1/7. Drug eruption due to peplomycin: an unusual form of stevens-johnson syndrome with pustules.A rare case of stevens-johnson syndrome (SJS) due to peplomycin in a 48-year-old man is described. The patient had squamous cell carcinoma on the scalp and underwent preoperative neoadjuvant chemotherapy with peplomycin. On the fifth day of the chemotherapy, he developed a fever and multiple dusky violaceous erythematous areas and pustules on his trunk, thighs, and palms. Erosive erythema and erosions also developed on his soles, scrotum, and oral mucosa. A biopsy specimen taken from the eruption on the thigh revealed marked liquefaction degeneration of the basal layer of the epidermis. Laboratory examinations demonstrated aggravation of liver function. Additionally, the patient developed conjunctivitis and corneal erosions. Although he had some subcorneal pustules, we diagnosed the case as an unusual form of SJS because of severe mucous membrane involvement. Oral prednisolone was administered, and the symptoms subsided. Then the patient underwent wide local excision. One month after surgery, we performed patch tests and a lymphocyte stimulation test with negative results. Then we re-administered peplomycin starting with 1/20 of a daily dose and gradually increasing the dose each day. After administration of the regular daily dose, the patient had a relapse of fever, eruptions, stomatitis, corneal erosions, and liver dysfunction. Therefore, a definite diagnosis of drug eruption due to peplomycin was made.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |
2/7. stevens-johnson syndrome as an unusual adverse effect of azithromycin.stevens-johnson syndrome mostly involves the skin and mucous membranes. The diagnosis is made when the characteristic rash appears 1 to 3 weeks after exposure to a known stimulus and cannot be explained by some other diagnosis. A 62-year-old woman was admitted for evaluation of toxo-allergic dermatitis and collagenosis. Ten days prior to admission she was taking a course of azithromycin for upper respiratory tract infection. After a few days she was feeling better but maculopapular, erythematous rash developed over her palms, accompanied by fever and chills as well as reddish discoloration around her eyes. Within the next few days the rash progressed to the feet. Routine hematologic, biochemical and immunologic studies did not confirm the diagnosis of inflammatory rheumatic disease. Corticosteroid therapy with methylprednisolone (1 mg/kg) for the presumed stevens-johnson syndrome was started and her condition improved in several days; she became afebrile and her skin lesions gradually disappeared. There is only one report, in a child, documenting the association of stevens-johnson syndrome with azithromycin, as in this patient.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |
3/7. Atypical varicella zoster as SJS-TEN overlap syndrome with involvement of palm and sole.A 14-month-old boy presented with generalised vesicular eruption involving the face, trunk and extremities accompanied by high grade fever. He had associated redness and purulent discharge from both eyes. Examination revealed erosions on the tongue, soft palate and genitalia with haemorrhagic crusts on the lips and nasal orifices. All laboratory investigations were within normal limits except leucocytosis. Chest x-ray showed left middle zone pneumonitis. Treatment was by paracetamol, antibiotics and oral acyclovir. Desquamation started from the eighth day. Our purpose in reporting this case is to highlight the fact that varicella can be atypical with distal involvement and can present as SJS-TEN overlap syndrome.- - - - - - - - - - ranking = 4keywords = palm (Clic here for more details about this article) |
4/7. mucocutaneous lymph node syndrome (Kawasaki disease) in adults.mucocutaneous lymph node syndrome has been reported to occur only in children. Three adults aged 16 to 27 years had findings compatible with this illness. patients with fever, polymorphous skin eruption, congested conjunctiva, reddened palms and soles, red lips and oral mucous membrane, and soft-tissue swelling of the peripheral extremities and who experience membranous desquamation of fingers and toes should be suspected of having mucocutaneous lymph node syndrome. No laboratory test is currently available for confirmation of the diagnosis.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |
5/7. mucocutaneous lymph node syndrome in the united states.Sixteen patients with an unusual and distinct symptom complex were encountered during a four-year period. Principal features of this syndrome are (1) fever lasting more than seven days; (2) conjunctival injection; (3) changes in the mouth consisting of erythema of the oropharynx, "strawberry tongue", and erythema of the lips; (4) indurative edema of hands and feet with palm and sole erythema followed by desquamation of the fingertips; and (5) an erythematous rash. Associated features were lymphadenopathy, pyuria, aseptic meningitis, diarrhea, arthritis, and arthralgia. Although usually a self-limited illness, one patient died with massive coronary artery thrombosis on the 19th day of illness. This syndrome appears to be clinically and pathologically similar to mucocutaneous lymph node syndrome, an illness prevalent in japan but previously unrecognized by American clinicians. Pathologic features suggest a relationship to infantile periarteritis nodosa.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |
6/7. A case report of stevens-johnson syndrome with mycoplasma pneumoniae infection.We encountered an 8 year old boy who suffered from stevens-johnson syndrome with mycoplasma pneumoniae infection. He had multiple erythema with vesicles in oral mucosa, and on his palms and feet, trunk and genital regions. We treated him with prednisolone (1 mg/kg per day) and antibiotics. His skin lesions improved dramatically, and a persistent fever and toxic general condition also showed dramatic improvement. Although the use of corticosteroids for stevens-johnson syndrome has recently been controversial, we thought that administration of corticosteroids was an effective treatment for some selective cases of stevens-johnson syndrome. The patient reported in this study had many beneficial effects in response to corticosteroid treatment.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |
7/7. A case of pneumonia with extrapulmonary manifestations.A 24-year-old man presented with a nonproductive cough, fever, and occasional shaking chills of one week's duration. he also had pleuritic left-sided chest pain on deep inspiration and a rash on his palms, soles, trunk, and mouth. His wife had been sick with "pleurisy" two weeks earlier; her symptoms had resolved with antibiotic therapy.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |