Psoriasiform rash is a notable immune-related cutaneous adverse event(ircAE)accounting for approximately 5%of all ircAEs1,2.Patients with cancer and pre-existing psoriasis face elevated risk of disease recurrence or e...Psoriasiform rash is a notable immune-related cutaneous adverse event(ircAE)accounting for approximately 5%of all ircAEs1,2.Patients with cancer and pre-existing psoriasis face elevated risk of disease recurrence or exacerbation after receiving immune checkpoint inhibitors(ICIs).A European multicenter study has reported a reactivation rate of 28.7%in this population3.ICIs also trigger de novo psoriatic lesions,which mirror conventional lesion subtypes(plaque,guttate,erythrodermic,or pustular).展开更多
Dear Editor,Herpes zoster(HZ),which is characterized by a unilateral painful dermatomal rash,is caused by reactivation of the latent varicella-zoster virus(VZV)in the dorsal root ganglia following primary infection du...Dear Editor,Herpes zoster(HZ),which is characterized by a unilateral painful dermatomal rash,is caused by reactivation of the latent varicella-zoster virus(VZV)in the dorsal root ganglia following primary infection during childhood[1].HZ tends to occur more frequently in older adults,in whom cellmediated immunity often declines.The incidence of HZ among immunocompetent unvaccinated individuals aged>50y is 9.92/1000 person-years[2].HZ ophthalmicus(HZO)occurs when HZ involves the first division of the trigeminal nerve,i.e.,the ophthalmic nerve[3].展开更多
The Asar va Ahyā’is a manual of agricultural production written in the early fourteenth century by the famous Iranian vizier and scholar Rashīd al-Dīn.Only chapter 6 to chapter 13 of the original work survive,deal...The Asar va Ahyā’is a manual of agricultural production written in the early fourteenth century by the famous Iranian vizier and scholar Rashīd al-Dīn.Only chapter 6 to chapter 13 of the original work survive,dealing with agriculture and horticulture,and nearly a third of the pages of which are devoted to introducing Chinese plants and related knowledge.In addition to introducing botanical knowledge,the book also covered information on all the aspects of the Yuan dynasty(1271–1368),including the taxation system,monetary system,military system,economy and trade,manufacturing techniques,ethnic customs,food culture,and other fields,providing important materials for research on the dissemination of species,exchange of technologies,communication of ethnic groups,and integration of cultures between China and the world during the thirteenth and fourteenth centuries.Rashīd al-Dīn,the book’s author,took advantage of his identities as a statesman and a businessman to collect rich information about plants all over the world.Motivated by his specific interest in Chinese culture,he included a huge amount of Chinese information in the book.Meanwhile,records in the Asar va Asyā’reflect the author’s practice of researching,planting,and cultivating plants,making the book not only a compilation of agricultural knowledge,but also a report that recorded the author’s agricultural practice.展开更多
Background: Rubella is an infectious disease of public health importance because infection ac-quired during early pregnancy often results in foetal abnormalities that are classified as con-genital rubella syndrome (CR...Background: Rubella is an infectious disease of public health importance because infection ac-quired during early pregnancy often results in foetal abnormalities that are classified as con-genital rubella syndrome (CRS). The burden of rubella infection in most developing countries is however not well documented because of lim-ited epidemiological data. Methods: Between 2006 and 2009, 781individuals with febrile rash illness seen in clinics in Akwa Ibom State were screened for rubella specific IgM antibodies using the ELISA technique. Statistical analysis was done using Graph prime version 5.3 statis-tical package at 95% confidence interval. The level of significance was established at P = 0.05 using Fisher’s exact two-tailed values. Results: Of 781 individuals screened for rubella specific IgM antibodies, 94 (12%) were found to be posi-tive. Incidence of 8.7% recorded in 2006 gradu-ally rose to 9.3% in 2007, 11.6% in 2008 and 14.3% in 2009. Those in the reproductive age group (> 16 years) were most affected (51.7%). However, this was not statistically significant (P = 0.228). Females (17.4%) were more suscepti-ble than males (6.2%) (P < 0.0001) an rural dwellers (12.8%) more susceptible than urban dwellers (10.5%) (P = 0.416). Conclusion: The study shows that the incidence of rubella in Akwa Ibom State, Nigeria is high. The lowest incidence was however found among individu-als below the reproductive age. Thus, the find-ings of this study can be used by policy makers to model the introduction of routine rubella vaccination into the country’ Expanded Program on Immunization Schedule (EPI).展开更多
Epidermal growth factor receptor tyrosine kinase inhibitor(EGFR-TKI)plays an important role in cancer therapy.However,EGFR is highly expressed in the skin and gives rise to one of the most concerning issues for the EG...Epidermal growth factor receptor tyrosine kinase inhibitor(EGFR-TKI)plays an important role in cancer therapy.However,EGFR is highly expressed in the skin and gives rise to one of the most concerning issues for the EGFR-TKI treatment,namely skin toxicity.Antibiotics and corticosteroids are usually used to treat the EGFR inhibitor-associated skin rash,with prominent side effects over long-time use.Pien Tze Huang(PZH)Unguentum Compositum is a traditional product for external application which is made of traditional Chinese medicine and oil base.Herein,we reported the case of a 50-year-old man who presented with skin rash on the face,head,and back induced by an EGFR-TKI named erlotinib.By using PZH Unguentum Compositum,we observed that the skin rash was mitigated and eventually disappeared.This case report suggests that PZH Unguentum Compositum may be an effective therapy in treating skin rash caused by EGFR-TKI with fewer side effects.展开更多
When febrile illnesses develop a rash in children, parents are very concerned about a serious disease. Many rashes associated with fever are caused by infectious diseases. Rashes are generally nonspecific and play a s...When febrile illnesses develop a rash in children, parents are very concerned about a serious disease. Many rashes associated with fever are caused by infectious diseases. Rashes are generally nonspecific and play a supportive role in differential diagnosis, but for some diseases, the appearance of the rash is essential in making a diagnosis. Here is presented the case of a 4-year-old boy with high fever, headache, abdominal pain, vomiting, diarrhea, and a generalized maculo-papular rash including palms and soles. On physical examination were found a black eschar, cervical lymphadenopathy, and hepatosplenomegaly. Laboratory findings resulted in moderate leukocytosis and moderate involvement of the liver and renal function. Based on this finding, a diagnosis of Mediterranean Spotted Fever was performed. The child recovered after medication with azithromycin. Because there is no reliable test that can confirm MSF in its early stages, the diagnosis is commonly made on the basis of clinical findings, so a high index of suspicion should be maintained while evaluating a child with fever and rash.展开更多
BACKGROUND Amyloidosis is a rare disease characterized by extracellular deposition of misfolded protein aggregated into insoluble fibrils.Gastrointestinal involvement in systemic amyloidosis is common,but is often sub...BACKGROUND Amyloidosis is a rare disease characterized by extracellular deposition of misfolded protein aggregated into insoluble fibrils.Gastrointestinal involvement in systemic amyloidosis is common,but is often subclinical or presents as vague and nonspecific symptoms.It is rare for gastrointestinal symptoms to be the main presenting symptom in patients with systemic amyloidosis,causing it to be undiagnosed until late-stage disease.CASE SUMMARY A 53 year-old man with diarrhea,hematochezia,and weight loss presented to a community hospital.Colonoscopy with biopsy at that time was suspicious for Crohn disease.Due to worsening symptoms including nausea,vomiting,and a new petechial rash,an abdominal fat pad biopsy was done.The biopsy showed papillary and adnexal dermal amyloid deposition,in a pattern usually seen with cutaneous amyloidosis.However,Cytokeratin 5/6 was negative,excluding cutaneous amyloidosis.The patterns of nodular amyloidosis,subcutaneous amyloid deposits and perivascular amyloid were not seen.Periodic Acid-Schiff stain was negative for lipoid proteinosis,Congo red was positive for apple green birefringence on polarization and amyloid typing confirmed amyloid light chain amyloidosis.Repeat endoscopic biopsies of the gastrointestinal tract showed amyloid deposition from the esophagus to the rectum,in a pattern usually seen in serum amyloid A in the setting of chronic inflammatory diseases,including severe inflammatory bowel disease.Bone marrow biopsy showed kappa-restricted plasma cell neoplasm.CONCLUSION Described is an unusual presentation of primary systemic amyloidosis,highlighting the risk of misdiagnosis with subsequent significant organ dysfunction and high mortality.展开更多
E3024 (3-but-2-ynyl-5-methyl-2-piperazin-1-yl-3,5-dihydro-4H-imidazo[4,5-d]pyridazin-4-one tosylate) is a dipeptidyl peptidase-IV (DPP-IV) inhibitor that was expected to be an antidiabetic agent. Its safety, tolerabil...E3024 (3-but-2-ynyl-5-methyl-2-piperazin-1-yl-3,5-dihydro-4H-imidazo[4,5-d]pyridazin-4-one tosylate) is a dipeptidyl peptidase-IV (DPP-IV) inhibitor that was expected to be an antidiabetic agent. Its safety, tolerability, pharmacokinetics (PK), and pharmacodynamics (PD) were investigated in a randomized, double-blind, placebo-controlled, ascending single-dose study in 48 healthy Japanese male subjects. Fasted subjects were orally administered E3024 (5, 10, 20, 40, or 80 mg) or placebo. E3024 was rapidly absorbed, with tmax values ranging between 0.33 and 3 h after dosing. The mean t1/2 ranged from 5.34 to 11.68 h. AUC0-inf and Cmax increased dose-proportionately. PK-PD relationship of E3024 was evaluated by using an Imax model, indicating that plasma E3024 concentrations and inhibitory effects of plasma DPP-IV activity were well correlated. The IC50 value was calculated as 33.7 ng/mL, which was consistent with in vitro data. Thus, E3024 showed a good PK profile and inhibited DPP-IV dose-dependently. Of 30 subjects administered E3024, 12 (40%) experienced adverse events (AEs). Dose escalation to 160 mg was abandoned owing to undesired subjective/objective findings in 4 of 6 subjects receiving 40 mg and 5 of 6 subjects receiving 80 mg. The most prominent AE was rash, but there were no serious AEs or deaths. The maximum tolerated dose was considered to be 20 mg. We hypothesized that histamine was a cause of the rash induction, and examined blood histamine levels of normal Fischer rats treated with E3024. Blood histamine levels were increased significantly by E3024 at 500 mg/kg (p < 0.001), but not by vildagliptin or valine-pyrrolidide (DPP-IV inhibitors) at the same dose. No blood histamine increases were observed in genetically mast cell-deficient Ws/Ws rats treated with E3024 at 500 mg/kg. In in vitro assays, E3024 induced histamine release from normal rat peritoneal mast cells in a concentration-dependent manner, but not from basophils. The structure-activity relationship study suggested that a piperazine group N-linked to the 2-position of the 5,6-membered fused heterocyclic rings was a key structural element for triggering histamine release.展开更多
