[Dermatologic effects of oral contraceptives].
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Adolescent↗
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[Idiopathic chronic hypoparathyroidism and its dermatological effects with special reference to impetigo herpetiformis].
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Chronic Disease↗
[Secondary dermatologic effects of serotonin reuptake inhibitor antidepressants: hypothesis of cross-reacting allergy. Apropos of 2 cases].
Toxidermia is a well-known complication of antidepressant therapy. The authors report two cases of adverse cutaneous reactions after treatment by several serotonin uptake blockers. The first case concerns a 38-year-old woman, who suffered from depressive disorder. She has been treated with fluoxetine. After eight days, a cutaneous reaction appeared. This reaction subsided when fluoxetine was stopped. Two months later, she had a prescription of paroxetine, and the same skin adverse effect appeared. The cutaneous lesion decreased with the suppression of paroxetine. The chronology of the eruption suggests that it was caused by an adverse reaction to the both serotonin uptake blockers. The second case concerns a 40-year-old man who had several prescriptions of antidepressant treatment in a period of one year: fluoxetine, fluvoxamine, paroxetine and sertraline. Each time a cutaneous reaction appeared. It is advisable to substitute after an adverse effect a medication from one of the other classes of antidepressants. But what we saw in these cases is that the serotonin uptake blockers could be involved in the same allergic reaction while these drugs have different chemistry structures. Only three of them have the same excipient. These cases ask the question of cross-reactivity between the serotonin uptake blockers.
1-Naphthylamine↗
Dermatological adverse effects with the antimalarial drug mefloquine: a review of 74 published case reports.
Mefloquine is a relatively new antimalarial drug which has been associated with a wide variety of adverse effects, including skin reactions. In order to evaluate the range and frequency of mefloquine's dermatological effects, we searched the scientific literature for published case reports of such effects. We found 74 case reports, published between the years 1983 and 1997. Pruritus and maculopapular rash are the dermatological effects most commonly associated with mefloquine: their approximate frequency is 4-10% for pruritus, and up to 30% for nonspecific maculopapular rash. Adverse effects associated less commonly with mefloquine include urticaria, facial lesions and cutaneous vasculitis. One case of Stevens-Johnson syndrome and one fatal case of toxic epidermal necrolysis occurred. Appropriate primary studies of mefloquine use should be carried out to elucidate the epidemiology and aetiology of dermatological and other adverse effects of the drug.
Adult↗
Dermatologic side effects of thalidomide in patients with multiple myeloma.
BACKGROUND: Thalidomide, an antiangiogenic agent, was approved by the Food and Drug Administration in 1998 for the treatment of erythema nodosum leprosum. Although its teratogenic and neurologic side effects are well known, its dermatologic side effects continue to be defined. OBJECTIVE: We report the dermatologic side effects in 87 patients with multiple myeloma enrolled in a comparative, open-label, clinical trial treated with thalidomide alone (50 patients) or thalidomide and dexamethasone (37 patients). METHOD: We reviewed the records of all patients enrolled in the clinical trial. The frequency, type, severity, and time of onset of all skin eruptions that were temporally related to thalidomide treatment were recorded. RESULTS: Minor to moderate skin eruptions were noted in 46% of patients taking thalidomide alone and in 43% of those taking thalidomide and dexamethasone. These included morbilliform, seborrheic, maculopapular, or nonspecific dermatitis. Severe skin reactions (exfoliative erythroderma, erythema multiforme, and toxic epidermal necrolysis) that required hospitalization and withdrawal of thalidomide developed in 3 patients receiving thalidomide and dexamethasone. CONCLUSION: The prevalence of dermatologic side effects of thalidomide appear to be higher than previously reported. Although in most patients they were minor, in a few patients they were quite severe, particularly when given in conjunction with dexamethasone for newly diagnosed myeloma. Further studies are needed to verify the extent of the interaction between thalidomide and dexamethasone in this group of patients.
Adult↗
Dermatologic side effects associated with gefitinib therapy: clinical experience and management.
