Pigmentation by transdermal fentanyl patch

<b>Introduction</b>: There has been no case report in which hyperpigmentation developed on the skin area where a transdermal fentanyl patch was applied in a patient. <b>Case report</b>: A 43-year-old man with recurrence of postoperative rectal cancer was treated by cetuximab plus irinotecan and panitumumab plus FOLFIRI. For cancer pain, transdermal fentanyl patch (Fentos®) was administered, and radiation from behind was performed. Hyperpigmentation then appeared on the chest and the abdominal skin sites where the patches were applied. The hyperpigmentation nearly disappeared four months after the fentanyl patch was discontinued. <b>Discussion</b>: The cause of the pigmentation was possibly due to post inflammatory hyperpigmentation secondary to contact dermatitis. It was desirable to conduct patch test and skin biopsy for making an accurate diagnosis. <b>Conclusion</b>: We should pay a careful attention to hyperpigmentation of the skin where a transdermal fentanyl patch is applied.

Bacterial contamination of drinking water and nutritional quality of diet in the areas of the western Solomon Islands devastated by the April 2, 2007 earthquake/tsunami

On 2nd April 2007, at 7:40 local time (20:40 GMT 1 April), a massive earthquake, the epicenter of which was 10 km deep and 45 km south-southeast of Gizo, the provincial capital of the Western Province, struck the Solomon Islands, killing 52 people and displacing approximately 5,000. This study, based on field research in May 2007, reports on the result of the cross-sectional assessment of the bacterial contamination (<I>E. coli, Vibrio</I> spp. and total bacteria) of drinking water and water sources and the longitudinal comparison of dietary intake and epidemiology in six earthquake- and tsunami-affected villages in the Western Province, Solomon Islands. The test-paper method revealed that 92.0% of drinking-water was unsafe in four camps of evacuated people. Only 3 out of 11 drink-water samples collected from safe water sources were free from contamination throughout the study villages. The reported occurrence of diarrhea, while only 7.6 per mil in 2001 and 4.8 per mil in 2003 in one of the study villages, was 12.7 person-days per mil after the disaster in 2007. Deterioration of dietary intakes was not observed. Although further studies are expected to follow up on the changes in water, diet, and health in mid- and long-term recovery operations, the rapid assessment suggested the need to provide safe water or purifiers and education regarding water and hygiene-related management in order to minimize health risks in devastated villages.