BACKGROUND Since May 2022,outbreaks of monkeypox have occurred in many countries around the world,and several cases have been reported in China.CASE SUMMARY A 38-year-old man presented with a small,painless,shallow ul...BACKGROUND Since May 2022,outbreaks of monkeypox have occurred in many countries around the world,and several cases have been reported in China.CASE SUMMARY A 38-year-old man presented with a small,painless,shallow ulcer on the coronary groove for 8 d.One day after the rash appeared,the patient developed inguinal lymphadenopathy with fever.The patient had a history of male-male sexual activity and denied a recent history of travel abroad.Monkeypox virus was detected by quantitative polymerase chain reaction from the rash site and throat swab.Based on the epidemiological history,clinical manifestations and nucleic acid test results,the patient was diagnosed with monkeypox.CONCLUSION Monkeypox is an emerging infectious disease in China.Monkeypox presenting as a chancre-like rash is easily misdiagnosed.Diagnosis can be made based on exposure history,clinical manifestations and nucleic acid test results.展开更多
Psoriatic arthritis is a kind of arthritis associated with psoriasis. The clinical manifestations of psoriatic arthritis with arthritis as the first symptom are often similar to ankylosing spondylitis and rheumatoid a...Psoriatic arthritis is a kind of arthritis associated with psoriasis. The clinical manifestations of psoriatic arthritis with arthritis as the first symptom are often similar to ankylosing spondylitis and rheumatoid arthritis. Thus differential diagnosis should be made in clinical practice so as to improve the therapeutic effect. Psoriatic arthritis skin lesions are usually papules or plaques, with scales on the surface and punctate hemorrhage on the basement. About 10% of patients with psoriatic arthritis have skin rash after the onset of arthritis. In order to provide a reference for clinicians, our study the analyzed the clinical diagnosis of psoriatic arthritis in combination with a case of psoriatic arthritis with concealed skin rash and related literatures.展开更多
<strong>Background:</strong> Dexpanthenol containing formula (BEPANTHEN<sup>®</sup>), formulated as a water in oil preparation, is currently widely marketed as a diaper care product aiming...<strong>Background:</strong> Dexpanthenol containing formula (BEPANTHEN<sup>®</sup>), formulated as a water in oil preparation, is currently widely marketed as a diaper care product aiming to protect baby’s buttocks and repair diaper dermatitis. Dexpanthenol is a well-known moisturizer with barrier-improving properties and the oily phase of the water in oil preparation forms a lipophilic film on the skin surface that isolates the skin from irritants (feces and urine). Prolonged contact with irritants triggers a local inflammation cascade responsible for the cutaneous erythema. To further investigate the protective properties of skin barrier preparations, we took advantage of an <i>ex vivo</i> model of healthy human skin discs especially designed to evaluate protective and/or repairing effects of topical preparations recommended for baby’s buttocks through the measurement of interleukin-1 alpha release (a cytokine considered as the <em>Primum movens</em> of the skin inflammatory reaction), following the application of different irritants. <strong>Methods: </strong>Healthy human skin discs have been incubated in the absence (control) or in the presence of two irritants,<em> i.e.</em> a “urine like + urease” preparation and sodium dodecyl sulfate, and in the presence of three ointments, one containing dexpanthenol, but not the other two. At the end of the incubation period, interleukin-1 alpha (IL-1<em>α</em>) was quantified in the explants culture media.<strong> Results: </strong>“Urine like + urease” preparation (ULU) and sodium dodecyl sulfate (SDS) both increased IL-1<em>α</em> production of skin explants by 181.1% (p < 0.001) and 88.3% (p < 0.001), respectively. The dexpanthenol containing formula significantly inhibited the ULU- and the SDS-induced IL-1<em>α</em> release by 67.42% (p < 0.001) and 46.55% (p < 0.001), respectively. Under the same experimental conditions, one of the formulas without dexpanthenol significantly inhibited the ULU-induced IL-1<em>α</em> release by 45.94% (p < 0.01) but not the SDS-induced one, and the other tested formulation displayed no significant effect on the IL-1<em>α</em> production regardless of the irritant applied. Moreover, the effect of the dexpanthenol containing formula on the ULU-induced IL-1<em>α</em> release was significantly higher than the effect of the other formula;a difference of 19.6 % (p < 0.05) was observed.<strong> Conclusion: </strong>Dexpanthenol containing formula (BEPANTHEN<sup>®</sup>) provides good protection of baby’s buttocks against irritants. Its protective effect seems to be superior compared with other products, which did not contain this ingredient. Moreover, the results obtained in the present study suggest that dexpanthenol displays <i>per se</i> a real IL-1<em>α</em> production inhibitory effect. This work, however, consists of preliminary studies and additional investigations involving more formulas and end-points such as the quantification of other pro- or anti-inflammatory cytokines and/or resolvins for example, are needed to better understand the cutaneous protective effect of dexpanthenol.展开更多