Gefitinib (ZD1839, Iressa ), a selective inhibitor of the epidermal growth factor receptor-tyrosine kinase, is currently in clinical trials to treat a variety of solid tumors. Similar side effects were seen in numerous clinical trials of gefitinib, including recent phase II trials (Iressa Dose Evaluation in Advanced Lung Cancer [IDEAL]-1 and IDEAL-2) in patients with advanced, previously treated non-small-cell lung cancer (NSCLC). The most frequent drug-related adverse effects reported in these trials were diarrhea, dry skin, acneiform rash, and nausea and vomiting. Recently, IDEAL-2 investigators and oncology nurses participated in a panel discussion on the management of dermatologic adverse effects associated with gefitinib treatment. These dermatologic effects were related to the mechanism of action of gefitinib and were not caused by a drug-related allergic reaction. In IDEAL-2, investigators managed the symptoms of dry skin and rash with a variety of treatments, including topical clindamycin, antibiotics, and corticosteroids. Most patients had a high level of tolerance for the dermatologic effects associated with gefitinib, which were milder than toxicities associated with chemotherapy. The severity of skin effects cycled over time during treatment but typically subsided after several weeks of gefitinib treatment. In general, dermatologic effects of gefitinib were easily managed, reversible, and well tolerated by these patients with advanced NSCLC.
Journal Article↗
Dermatological side effects of brimonidine: a report of three cases.
Brimonidine is a potential first line therapy for primary open angle glaucoma (OAG) and ocular hypertension (OHT). It is known to cause various ocular and systemic side effects. Being a newer drug, the whole spectrum of its adverse effects is not known. The dermatological side effects caused by brimonidine have rarely been reported before. We present three OAG patients who presented to us with contact dermatitis of periorbital skin and lichen planus of nail following the use of topical brimonidine (0.2% twice a day) for more than six months. These side effects slowly disappeared on discontinuing the drug but reappeared on reintroducing topical formulation. Such side effects from the use of brimonidine have not been reported before.
Administration, Topical↗
Dermatologic adverse effects of lenalidomide therapy for amyloidosis and multiple myeloma.
OBJECTIVES: To examine dermatologic adverse effects of lenalidomide in patients with amyloidosis and multiple myeloma and to determine whether the adverse effects are different when lenalidomide is used alone compared with when it is used in combination with dexamethasone. DESIGN: Retrospective review of medical records. SETTING: Tertiary referral center. PATIENTS: Seventy-five patients with multiple myeloma and 23 patients with amyloidosis participating in clinical trials. INTERVENTION: In the 75 patients with multiple myeloma, lenalidomide was the treatment in 24 and lenalidomide and dexamethasone in 51. In the 23 patients with amyloidosis, lenalidomide was used alone. MAIN OUTCOME MEASURES: The frequency, type, severity, and time of onset of all skin eruptions that were temporally related to lenalidomide treatment were recorded. RESULTS: In the patients with amyloidosis treated with lenalidomide, 10 (43%) had rashes. In the patients with multiple myeloma, rashes occurred in 7 (29%) of those receiving lenalidomide alone and in 15 (29%) of those receiving lenalidomide and dexamethasone. The rashes were characterized as morbilliform, urticarial, dermatitic, acneiform, and undefined. Severe rashes required permanent discontinuation of lenalidomide therapy in 2 patients. In 23 patients (72%), rashes occurred in the first month after therapy was initiated; however, delayed-onset rashes occurred in 9 (28%). CONCLUSIONS: The prevalence of dermatologic adverse effects in patients receiving lenalidomide was higher in those with amyloidosis than in those with multiple myeloma. The prevalence of skin eruptions was not diminished by the concurrent use of systemic corticosteroids. Most skin eruptions were mild and did not necessitate withdrawal of lenalidomide therapy.
Amyloidosis↗
Chemotherapy and cutaneous toxicities: implications for oncology nurses.
OBJECTIVE: To review common cutaneous effects and dermatologic or cutaneous toxicities related to the administration of chemotherapy. These range from mostly cosmetic, such as hyperpigmentation or alopecia, to dose-limiting toxicities such as palmar-plantar erythrodysesthesia or hand-foot syndrome. DATA SOURCES: Current research, published literature, and internet resources. CONCLUSION: Assessment and grading of associated toxicities of therapy is an integral part of caring for this patient population. Early intervention may reduce toxicities associated with therapies for this patient population IMPLICATIONS FOR NURSING PRACTICE: As more patients receive chemotherapy, dermatologic effects are becoming more common. Oncology nurses must be skilled in managing these side effects.
