1/22. Treatment of pruritis of reactive perforating collagenosis using transcutaneous electrical nerve stimulation.Reactive perforating collagenosis is a form of perforating dermatosis due to transepithelial elimination of collagen and characterized by itchy papulonodular eruptions frequently seen in patients with diabetes mellitus and end stage renal failure. pruritus is often severe and treatment is difficult. Two adult Chinese diabetic patients with acquired reactive perforating collagenosis unresponsive to topical therapies and oral antihistamines, were treated with transcutaneous electrical nerve stimulation. There was a significant reduction of itch followed by gradual resolution of the skin lesions.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
2/22. A case report of olanzapine-induced hypersensitivity syndrome.hypersensitivity syndrome is defined as a drug-induced complex of symptoms consisting of fever, rash, and internal organ involvement. The hypersensitivity syndrome is well recognized as being caused by anticonvulsants. Olanzapine is an atypical antipsychotic agent whose side effects include sedation, weight gain, and increased creatinine kinase and transaminase levels. To date, there have been no reports of hypersensitivity syndrome related to this drug. A 34-year-old man developed a severe generalized pruritic skin eruption, fever, eosinophilia, and toxic hepatitis 60 days after ingestion of olanzapine. After termination of olanzapine treatment, the fever resolved, the skin rash was reduced, eosinophil count was reduced to normal, and the transaminase levels were markedly reduced. Clinical features and the results of skin and liver biopsies indicated that the patient developed hypersensitivity syndrome caused by olanzapine.- - - - - - - - - - ranking = 0.012591455143271keywords = organ (Clic here for more details about this article) |
3/22. vancomycin anaphylaxis in a patient with vancomycin-induced red man syndrome.vancomycin is a powerful glycopeptide antibiotic that is increasingly being used owing to the emergence of highly resistant organisms such as methicillin-resistant staphylococcus aureus. Although a generally safe medication, administration of vancomycin is not benign, and there have been a number of adverse reactions reported. We present the case of a patient with vancomycin-induced red man syndrome who developed vancomycin anaphylaxis. Our case illustrates that red man syndrome may be a marker for true vancomycin allergy, although it was generally not thought of as so in the past.- - - - - - - - - - ranking = 0.012591455143271keywords = organ (Clic here for more details about this article) |
4/22. The use of TENS for pruritus relief in the burns patient: an individual case report.The case report outlines the use of transcutaneous electrical nerve stimulation (TENS) for the relief of pruritus in a 19-year-old patient who had sustained 70% mixed-thickness flame burns. Once healed, two electrodes were applied to the region of most severe itching, which was the lumbar spine. They were applied at 10 AM and remained in place until he went to bed. A visual analog scale (VAS) rating of itching was used to measure the sensation subjectively before application, immediately after application, and 4 hours after continuous application. Readings were taken for 5 consecutive days and then followed up during a 2-week period. At this time the patient discontinued the use of TENS, because itching had decreased significantly. Results showed that between day 1 and day 16 there was a 50% improvement before application and a 100% improvement 4 hours after application of TENS. These results suggest that a study to investigate the effect of TENS for the relief of pruritus in the burn patient would be justified to provide an alternative, noninvasive treatment approach.- - - - - - - - - - ranking = 0.2keywords = nerve (Clic here for more details about this article) |
5/22. Cutaneous sensory nerve fibers are decreased in number after peripheral and central nerve damage.Two dermatologic patients displaying peripheral and central nerve damage, respectively, are described. Cutaneous nerve fibers in both patients were studied in skin biopsy specimens taken from neuropathic areas and from the contralateral side, immunocytochemistry being applied to a pan-neuronal marker, a protein gene-product (PGP 9.5). One of the patients, suffering from compression of the ulnar nerve, had dyshidrotic eczema of the hands that was absent on areas of skin that were neuropathic. The cutaneous innervation (most of which was sensory) was reduced by 50% in the neuropathic area as compared with the contralateral side. The other patient had unilateral pruritus on the parethic side after a stroke. The cutaneous innervation of that side was reduced by 80% as compared with the other side. It seems that peripheral sensory innervation is a prerequisite for inflammation, whereas spontaneous itching may emanate from a central nervous system disorder such as a stroke and continue on in partly denervated skin.- - - - - - - - - - ranking = 2.2keywords = nerve (Clic here for more details about this article) |
