly on the legs. Read More

    Disseminated eruptive granuloma annulare induced by levetiracetam.
    Cutan Ocul Toxicol 2017 Jan 17:1-2. Epub 2017 Jan 17.
    c Neurology, Abant Izzet Baysal Universitesi , Bolu , Turkey.
    Granuloma annulare (GA) is a benign, granulomatous cutaneous disease without clear etiology. Disseminated and drug induced granuloma annulare is a rare presentation. We present a 47-year-old woman with diffuse circular erythematous eruptions following treatment with levetiracetam. Read More

    Disorders characterized by predominant or exclusive dermal inflammation.
    Semin Diagn Pathol 2016 Dec 14. Epub 2016 Dec 14.
    Section of Dermatopathology, Division of Surgical Pathology & Cytopathology, University of Virginia Medical Center, Room 3020 University of Virginia Hospital, 1215 Lee Street, Charlottesville, VA 22908-0214, USA. Electronic address:
    Some cutaneous inflammatory disorders are typified by a predominant or exclusive localization in the dermis. They can be further subdivided by the principal cell types into lymphocytic, neutrophilic, and eosinophilic infiltrates, and mixtures of them are also seen in a proportion of cases. This review considers such conditions. Read More

    Acute generalized exanthematous pustulosis: clinical characteristics, etiologic associations, treatments, and outcomes in a series of 28 patients at Mayo Clinic, 1996-2013.
    Int J Dermatol 2017 Apr 13;56(4):405-414. Epub 2017 Jan 13.
    Department of Dermatology, Mayo Clinic, Rochester, MN, USA.
    Background: Acute generalized exanthematous pustulosis (AGEP) is a rare skin condition typically caused by medications. The objective of this study was to examine the clinical features, causes, and outcomes of AGEP at a sole tertiary care center.

    Methods: A retrospective review of patients with AGEP (European Study of Severe Cutaneous Adverse Reactions score of ≥ 5) seen at Mayo Clinic (Rochester, MN, USA) between January 1, 1996, and December 31, 2013, was conducted. Read More

    Oral and vulvo-vaginal lichenoid reactions due to mitotane (Lysodren): A case report.
    Medicine (Baltimore) 2017 Jan;96(2):e5075
    aDepartment of Dental Surgery bDepartment of Endocrinology, Brest University Hospital, Brest cDepartment of Dermatology, Quimper Hospital, Quimper dDepartment of Oral Surgery, Brest University Hospital, Brest, France.
    Background: The purpose of pharmacovigilance (drug safety) is collection, detection, assessment, monitoring, and prevention of adverse effects with pharmaceutical products. It is meant to identify, characterize, prevent, or minimize actual or potential risks relating to medicinal products. To prevent these adverse effects and improve our practice, health professionals have a duty to report side effects to assess this risk and evaluate the benefit/risk requirements. Read More

    Anesthetic Management of a Patient with DRESS Syndrome for Renal Transplantation.
    Int J Organ Transplant Med 2016 1;7(4):234-236. Epub 2016 Nov 1.
    Department of Anesthesiology and Critical Care, Institute of Kidney Diseases and Research Centre and Institute of Transplantation Sciences, Ahmedabad, Gujarat, India.
    Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare but potentially life-threatening hypersensitivity reaction characterized by widespread erythematous skin eruptions with fever, lymphadenopathy and visceral involvement-hepatitis, nephritis, pericarditis, and pneumonitis. There are numerous reports describing the management of such patients in intensive care units but hardly any describing the intraoperative anesthetic management of such patients. Herein, we report on a patient with DRESS syndrome who was scheduled for renal transplantation. Read More

    Histologic Assessment of Lichenoid Dermatitis Observed in Patients With Advanced Malignancies on Antiprogramed Cell Death-1 (anti-PD-1) Therapy With or Without Ipilimumab.
    Am J Dermatopathol 2017 Jan;39(1):23-27
    *Tissue Pathology and Diagnostic Oncology, Westmead Hospital, Sydney, Australia; †Department of Dermatology, Westmead Hospital, Sydney, Australia; and ‡Sydney Medical School, University of Sydney, Sydney, Australia.
    Lichenoid drug reaction is a common adverse reaction in patients taking immune-modulatory agents such as antiprogramed cell death (PD-1) and cytotoxic T lymphocyte antigen-4 agents. The authors describe the clinical and histologic features of lichenoid drug reaction in 20 biopsies from 15 patients on anti-PD-1 agents and 9 biopsies from 7 patients on anti-PD-1 plus ipilimumab therapy. Clinically, all except 2 patients presented with discrete, violaceous exanthematous papules to plaques. Read More

