The Journal of dermatological treatment
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Necrotizing fasciitis is an uncommon, rapidly spreading infection, affecting primarily the deep fascia, which may result in secondary necrosis of the subcutaneous tissue, fascia and muscle. We report a patient that had the cardinal features; namely, excruciatingly painful lesions, demonstration of gas in the tissue and an obnoxious foul odor, prominent erythema, induration, patchy necrosis, and loss of sensation in the left buttock and thigh. ⋯ Debridement and intensive supportive therapy comprising antibiotics, analgesics and fluids were given. The outcome of the therapy was gratifying.
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Case Reports
Cutaneous adverse effects during therapy with an epidermal growth factor receptor (EGFR) inhibitor.
The use of epidermal growth factor receptor (EGFR) inhibitors for the treatment of solid tumours is now increasing. Cutaneous side effects, namely acneiform eruption, xerosis, telangiectasia, hyperpigmentation, fissures, hair and nail changes, are reported in literature. We describe a case of a man treated with an EGFR-inhibitor (erlotinib) for a cell lung cancer who developed skin manifestations localized in an uncommon area and with an atypical evolution.
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Randomized Controlled Trial Multicenter Study
A randomized study of the safety, absorption and efficacy of pimecrolimus cream 1% applied twice or four times daily in patients with atopic dermatitis.
Pimecrolimus cream 1% (Elidel), a non-steroid inhibitor of inflammatory cytokines, is effective in the treatment of atopic dermatitis, without corticosteroid-related side effects such as skin atrophy. It is indicated for twice-daily application. More frequent applications might be expected either to enhance efficacy or increase toxicity. This study compared the safety, efficacy and systemic absorption of pimecrolimus administered twice daily (recommended dose) and four times daily early in the treatment of patients with moderate to severe atopic dermatitis. ⋯ The data suggest that increasing pimecrolimus application from twice daily to four times daily to treat moderate to severe atopic dermatitis for up to 3 weeks does not alter the safety profile nor does it increase the efficacy of treatment. Systemic absorption of pimecrolimus applied BID and QID is minimal and is not different between dosing regimens. Patients and physicians familiar with the potential hazards of overuse of topical corticosteroids should be reassured that if pimecrolimus is applied at twice the recommended BID dose for short periods of time, there is no effect on safety, tolerability, or systemic absorption.
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Case Reports
Treatment of hidradenitis suppurativa with infliximab in a patient with Crohn's disease.
Hidradenitis suppurativa is a chronic, inflammatory, scarring disease characterized by recurrent flares. Recently, a group of 'autoinflammatory disorders' has been described. These disorders are characterized by recurrent inflammatory episodes not mediated by autoantibodies or antigen-specific T-cells. Some of these autoinflammatory disorders have been successfully treated with anti-tumor necrosis factor antibodies. ⋯ This case suggests that infliximab may be effective in the treatment of hidradenitis suppurativa in association with Crohn's disease. We also suggest that hidradenitis suppurativa may be closely linked with this new group of autoinflammatory disorders.
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Randomized Controlled Trial Multicenter Study
An observer-blind parallel-group, randomized, multicentre clinical and microbiological study of a topical clindamycin/zinc gel and a topical clindamycin lotion in patients with mild/moderate acne.
A topical acne treatment in which clindamycin phosphate equivalent to 1% clindamycin is presented in a gel formulation has received marketing authorizations in a number of EU and non-EU countries. Clindamycin/zinc gel contains zinc acetate in a formulation that reduces systemic absorption of clindamycin through the skin. ⋯ The equivalent efficacy and safety of clindamycin/zinc gel either once or twice daily to clindamycin lotion twice daily has been demonstrated. It is suggested that a treatment regime of one application per day may significantly enhance compliance and thus treatment success in acne patients.