1/21. Case report. sporotrichosis successfully treated with itraconazole in japan.A case of lymphocutaneous sporotrichosis that had developed from the dorsum nasi to the left buccal region of a 65-year-old woman was treated with itraconazole 100 mg day-1. The lesion healed in 10 weeks after starting treatment leaving crusts, mild erythema and pigmentation, and the treatment was completed 16 weeks after the start of treatment. Neither adverse reactions nor abnormal clinical laboratory values were noted. Until the present time, 1 year and 2 months after the completion of treatment, no recurrence has been observed. In japan, 43 cases of sporotrichosis have been treated with itraconazole, and 38 cases (88%) have been assessed as effective or better. The mean dose of itraconazole and the mean duration of administration are 100 mg day-1 and 11 weeks, respectively, in these reported Japanese cases. The use of itraconazole is expected to be one of the effective therapies for sporotrichosis.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
2/21. Vegetant bromoderma in an infant.Bromoderma is a cutaneous reaction caused by the use of products containing bromide. In this report we describe a 2-month-old girl who was admitted to our institution with vegetative lesions on the face and scalp owing to the administration of a syrup containing sodium bromide.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
3/21. hiv seronegative eosinophilic pustular folliculitis successfully treated with metronidazole.We describe a patient with eosinophilic pustular folliculitis (EPF) who initially responded to oral indomethacin, the most often-used therapy for EPF, but eventually became refractory to continuous administrations. Treatment with metronidazole resulted in complete clearance of the lesion.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
4/21. Chronic actinic dermatitis treated with cyclosporine-A.Chronic actinic dermatitis (CAD) groups together all chronic photodermatosis with light photosensitivity. We report the case of a 69-year-old man who, for over one year, had presented a reddish-brown erythema and shedding, with thickened and hypo-elastic skin on the face, scalp, neck and on the back of the hands and forearms. patch tests were positive to isoeugenolo 1% and photo-patch tests showed a positivity to phenotiazine 2%. After a short and ineffective treatment with beta-carotene and photo-protectors, the clinical picture was resolved with the administration of oral steroids but with a relapse of the dermatitis once the dosage was lowered. We therefore started treatment with cyclosporine-A (4.5 mg/kg/die), which resulted in a rapid improvement of the clinical picture, but with a reappearance of the manifestations when the dosage was lowered. The treatment was resumed and we observed that the dose of 1.5/mg/kg/die resulted morbus-static. The patient is still being treated with this drug at this dosage. The result is that the disease is under control and no side effects are present. As we consider CAD an invalidating disease it seems to us that Cy-A could be taken into consideration as an alternative to traditional treatments.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
5/21. Demodex abscesses: clinical and therapeutic challenges.A 53-year-old man had a 6-week history of confluent erythematous papules, pustules, and abscesses of the face initially limited to the right nasolabial fold. Histologic investigation revealed a perifollicular infiltrate with lymphocytes, histiocytes, and many Demodex folliculorum mites. A large number of mites were seen in skin scrapings. The skin manifestations progressed and persisted for the following 5 years and were unresponsive to numerous antiparasitic treatments, including repeated oral administration of ivermectin and external application of lindane, permethrin, and benzoyl benzoate. Therapy with oral administration of 250 mg metronidazole 3 times a day for 2 weeks resulted in rapid and lasting recovery. Demodex folliculitis remains a diagnostic and therapeutic challenge. Antiparasitic therapies used against lice or scabies may fail in control of D folliculorum mites. In the presence of clinical and microscopic findings typical of Demodex folliculitis or abscesses, treatment failure with acaricidal agents does not exclude the diagnosis. Oral metronidazole seems to work in the management of this chronic mite infestation.- - - - - - - - - - ranking = 2keywords = administration (Clic here for more details about this article) |
