Subject(s)
Factitious Disorders , Malingering , Stevens-Johnson Syndrome , Trimethoprim, Sulfamethoxazole Drug Combination/adverse effects , Anti-Bacterial Agents/adverse effects , Diagnosis, Differential , Factitious Disorders/diagnosis , Factitious Disorders/physiopathology , Humans , Male , Middle Aged , Psychological Techniques , Stevens-Johnson Syndrome/diagnosis , Stevens-Johnson Syndrome/etiology , Stevens-Johnson Syndrome/psychology , Stevens-Johnson Syndrome/therapyABSTRACT
Cyanoacrylates are widely used as topical skin adhesives in emergency departments, clinics, and operating rooms. We report 4 patients who developed allergic contact dermatitis (ACD) following postsurgical closure with 2-octyl cyanoacrylate. These patients were challenged with a novel method of use testing to confirm sensitivity to 2-octyl cyanoacrylate. The popularity of skin adhesives makes this emerging allergen worthy of examination. It is possible that cyanoacrylate allergy currently is underrecognized.
Subject(s)
Cyanoacrylates/adverse effects , Dermatitis, Allergic Contact , Hydroxyzine/administration & dosage , Postoperative Complications , Tissue Adhesives/adverse effects , Triamcinolone Acetonide/administration & dosage , Administration, Topical , Adult , Aged , Cyanoacrylates/administration & dosage , Dermatitis, Allergic Contact/diagnosis , Dermatitis, Allergic Contact/drug therapy , Dermatitis, Allergic Contact/etiology , Dermatitis, Allergic Contact/physiopathology , Female , Glucocorticoids/administration & dosage , Histamine H1 Antagonists/administration & dosage , Humans , Patch Tests/methods , Postoperative Complications/diagnosis , Postoperative Complications/drug therapy , Postoperative Complications/physiopathology , Surgical Procedures, Operative/methods , Tissue Adhesives/administration & dosage , Treatment OutcomeABSTRACT
We present a case of cutaneous and systemic infection with Scedosporium apiospermum occurring in a patient with systemic lupus erythematosus. Scedosporium apiospermum is a rare cause of systemic mycosis but is associated with a high rate of mortality in immunocompromised hosts. Because the patient presented in an advanced state of infection, supportive measures were unsuccessful and definitive diagnosis could not be made until postmortem examination. We discuss the presentation, pathology, diagnosis, and treatment strategies for Scedosporium infection.
Subject(s)
Mycetoma/diagnosis , Mycetoma/microbiology , Scedosporium/isolation & purification , Aged , Autopsy , Biopsy , Diagnosis, Differential , Fatal Outcome , Female , Humans , Lupus Erythematosus, Systemic/complicationsABSTRACT
Burn patients with extensive involvement of body surface area (BSA >30%) represent a challenge in wound treatment. Multiple topical agents may be used for cleansing, barrier protection, and antimicrobial control leading to complications of contact and/or irritant dermatitis, which may further complicate re-epithelization and eventual wound healing. We present 4 patients who sustained extensive burns during Operation Iraqi Freedom/Operation Enduring Freedom and later developed contact dermatitis to mafenide acetate, a common topical antimicrobial used in burn care treatment, also known as Sulfamylon (alpha-amino-p-toluenesulfonamide monoacetate). All patients who were patch tested to mafenide acetate 7% solution were positive. A rechallenge with mafenide acetate resulted in recrudescence of the eruption in 2 out of the 4 patients. Though cutaneous reactions to mafenide acetate were reported by Yaffe and Dressler in 1969, the most recent case reports are from 1995. This paper presents more recent examples of cutaneous reactions to mafenide acetate, while also reviewing the literature.
Subject(s)
Dermatitis, Allergic Contact/etiology , Drug Eruptions/etiology , Mafenide/adverse effects , Administration, Cutaneous , Adult , Anti-Infective Agents, Local/adverse effects , Anti-Infective Agents, Local/therapeutic use , Blast Injuries/drug therapy , Burns/drug therapy , Dermatitis, Allergic Contact/diagnosis , Drug Eruptions/diagnosis , Humans , Iraq , Mafenide/therapeutic use , Male , Military Personnel , United States , WarfareABSTRACT
A 19-year-old woman presented with a five-year history of guttate macules and yellow to skin-colored papules with collarette of fine scale on the trunk and the upper and lower extremities. Guttate pityriasis lichenoides chronica is an uncommon presentation of this T-cell-mediated disease. It is of unknown etiology; however, an infectious agent has been suspected. It is considered in a spectrum with pityriasis lichenoides et varioloformis acuta and rarely mycosis fungoides and CD30 lymphomas. Improvement has been shown after treatment with oral tetracyclines, ultraviolet B and UVA1 phototherapy, and PUVA photochemotherapy.
