1/7. Amoxycillin-induced flexural exanthem.We describe a 37-year-old man who developed an acute, inflammatory flexural eruption shortly after taking amoxycillin, then erythema multiforme-like lesions on the palms and soles. The eruption resolved with systemic corticosteroids, and positive patch tests with amoxycillin supported a drug-induced aetiology. A few similar cases have been described as the 'baboon syndrome' or intertriginous drug eruptions. We draw attention to this rare, distinctive drug eruption.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |
2/7. Selective serotonin reuptake inhibitor-induced rash: case report and review of the literature.Selective serotonin reuptake inhibitors (SSRIs) are one of the most frequently prescribed classes of drugs. Rashes induced by SSRIs seldom have been reported in the literature. Computerized medline and Current Contents searches yielded a report of two cases of rash induced specifically by paroxetine. We describe a patient who developed a rash that appeared on day 3 of treatment with oral paroxetine 20 mg/day. Her rash was morbilliform, pruritic, and generalized over the trunk and limbs, with some facial involvement. There was no palm or sole involvement. The patient reported that she had experienced a similar reaction to fluoxetine, which may suggest a drug class effect. The rash resolved within 2 days of drug discontinuation and treatment with oral diphenhydramine and topical hydrocortisone cream.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |
3/7. Atypical papulovesicular rash due to infection with rickettsia conorii.We present an unusual case of rickettsia conorii infection that was associated with cutaneous papulovesicular lesions on a patient who had returned from the bushveld of south africa. The lesions were diffusely scattered across the trunk, extremities, and both palms. Several recent reports have documented similar papulovesicular or pustulovesicular rashes that occurred on travelers returning from southern Africa. These rashes resemble the lesions of rickettsialpox. Evidence suggests that these atypical exanthems may be due to variant strains of R. conorii or to an unusual host response to infection with this organism; thus, infection with R. conorii should be included in the list of diseases that cause poxlike lesions.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |
4/7. Infectious disease capsules: a pox on your house.A 31-year-old, previously healthy white man presented to the emergency department with complaints of malaise, fevers, shortness of breath, a non-productive cough, and a "rash." His physical exam revealed a temperature of 100.2F, a pulse of 129 bpm, respiratory rate of 14 BPM, and blood pressure of 140/74 mm Hg. He was alert, oriented, and in no distress. His oropharynx was dry, his neck was supple, and cervical lymphadenopathy was absent. He had tachycardia, bilateral wheezes, and rhonchi with prolonged expirations. There was a diffuse vesicular eruption enveloping his entire body with involvement sparing his palms and soles (Figures 1 and 2). Laboratory values showed a hemoglobin of 16.0 g/dL and a white blood cell count of 7100 cells/pL, with 39%neutrophils, 23% bands, and 35% lymphocytes. His platelet count was mildly decreased to 86,000 x 103/pL. Chest radiograph revealed bilateral diffuse interstitial infiltrates. A diagnosis of acute varicella-zoster virus pneumonia (varicella pneumonia) was made, and the patient was started on IV acyclovir (10 mg/kg every 8 hours). Upon further questioning, the patient stated that his daughter had been diagnosed with "chickenpox" 7 days ago. The patient had numerous exposures to chickenpox in the past but had never developed clinical expressions of varicella. He was not at risk for hiv infection, not having multiple sexual partners, IV drug abuse, or blood transfusions. During the 1 day of in-hospitalization, his fever abated and the pulmonary signs diminished.Following discharge, IV acyclovir was replaced by valacyclovir to complete a 7-day course of therapy.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |
5/7. A syndromic rash in patients attending methadone clinics in new south wales.We report an outbreak of a "rash" syndrome in patients attending methadone clinics in new south wales. It presents with a pruritic, exanthematous or purpuric rash involving the trunk, limbs, palms and soles, which develops over a week and proceeds in most patients to desquamation (mainly of palms and soles) persisting for 3-4 weeks. Mucosae are not involved, and patients are generally systemically well. To date, the rash has affected 22% of 316 patients attending one methadone clinic in western Sydney, as well as patients in clinics elsewhere in Sydney and rural NSW. The aetiology is as yet unknown.- - - - - - - - - - ranking = 2keywords = palm (Clic here for more details about this article) |
6/7. Histologic patterns of polyethylene glycol-liposomal doxorubicin-related cutaneous eruptions.polyethylene glycol (PEG)-liposomal doxorubicin (Stealth R, Doxil) is a formulation of doxorubicin, which is encapsulated in liposomes formulated with PEG. It is favored in the palliative setting over doxorubicin because of its generally favorable side effect profile. Adverse reactions are predominantly skin eruptions. We report 3 cases of women with breast cancer undergoing treatment with liposomal doxorubicin who developed palmar-plantar erythrodysesthesia and diffuse morbilliform eruptions. Biopsies in the 2 cases demonstrated vacuolar interface dermatitis with epidermal dysmaturation and the third case suggested a drug eruption. Additionally, we report a woman with metastatic breast cancer who developed a similar morbilliform eruption soon after completing a regimen of liposomal doxorubicin. The biopsy revealed an atypical squamous proliferation showing epidermal dysmaturation with focal evidence of interface damage. Both clinician and pathologist alike should be cognizant of this cutaneous eruption, as well as the histologic patterns.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |
7/7. Exanthematic type of pustular psoriasis consisting of two types of pustular lesion.A 35-year-old female developed generalized pustules within a short period of time. Clinically, two distinct types of pustules were observed, viz. erythematous patches studded with crops of small pustules, and isolated large pustules with a red halo. Histologically, the former were subcorneal spongiform pustules, whereas the latter were unilocular pustules involving the hair follicular infundibulum or a subcorneal unilocular pustule on the palmo-plantar skin. On the basis of the sudden appearance of the pustules without any pre-existing lesions of psoriasis and the histological findings of the spongiform pustules, we made a diagnosis of the exanthematic type of pustular psoriasis. The lesions responded in a dose-dependent fashion to oral cyclosporin.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |