[A case of appearance of a prominent rash in response to alternate-day S-1 administration as adjuvant chemotherapy for lower gingival cancer].

We report the development of a prominent rash in response to alternate-day S-1 administration in a patient with oral cancer. The patient was a 75-year-old woman with left-side lower gingival cancer(T4N1M0). After chemoradiotherapy, the patient underwent radical surgery. She was treated with oral S-1, administered on alternate days at a dosage of 80mg/day (orally, twice per day), as postoperative adjuvant chemotherapy. Edematous erythema, accompanied by strong itching and paraesthesia, appeared focally on the face and the limbs 1 month after beginning S-1 treatment. Since the rash was determined to be drug-induced, S-1 administration was stopped, and steroid, antihistamine, and topical steroid treatment was initiated. The symptoms gradually improved, and the rash disappeared without recurrence approximately 1 month later. Although alternate-day administration is considered to be a safe and effective method to administer S-1 oral therapy, it should be noted that cutaneous symptoms might appear after a fixed dosage is exceeded.

Accurate diagnosis and treatment of Vibrio vulnificus infection: a retrospective study of 12 cases

BACKGROUND AND AIMS: Vibrio vulnificus causes an infectious disease that has extremely poor convalescence and leads to necrotic fasciitis. In this study, we sought to define the characteristic epidemiology of V. vulnificus infection and clarify its diagnosis at the global level. METHODS: Over a period of 10 years, we investigated the appearance of symptoms, underlying conditions, treatment, and mortality in 12 patients (eight men, four women; >50 years old; average age, 66 years,) infected with V. vulnificus. RESULTS: The development of symptoms occurred primarily between June and September, a period during which seawater temperature rises and the prevalence of V. vulnificus increases. All patients had underlying diseases, and seven patients reported a history of consuming fresh fish and uncooked shellfish. The patients developed sepsis and fever with sharp pain in the limbs. Limb abnormalities were observed on visual examination. All patients underwent debridement; however, in the survival group, the involved limb was amputated early in 80% patients. The mortality rate was 58.3%. CONCLUSION: Recognition of the characteristic epidemiology and clinical features of this disease is important, and positive debridement should be performed on suspicion. When the illness reaches an advanced stage, however, amputation should be the immediate treatment of choice.

Accurate diagnosis and treatment of Vibrio vulnificus infection: a retrospective study of 12 cases.

BACKGROUND AND AIMS: Vibrio vulnificus causes an infectious disease that has extremely poor convalescence and leads to necrotic fasciitis. In this study, we sought to define the characteristic epidemiology of V. vulnificus infection and clarify its diagnosis at the global level. METHODS: Over a period of 10 years, we investigated the appearance of symptoms, underlying conditions, treatment, and mortality in 12 patients (eight men, four women; >50 years old; average age, 66 years,) infected with V. vulnificus. RESULTS: The development of symptoms occurred primarily between June and September, a period during which seawater temperature rises and the prevalence of V. vulnificus increases. All patients had underlying diseases, and seven patients reported a history of consuming fresh fish and uncooked shellfish. The patients developed sepsis and fever with sharp pain in the limbs. Limb abnormalities were observed on visual examination. All patients underwent debridement; however, in the survival group, the involved limb was amputated early in 80% patients. The mortality rate was 58.3%. CONCLUSION: Recognition of the characteristic epidemiology and clinical features of this disease is important, and positive debridement should be performed on suspicion. When the illness reaches an advanced stage, however, amputation should be the immediate treatment of choice.