Objective:To observe the efficacy and safety of Yinqiao Sanhuang Paste combined with traditional Chinese medicine plaster in treating drug rash caused by targeted therapy in lung cancer.Methods:A total of 100 lung can...Objective:To observe the efficacy and safety of Yinqiao Sanhuang Paste combined with traditional Chinese medicine plaster in treating drug rash caused by targeted therapy in lung cancer.Methods:A total of 100 lung cancer patients treated at our hospital from January 2021 to December 2023 were selected and randomly divided into an observation group and a control group,with 50 patients in each group.The control group received conventional medication,while the observation group was treated with Yinqiao Sanhuang Paste combined with traditional Chinese medicine plaster.The clinical symptom improvement and adverse reactions in both groups were observed.Results:The effective rate in the control group was 80.00%,while in the observation group,it was 96.00%,with a statistically significant difference between the two groups(P<0.05).The onset time,duration,and significant effect time in the control group were(2.41±0.29)days,(4.42±1.21)days,and(5.45±0.29)days,respectively;in the observation group,they were(2.44±0.21)days,(4.28±1.11)days,and(5.57±1.01)days,respectively.There was no statistically significant difference in the total onset time and total duration between the two groups(P>0.05).The incidence of adverse reactions in the control group was 28.00%,higher than the observation group’s 10.00%(P<0.05).Conclusion:Yinqiao Sanhuang Paste combined with traditional Chinese medicine plaster can effectively reduce the symptoms of drug rash induced by targeted therapy in lung cancer and lower the incidence of adverse reactions,indicating good clinical application value.展开更多
Objective: to investigate the application of detailed care in the treatment of rashes caused by NSCLC with molecular targeted drugs. Methods: from March 2019 to May 2020, 80 patients with rashes caused by NSCLC were e...Objective: to investigate the application of detailed care in the treatment of rashes caused by NSCLC with molecular targeted drugs. Methods: from March 2019 to May 2020, 80 patients with rashes caused by NSCLC were enrolled in our department. The control group received routine care, and the detail intervention group received detailed care. The skin symptom scores, negative emotional and psychological scores and favorable comments were compared between the two groups before and after care. Results: the skin symptom score and negative emotional and psychological score of the two groups before care were compared, P > 0.05, and the skin symptom score and negative emotional and psychological score of the two groups after care were significantly reduced, the skin symptom score and negative emotional and psychological score of the two groups were lower than before care, P < 0.05. The skin symptom score and negative emotional and psychological score of detail intervention group were significantly lower than those of reference group, P < 0.05. The nursing praise of detail intervention group was higher than that of reference group, P < 0.05. Conclusion: detailed care for patients with rashes caused by NSCLC treated with molecular-targeted drugs is effective. Its application can help the rash symptoms of patients subside in a short time, and reduce the adverse emotions caused by long-term rashes. Patients have a high evaluation of nursing.展开更多
Juvenile dermatomyositis(JDM)is a chronic pediatric autoimmune disease characterized by proximal muscle weakness and distinctive skin manifestations[1,2].The first-line treatment for JDM involves the combination of gl...Juvenile dermatomyositis(JDM)is a chronic pediatric autoimmune disease characterized by proximal muscle weakness and distinctive skin manifestations[1,2].The first-line treatment for JDM involves the combination of glucocorticoids with either methotrexate(MTX)or cyclosporine[3,4].For severe and refractory juvenile dermatomyositis,options such as tacrolimus.展开更多
Fever and rash illnesses(FRIs)are a series of common diseaseswith fever and rashes as clinicalmanifestations,most of which are caused by viral infection.The rashes of FRIs are generally nonspecific;therefore it is dif...Fever and rash illnesses(FRIs)are a series of common diseaseswith fever and rashes as clinicalmanifestations,most of which are caused by viral infection.The rashes of FRIs are generally nonspecific;therefore it is difficult to identify FRIassociated viruses solely based on clinical symptoms.To achieve rapid and accurate identification of FRI pathogens,a multiplex one-step real-time reverse transcription-polymerase chain reaction(RT-PCR)assay was developed and evaluated in this study.Primers and probes were selected for the detection of measles virus(MeV),rubella virus(RV),human enterovirus(EV),varicella-zoster virus(VZV),dengue virus(DENV),human parvovirus B19(B19),Epstein-Barr virus(EBV),and human herpes virus 6(HHV-6),which cover the most common pathogenic viruses of FRIs.Detection of the eight FRI-associated viruses,which was divided into two groups/tubes,was simultaneously performed under universal optimized reaction conditions in multiplex one-step real-time RT-PCR assay.The multiplex realtime RT-PCR showed high sensitivity and specificity in detecting the eight FRI-associated viruses.The limits of detection(LODs)for the eight viruses were in the range of 47–177 copies/reaction,and no cross reactions for the eight FRIassociated viruses were found in the multiplex assay.In addition,the results of the multiplex real-time RT-PCR assay were consistent with the results of a monoplex real-time RT-PCR assay and sequencing for clinical specimens obtained from FRI patients.With its advantages of high efficiency and rapid and accurate diagnosis,multiplex real-time RT-PCR was very feasible for the early diagnosis of FRI pathogenic viruses and would be of great help for the proper treatment,monitoring,and initiation of preventive measures for FRI cases.展开更多
