Furosemide induced bullous pemphigoid: a case report

Bullous pemphigoid is an acquired autoimmune disease characterized by subepidermal vesicles and bullae. The etiology is mostly idiopathic with the highest occurrence in elderly patients. However, it is now well-accepted that bp has been triggered by or associated with drug therapy. Over 50 agents have been implicated as a cause of Drug-induced bullous pemphigoid, including diuretics, ace inhibitors, and antibiotics. We present a case of Bullous pemphigoid in a 75 year old male probably induced by furosemide. A 75 year old male was admitted to the dermatology department of KIMS hospital, Bengaluru. Presented with multiple tense bullae and vesicles over both upper limbs, forearm and few collapsed bullae and vesicles over the extensor aspect of forearm. Patient had a past history of myocardial infarction and undergone coronary artery bypass grafting for the same and treated with multiple medications. Among the treatment given injection furosemide was the one of the drug, after which he developed lesions and also presented with fluid filled bullae. A diagnosis of bullous pemphigoid was made based on clinical history and was treated with prednisolone, halobetasol and antibiotics. The lesions improved significantly with the above management and patient recovered enough to be discharged from the hospital after 5 days. Severe and serious reactions such as bullous pemphigoid can be caused by used drugs like furosemide.

The effect of alteration map of insulin injection sites on insulin intensive therapy for type 2 diabetes / 现代临床护理

Objective To explore the application of rotation map of insulin injection site in patients with type 2 diabetes in-sulin intensive therapy.Methods 240 patients with type 2 diabetes hospitalized in the endocrinology department for insulin intensive therapy were enrolled in the study by random sampling method from February to September 2016.The patients were divided into ob-servation group and control group by random digit table, 120 cases in each group. The routine insulin injection method was used to guide the patients in the control group. The patients in the observation group were guided by the rotation map of insulin-injection sites during the hospital stay.In the three months and six months after discharge,the two groups were compared in terms of cutaneous reaction. Result The cutaneous reaction of the insulin injection site in the two groups was compared,showing that the incidences of cutaneous reaction in the observation group were significantly lower than the control group 3 months and 6 months after discharge(P<0.05). Conclusion The rotation map of insulin injection sites can prevent patients from repeatedly injecting insulin and thus reduce the incidence of cutaneous reaction.It is worthy of clinical application.

Influence of Cortex mori on the Capsaicin-induced Neurogenic Inflammation / 대한해부학회지

The root bark of mulberry (Morus alba L. Cortex Mori and other plant of the genus Morus) has been used as an antiphlogistic, diuretic, and expectorant in herbal medicine, and the crude drug is known as "Sangbaikpi" in Korea. Capsaicin, a neurotoxin extracted from a red peppers, has selective effects on peptide-containing C-fiber and induces the release of neuropeptides from sensory nerve ending. But, any reports about the influences of Cortex mori (CM) on the capsaicin-induced neurogenic inflammation were not found, and the precise mechanism of capsaicin-induced neurogenic inflammation remains incompletely understood. The purpose of this study was to determine whether CM could inhibit the capsaicin-induced cutaneous reaction, and to find out its action mechanism. For this purpose, influences of CM on the capsaicin-induced cutaneous reaction (vascular permeability) in back skin of Sprague-Dawley rat, capsaicin-induced histamine release, calcium influx and the change of intracellular cAMP level in rat peritoneal mast cell were estimated. Results obtained were as follows; 1. Pretreatment of CM inhibited remarkably the capsaicin-induced cutaneous reaction. 2. The capsaicin-induced histamine release was inhibited by pretreatment with CM. 3. Capsaicin-induced calcium influx into mast cell was also inhibited by pretreatment with CM. 4. Capsaicin-induced decrease of cAMP level in the mast cell was inhibited significantly by pretreatment with CM. These results suggest that CM contains some substances with an anti-neurogenic inflammatory activity which inhibit the capsaicin-induced cutaneous reaction through the mechanism of mast cell stabilization.

A case of delayed cutaneous reaction caused by jellyfish / 대한피부과학회지

A 10-year-old boy had a recurrence of cutaneous lesions 1 week after only one exposure to jellyfish on the lower extremity. The recurring lesion was charaeterized by pruritic several linear or whiplash-like erythematous and some edematous papuloplaques. The histopathologic findings showed focal hyperkeratosis, acanthosis in epidermis and mild perivascular infiltration of inflammatory cells, capillary proliferations in dermis.