6/21. Systemic acyclovir reaction subsequent to acyclovir contact allergy: which systemic antiviral drug should then be used?Allergic contact dermatitis caused by acyclovir is rare. We report the 5th case of systemic acyclovir reaction subsequent to acyclovir contact dermatitis, with investigations made to determine an alternative antiviral treatment. A 23-year-old woman, after dermatitis while using Zovirax cream, went on to develop urticaria after oral acyclovir. patch tests were performed with the components of Zovirax cream (acyclovir, propylene glycol and sodium lauryl sulfate) and with other antiviral drugs. patch tests were positive to Zovirax cream, acyclovir, valacyclovir and propylene glycol. Patch and prick tests with famciclovir were negative, but its oral administration caused an itchy erythematous dermatitis on the trunk and extremities. Our patient developed a systemic acyclovir reaction subsequent to acyclovir allergic contact dermatitis, with cross-reactions to valacyclovir and famciclovir. Their common chemical structure is the 2-aminopurine nucleus. It is probably this part of the molecule that provokes both contact allergy and systemic reactions. The only antiviral drugs not having this core are foscarnet and cidofovir, and these could therefore be alternatives.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
7/21. The successful use of topical tacrolimus treatment for a chronic actinic dermatitis patient with complications of idiopathic leukopenia.Chronic actinic dermatitis (CAD) is a photosensitivity disorder marked by severe eczematous lesions on exposed areas. Although associations with contact dermatitis, atopic dermatitis, and human immunodeficiency virus (hiv) have been suggested, its pathogenesis remains unknown. CAD is often refractory, and systemic administration of cyclosporin A has been the treatment of choice. Recently, topical tacrolimus therapy has been reported to be effective. We report the efficacy of topical tacrolimus treatment in a CAD patient who also had the complication of idiopathic leukopenia. A phototest showed marked suppression of erythema formation in the skin pre-treated with tacrolimus before UVB radiation but not in the skin treated after the irradiation. Therefore, it is suggested that tacrolimus may prevent UV-B induced erythema by suppressing a very early phase of the inflammatory process in CAD.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
8/21. Fulminant herpetic sycosis: atypical presentation of primary herpetic infection.Fulminant herpetic sycosis is a rare but well-known manifestation of herpes simplex virus (HSV) infection occurring in the context of viral recurrence in immunodepressed patients. We present here the case of a 32-year-old male patient, without notable medical history, who developed papulovesicular lesions of the beard accompanied by fever, painful cervical lymphadenopathy and odynophagia, with a clinical evolution that was initially unfavourable under antibiotic treatment. The diagnosis of herpetic sycosis was established by means of direct immunofluorescence and culture which confirmed positivity for HSV-1 and serologies compatible with a primary viral infection. No sign for a latent immune deficit was found at the time of investigations. The clinical evolution was rapidly favourable with administration of intravenous aciclovir for 1 week. To our knowledge, herpetic sycosis as a presentation of primary viral infection has not been reported previously. The possibility of a herpetic sycosis of the beard must be considered in the case of non-response to antibiotic or antifungal treatment.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
9/21. Delayed-type hypersensitivity to amide local anesthetics.We present a 54-year-old woman who suffered eczematous eruptions on her face after the administration of lidocaine and mepivacaine for dental surgeries. patch tests showed delayed-type-hypersensitivity to the amide local anesthetics lidocaine and mepivacaine with cross reaction to other amynoacylderivatives (prilocaine,bupivacaine) but not articaine.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
10/21. Allergic reaction caused by articaine.We report the case of a 51-year-old woman who had an immediate skin reaction after subcutaneous administration of a local anesthetic (LA) composed of articaine and epinephrine before a dental procedure. The patient subsequently underwent further dental procedures without LA. Skin prick tests performed with commercial LAs (lidocaine, mepivacaine, bupivacaine and articaine) were negative with epinephrine and all LAs except articaine. In 10 healthy controls, skin prick tests with articaine were negative. Subcutaneous challenge test with mepivacaine (0.3 and 0.5 ml) was negative. Provocations with the remaining anesthetics of the amide group were not carried out due to the patient's refusal.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
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