6/22. Notalgia paresthetica with a significant increase in the number of intradermal nerves.Notalgia paresthetica is an isolated mononeuropathy involving the skin over or near the scapula. The cause remains unknown. We histologically observed a significant increase in the number of dermal nerves in a case of notalgia paresthetica. Immunohistochemical examination using a neural marker, S-100, positively stained the nerves. Interestingly, a biopsy from perilesional skin also showed an abnormal nerve proliferation.- - - - - - - - - - ranking = 1.4keywords = nerve (Clic here for more details about this article) |
7/22. Epidural clonidine relieves intractable neuropathic itch associated with herpes zoster-related pain.OBJECTIVE: We present a case of intense herpes zoster-related pain and itching in the ophthalmic division of the trigeminal nerve (V1). Successful pain and itch management was achieved after insertion of a high thoracic epidural catheter with a continuous infusion of bupivacaine and clonidine. CASE REPORT: A 73-year-old woman with metastatic malignant melanoma developed acute herpes zoster-related pain and itching unresponsive to conventional oral medications. The patient described severe and frequent attacks of lancinating pain occurring in the dermatomal distribution of the left ophthalmic division of the trigeminal nerve. She also had a disturbing itch in the same distribution as her pain. The patient had significant reduction in the frequency and intensity of the lancinating attacks after placement of a thoracic epidural catheter with continuous infusion of 1 microg/mL clonidine and 0.05% bupivacaine. The itching resolved completely as well. CONCLUSION: High thoracic epidural infusion of bupivacaine and clonidine was beneficial in relieving neuropathic itch in a patient with acute herpes zoster-related pain in the distribution of the trigeminal nerve.- - - - - - - - - - ranking = 0.6keywords = nerve (Clic here for more details about this article) |
8/22. clomipramine-induced hypersensitivity syndrome with unusual clinical features.Drug-induced hypersensitivity syndrome is a severe drug eruption with fatal visceral organ failures associated with human herpesvirus-6 (HHV-6) reactivation. We present a case of clomipramine-induced hypersensitivity syndrome, which displayed in succession two different reactions akin to those described for Gianotti-Crosti syndrome and infectious mononucleosis. HHV-6 reactivation was confirmed serologically after the latter reaction, suggesting that our case may have represented a biphasic reaction to HHV-6 reactivation.- - - - - - - - - - ranking = 0.012591455143271keywords = organ (Clic here for more details about this article) |
9/22. A 34-year-old man with chronic itching and peripheral and submucosal eosinophilia.A 34-year-old man with peripheral eosinophilia, chronic pruritus, and colonic eosinophilic infiltration is presented as a patient-oriented problem-solving case report to show the important aspects of differential and specific diagnosis, treatment, prognosis, and caveats in the approach to the workup of the patient with eosinophilia. Allergic rhinitis, asthma, atopy, and drug-induced eosinophilia should come to mind in the initial differential diagnosis of any patient with peripheral eosinophilia. Also included in the differential after allergic disease processes would be the general categories of infectious, neoplastic, and the various forms of organ-specific eosinophilic infiltration and idiopathic syndromes. The importance of ruling out infectious causes for eosinophilia is paramount, especially given the dangers of immunosuppressive treatments often used to treat other conditions associated with eosinophilia.- - - - - - - - - - ranking = 0.012591455143271keywords = organ (Clic here for more details about this article) |
10/22. Multiple pruritic papules from lone star tick larvae bites.BACKGROUND: ticks are the second most common vectors of human infectious diseases in the world. In addition to their role as vectors, ticks and their larvae can also produce primary skin manifestations. Infestation by the larvae of ticks is not commonly recognized, with only 3 cases reported in the literature. The presence of multiple lesions and partially burrowed 6-legged tick larvae can present a diagnostic challenge for clinicians. observation: We describe a 51-year-old healthy woman who presented to our clinic with multiple erythematous papules and partially burrowed organisms 5 days after exposure to a wooded area in southern kentucky. She was treated with permethrin cream and the lesions resolved over the following 3 weeks without sequelae. The organism was later identified as the larva of Amblyomma species, the lone star tick. CONCLUSIONS: Multiple pruritic papules can pose a diagnostic challenge. The patient described herein had an unusually large number of pruritic papules as well as tick larvae present on her skin. Recognition of lone star tick larvae as a cause of multiple bites may be helpful in similar cases.- - - - - - - - - - ranking = 0.025182910286542keywords = organ (Clic here for more details about this article) |
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