1/4. patients with acute skin loss: are they best managed on a burns unit?patients who are critically ill and have large areas of skin loss or breakdown present a difficult management problem. They require the combination of intensive therapy facilities to support failing organs and specialized skin care, sometimes including extensive debridement and reconstruction. The expertise required for both aspects of treatment are found uniquely on a burns unit. We present five patients with large areas of cutaneous loss or damage secondary to a variety of non-burn aetiologies who were managed on a burns unit. We suggest that a burns unit may be the most appropriate place for such patients to be treated during both the acute phase of their illness and the later stages of surgical reconstruction and physical rehabilitation.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/4. Nimesulide-induced fixed drug eruption.BACKGROUND: Nimesulide is a cyclooxygenase (COX) inhibitor with a high degree of selectivity to COX-2. It is a widely used and well tolerated nonsteroidal antiinflammatory drug that also has analgesic and antipyretic properties. The most frequently reported side effects concern the gastrointestinal tract. pruritus and skin rash are the most common cutaneous adverse reactions. There are only eight cases of fixed drug eruptions due to nimesulide, described in the literature. CASE REPORT: The authors report a case of a patient with a history of antihistamine hypersensitivity who developed a bullous form of pigmented fixed drug eruption after nimesulide ingestion. patch tests performed on residual skin lesion were positive to nimesulide, confirming that this was the culprit drug. CONCLUSIONS: Fixed drug eruptions are common cutaneous drug reactions, often misdiagnosed. A detailed anamnesis and physical examination are the key to suspect this condition.- - - - - - - - - - ranking = 13.088752861386keywords = physical examination, physical (Clic here for more details about this article) |
3/4. tocainide: a severe adverse reaction.tocainide is a primary analog of lidocaine with antiarrhythmic properties used to treat ventricular rhythm disorders. A 76-year-old man with benign paroxysmal premature ventricular contractions was treated with tocainide and developed a generalized maculopapular lupoid eruption, bleeding from the lips and gingivae, vertigo, gross tremors of the extremities, fever, and short-term memory loss, which required hospitalization. The patient recovered slowly over three months with no permanent sequelae after discontinuing the drug and receiving rigorous supportive care. His excellent physical status and absence of concomitant illness contributed to an uneventful recovery. tocainide is a potent cardioactive drug with a long biological half-life and should be used with caution.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/4. erythema nodosum caused by omeprazole.We report a case of erythema nodosum caused by omeprazole. This side effect of omeprazole has not been previously reported. A 35-year-old white woman developed multiple tender erythematous nodules over the anterior aspect of her upper and lower extremities, fever, malaise, and edema. Her symptoms resolved with withdrawal of all preexisting medications and conservative treatment. Her symptoms flared soon after a rechallenge with omeprazole. A thorough history, physical examination, laboratory evaluation, and roentgenogram failed to reveal another cause for erythema nodosum. It is clear from the rechallenge that this patient's erythema nodosum was caused by omeprazole. We consider that omeprazole should be added to the list of medications known to cause erythema nodosum.- - - - - - - - - - ranking = 13.088752861386keywords = physical examination, physical (Clic here for more details about this article) |