Objective:The aim of this study is to evaluate the efficacy of Traditional Chinese Medicine(TCM)in the treatment of rash caused by epidermal growth factor receptor inhibitors(EGFRIs).Materials and Methods:Foreign lang...Objective:The aim of this study is to evaluate the efficacy of Traditional Chinese Medicine(TCM)in the treatment of rash caused by epidermal growth factor receptor inhibitors(EGFRIs).Materials and Methods:Foreign language database(such as Pub Med,Web of Science,Cochrane Library,EMBASE)and Chinese language database(such as China National Knowledge Infrastructure,VIP Database for Chinese Technical Periodicals[VIP],Wangfang,CBM disc)were searched for all trials of TCM in the treatment of rash caused by EGFRIs until January of 2019.We also looked through the references of relevant studies to supplement additional trials.The SPSS 25.0 was used for statistics of TCM with high frequency,and Review Manager 5.3 was used for meta-analysis.Results:A total of 22 studies were included in the study.We selected TCM whose frequency were>3.0%.They were Lonicera japonica(金银花),Licorice Roots Northwest Origin(生甘草),Cortex Dictamni(白鲜皮),Radix Sophorae Flavescentis(苦参),Schizonepeta(荆芥),Saposhnikovia Divaricate(防风).The meta-analysis revealed that the efficacy of TCM in treating EGFRIs-related rash was better than that of Western medicine or none.Conclusions:TCM could significantly relieve rash caused by EGFRIs,which is worth popularizing.Moreover,the mechanism deserves to be further explored.展开更多
基金supported by grants from the National Natural Science Foundation of China(Nos.82373372 and U22A20330)Key Project of Research and Development Plan in Heilongjiang Province(Nos.2022ZX06C01 and JD2023SJ40)+1 种基金National Cancer Center Climbing Fund(No.NCC201908A03)Beijing Xisike Clinical Oncology Research Foundation(No.Y-HR2020MS-0900).
文摘Psoriasiform rash is a notable immune-related cutaneous adverse event(ircAE)accounting for approximately 5%of all ircAEs1,2.Patients with cancer and pre-existing psoriasis face elevated risk of disease recurrence or exacerbation after receiving immune checkpoint inhibitors(ICIs).A European multicenter study has reported a reactivation rate of 28.7%in this population3.ICIs also trigger de novo psoriatic lesions,which mirror conventional lesion subtypes(plaque,guttate,erythrodermic,or pustular).
文摘Dear Editor,Herpes zoster(HZ),which is characterized by a unilateral painful dermatomal rash,is caused by reactivation of the latent varicella-zoster virus(VZV)in the dorsal root ganglia following primary infection during childhood[1].HZ tends to occur more frequently in older adults,in whom cellmediated immunity often declines.The incidence of HZ among immunocompetent unvaccinated individuals aged>50y is 9.92/1000 person-years[2].HZ ophthalmicus(HZO)occurs when HZ involves the first division of the trigeminal nerve,i.e.,the ophthalmic nerve[3].
文摘The Asar va Ahyā’is a manual of agricultural production written in the early fourteenth century by the famous Iranian vizier and scholar Rashīd al-Dīn.Only chapter 6 to chapter 13 of the original work survive,dealing with agriculture and horticulture,and nearly a third of the pages of which are devoted to introducing Chinese plants and related knowledge.In addition to introducing botanical knowledge,the book also covered information on all the aspects of the Yuan dynasty(1271–1368),including the taxation system,monetary system,military system,economy and trade,manufacturing techniques,ethnic customs,food culture,and other fields,providing important materials for research on the dissemination of species,exchange of technologies,communication of ethnic groups,and integration of cultures between China and the world during the thirteenth and fourteenth centuries.Rashīd al-Dīn,the book’s author,took advantage of his identities as a statesman and a businessman to collect rich information about plants all over the world.Motivated by his specific interest in Chinese culture,he included a huge amount of Chinese information in the book.Meanwhile,records in the Asar va Asyā’reflect the author’s practice of researching,planting,and cultivating plants,making the book not only a compilation of agricultural knowledge,but also a report that recorded the author’s agricultural practice.
文摘Background: Rubella is an infectious disease of public health importance because infection ac-quired during early pregnancy often results in foetal abnormalities that are classified as con-genital rubella syndrome (CRS). The burden of rubella infection in most developing countries is however not well documented because of lim-ited epidemiological data. Methods: Between 2006 and 2009, 781individuals with febrile rash illness seen in clinics in Akwa Ibom State were screened for rubella specific IgM antibodies using the ELISA technique. Statistical analysis was done using Graph prime version 5.3 statis-tical package at 95% confidence interval. The level of significance was established at P = 0.05 using Fisher’s exact two-tailed values. Results: Of 781 individuals screened for rubella specific IgM antibodies, 94 (12%) were found to be posi-tive. Incidence of 8.7% recorded in 2006 gradu-ally rose to 9.3% in 2007, 11.6% in 2008 and 14.3% in 2009. Those in the reproductive age group (> 16 years) were most affected (51.7%). However, this was not statistically significant (P = 0.228). Females (17.4%) were more suscepti-ble than males (6.2%) (P < 0.0001) an rural dwellers (12.8%) more susceptible than urban dwellers (10.5%) (P = 0.416). Conclusion: The study shows that the incidence of rubella in Akwa Ibom State, Nigeria is high. The lowest incidence was however found among individu-als below the reproductive age. Thus, the find-ings of this study can be used by policy makers to model the introduction of routine rubella vaccination into the country’ Expanded Program on Immunization Schedule (EPI).
