- |||||||||| prednisolone / Generic mfg.
The unusual suspect () - Jun 23, 2022 - Abstract #BAD2022BAD_730;
Where treatment is required, EC normally responds very rapidly to oral prednisolone but can often relapse when the dose is reduced. Our patient responded very well to 6 weeks of oral prednisolone; no relapse was recorded.
- |||||||||| prednisolone / Generic mfg., doxycycline / Generic mfg.
Phototherapy to treat a COVID-19 vaccine reaction () - Jun 23, 2022 - Abstract #BAD2022BAD_712;
Direct immunofluorescence was negative. He received a tapering dose of oral prednisolone with mometasone topically...He was trialled on oral doxycycline for 1 month, which led to a marked improvement in the morbilliform rash...Our case highlights that phototherapy can be used in the treatment of cutaneous side-effects that arise after COVID-19 vaccines. To the best of our knowledge, this case is one of the first to use narrowband UVB phototherapy to treat a cutaneous side-effect of an mRNA vaccine.
- |||||||||| dexamethasone / Generic mfg., fluticasone / Generic mfg., paracetamol / Generic mfg.
Leser-Trélat sign: can it follow COVID-19 infection? () - Jun 23, 2022 - Abstract #BAD2022BAD_695;
Therefore, the appearance of the Leser-Trélat sign after COVID-19 infection was a possibility in this patient. The role of transforming growth factor-α and tumour necrosis-α in eruptive seborrhoeic keratoses, as well as in COVID-19 infection, can be a common area of interest to explore in the aetiology of this entity.
- |||||||||| Psoralen / EMD Serono, Remicade (infliximab) / Merck (MSD), Mitsubishi Tanabe, J&J, Rituxan (rituximab) / Biogen, Zenyaku Kogyo, Roche
Eosinophilic fasciitis triggered by intensive exercise () - Jun 23, 2022 - Abstract #BAD2022BAD_677;
Haematological associations have been seen, including aplastic anaemia; lymphoma. Treatment options for EF include prednisolone, UVA1/psoralen + UVA, immunosuppressive systemic agents (including ciclosporin; methotrexate), biological agents (including infliximab; rituximab); physiotherapy.
- |||||||||| mometasone furoate / Generic mfg.
The VOICE registry: a vitiligo database – our first year (Boisdale 1 & 2) - Jun 23, 2022 - Abstract #BAD2022BAD_625;
The most commonly prescribed treatments are tacrolimus 0·1% ointment (46%), followed by narrowband ultraviolet B (NB-UVB) phototherapy (36%); topical mometasone furoate 0·1% ointment (33%)...We hope that by demonstrating the usefulness of our database, other centres across the country will be encouraged to participate in the study; enter their vitiligo cohort into the database, enabling us to create a national database that enhances research within vitiligo in the UK. Planned future projects include deep phenotyping; whole-exome sequencing.
- |||||||||| dexamethasone / Generic mfg.
MicroRNA146aand microRNA126 in the serum of patients with vitiligoand its relation to disease activity () - Jun 23, 2022 - Abstract #BAD2022BAD_574;
Patients with activity of the disease were treated with dexamethasone 4 mg on 2 consecutive days after breakfast for 8 weeks, to achieve stabilization of the disease...We concluded that the levels of miRNA126 are inversely proportional to the activity of the disease, the levels of miRNA146a are directly proportional to the activity of vitiligo. In addition to clinical markers of disease activity, we have found biochemical markers of activity as a noninvasive tool vs. the biopsy needed to demonstrate the CD8+ lymphocyte infiltrate, which, until now, is the reference standard used to determine disease activity.
- |||||||||| flucloxacillin sodium / Generic mfg., mometasone furoate / Generic mfg., acyclovir / Generic mfg.
An evolving blistering eruption in a newborn: a diagnostic conundrum () - Jun 23, 2022 - Abstract #BAD2022BAD_505;
He was commenced on intravenous aciclovir; flucloxacillin for presumed herpes simplex virus (HSV) infection; a superadded bacterial infection...He was commenced on topical mometasone furoate ointment to the affected areas under occlusion with nonadherent dressings...The treatment is mainly supportive with emollients, topical steroids; antihistamines. In conclusion, this case was a diagnostic challenge as it was not a typical presentation for a cutaneous mastocytoma,; the large size we believe has not been reported before.