Alopecia↗
The effect of dermatology consultations in secondary care on treatment outcome and quality of life in new adult patients with atopic dermatitis.
BACKGROUND: The prevalence of atopic dermatitis (AD) is increasing worldwide, and many patients present to secondary care in adult life. This is a significant contribution to the workload of all dermatology departments. There are no studies investigating the impact of a dermatology consultation within secondary care. OBJECTIVES: To examine the effect of dermatology consultations in secondary care on treatment outcome and quality of life in new adult patients with AD. METHODS: This prospective observational study recruited new adult patients with AD referred from primary care. Eczema severity was assessed using the SCORAD (Severity Scoring of AD) index and subjective good or poor clinical outcome. The Dermatology Life Quality Index (DLQI) was used to quantify the impact of AD on adult patients. Patients were assessed at initial consultation (T1), 6 weeks (T2) and 3 months (T3). Statistical analysis was performed using independent t-tests, repeated-measures analysis of variance, correlation coefficients and Bonferroni post hoc comparisons. RESULTS: Sixty-three patients were recruited (37 women, 26 men) with a mean age of 34 years. Mean SCORAD at T1 was 48.2 and the majority (51%) had severe eczema (objective SCORAD>40). Mean SCORAD reduced by 52% from T1 to T2 (P<0.001) but there was no significant change in SCORAD from T2 to T3. A subjective good clinical outcome was validated by a decrease in SCORAD of >20 (P<0.001). Patients in the good clinical outcome group were significantly older than those in the poor clinical outcome group (38 vs. 27 years, P<0.05). The mean age at presentation of women was significantly younger than men (29 vs. 43 years, P<0.01). Women's mean SCORAD improved over all three visits, while men's mean SCORAD improved from T1 to T2 but worsened from T2 to T3 (P<0.001). The mean DLQI reduced over all three visits, from 9.5 at T1 to 8.8 at T2 and 7.0 at T3, and was significantly correlated with SCORAD at T1 and T2 (P<0.01). Patients accurately self-scored their eczema on a body map as shown by a significant correlation between these scores and SCORAD at T1 and T2 (P<0.001). CONCLUSIONS: We have shown that within the first 3 months of referral to secondary care, new adult patients with AD have the greatest improvement in AD, measured by SCORAD, after their initial appointment. Quality of life, as measured by DLQI, continued to improve over all three visits.
Adolescent↗
Dermatologic side effects associated with the epidermal growth factor receptor inhibitors.
Epidermal growth factor receptor (EGFR) inhibitors are associated with unique and dramatic dermatologic side effects. Cetuximab, erlotinib, and gefitinib have been approved for patients with colorectal and non-small cell lung cancer refractory or intolerant to chemotherapy. Our aim was to describe key clinical features of common dermatologic adverse reactions among EGFR inhibitors, focusing mainly on skin toxicity, as well as to discuss the pathology, possible causes, and suggested treatments for these reactions. The most commonly encountered adverse effect was a mild skin toxicity characterized by a sterile follicular and pustular rash that may be treated empirically and usually does not require treatment modification. Although the precise mechanism for development of rash is not well defined, it is related to inhibition of EGFR-signaling pathways in the skin, and may serve as visible markers of anti-tumor activity and therapeutic efficacy. Secondary adverse reactions seen with anti-EGFR therapy include xerosis, pruritus, paronychia, hair abnormality, and mucositis.
Antibodies, Monoclonal↗
Prevention of dermatologic side effects of bimatoprost 0.03% topical therapy.
PURPOSE: To investigate the efficacy of reducing the drop-skin contact to prevent dermatologic side effects of bimatoprost 0.03% topical therapy. DESIGN: Prospective, randomized, single-blinded, internally controlled study. METHODS: Enrolled subjects started bimatoprost 0.03% therapy once at night in both eyes and were instructed to wipe selectively only one eye (eye 1) with an adsorbent pad during and after drops administration for four months. The fellow eye acted as the internal control. Eyelash growth, regional skin hypertrichosis, and pigmentation on the periocular skin were assessed at baseline and during the four months of follow-up. RESULTS: A lower incidence of eyelash growth and skin pigmentation in the inferonasal pericanthal region were observed in eye 1. The incidence of pigmentation in the inferotemporal skin region and skin hypertrichosis were similar in the two eyes. CONCLUSION: The reduction of the drop-skin contact affects the regional incidence and the extent of dermatologic skin changes that are related to bimatoprost 0.03% topical therapy.