    Clinical Outcomes and Complications Associated with Fractional Lasers: A Review of 730 Patients.
    Aesthetic Plast Surg 2017 Feb 28;41(1):171-178. Epub 2016 Dec 28.
    FACES+ Plastic Surgery, Dermatology, Skin and Laser Center, La Jolla, CA, USA.
    Background: Fractional lasers were introduced to provide increased safety, while maintaining high efficacy and patient satisfaction. Patients with virtually all Fitzpatrick skin types could be safely treated using a wide spectrum of wavelengths and a broad array of skin conditions, and aging could be addressed. Although safety studies have been reported for ablative CO2 and erbium lasers, surprisingly few data are available on adverse events and complications associated with fractional lasers. Read More

    Idelalisib-induced colitis and skin eruption mimicking graft-versus-host disease.
    Clin J Gastroenterol 2017 Apr 26;10(2):142-146. Epub 2016 Dec 26.
    Department of Pathology, Saint Louis University School of Medicine, St. Louis, MO, USA.
    Introduction: Idelalisib is a selective inhibitor of the delta isoform of phosphatidylinositol 3-kinase which was approved by the United States Federal Drug Administration in 2014 for the treatment of relapsed chronic lymphocytic leukemia and indolent non-Hodgkin lymphoma. Drug-induced injury of the gastrointestinal tract is a relatively frequent but usually under-recognized disease entity.

    Case Presentation: We report the case of a 56-year-old male with a history of relapsed follicular lymphoma status post allogenic bone marrow transplant who developed severe diarrhea with a skin eruption mimicking graft-versus-host disease (GVHD) 6 months after starting idelalisib. Read More

    Interleukin-15 Is Associated with Severity and Mortality in Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis.
    J Invest Dermatol 2017 May 21;137(5):1065-1073. Epub 2016 Dec 21.
    Whole-Genome Research Core Laboratory of Human Diseases, Chang Gung Memorial Hospital, Keelung, Taiwan; Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Taipei, Linkou and Keelung, Taiwan; Chang Gung Immunology Consortium, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen, China. Electronic address:
    Early diagnosis and prognosis monitoring for Stevens-Johnson syndrome/toxic epidermal necrolysis (TEN) still remain a challenge. This study aims to explore any cytokine/chemokine with prognostic potential in Stevens-Johnson syndrome/TEN. Through screening a panel of 28 serological factors, IL-6, IL-8, IL-15, tumor necrosis factor-α, and granulysin were upregulated in patients with Stevens-Johnson syndrome/TEN and selected for the further validation in total 155 patients with Stevens-Johnson syndrome/TEN, including 77 from Taiwan and 78 from the Registry of Severe Cutaneous Adverse Reactions. Read More

    Cutaneous Side Effects and Transepidermal Water Loss To Gefitinib: A Study of 11 Patients.
    Dermatol Ther (Heidelb) 2017 Mar 21;7(1):133-141. Epub 2016 Dec 21.
    Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran-Dr. Hasan Sadikin General Hospital, Bandung, Indonesia.
    Introduction: Cutaneous side effects caused by epidermal growth factor receptor (EGFR) inhibitors occurred in 45-100% of patients which may lead to therapy modification or interruption. This study aimed to evaluate cutaneous side effects and transepidermal water loss (TEWL) values in non-small cell lung carcinoma (NSCLC) patients who received gefitinib EGFR inhibitor.

    Methods: A descriptive observational study with cross-sectional design and a consecutive sampling method was conducted from 1 February to 4 March 2016. Read More

    Review of Toxic Epidermal Necrolysis.
    Int J Mol Sci 2016 Dec 18;17(12). Epub 2016 Dec 18.
    Dermatology Department, Royal North Shore Hospital, 2065 Sydney, Australia.
    Toxic epidermal necrolysis (TEN) is a rare but life threatening mucocutaneous reaction to drugs or their metabolites. It is characterised by widespread keratinocyte apoptosis and sloughing of the skin, erosions of the mucous membranes, painful blistering, and severe systemic disturbance. The pathophysiology of TEN is incompletely understood. Read More

    Streptococcus agalactiae Endophthalmitis in Boston Keratoprosthesis in a Patient with Steven-Johnson Syndrome.
    Middle East Afr J Ophthalmol 2016 Oct-Dec;23(4):329-331
    King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
    A 25-year-old Syrian male with a previous episode of Stevens-Johnson syndrome with bilateral corneal cicatrization previously underwent surgery for Type 1 Boston Keratoprosthesis (K-Pro). Sixteen months after the K-Pro surgery, the patient presented with decreased vision to hand motion and microbial keratitis of the graft around the K-Pro with purulent discharge. Corneal scrapings were nonrevealing. Read More