- |||||||||| Zyclara (imiquimod) / Mochida, Viatris, Bausch Health
Epidermolysis bullosa-associated verruciform xanthomas: case series and review of the literature (Alsh 1 & 2) - Jun 23, 2022 - Abstract #BAD2022BAD_357;
A variety of modalities have been used to treat RDEB-associated VXs, including surgical excision, topical corticosteroids, topical 5% imiquimod and cryotherapy. The size of lesions arising in RDEB, as in our cases, may limit the feasibility of excision, but cryotherapy and topical steroids appear to be safe and well tolerated.
- |||||||||| An unusual case of secondary syphilis masquerading as pemphigus vulgaris () - Jun 23, 2022 - Abstract #BAD2022BAD_292;
Treatment was commenced with oral prednisolone; aciclovir to cover for a likely superimposed herpes simplex infection, due to the well-circumscribed appearance of the erosions. One week later our patient presented to the emergency department with unilateral weakness; slurred speech...She was commenced on intravenous (IV) steroids, doxycycline; nicotinamide...Treatment was commenced with IV benzylpenicillin; her cutaneous symptoms resolved over the subsequent days...As our case illustrates, syphilis is also associated with a multitude of complications that may further impede or delay diagnosis; recovery for our patients. It is imperative that clinicians continue to have a high index of suspicion for the diagnosis of syphilis in unusual dermatological presentations that are slow to respond to standard treatment.
- |||||||||| piperacillin sodium/tazobactam sodium / Generic mfg., prednisolone / Generic mfg., azacitidine / Generic mfg.
Sweet syndrome: the phenotypic spectrum identified through clinicopathological correlation () - Jun 23, 2022 - Abstract #BAD2022BAD_234;
Despite a week of intravenous piperacillin/tazobactam for a suspected localized infection, there was no improvement; skin biopsies were taken...Oral prednisolone was commenced with full resolution of symptoms; weaned while a further two cycles of azacitidine were given, with no recurrence of SS...The presence of deep extension of the inflammatory infiltrate, in conjunction with necrosis, raises the differential diagnosis of necrotizing SS; necrotizing fasciitis, which requires close clinicopathological; microbiological correlation to reach the correct diagnostic conclusion. Identifying this variant of SS ensures that the correct management is instigated avoiding inappropriate antibiotic use or extensive surgical intervention.
- |||||||||| Severe epidermolysis bullosa acquisita in a patient with graft-versus-host disease: causal or coincidental? (Alsh 1 & 2) - Jun 23, 2022 - Abstract #BAD2022BAD_225;
Dapsone was considered but precluded by G6PD deficiency; there were clinical; adherence concerns about using mycophenolate mofetil...Ann Dermatol Venereol 2014; 141: 369–73 (in French)]. As a fifth case of EBA, our patient provides further evidence of a likely pathophysiological relationship between GvHD; autoimmune subepidermal bullous dermatoses,; highlights the significant challenges of managing these vulnerable patient groups during the COVID-19 pandemic.
- |||||||||| Plasma cell mucositis: a complex and challenging condition (Lomond) - Jun 23, 2022 - Abstract #BAD2022BAD_209;
Surgical intervention is occasionally indicated to treat associated complications such as tracheal strictures. This reported case of plasma cell mucositis, with a wide range of clinical presentations illustrates the diagnostic and management challenges requiring multidisciplinary input across many specialties.
- |||||||||| Stelara (ustekinumab) / J&J
Getting to the bottom of things () - Jun 23, 2022 - Abstract #BAD2022BAD_163;
Tinea incognito was considered but mycology was negative; there was no response to a prolonged course of oral itraconazole...However, when she replaced her toilet seat with a plastic one her rash promptly resolved, allowing methotrexate to be stopped...Severe cases have been linked to exotic hard woods like teak. This case stresses the importance of recognizing characteristic distribution of toilet seat dermatitis; of patch testing patients to their own toilet seats.
- |||||||||| First reported case of parvovirus triggering painful widespread livedoid vasculopathy: another virus causing hypercoagulability? (Lomond) - Jun 23, 2022 - Abstract #BAD2022BAD_155;
Codeine, Oramorph, amitriptyline; pregabalin were required for lower limb pain...Pentoxifylline 400 mg twice daily was also initiated; over months areas slowly healed; after a year, the oral steroids; azathioprine were slowly weaned...Hypercoagulability after viral infection or viral antigen exposure has been hugely topical throughout the COVID-19 pandemic. LV cases that are otherwise being classed as ‘idiopathic’ owing to no autoimmune or coagulopathy being identified could be further investigated for parvovirus; other seasonal virus infections to see if this is an important aetiological factor.
