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At least 667 records · Page 37Linked to original sources

Laser treatment of erythema and telangiectasia associated with rosacea.

The response of rosacea-associated erythema and telangiectasia to treatment with the pulsed tunable dye laser (PDL) was evaluated in 12 patients. Improvements in erythema, telangiectasia, flushing, the physician's and the patient's perception of overall severity, treatment tolerability, and the adverse side effects were examined. With the sole exception of the patient's assessment of overall severity we have found highly significant improvements in all other parameters evaluated, with excellent tolerance of treatment. We therefore conclude that the PDL is a safe and effective treatment for the erythemato-telangiectatic component of rosacea.

Adult↗

Erythema multiforme and Stevens-Johnson syndrome following radiotherapy.

Erythema multiforme (EM) and Stevens-Johnson syndrome (SJS) are thought to be hypersensitivity syndromes with various causes, and radiotherapy might be one of the causes of these syndromes. We herein report two cases of EM/SJS following radiotherapy. The first case was a 63-year-old woman with breast cancer. At the end of postoperative radiotherapy with 60 Gy, severe pruritic erythema appeared in the irradiated area and spread over the whole body. She was diagnosed with EM by a skin biopsy. The second case was a 77-year-old woman with uterine cervical cancer who underwent postoperative radiotherapy. At a dose of 30.6 Gy, pruritic redness appeared in the irradiated area and the precordial region, and it became widespread rapidly with polymorphic transformation. Although without any histological confirmation, SJS was strongly suspected because of her pruritic conjunctivitis. Because both patients were given medicines during irradiation, radiotherapy may not be the only cause of EM/SJS. However, it should be noted that radiotherapy might trigger EM/SJS.

Aged↗

Comparison of azithromycin and doxycycline in the treatment of erythema migrans.

BACKGROUND: A randomized, multicenter, open clinical trial was undertaken in order to compare the efficacies of azithromycin and doxycycline in the treatment of patients with Lyme disease associated with erythema migrans. PATIENTS AND METHODS: A total of 48 patients was treated orally with azithromycin, 500 mg bid on the 1st day, followed by 500 mg once daily for the next 4 days or doxycycline (40 patients) 100 mg bid for 14 days. RESULTS: Intention-to-treat analysis of clinical efficacy showed no difference between the two treatment regimens. Clinical success was observed in 46 (95.8%) azithromycin- and 33 (82.5%) doxycycline-treated patients, (p = 0.0731). Minor symptoms persisted or appeared in the posttreatment period in two of 47 azithromycin- and three of 35 doxycycline-treated patients (p = 0.646). Major manifestations appeared only in two patients in the doxycycline group (p = 0.179). There was no difference in the tolerability of both drugs. CONCLUSION: Azithromycin (a total dose of 3 g) is equally effective as standard doxycycline treatment for erythema migrans in adult patients.

Administration, Oral↗

Human parvovirus B19 arthropathy in two adults after contact with childhood erythema infectiosum.

An arthropathy has been recently described in association with human parvovirus infection (HPV-B19). Human parvovirus B19 has also been implicated as the etiologic agent in erythema infectiosum, a childhood exanthem that may occur in adults in association with joint manifestations. In this study, two adults are described, in whom an acute arthropathy and rash developed after contact with children with erythema infectiosum.

Adult↗

Erythema nodosum associated with pregnancy. Case reports.

Four cases of erythema nodosum associated with pregnancy are reported and the literature reviewed. Erythema nodosum in pregnancy is a self-limited condition requiring minimal supportive treatment. No adverse effects upon pregnancy course or fetal outcome were noted. It is suggested that pregnancy may serve as an etiological basis for the disease.

Adult↗

Erythema multiforme. Clinical characteristics and natural history in fifty patients.

Erythema multiforme is a chronic mucocutaneous inflammatory disease with a variable recurrent pattern. Thirty female and twenty male patients, ranging in age from 11 to 75 years, were studied. Twelve patients had oral lesions only, nineteen had oral and lip changes, and nineteen had oral, lip, and skin involvements. Most of the patients had a noncyclical pattern of attacks which required systemic corticosteroid therapy. When the disease attacks electively were not treated, healing would vary between 2 and 24 weeks. This study confirmed the idiopathic nature and extremely variable features of erythema multiforme. Frequency, location, duration, and severity of attacks did not shed any clues as to trigger mechanisms (etiology), persons who might be predisposed to such attacks, treatment responses, or prognosis.

