An unusual side effect of isotretinoin: retinoid dermatitis affecting external urethral meatus

Isotretinoin (Iso) is the most effective drug against severe nodulocystic acne. As a synthetic oral retinoid, Iso exerts its actions by modulating cell growth and differentiation. Targeting all the pathophysiologic processes in acne development, Iso has been considered to be an unique drug, however it has several side effects. While chelitis, xerosis, ocular sicca, arthralgia, myalgia, headache, hyperlipidemia are the most common side effects, teratogenicity and depressive symptoms are the most concerning ones. In addition, Iso has unusual side effects which have been described for the first time in the literature. Here, we report a remarkable side effect of Iso in a 23-years-old male patient with retinoid dermatitis affecting the external uretral meatus. To our knowledge, only few cases of retinoid dermatitis in the urethral mucosa due to Iso have been reported in the literature so far.     

Virologic and genetic evaluation of vemurafenib-induced skin cancers

We describe the occurrence of a giant squamous cell carcinoma in a patient receiving vemurafenib for the treatment of late melanoma mestastases. Although the development of keratoacanthomas and squamous cell carcinomas (SCC) has been described during vemurafenib therapy, most of the reported cases are treated with surgical excision. In the present case, SCC regressed after drug withdrawal.     

Dual Antiplatelet Therapy Duration Determines Outcome After 2- But Not 1-Stent Strategy in Left Main Bifurcation Percutaneous Coronary Intervention

Objectives

The aim of this study was to investigate clinical outcomes after left main coronary artery (LM) bifurcation percutaneous coronary intervention (PCI) and the impact of the duration of dual antiplatelet therapy (DAPT) according to treatment strategy.

Improving the Gastrointestinal Tolerability of Aspirin in Older People

Interventions to reduce mortality and disability in older people are vital. Aspirin is cheap and effective and known to prevent cardiovascular and cerebrovascular disease, many cancers, and Alzheimer dementia. The widespread use of aspirin in older people is limited by its gastrointestinal side effects. Understanding age-related changes in gastrointestinal physiology that could put older people at risk of the side effects of aspirin may direct strategies to improve tolerance and hence lead to greater numbers of older people being able to take this effective intervention.     

Managing paediatric musculoskeletal diseases with biological agents

The introduction of biological agents (BA) has markedly improved the outcome for children with musculoskeletal (MSK) diseases over the past two decades. Several BA have been developed, which alone or in combination with other immunomodulators, such as disease-modifying anti-rheumatic drugs (DMARD), have resulted in disease remission as an achievable target. Their use has also led to the reduction of reliance of steroid treatment and its undesirable side effects. The widest range of BA has been used for managing juvenile idiopathic arthritis (JIA), which is the most common rheumatic disease in childhood. However, they have also been successfully used in refractory cases of juvenile systemic lupus erythematosus (JSLE), juvenile dermatomyositis (JDM) and autoinflammatory syndromes. The efficacy of BA has been demonstrated in several clinical trials. It is important to highlight that BA biologics are costly and also have the potential for toxicity. They have been associated with adverse events such as serious infections, malignancy, hepatotoxicity, and demyelination. This article summarizes the clinical experience of the available BA, discusses the known risks and side effects and aims to offer the reader a general overview of their use in the management of paediatric musculoskeletal disease.