- |||||||||| Riarify (beclometasone/formoterol/glycopyrrolate) / Chiesi
Bromoderma in a patient with chronic obstructive pulmonary disease (Lomond) - Jun 23, 2022 - Abstract #BAD2022BAD_123;
This case highlights the importance of considering inhaled medications in any case of a possible cutaneous drug reaction. To our knowledge this is the first reported case of glycopyrronium bromide inducing bromoderma.
- |||||||||| An interesting case of COVID-19 presenting as an acute generalized exanthematous pustulosis (AGEP)-like skin eruption () - Jun 23, 2022 - Abstract #BAD2022BAD_100;
Within 24 h, the morphology of the rash changed; he had a scaly, papulopustular rash affecting the trunk, more superficial pustular lesions affecting the proximal thighs and deep-seated, necrotic-looking nodules affecting the distal thighs. He received a week of intravenous antibiotics and a short course of aciclovir, alongside regular emollients and mouth care...After the initial investigations excluded an infective cause, he was started on topical mometasone furoate, with a dramatic resolution of the rash within a 2-week timeframe...A few cases of AGEP associated with SARS-CoV-2 have been described in the literature, associated with medications such as cefepime and hydroxychloroquine...As far as we know this is the first case of COVID-19 presenting as a widespread, rapidly progressing AGEP-like eruption. Anecdotally, our patient has since had his first vaccination (AstraZeneca) with no untoward side-effects or recurrence of the rash.
- |||||||||| Dovonex (calcipotriol) / LEO Pharma, Novartis
A tough row to hoe: treating a novel recalcitrant facial rash (Lomond / M5) - Jun 23, 2022 - Abstract #BAD2022BAD_89;
She had been initially treated for psoriasis with clobetasone butyrate cream and Dovonex®, and subsequently for actinic keratosis with Efudix® cream without success...New areas continued to occur that responded to mometasone furoate 0·1% ointment...None of the other cases reported in literature describe an association with pregnancy, but in one of our patients the rash started and was subsequently aggravated with pregnancy. The treatment of FDD cannot be generalized and needs to be tailored on a case-by-case basis.
- |||||||||| A contrasting diagnosis: iododerma (Lomond) - Jun 23, 2022 - Abstract #BAD2022BAD_81;
Rivaroxaban; levothyroxine were her only long-term medications...Direct immunofluorescence was negative; a tissue culture for atypical mycobacteria was negative. The patient was commenced on high-dose intravenous methylprednisolone at 500 mg for 3 days followed by 40 mg prednisolone orally for 1 week, but there was a limited response. Our initial differential was Sweet syndrome or pyoderma vegetans; however, the patient had no fevers; no risk factors (malignancy, inflammatory disease, infection, etc.)...Most describe an acneiform eruption that subsequently evolves to vegetative plaques (Chalela JG, Aguilar L. Iododerma from contrast material. N Engl J Med 2016; 374: 2477). Iododerma is largely a diagnosis of exclusion, but histopathology; urine; serum iodine levels can help support diagnosis.
- |||||||||| mometasone furoate / Generic mfg., isotretinoin oral / Generic mfg.
A case of reactive angioendotheliomatosis with resolution following improved glycaemic control (Lomond / M5) - Jun 23, 2022 - Abstract #BAD2022BAD_79;
One could postulate that chronic vascular inflammation caused by diabetes could play a role in this condition. Treatment tends to focus on resolution of the underlying systemic condition, but case reports for isotretinoin have shown some improvement.
- |||||||||| How and when to treat AQP4-IgG-positive NMOSD (Elicium) - Jun 22, 2022 - Abstract #ECTRIMS2022ECTRIMS_313;
The international randomized controlled trials and the open label extension studies of 3 monoclonal antibodies (eculizumab, satralizumab and inebilizumab) in spNMOSD have proven their sustained efficacy and relative safety...3) Symptomatic therapy for pain, tonic spasm, bowel-bladder disturbance, etc should be done to relive the sequelae. In this presentation, the therapeutic evidence and issues of spNMOSD will be reviewed and the challenges that lie ahead will be discussed.
- |||||||||| hydrocortisone / Generic mfg., desmopressin / Generic mfg.
Journal: Xanthomatous hypophysitis causing hypogonadotropic hypogonadism resulting in delayed presentation of slipped capital femoral epiphysis. (Pubmed Central) - Jun 22, 2022
Although endocrine dysfunction & hypogonadism has been recognised to be a risk factor for SCFE at an atypically older age, due to reduced androgen levels leading to a weakened physeal plate, this is the first known case of a Xanthomatous Hypophysitis resulting in pituitary dysfunction and eventual SCFE. This case highlights that an increased range of pituitary disorders should be considered in late presentations of SCFE; and vice versa the risk of SCFE should be considered in patients with prolonged hypogonadotropic hypogonadism.