Adolescent↗

Histopathologic spectrum of oral erythema multiforme.

The histopathologic tissue patterns found in twenty-five patients with oral erythema multiforme were as variable as the clinical appearances. The biopsies served an important role in ruling out malignancy, dysplasia, and other classified diseases. While all of the specimens were designated as showing nonspecific inflammatory reactions, in many biopsy specimens there were sufficient characteristic connective tissue and epithelial changes to suggest a tissue diagnosis consistent with the clinical diagnosis of erythema multiforme.

Adult↗

Quantification of patient to patient variation of skin erythema developing as a response to radiotherapy.

A method is described to determine accurately skin redness during a course of radiotherapy using reflectance spectroscopy utilizing information from across the visible spectrum according to the L*a*b* color coordinate system. The method was used to quantify the development of skin erythema during and after electron beam irradiation of the chest wall following mastectomy. A number of factors were identified which could influence the wide variation in response seen between patients. These were: intra- and inter-observer variation; intra- and inter-patient variation and variation in the actual dose delivered. Statistical analysis, including an analysis of variance of inter- and intra-patient variation, revealed that the major factor that accounts for the observed difference between patients is a true inter-patient variation, with a coefficient of variation, corrected for intra-patient variation, of 43%. Within the narrow dose range administered in this study, there was no demonstrable dose-effect relationship, raising questions about the role of cell death in the basal layer of the epidermis in the pathogenesis of radiation induced erythema.

Adult↗

Reticular erythema with ostial porokeratosis.

An asymptomatic reticular erythema associated with myriads of monomorphous micropapules developed in a symmetric distribution concentrated on the inner aspects of both arms and both legs of a 15-year-old girl. Skin biopsy specimens revealed cornoid lamellae within multiple appendageal ostia and focal lymphocytic inflammation in the papillary dermis. Reticular erythema with ostial porokeratosis is one of an increasing number of clinical presentations of punctate porokeratosis that lack a classic marginated rim.

Adolescent↗

Acne fulminans with hepatosplenomegaly and erythema nodosum migrans.

Acne fulminans is a rare form of acne characterized by ulcerative nodules and associated with systemic complications. We report the case of a 17-year-old boy with cystic acne who experienced sudden onset of acne fulminans associated with fever, weight loss, hepatosplenomegaly, and erythema nodosum migrans. To the best of our knowledge, this is the first reported case of acne fulminans manifested by hepatomegaly and erythema nodosum migrans.

Acne Vulgaris↗

Erythema multiforme after contact dermatitis in response to an epoxy sealant.

A case of erythema multiforme associated with an allergic contact dermatitis in response to an epoxy-based compound is presented. Patch tests revealed a positive reaction to both the epoxy resin and the hardener. Chemicals applied directly to the skin should be considered as a potential cause of erythema multiforme.

Arm↗

Annular erythema associated with Sjögren's syndrome: a variant of systemic lupus erythematosus.

We present a Burmese patient with widespread annular erythema associated with Sjögren's syndrome. Unlike previously described cases, the disease occurred in the setting of systemic lupus erythematosus. Photoprovocation testing revealed light sensitivity in the UVA range with elicitation of subacute cutaneous lupus erythematosus-like lesions. The presence of an erythema annulare centrifugum-like eruption should initiate the search for Sjögren's syndrome and systemic lupus erythematosus.

Adult↗

Erythema elevatum diutinum in a patient with relapsing polychondritis.

A 69-year-old man with a history of relapsing polychondritis developed a widespread cutaneous eruption that was clinically and histologically typical of erythema elevatum diutinum. This eruption was accompanied by a recurrence of arthralgias. The significance of this association between relapsing polychondritis and erythema elevatum diutinum, which has not been previously reported, is discussed.

Aged↗

Chronic cutaneous lupus erythematosus presenting as periorbital edema and erythema.

