J Drugs Dermatol
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Review Case Reports
Allergic contact dermatitis to mafenide acetate: a case series and review of the literature.
Burn patients with extensive involvement of body surface area (BSA >30%) represent a challenge in wound treatment. Multiple topical agents may be used for cleansing, barrier protection, and antimicrobial control leading to complications of contact and/or irritant dermatitis, which may further complicate re-epithelization and eventual wound healing. We present 4 patients who sustained extensive burns during Operation Iraqi Freedom/Operation Enduring Freedom and later developed contact dermatitis to mafenide acetate, a common topical antimicrobial used in burn care treatment, also known as Sulfamylon (alpha-amino-p-toluenesulfonamide monoacetate). ⋯ A rechallenge with mafenide acetate resulted in recrudescence of the eruption in 2 out of the 4 patients. Though cutaneous reactions to mafenide acetate were reported by Yaffe and Dressler in 1969, the most recent case reports are from 1995. This paper presents more recent examples of cutaneous reactions to mafenide acetate, while also reviewing the literature.
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Although the injection of Botox Cosmetic for the treatment of dynamic rhytids is safe and effective, there is a potential risk for foreign body embolization. This case report documents the presence of a rubber particle in the reconstituted Botox product. ⋯ Alternatively, alteration of the manufacturing process for the bottle cap may reduce the risk of coring a piece of the cap during reconstitution. Injectors should be aware of this risk and visually inspect Botox prior to injection.
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Review Comparative Study
A comparison of available and investigational antibiotics for complicated skin infections and treatment-resistant Staphylococcus aureus and enterococcus.
This article compares vancomycin, teicoplanin, quinupristin-dalfopristin, linezolid, daptomycin, tigecyline, dalbavancin, telavancin, ceftobiprole, oritavancin, and ramoplanin for the treatment of complicated skin and skin structure infections (cSSSI), methicillin-resistant Staphylococcus aureus (MRSA), enterococcus, and vancomycin-resistant enterococcus. Vancomycin, a glycopeptide antibiotic, is administered intravenously, and is the mainstay of treatment for MRSA and cSSSI. While not available in the U. ⋯ Ceftobiprole, a cephalosporin effective against MRSA, has few side effects. Oritavancin demonstrates similar activity to vancomycin but possesses extended activity against vancomycin-resistant Staphylococcus and enterococci. Ramoplanin, a macrocyclic depsipeptide, is unstable in the bloodstream but can be taken orally to treat Clostridium difficile colitis.
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The changing face of America highlights the importance of understanding dermatologic conditions of skin of color. Hyperpigmentation is the most common and distressing condition afflicting this unique subset of the population. ⋯ This article will highlight common over-the-counter agents addressing their advantages and disadvantages. Combination agents with sunscreen will often be the most effective treatment available.
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Post-herpetic neuralgia (PHN) is primarily a disease of the elderly and often refractory to treatment. Randomized and controlled trials have yielded several significant advances in the treatment and prevention of this disease. Treatment advances include the lidocaine patch, opioid analgesics, nortriptyline, amitriptyline, and gabapentin. ⋯ But most adults have already had varicella and are at risk for HZ and PHN as they age. Therefore, a more potent vaccine against varicella has been developed for use in adults. This vaccine offers a new and significant advance in the prevention of HZ and its most noteworthy complication, PHN.