文摘Epidermal growth factor receptor tyrosine kinase inhibitor(EGFR-TKI)plays an important role in cancer therapy.However,EGFR is highly expressed in the skin and gives rise to one of the most concerning issues for the EGFR-TKI treatment,namely skin toxicity.Antibiotics and corticosteroids are usually used to treat the EGFR inhibitor-associated skin rash,with prominent side effects over long-time use.Pien Tze Huang(PZH)Unguentum Compositum is a traditional product for external application which is made of traditional Chinese medicine and oil base.Herein,we reported the case of a 50-year-old man who presented with skin rash on the face,head,and back induced by an EGFR-TKI named erlotinib.By using PZH Unguentum Compositum,we observed that the skin rash was mitigated and eventually disappeared.This case report suggests that PZH Unguentum Compositum may be an effective therapy in treating skin rash caused by EGFR-TKI with fewer side effects.
文摘When febrile illnesses develop a rash in children, parents are very concerned about a serious disease. Many rashes associated with fever are caused by infectious diseases. Rashes are generally nonspecific and play a supportive role in differential diagnosis, but for some diseases, the appearance of the rash is essential in making a diagnosis. Here is presented the case of a 4-year-old boy with high fever, headache, abdominal pain, vomiting, diarrhea, and a generalized maculo-papular rash including palms and soles. On physical examination were found a black eschar, cervical lymphadenopathy, and hepatosplenomegaly. Laboratory findings resulted in moderate leukocytosis and moderate involvement of the liver and renal function. Based on this finding, a diagnosis of Mediterranean Spotted Fever was performed. The child recovered after medication with azithromycin. Because there is no reliable test that can confirm MSF in its early stages, the diagnosis is commonly made on the basis of clinical findings, so a high index of suspicion should be maintained while evaluating a child with fever and rash.
文摘BACKGROUND Amyloidosis is a rare disease characterized by extracellular deposition of misfolded protein aggregated into insoluble fibrils.Gastrointestinal involvement in systemic amyloidosis is common,but is often subclinical or presents as vague and nonspecific symptoms.It is rare for gastrointestinal symptoms to be the main presenting symptom in patients with systemic amyloidosis,causing it to be undiagnosed until late-stage disease.CASE SUMMARY A 53 year-old man with diarrhea,hematochezia,and weight loss presented to a community hospital.Colonoscopy with biopsy at that time was suspicious for Crohn disease.Due to worsening symptoms including nausea,vomiting,and a new petechial rash,an abdominal fat pad biopsy was done.The biopsy showed papillary and adnexal dermal amyloid deposition,in a pattern usually seen with cutaneous amyloidosis.However,Cytokeratin 5/6 was negative,excluding cutaneous amyloidosis.The patterns of nodular amyloidosis,subcutaneous amyloid deposits and perivascular amyloid were not seen.Periodic Acid-Schiff stain was negative for lipoid proteinosis,Congo red was positive for apple green birefringence on polarization and amyloid typing confirmed amyloid light chain amyloidosis.Repeat endoscopic biopsies of the gastrointestinal tract showed amyloid deposition from the esophagus to the rectum,in a pattern usually seen in serum amyloid A in the setting of chronic inflammatory diseases,including severe inflammatory bowel disease.Bone marrow biopsy showed kappa-restricted plasma cell neoplasm.CONCLUSION Described is an unusual presentation of primary systemic amyloidosis,highlighting the risk of misdiagnosis with subsequent significant organ dysfunction and high mortality.
文摘E3024 (3-but-2-ynyl-5-methyl-2-piperazin-1-yl-3,5-dihydro-4H-imidazo[4,5-d]pyridazin-4-one tosylate) is a dipeptidyl peptidase-IV (DPP-IV) inhibitor that was expected to be an antidiabetic agent. Its safety, tolerability, pharmacokinetics (PK), and pharmacodynamics (PD) were investigated in a randomized, double-blind, placebo-controlled, ascending single-dose study in 48 healthy Japanese male subjects. Fasted subjects were orally administered E3024 (5, 10, 20, 40, or 80 mg) or placebo. E3024 was rapidly absorbed, with tmax values ranging between 0.33 and 3 h after dosing. The mean t1/2 ranged from 5.34 to 11.68 h. AUC0-inf and Cmax increased dose-proportionately. PK-PD relationship of E3024 was evaluated by using an Imax model, indicating that plasma E3024 concentrations and inhibitory effects of plasma DPP-IV activity were well correlated. The IC50 value was calculated as 33.7 ng/mL, which was consistent with in vitro data. Thus, E3024 showed a good PK profile and inhibited DPP-IV dose-dependently. Of 30 subjects administered E3024, 12 (40%) experienced adverse events (AEs). Dose escalation to 160 mg was abandoned owing to undesired subjective/objective findings in 4 of 6 subjects receiving 40 mg and 5 of 6 subjects receiving 80 mg. The most prominent AE was rash, but there were no serious AEs or deaths. The maximum tolerated dose was considered to be 20 mg. We hypothesized that histamine was a cause of the rash induction, and examined blood histamine levels of normal Fischer rats treated with E3024. Blood histamine levels were increased significantly by E3024 at 500 mg/kg (p < 0.001), but not by vildagliptin or valine-pyrrolidide (DPP-IV inhibitors) at the same dose. No blood histamine increases were observed in genetically mast cell-deficient Ws/Ws rats treated with E3024 at 500 mg/kg. In in vitro assays, E3024 induced histamine release from normal rat peritoneal mast cells in a concentration-dependent manner, but not from basophils. The structure-activity relationship study suggested that a piperazine group N-linked to the 2-position of the 5,6-membered fused heterocyclic rings was a key structural element for triggering histamine release.