We report two unusual cases of cutaneous lupus erythematosus presenting as dramatic eyelid edema and erythema. Neither patient had evidence of systemic or other significant cutaneous involvement. The eyelid edema and erythema were unilateral in one case and bilateral in the other. Both cases responded to therapy with antimalarial drugs.

Antimalarials↗

Recurrent erythema migrans despite extended antibiotic treatment with minocycline in a patient with persisting Borrelia burgdorferi infection.

Erythema migrans recurred in a patient 6 months after a course of treatment with minocycline for Lyme disease. Polymerase chain reaction on heparinized peripheral blood at that time demonstrated the presence of Borrelia burgdorferi-specific DNA. The patient was seronegative by Lyme enzyme-linked immunosorbent assay but showed suspicious bands on Western blot. Findings of a Warthin-Starry stain of a skin biopsy specimen of the eruption revealed a Borrelia-compatible structure. Reinfection was not believed to have occurred. Further treatment with minocycline led to resolution of the erythema migrans.

Aged↗

Doxycycline versus tetracycline therapy for Lyme disease associated with erythema migrans.

BACKGROUND: Doxycycline is widely used to treat Lyme disease associated with erythema migrans. Whether it is comparable to tetracycline is unknown. OBJECTIVE: We conducted a two-part retrospective analysis of (1) the safety and efficacy of doxycycline compared with tetracycline and (2) the safety and efficacy of a 14-day versus a 20-day course of doxycycline. METHODS: Twenty-seven patients given tetracycline (500 mg four times a day for 14 days [group 1]) were compared retrospectively with 21 patients who received doxycycline (100 mg two or three times a day for 14 days [group 2]). The results for group 2 were also compared with that of 38 patients who received doxycycline for 20 days (100 mg three times daily) in a prospective treatment trial (group 3). RESULTS: There was no significant difference in the incidence of adverse drug effects or in efficacy at 1 month, but at 1 year there was a trend toward a better outcome in the group treated with tetracycline (p = 0.08). A 14-day course of doxycycline was comparable to a 20-day course in the incidence of adverse drug effects and in clinical outcome. CONCLUSION: The principal advantage of doxycycline over tetracycline for the treatment of Lyme disease associated with erythema migrans is the convenience of less frequent dosing, not enhanced efficacy or safety. There appears to be no advantage in extending treatment with doxycycline from 14 to 20 days.

Administration, Oral↗

Acral erythema and systemic toxicity related to CHA induction therapy in acute myeloid leukemia.

Seventy-two adult patients with previously untreated acute myeloid leukemia received the CHA regimen as induction chemotherapy: CCNU 80 mg/m2 on day 1, Adriamycin 35 mg/m2 i.v. on days 1, 2 and 3, and continuous infusion of cytarabine 100 mg/m2/24 h from day 1 to 10. Forty-nine patients (68%) presented at least one of the following symptoms: acral erythema with dysesthesias in the palms and/or soles (39%); cholestatic hepatitis (39%); profuse sterile diarrhea associated with abdominal distention (33%); acute cerebellar dysfunction (32%) and non-cardiogenic pulmonary edema (21%). Most of these toxic symptoms appeared 8-20 days after the first dose. As these clinical features were absent or exceptional in patients treated with another regimen within a controlled trial, they are reported as toxic-side-effects of the chemotherapy regimen. Acral erythema was found to be predictive of complete remission (P less than 0.01, odds ratio: 6.33); neurotoxicity was prognostic for death in aplasia (P less than 0.05); the absence of any of the five symptoms was associated with failure of the induction regimen (P less than 0.02).

Adolescent↗

The reliability of two observation methods of nonblanchable erythema, Grade 1 pressure ulcer.

Accurate identification of nonblanchable erythema (NBE) is essential in pressure ulcer prevention. This descriptive study assessed interrater reliability between a researcher and trained nurses in observing blanchable erythema and NBE and examined the predictive validity and level of agreement between two observation methods for NBE. Findings suggest that the transparent disk method should be preferred to the finger method. The interrater reliability between the researcher and the nurses was substantial and was higher for the observations at the sacrum than for those at the heels. Educational level and years of nursing experience did not seem to influence interrater reliability.

Adult↗