    [Triggers of exanthematous drug eruptions: Stop intake, treat through or desensitization?]
    Hautarzt 2017 Jan;68(1):29-35
    Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Technische Universität München, Biedersteiner Str. 29, 80802, München, Deutschland.
    Drug hypersensitivity reactions affect over 7% of the population and are problematic both for patients and doctors. They frequently occur in the form of exanthematous drug eruptions. The clinical manifestation of delayed hypersensitivity reactions is very variable ranging from localized fixed drug eruptions to life-threatening, severe bullous mucocutaneous eruptions or systemic drug hypersensitivity syndromes. Read More

    Effects of Colloidal Oatmeal Lotion on Symptoms of Dermatologic Toxicities Induced by Epidermal Growth Factor Receptor Inhibitors.
    Adv Skin Wound Care 2017 Jan;30(1):27-34
    Ya-Ting Ke, RN, is a Head Nurse, Emergency Department, Chi-Mei Medical Center, Tainan, Taiwan; and Doctoral Student, School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan. Chia-Chi Kuo, RN, is an Advanced Practice Nurse, Emergency Department, Chi-Mei Medical Center, Tainan, Taiwan; and Doctoral Candidate, School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan; and Assistant Professor, Department of Nursing, Chang Jung Christian University, Tainan, Taiwan. Acknowledgments: This work was sponsored by grants from the Chi Mei Medical Center, Tainan, Taiwan (CMHCR10110). The authors thank Li-Chien Yang, Kuei-Ching Wang, and Ling-Ling Liang, the head nurses of the Center of Evidence-Based Medicine, Nursing Department, Chi Mei Medical Center, and Chia-Hui Tsai, the Clinical Instructor of the Department of Nursing, Tajen University, Pingtung County, Taiwan, for their dedication to evidence collection and critical appraisal. They also thank attending physicians, Drs Yin-Hsun Feng and Wei-Yu Chen, and the chemotherapy team of the Division of Hematology and Oncology, Chi Mei Medical Center, for their assistance in study recruitment. The authors have disclosed that they have no financial interests related to this article. Submitted December 18, 2014; accepted in revised form August 4, 2015.
    Objective: The common adverse effects associated with targeted therapy for cancer, such as epidermal growth factor receptor inhibitors (EGFRIs), are dermatologic toxicities that cause the patient physical discomfort and affect treatment. Colloidal oatmeal lotion (COL) has been proven to help prevent dermatitis and xerosis. Evidence of its effect on EGFRI-induced dermatologic toxicities, however, is limited. Read More

    Combined exposure of diesel exhaust particles and respirable Soufrière Hills volcanic ash causes a (pro-)inflammatory response in an in vitro multicellular epithelial tissue barrier model.
    Part Fibre Toxicol 2016 12 12;13(1):67. Epub 2016 Dec 12.
    BioNanomaterials, Adolphe Merkle Institute, University of Fribourg, Chemin des Verdiers 4, CH-1700, Fribourg, Switzerland.
    Background: There are justifiable health concerns regarding the potential adverse effects associated with human exposure to volcanic ash (VA) particles, especially when considering communities living in urban areas already exposed to heightened air pollution. The aim of this study was, therefore, to gain an imperative, first understanding of the biological impacts of respirable VA when exposed concomitantly with diesel particles.

    Methods: A sophisticated in vitro 3D triple cell co-culture model of the human alveolar epithelial tissue barrier was exposed to either a single or repeated dose of dry respirable VA (deposited dose of 0. Read More

    The contribution of keratinocytes in capecitabine-stimulated hand-foot-syndrome.
    Environ Toxicol Pharmacol 2017 Jan 5;49:81-88. Epub 2016 Dec 5.
    Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, Institute of Pharmacology and Toxicology, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China. Electronic address:
    Capecitabine, as the first-line treatment for multiple tumor types, has a serious drawback of hand-foot-syndrome (HFS) that limits its clinical use. However, the pathophysiology and mechanism of capecitabine-induced HFS is rarely known. Here we built the experimental mouse model of HFS induced by capecitabine at first and it was shown that 3 of 6 mice appeared HFS in the 5th day and 5 mice occurred HFS in the 30th day. Read More

    Drug reaction with eosinophilia and systemic symptoms (DRESS): incidence, pathogenesis and management.
    Expert Opin Drug Saf 2017 Feb 21;16(2):139-147. Epub 2016 Dec 21.
    a Department of Dermatology , Kyorin University School of Medicine , Tokyo , Japan.
    Introduction: Drug-induced hypersensitivity syndrome(DiHS), often referred to as drug reaction with eosinophilia and systemic symptoms (DRESS), is a life-threatening multi-organ system reaction induced by drugs and associated with sequential reactivations of herpesviruses. This syndrome has several unique features, creating uncertainty over whether it represents true drug eruption. Areas covered: A literature review of all the cases was made by a Pub Med search. Read More

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