ABSTRACT
Combining sutures with adhesive strips to avoid the 'cheese-wiring' effect in individuals with fragile skin is a method that has been described previously. Here we demonstrate its application in an individual with Ehlers-Danlos Syndrome.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Dendritic Cell Sarcoma, Follicular/drug therapy , Paraneoplastic Syndromes/drug therapy , Pemphigus/drug therapy , Antibodies, Monoclonal, Murine-Derived/administration & dosage , Cyclosporine/administration & dosage , Dendritic Cell Sarcoma, Follicular/complications , Dendritic Cell Sarcoma, Follicular/diagnosis , Fatal Outcome , Female , Humans , Middle Aged , Paraneoplastic Syndromes/complications , Paraneoplastic Syndromes/diagnosis , Pemphigus/complications , Pemphigus/diagnosis , RituximabABSTRACT
BACKGROUND: Allopurinol has been reported as a common cause of severe cutaneous adverse reactions (SCARs). Recent studies in various populations suggest that HLA-B*58:01 is a strong genetic marker for allopurinol-induced SCAR, especially in populations with a high frequency of HLA-B*58:01. OBJECTIVES: To confirm the association link between HLA-B*58:01 and hypersensitivity reactions attributed to allopurinol use in Han Chinese patients in Hong Kong. METHODS: We performed a case-control study to investigate whether the HLA-B*58:01 allele predisposes to allopurinol-induced SCAR in Han Chinese patients in Hong Kong. The HLA-B*58:01 genotyping was performed in 20 patients with allopurinol-induced SCAR or erythema multiforme major (EMM; n = 1) and in 30 patients tolerant to allopurinol. RESULTS: All of the 19 patients with allopurinol-induced SCAR examined but not the patient with EMM carried HLA-B*58:01 whereas only four (13%) of the control patients had this allele. The positive rate of the HLA-B*58:01 was significantly higher in the cases than in the allopurinol-tolerant control group [odds ratio (OR) 123·5, 95% confidence interval (CI) 12·8-1195·1; P < 1 × 10(-4) ] and was even higher after removal of the patient with EMM (OR 229·7, 95% CI 11·7-4520·4). The sensitivity and specificity of the HLA-B*58:01 allele for prediction of allopurinol-induced SCAR were 100% and 86·7%, respectively. CONCLUSIONS: This study confirmed the strong association between the HLA-B*58:01 and allopurinol-induced SCAR in Hong Kong Han Chinese patients. A screening test for the HLA-B*58:01 allele should effectively reduce the risk for allopurinol-induced SCAR in Chinese populations.
Subject(s)
Allopurinol/adverse effects , Drug Eruptions/genetics , HLA-B Antigens/genetics , Uricosuric Agents/therapeutic use , Adult , Aged , Aged, 80 and over , Asian People/ethnology , Case-Control Studies , Drug Eruptions/ethnology , Female , Genetic Predisposition to Disease/ethnology , Genetic Predisposition to Disease/genetics , Genotype , Hong Kong/ethnology , Humans , Male , Middle AgedSubject(s)
Fetofetal Transfusion/diagnosis , Prenatal Diagnosis , Twins , Adult , Cesarean Section , Diagnosis, Differential , Fatal Outcome , Female , Fetal Death , Fetofetal Transfusion/diagnostic imaging , Fetofetal Transfusion/embryology , Hernia, Umbilical/embryology , Hernia, Umbilical/pathology , Humans , Infant, Newborn , Male , Pregnancy , Pregnancy Trimester, Second , Twins, Conjoined/embryology , Twins, Conjoined/pathology , UltrasonographyABSTRACT
Cases of congenitally missing permanent teeth involving only maxillary canines are uncommon. Prevalence studies have revealed that it is a rare finding in Caucasian populations, but it may be relatively more common in Asian groups. This report describes radiographic findings in 32 Chinese children with congenitally missing maxillary permanent canines. The aetiology of such an anomaly is obscure, but the racial difference in prevalence suggests that genetic factors may be more influential than environmental ones.
