ABSTRACT
We present an interesting and novel case of a de novo generalized pustular psoriasis following administration of first dose of Oxford-AstraZeneca COVID-19 vaccine in a patient with no pre-existing psoriasis or any previous dermatological issue.
Subject(s)
COVID-19/prevention & control , ChAdOx1 nCoV-19/adverse effects , Drug Eruptions/etiology , Psoriasis/chemically induced , Aged , Female , Humans , Psoriasis/drug therapy , SARS-CoV-2ABSTRACT
BACKGROUND: Aquagenic wrinkling of the palms (AWP) is a rare condition characterised by the development of oedema and excessive wrinkling of the palms following exposure to water. It has frequently been associated with cystic fibrosis (CF). Early reports of AWP have only been case reports or small case series; there has only been one reported prevalence study of AWP in a CF population. OBJECTIVE: To determine the incidence and characteristics of AWP in the adult CF population in Northern Ireland. METHODS: 105 CF patients were interviewed. The patients were asked whether they noticed excess wrinkling of the hands when exposed to water. If they answered 'yes', further questions were asked regarding clinical characteristics. The atopic status, CF genotype and drug history were recorded for each patient. Formal testing of 7 patients was carried out. RESULTS: Out of the 105 patients who were interviewed, 43 (41%) described AWP. Of the 43 patients with AWP, 20 were male and 23 were female. There was no association of AWP with genotype, atopy or concomitant drug intake. CONCLUSION: AWP appears to have an equal sex incidence, and the high number of cases in the population studied would suggest that this condition is underreported.
Subject(s)
Cystic Fibrosis/epidemiology , Skin Aging , Water/adverse effects , Adolescent , Adult , Cystic Fibrosis/drug therapy , Cystic Fibrosis/genetics , Cystic Fibrosis Transmembrane Conductance Regulator/genetics , Female , Humans , Incidence , Male , Middle Aged , Northern Ireland/epidemiology , Tobramycin/adverse effects , Tobramycin/therapeutic use , Treatment Outcome , Young AdultABSTRACT
Pseudoporphyria is a bullous photosensitivity, the commonest aetiology being secondary to various ingested medications. Voriconazole is a relatively new second-generation triazole antifungal agent. There have only been two reports of pseudoporphyria secondary to voriconazole. We report the third case of this phenomenon occurring in a lady being treated for disseminated candidal infection.
Subject(s)
Antifungal Agents/adverse effects , Drug Eruptions/diagnosis , Drug Eruptions/etiology , Pyrimidines/adverse effects , Triazoles/adverse effects , Candidiasis/drug therapy , Female , Humans , Middle Aged , Porphyria, Acute Intermittent/diagnosis , VoriconazoleABSTRACT
BACKGROUND: Follow-up of patients after treatment of basal cell carcinoma (BCC) allows for monitoring of recurrence and detection of new tumours, but adds a significant burden to outpatient clinics. At the skin tumour clinic in the dermatology department, the Royal Hospitals, Belfast, all patients are reviewed for 2 years after surgical excision of a low-risk primary BCC. OBJECTIVES: An audit was undertaken to determine the quality of data set recorded relating to prognostic factors for BCCs to determine the rate of recurrence and number of new primary tumours detected and to determine the completeness of follow-up by patients. METHOD: Patients who had primary BCCs treated by excision were identified from a database held at the clinic. Medical charts were reviewed to determine data recorded about lesions, the number of recurrent BCCs and new tumours detected, and the number of patients completing follow-up. RESULTS: Between January 1999 and December 2000, 114 patients had 121 primary BCCs excised. BCC location and size were recorded in 100% and 35% of cases, respectively. Histological type was stated for morphoeic or multifocal lesions. Two years of follow-up was completed by 53% of patients and 1 year by 78% of patients. The rate of recurrence was low, with 2 BCC recurring within 2 years of excision. The risk of developing a new BCC was 11.6% in the first year and 6.3% in the second year. CONCLUSIONS: Follow-up of patients after excision of a low-risk BCC at the clinic has been reduced to 1 year. A proforma has been developed to encourage documentation of prognostic factors.
Subject(s)
Carcinoma, Basal Cell/surgery , Guideline Adherence , Practice Guidelines as Topic , Skin Neoplasms/surgery , Adolescent , Adult , Aged , Aged, 80 and over , Carcinoma, Basal Cell/diagnosis , Female , Follow-Up Studies , Humans , Incidence , Male , Medical Audit , Middle Aged , Neoplasm Recurrence, Local/diagnosis , Neoplasm Recurrence, Local/epidemiology , Practice Patterns, Physicians'/statistics & numerical data , Prognosis , Risk Factors , Skin Neoplasms/diagnosis , Treatment OutcomeABSTRACT
This report updated an analysis of a 14-year experience of moderately high-dose (4500 to 5000 cGy) preoperative radiation as an adjuvant to low anterior resection of 95 cases of adenocarcinoma of the rectum. The treatment was well tolerated without treatment-related mortality and with a low incidence (5.2%) of severe complications. The local recurrence rate was 4.2%, and distant failure rate was 10.5%. At 5 years, the actuarial survival rate was 66% and the disease-free survival rate was 64%. At 10 years, the actuarial survival rate and disease-free survival rate were 52%. The authors concluded that moderately high-dose (4500 to 5000 cGy) neoadjuvant radiation in clinically resectable adenocarcinoma of the rectum in which one segment of the anastomosis was in the preoperative radiation field is a safe, effective adjuvant to low anterior resection and that it offered patients excellent local control, long-term survival, and sphincter preservation. Results could be enhanced by chemotherapy, and the authors urged well-designed prospective randomized multicenter trials to determine the most appropriate drugs, dosage, and sequencing of co-adjuvant preoperative radiation therapy and chemotherapy with surgery.
