Journal of the American Academy of Dermatology
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J. Am. Acad. Dermatol. · Jun 2004
Review Case ReportsCutaneous drug eruption from cetirizine and hydroxyzine.
Topical application of the antihistamines commonly leads to sensitization for patients, but skin reactions provoked by their systemic use are very rare. The antihistamines cetirizine and hydroxyzine are piperazine derivatives, on the structural basis of an ethylenediamine, but the cross-reactions between the 2 have rarely been reported. ⋯ Oral challenge tests performed with cetirizine and hydroxyzine led to the same cutaneous reactions. He was given the diagnosis of drug eruption from cetirizine and hydroxyzine, which suggests that there were cross-reactions among cetirizine, hydroxyzine, and ethylenediamine.
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Arthropods are important in medicine for a multitude of reasons. Their bites and stings may induce allergic reactions, ranging from annoying to life-threatening. Many arthropod products are also capable of inciting allergic responses in sensitized persons. ⋯ Animals in these two classes are probably responsible for more morbidity and mortality worldwide than are any other group of venomous creatures. In general, the diagnosis of arthropod bites and stings is dependent on maintenance of a high index of suspicion and familiarity with the arthropod fauna not only in one's region of practice, but also in the travel regions of one's patients. Learning objective At the completion of this learning activity, participants should be familiar with the clinical manifestations caused by a variety of arthropods as well as the treatment and possible sequelae of arthropod attacks.
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J. Am. Acad. Dermatol. · Jun 2004
Case ReportsMirtazapine for reducing nocturnal itch in patients with chronic pruritus: a pilot study.
Nocturnal pruritus is a significant problem for patients with inflammatory skin diseases and many systemic diseases. The oral therapies currently available have a limited effect. We present an open, uncontrolled pilot study of 3 patients with inflammatory skin diseases and severe nocturnal pruritus who underwent treatment with mirtazapine (Remeron), a noradrenergic and specific serotonergic antidepressant. Mirtazapine is a safe medication without serious side effects and may be an effective alternative for the treatment of nocturnal pruritus.