ABSTRACT
Medications used to treat human ailments are known to cause cutaneous reactions which may vary in their severity. Leflunomide, an immunomodulating agent recently introduced to treat rheumatoid arthritis, is reported to cause severe cutaneous reactions. We are reporting five such cases. All our patients were started on leflunomide for rheumatoid arthritis, 4-6 weeks before the onset of cutaneous reaction and were admitted to the hospital with the common complaints of fever, skin rash and generalized weakness. All of them had characteristic pattern of events such as delayed onset of reaction, widespread and long lasting skin rash and internal organ involvement. These features suggest a possibility of drug hypersensitivity syndrome to leflunomide. Careful dosing and periodic monitoring of patients treated with leflunomide for possible adverse drug reaction is recommended.
Subject(s)
Drug Eruptions/diagnosis , Isoxazoles/adverse effects , Adult , Arthritis, Rheumatoid/complications , Arthritis, Rheumatoid/drug therapy , Drug Eruptions/drug therapy , Drug Eruptions/etiology , Female , Humans , Isoxazoles/therapeutic use , Leflunomide , Male , Middle Aged , Severity of Illness Index , Steroids/therapeutic useABSTRACT
Nevoid hyperkeratosis of the nipple and areola is an unusual condition. Two female patients aged 31 and 18 years presented with chronic unilateral warty lesions of the nipple. One patient had difficulty in breastfeeding from the affected side. A skin biopsy showed acanthosis, hyperkeratosis, papillomatosis and lymphocytic infiltrate in the dermis. There was no significant improvement with topical tretinoin cream in both the patients.
Subject(s)
Hyperkeratosis, Epidermolytic/pathology , Nevus/pathology , Nipples/pathology , Adolescent , Adult , Chronic Disease , Female , Humans , Hyperkeratosis, Epidermolytic/diagnosis , Hyperkeratosis, Epidermolytic/drug therapy , Nevus/diagnosis , Nevus/drug therapy , Warts/diagnosis , Warts/pathologyABSTRACT
BACKGROUND: Chronic urticaria is one of the perplexing problems faced by clinicians. There are a few reports associating house dust mite sensitivity with chronic urticaria, based upon the patient's history as well as intradermal skin testing and in vitro analysis. AIMS: To investigate the possible association between house dust mite sensitivity and chronic urticaria. METHODS: In this case control study three groups of patients were enrolled. Group I: Chronic urticaria (73 subjects). Group II: Chronic urticaria with collateral allergic disorders (49 subjects). Group III: Normal subjects without chronic urticaria or other allergies (25 subjects). All the patients underwent skin prick testing with antigens of the house dust mite, Dermatophagoides pteronyssinus (DP) and Dermatophagoides farinae (DF), with positive and negative controls. RESULTS: Among the patients with chronic urticaria, 78/122 (64%) patients had skin sensitivity to house dust mites. Out of these, 39/73 (53%) had chronic urticaria alone and 39/49 (79%) had chronic urticaria with other associated allergies. Among the normal control subjects, 7/25(28%) reacted positively to house dust mites. CONCLUSION: This study suggests a possible association of house dust mite sensitivity with chronic urticaria.
Subject(s)
Pyroglyphidae , Urticaria/immunology , Adult , Animals , Case-Control Studies , Chronic Disease , Female , Humans , MaleABSTRACT
PIP: This article reports on a study designed to compare the efficacy and cost effectiveness of 2 selective media for culture of gonorrhea, the Chacko-Nair medium and the Thayer-Martin medium. The Chacko-Nair medium, an enriched egg=beef selective medium, is easily prepared from locally available ingredients in India. The Thayer-Martin medium, the standard selective medium used throughout the world, uses ready-made ingredients. In order to test the 2 mediums, researchers collected the urethral discharge of 240 male patients with acute gonorrhea and smear positive for N. gonorrhoea attending the Skin & STD, OPD of Chigateri General Hospital. All 240 specimens were subjected to culture study with the Chacko-Nair medium, and 190 were subjected to study with the Thayer-Martin Medium. The initial 30 cases under the Chacko-Nair medium did not show growth, since beef extract was used instead of fresh beef. Fresh beef was used in the remaining 210 samples, and they all showed profuse growth of organisms. All 190 sample under the Thayer-Martin medium showed good growth. While both mediums showed growth in 100% of the cases, the cost of the 2 differs considerably. Since all the ingredients are available locally, the Chacko-Nair medium is very cheap compared to the Thayer-Martin medium, whose ready-made ingredients are expensive and often difficult to procure. The Chacko-Nair medium, which can be prepared at any standard Microbiology Laboratory, has been used regularly at the Institute of Venerology in Madras, and has show results comparable to the Thayer-Martin medium. The report concludes that the Chacko-Nair medium is a good alternative to the Thayer-Martin medium.^ieng