- |||||||||| fluticasone propionate/salmeterol xinafoate inhalation powder / Generic mfg.
Preclinical, Journal: In Vitro Performance of the Wixela Inhub Inhaler Using Severe Chronic Obstructive Pulmonary Disease Patient Inhalation Profiles. (Pubmed Central) - Jun 22, 2022
This study demonstrates that severe COPD patients are likely to achieve a consistent inhaled dose from Wixela Inhub, with low flow dependency observed within this patient population. In addition, both breathing simulators, which differ significantly in design, produced similar results for fluticasone propionate, but yielded slightly (but statistically significant) different results for salmeterol.
- |||||||||| hydrocortisone / Generic mfg.
Journal: Adrenocortical Dysfunctions in Neonatal Septic Shock. (Pubmed Central) - Jun 22, 2022
Thus, the prevalence of adrenal insufficiency was 27% at the onset of neonatal septic shock, 95% confidence interval: 12%-46%. Seventeen (57%) neonates with septic shock had cortisol levels (< 15 µg/dL) with adequate rise (≥ 9 µg/dL) after ACTH stimulation indicating depressed baseline levels, which responded to ACTH stimulation.
- |||||||||| Olumiant (baricitinib) / Incyte, Eli Lilly
Retrospective data, Journal: Efficacy of the combination of baricitinib, remdesivir, and dexamethasone in hypoxic adults with COVID-19: A retrospective study. (Pubmed Central) - Jun 22, 2022
Therefore, the synergistic action of all tested drugs on the major pathways of inflammation (phospholipases A, metalloproteinases, and histamine) seems to be efficient to neutralize the necrotic activity of the venom. Our study suggests that the combination of baricitinib, dexamethasone, and remdesivir is effective and tolerable in hypoxic patients with COVID-19.
- |||||||||| NC-2600 / Nippon Chemiphar
Preclinical, Journal: Anti-inflammatory Effects of Novel P2X4 Receptor Antagonists, NC-2600 and NP-1815-PX, in a Murine Model of Colitis. (Pubmed Central) - Jun 22, 2022
In THP-1 cells, lipopolysaccharide and ATP upregulated IL-1β release and NLRP3, caspase-1, caspase-5, and caspase-8 activity, but not of caspase-4. These changes were prevented by NC-2600 and NP-1815-PX treatment. For the first time, the above findings show that the selective inhibition of P2X4 receptors represents a viable approach to manage bowel inflammation via the inhibition of NLRP3 inflammasome signaling pathways.
- |||||||||| hydrocortisone / Generic mfg.
Journal, HEOR: Quality of Life and Its Determinants in Patients with Adrenal Insufficiency: A Survey Study at Three Centers in the USA. (Pubmed Central) - Jun 22, 2022
These changes were prevented by NC-2600 and NP-1815-PX treatment. For the first time, the above findings show that the selective inhibition of P2X4 receptors represents a viable approach to manage bowel inflammation via the inhibition of NLRP3 inflammasome signaling pathways. In patients with AI, QoL could be improved by addressing certain determinants, such as avoiding GC overreplacement, providing in-depth education on self-management, offering more comprehensive insurance coverage, and ensuring better family support.
- |||||||||| hydrocortisone / Generic mfg.
Journal: Critical illness-induced corticosteroid insufficiency: what it is not and what it could be. (Pubmed Central) - Jun 22, 2022
Acute stress may trigger a life-threatening adrenal crisis when a disease of the hypothalamic-pituitary-adrenal (HPA) axis is present and not adequately treated with stress doses of hydrocortisone...Such a central HPA-axis suppression may be maladaptive by contributing to lingering vasopressor need and encephalopathy, hence preventing recovery. Here, we review this concept of CIRCI and we advise on how to recognize and treat this poorly-understood condition.
- |||||||||| Xpovio (selinexor) / Karyopharm, Menarini, FORUS Therap
Journal: Guidance for Use and dosing of Selinexor in Multiple Myeloma in 2021: Consensus From International Myeloma Foundation Expert Roundtable. (Pubmed Central) - Jun 22, 2022
With more available safety and efficacy data supporting the increased interval between dosing of selinexor (and lesser cumulative weekly dosing) and schedule, contrary to the originally approved dose of 160 mg per week, the supportive care guidelines needed to be revisited. The current manuscript summarizes the supportive care solutions with weekly dosing of selinexor and identifies the ideal potential patient for selinexor treatment.
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