Adult↗
Dermatologic side effects of psychopharmacologic agents.
Exanthematous eruptions, urticaria, photosensitivity, pigmentary problems, acne, alopecia, fixed drug eruptions, and lichenoid reactions are the most common dermatologic side effects associated with the administration of psychopharmacologic agents. The cutaneous findings associated with the various eruptions and the most common inciting psychiatric medications are discussed.
Antipsychotic Agents↗
Results and side effects of dermatologic radiotherapy: a retrospective study of irradiated cutaneous epithelial neoplasms.
BACKGROUND: Ionizing radiation therapy has a well-defined role among several therapeutic options available for the management of cutaneous neoplasms. However, many dermatologists today are not aware of its potential. OBJECTIVE: Our purpose was to evaluate the effectiveness and safety of radiotherapy in a large series of patients with primary malignant epithelial neoplasms (PMENs), who had been subjected to radiotherapy between 1982 and 1995. METHODS: A retrospective study was performed on 1188 patients with a total of 2002 PMENs that had been treated by contact, superficial, and intermediate x-ray therapy. RESULTS: Complete remission was obtained in 98.7% of the irradiated lesions. The 5-year cure rate was 90.73%. Cosmetic results were evaluated as "good" or "acceptable" in 84.01% of the treated lesions. Acute complications occurred in 1.94% and chronic complications in 0.34%. To date, neither radio-induced skin neoplasms nor late stochastic effects have been observed. CONCLUSION: This study confirms that dermatologic radiotherapy is an effective and reliable form of treatment of PMENs and has a favorable cure rate/toxicity ratio.
Adult↗
[Side effects of dermatologic local therapy].
After application of dermatics systemic as well as topical side effects are to be expected, the latter also by usage of remedies and cosmetics. Even though life-threatening or lethal complications caused by potent substances like mercury compounds, phenols, salicylic acid, boric acid and others seldom have been observed, it is necessary to prevent them completely. Most frequent are allergic contact eczemas, but occasionally also toxic irritations of the skin can be registered. The side effects discussed, especially those caused by steroids and antibiotics, demand strong criteria for indication, scientific mode of administration and intensification of the topical efforts for standardization of dermatological treatment.
Administration, Topical↗
Bacitracin in dermatology: its effectiveness in topical therapy.
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Bacitracin↗
[Effectiveness of dermatologic minor surgery in the office of the family physician and patient satisfaction in relation with ambulatory surgery].
BACKGROUND: The minor surgery by family physicians increase the primary care competences. The purpose of this work is to prove patients' satisfaction and minor surgery effectiveness practiced by family physicians in health centers with respect to ambulatory's general surgeon. MATERIAL AND METHODS: Case-control retrospective study, comparing dermatological surgical procedures performed by 4 family physicians and 8 3rd-year Family Physician residents with surgical procedures wade made by a surgeon over one a year period. Variables analysed include: descriptive samples homogeneity, surgery effectiveness (waiting time, esthetic results, healing time and number of visits, and histopathologic correlation) and patients' satisfaction (with the waiting time, with the results of surgery and with the physician). RESULTS: Minor surgical procedures carried out by 146 family physicians and 61 general surgeons were compared, in congruence with the analyzed descriptive homogeneity's parameters. Family physicians average waiting time was the lower, with a mean of 45 days less than the surgeon. Patient's satisfaction with the physician was higher when family physician were involved (p < 0.001); the same could be applied for the waiting time (p < 0.001). There were no significant differences over the effectiveness and patients' satisfaction. CONCLUSION: The dermatologic minor surgery by family physician is effective, satisfactory for patients, and has less waiting time. This results justify the introduction of minor surgery in the family physicians office.
Adolescent↗
[Drug-induced exanthemas and medicamentous contact eczemas as manifestations of undesirable drug effects in dermatology].
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Czechoslovakia↗