文摘BACKGROUND Since May 2022,outbreaks of monkeypox have occurred in many countries around the world,and several cases have been reported in China.CASE SUMMARY A 38-year-old man presented with a small,painless,shallow ulcer on the coronary groove for 8 d.One day after the rash appeared,the patient developed inguinal lymphadenopathy with fever.The patient had a history of male-male sexual activity and denied a recent history of travel abroad.Monkeypox virus was detected by quantitative polymerase chain reaction from the rash site and throat swab.Based on the epidemiological history,clinical manifestations and nucleic acid test results,the patient was diagnosed with monkeypox.CONCLUSION Monkeypox is an emerging infectious disease in China.Monkeypox presenting as a chancre-like rash is easily misdiagnosed.Diagnosis can be made based on exposure history,clinical manifestations and nucleic acid test results.
文摘Psoriatic arthritis is a kind of arthritis associated with psoriasis. The clinical manifestations of psoriatic arthritis with arthritis as the first symptom are often similar to ankylosing spondylitis and rheumatoid arthritis. Thus differential diagnosis should be made in clinical practice so as to improve the therapeutic effect. Psoriatic arthritis skin lesions are usually papules or plaques, with scales on the surface and punctate hemorrhage on the basement. About 10% of patients with psoriatic arthritis have skin rash after the onset of arthritis. In order to provide a reference for clinicians, our study the analyzed the clinical diagnosis of psoriatic arthritis in combination with a case of psoriatic arthritis with concealed skin rash and related literatures.
文摘<strong>Background:</strong> Dexpanthenol containing formula (BEPANTHEN<sup>®</sup>), formulated as a water in oil preparation, is currently widely marketed as a diaper care product aiming to protect baby’s buttocks and repair diaper dermatitis. Dexpanthenol is a well-known moisturizer with barrier-improving properties and the oily phase of the water in oil preparation forms a lipophilic film on the skin surface that isolates the skin from irritants (feces and urine). Prolonged contact with irritants triggers a local inflammation cascade responsible for the cutaneous erythema. To further investigate the protective properties of skin barrier preparations, we took advantage of an <i>ex vivo</i> model of healthy human skin discs especially designed to evaluate protective and/or repairing effects of topical preparations recommended for baby’s buttocks through the measurement of interleukin-1 alpha release (a cytokine considered as the <em>Primum movens</em> of the skin inflammatory reaction), following the application of different irritants. <strong>Methods: </strong>Healthy human skin discs have been incubated in the absence (control) or in the presence of two irritants,<em> i.e.</em> a “urine like + urease” preparation and sodium dodecyl sulfate, and in the presence of three ointments, one containing dexpanthenol, but not the other two. At the end of the incubation period, interleukin-1 alpha (IL-1<em>α</em>) was quantified in the explants culture media.<strong> Results: </strong>“Urine like + urease” preparation (ULU) and sodium dodecyl sulfate (SDS) both increased IL-1<em>α</em> production of skin explants by 181.1% (p < 0.001) and 88.3% (p < 0.001), respectively. The dexpanthenol containing formula significantly inhibited the ULU- and the SDS-induced IL-1<em>α</em> release by 67.42% (p < 0.001) and 46.55% (p < 0.001), respectively. Under the same experimental conditions, one of the formulas without dexpanthenol significantly inhibited the ULU-induced IL-1<em>α</em> release by 45.94% (p < 0.01) but not the SDS-induced one, and the other tested formulation displayed no significant effect on the IL-1<em>α</em> production regardless of the irritant applied. Moreover, the effect of the dexpanthenol containing formula on the ULU-induced IL-1<em>α</em> release was significantly higher than the effect of the other formula;a difference of 19.6 % (p < 0.05) was observed.<strong> Conclusion: </strong>Dexpanthenol containing formula (BEPANTHEN<sup>®</sup>) provides good protection of baby’s buttocks against irritants. Its protective effect seems to be superior compared with other products, which did not contain this ingredient. Moreover, the results obtained in the present study suggest that dexpanthenol displays <i>per se</i> a real IL-1<em>α</em> production inhibitory effect. This work, however, consists of preliminary studies and additional investigations involving more formulas and end-points such as the quantification of other pro- or anti-inflammatory cytokines and/or resolvins for example, are needed to better understand the cutaneous protective effect of dexpanthenol.
文摘Objective:To observe the efficacy and safety of Yinqiao Sanhuang Paste combined with traditional Chinese medicine plaster in treating drug rash caused by targeted therapy in lung cancer.Methods:A total of 100 lung cancer patients treated at our hospital from January 2021 to December 2023 were selected and randomly divided into an observation group and a control group,with 50 patients in each group.The control group received conventional medication,while the observation group was treated with Yinqiao Sanhuang Paste combined with traditional Chinese medicine plaster.The clinical symptom improvement and adverse reactions in both groups were observed.Results:The effective rate in the control group was 80.00%,while in the observation group,it was 96.00%,with a statistically significant difference between the two groups(P<0.05).The onset time,duration,and significant effect time in the control group were(2.41±0.29)days,(4.42±1.21)days,and(5.45±0.29)days,respectively;in the observation group,they were(2.44±0.21)days,(4.28±1.11)days,and(5.57±1.01)days,respectively.There was no statistically significant difference in the total onset time and total duration between the two groups(P>0.05).The incidence of adverse reactions in the control group was 28.00%,higher than the observation group’s 10.00%(P<0.05).Conclusion:Yinqiao Sanhuang Paste combined with traditional Chinese medicine plaster can effectively reduce the symptoms of drug rash induced by targeted therapy in lung cancer and lower the incidence of adverse reactions,indicating good clinical application value.
