Adverse Drug Reactions to First-line Anti-tubercular Drugs Based on Individual Case Safety Report in a Single Tertiary Hospital / 대한내과학회지

Background/Aims@#Tuberculosis has incidence and mortality rates that are among the highest for all communicable diseases. Adverse drug reactions (ADRs) to anti-tubercular drugs are common, and have a major impact on treatment maintenance and prognosis. It is important to understand the characteristics of ADRs and establish a suitable management plan. @*Methods@#We retrospectively reviewed patients with ADRs during treatment with first-line antitubercular drugs such as isoniazid, rifampicin, ethambutol, and pyrazinamide from 2009 to 2018. Age, sex, and total treatment period, and the onset, severity, seriousness, and system organ class of ADRs, were analyzed to understand the characteristics of first-line anti-tubercular drug-related ADRs. @*Results@#A total of 1,606 of 5,482 patients (29.3%) experienced ADRs after administration of first-line anti-tubercular drugs. The incidence of ADRs related to isoniazid, rifampicin, ethambutol, and pyrazinamide was 22.2%, 21.3%, 24.5%, and 29.6%, respectively. A total of 2,098 ADR reports were made (mean of 1.3 ± 0.6 per patient). The rates of mild, moderate, and severe ADRs were 32.4%, 61.1%, and 6.5%, respectively. There were 127 reports (6.1%) of serious ADRs. Skin and appendage disorders were most frequently reported (27.5%), followed by gastrointestinal disorders (17.5%), and liver and biliary system disorders (13.1%). The total treatment period was longer in patients who experienced ADRs (224.0 ± 3.1 days vs. 247.0 ± 4.7 days, p = 0.009). @*Conclusions@#The incidence of ADRs to first-line anti-tuberculosis drugs was 29.3%, and 6.5% were severe ADRS. ADRs prolonged the overall treatment duration, indicating the importance of their detection and management.

Disseminated Eczema Herpeticum Transmitted by Self-inoculation / 대한피부과학회지

Eczema herpeticum is a widespread Herpes simplex virus(HSV) infection, which usually develops in patients with atopic dermatitis. Because pruritus in patients with atopic dermatits leads them to scratch their bodies, it causes the dissemination of Herpes simplex virus. A delay in diagnosing this condition may result in intense and rapid spread of the cutaneous lesions. We report a patient who underwent a prolonged friction with a rough nylon towel while bathing and developed eczema herpeticum. We suspect a bath with a rough nylon towel as a possible route of spread.

A Case of Fibrous Hamartoma of Infancy with Overlying Hypertrichosis / 대한피부과학회지

Fibrous hamartoma of infancy is an uncommon benign soft tissue tumor, characterized by three different tissue components histologically; 1)intersecting trabeculae of fibrous tissue, 2)immature cells with mucoid matrix, and 3)mature fat. The majority of fibrous hamartoma of infancy occur within the first year of life as a painless nodule and a few cases have overlying skin changes, including alteration in pigmentaion, eccrine gland hyperplasia and increased hair. We report a case of fibrous hamartoma of infancy on the buttock with overlying hypertrichosis in an 8-month-old male patient.

Four Cases of Atopic Dermatitis with Topical Tacrolimus Therapy / 대한피부과학회지

Tacrolimus is a macrolide antibiotic that was isolated from soil microorganism. Its mechanism of action is based on calcineurin inhibition, which results in suppression of antigen-specific T-cell activation and inhibition of inflammatory cytokine release. Four patients with atopic dermatitis participated in this study of the efficacy of topical tacrolimus. Our cases showed significant improvement in the signs and symptoms of atopic dermatitis within a week of starting topical tacrolimus. We report 4 cases of atopic dermatitis treated with 0. 1% tacrolimus ointment.

A Case of Fordyce's Disease with Wide Distribution

Fordyce's disease is a condition known as ectopically located sebaceous glands on the vermilion borders of the lips and oral mucosa. Clinically, it is groups of minute, yellowish, globoid macules and papules. Histologically, it is characterized by sebaceous glands not associated with hair follicles. We report on a 40-year-old man with Fordyce's disease showing particularly wide distribution on the buccal mucosa and upper lip.

Three Cases of Buckwheat Allergy / 대한피부과학회지

The most common symptom of buckwheat allergy was asthmatic attack and less common were nasal symptoms, eye symptoms, urticaria, and gastrointestinal symptoms. The pathomechanism of this allergy is type I, IgE-mediated immediate type reaction. Three cases showed respiratory discomforts after exposure to buckwheat and revealed positive reactions to buckwheat in the skin prick test. We report typical three cases of buckwheat allergy.

A Case of Kikuchi's disease associated with Systemic Lupus Erythematosus / 대한피부과학회지

Described originally in young Japanese women, Kikuchi's disease produces a histiocytic necrotizing lymphadenitis of predominant cervical lymph nodes. Histiocytic necrotizing lymphadenitis, Kikuchi's disease, is a condition rarely associated with systemic lupus erythematosus(SLE). We present a 34-year-old woman with tender multiple cervical lymphadenopathy of 1-year duration and SLE symptoms. Histologic examination of lymph node shows histiocytic necrotizing lymphadenitis. She showed high titer of antinuclear antibody, skin lesion with photosensitivity, thrombocytopenia and arthritis. We describe a case of Kikuchi's disease associated with SLE.

A Case of Eruptive Steatocystoma Multiplex on the Scalp / 대한피부과학회지

A 46-year-old man had noticed an asymptomatic, small, yellowish, papular eruption on the scalp about one year ago. Since then, the lesions had slowly increased in size and number. There was no family history of similar lesions. An incision made into the cysts discharged oily yellow material. Biopsy of a lesion disclosed that the cysts had typical features of steatocystoma multiplex histologically. This case was a unique eruptive variety of steatocystoma multiplex on the scalp.

A Case of Alopecia Areata in a Patient taking Cyclosporine / 대한피부과학회지

We report a case of alopecia areata in a 32-year-old man that developed during the course of cyclosporine therapy following kidney transplantation. Cyclosporine has been reported to be of value in the treatment of alopecia areata. It would therefore appear unlikely that alopecia areata would develop in our patient while he was undergoing cyclosporine therapy. To our knowledge, this is a rare case report of alopecia areata in a patient taking cyclosporine in Korean dermatologic literature.