文摘Objective: to investigate the application of detailed care in the treatment of rashes caused by NSCLC with molecular targeted drugs. Methods: from March 2019 to May 2020, 80 patients with rashes caused by NSCLC were enrolled in our department. The control group received routine care, and the detail intervention group received detailed care. The skin symptom scores, negative emotional and psychological scores and favorable comments were compared between the two groups before and after care. Results: the skin symptom score and negative emotional and psychological score of the two groups before care were compared, P > 0.05, and the skin symptom score and negative emotional and psychological score of the two groups after care were significantly reduced, the skin symptom score and negative emotional and psychological score of the two groups were lower than before care, P < 0.05. The skin symptom score and negative emotional and psychological score of detail intervention group were significantly lower than those of reference group, P < 0.05. The nursing praise of detail intervention group was higher than that of reference group, P < 0.05. Conclusion: detailed care for patients with rashes caused by NSCLC treated with molecular-targeted drugs is effective. Its application can help the rash symptoms of patients subside in a short time, and reduce the adverse emotions caused by long-term rashes. Patients have a high evaluation of nursing.
基金supported by the National Key R&D Program of China(Grant No.2021YFC2702001)Project supported by the Young Scientists Fund of the National Natural Science Foundation of China(Grant No.82101423).
文摘Juvenile dermatomyositis(JDM)is a chronic pediatric autoimmune disease characterized by proximal muscle weakness and distinctive skin manifestations[1,2].The first-line treatment for JDM involves the combination of glucocorticoids with either methotrexate(MTX)or cyclosporine[3,4].For severe and refractory juvenile dermatomyositis,options such as tacrolimus.
基金supported by the Key Technologies R&D Program of the National Ministry of Science[grant numbers 2018ZX10711001,2018ZX10713002,2018ZX10713001-003,and 2017ZX10104001-002].
文摘Fever and rash illnesses(FRIs)are a series of common diseaseswith fever and rashes as clinicalmanifestations,most of which are caused by viral infection.The rashes of FRIs are generally nonspecific;therefore it is difficult to identify FRIassociated viruses solely based on clinical symptoms.To achieve rapid and accurate identification of FRI pathogens,a multiplex one-step real-time reverse transcription-polymerase chain reaction(RT-PCR)assay was developed and evaluated in this study.Primers and probes were selected for the detection of measles virus(MeV),rubella virus(RV),human enterovirus(EV),varicella-zoster virus(VZV),dengue virus(DENV),human parvovirus B19(B19),Epstein-Barr virus(EBV),and human herpes virus 6(HHV-6),which cover the most common pathogenic viruses of FRIs.Detection of the eight FRI-associated viruses,which was divided into two groups/tubes,was simultaneously performed under universal optimized reaction conditions in multiplex one-step real-time RT-PCR assay.The multiplex realtime RT-PCR showed high sensitivity and specificity in detecting the eight FRI-associated viruses.The limits of detection(LODs)for the eight viruses were in the range of 47–177 copies/reaction,and no cross reactions for the eight FRIassociated viruses were found in the multiplex assay.In addition,the results of the multiplex real-time RT-PCR assay were consistent with the results of a monoplex real-time RT-PCR assay and sequencing for clinical specimens obtained from FRI patients.With its advantages of high efficiency and rapid and accurate diagnosis,multiplex real-time RT-PCR was very feasible for the early diagnosis of FRI pathogenic viruses and would be of great help for the proper treatment,monitoring,and initiation of preventive measures for FRI cases.
文摘Objective:The aim of this study is to evaluate the efficacy of Traditional Chinese Medicine(TCM)in the treatment of rash caused by epidermal growth factor receptor inhibitors(EGFRIs).Materials and Methods:Foreign language database(such as Pub Med,Web of Science,Cochrane Library,EMBASE)and Chinese language database(such as China National Knowledge Infrastructure,VIP Database for Chinese Technical Periodicals[VIP],Wangfang,CBM disc)were searched for all trials of TCM in the treatment of rash caused by EGFRIs until January of 2019.We also looked through the references of relevant studies to supplement additional trials.The SPSS 25.0 was used for statistics of TCM with high frequency,and Review Manager 5.3 was used for meta-analysis.Results:A total of 22 studies were included in the study.We selected TCM whose frequency were>3.0%.They were Lonicera japonica(金银花),Licorice Roots Northwest Origin(生甘草),Cortex Dictamni(白鲜皮),Radix Sophorae Flavescentis(苦参),Schizonepeta(荆芥),Saposhnikovia Divaricate(防风).The meta-analysis revealed that the efficacy of TCM in treating EGFRIs-related rash was better than that of Western medicine or none.Conclusions:TCM could significantly relieve rash caused by EGFRIs,which is worth popularizing.Moreover,the mechanism deserves to be further explored.
