Hand‐foot‐skin reaction related to use of the multikinase inhibitor sorafenib and hard orthotics

Hand‐foot‐skin reaction is a distinct clinical condition arising in association with the use of multikinase inhibitors, including sorafenib. Because multikinase inhibitors are increasingly being used in children with cancer, recognition of this previously unfamiliar condition is of importance to pediatric dermatologists. We describe the diagnosis and successful treatment of a case of hand‐foot‐skin reaction in a child taking sorafenib for an unresectable desmoid tumor.     

Insecticide resistance in head lice: clinical,parasitological and genetic aspects

Insecticide treatment resistance is considered to be a major factor in the increasing number of infestations by head lice. The large insecticide selection pressure induced by conventional topical pediculicides has led to the emergence and spread of resistance in many parts of the world. Possible mechanisms of resistance include accelerated detoxification of insecticides by enzyme-mediated reduction, esterification, oxidation that may be overcome by synergistic agents such as piperonyl butoxide, alteration of the binding site, e.g. altered acetylcholinesterase or altered nerve voltage-gated sodium channel, and knockdown resistance (kdr). Clinical, parasitological and molecular data on resistance to conventional topical pediculicides show that treatments with neurotoxic insecticides have suffered considerable loss of activity worldwide. In particular, resistance to synthetic pyrethroids has become prominent, probably because of their extensive use. As other treatment options, including non-insecticidal pediculicides such as dimeticone, are now available, the use of older insecticides, such as lindane and carbaryl, should be minimized, owing to their loss of efficacy and safety concerns. The organophosphorus insecticide malathion remains effective, except in the UK, mostly in formulations that include terpineol.     

Case of Fusarium paronychia successfully treated with occlusive dressing of antifungal cream

We report a case of refractory Fusarium paronychia in a 42‐year‐old man with Behçet's disease receiving oral cyclosporin and corticosteroid. Symptoms resembling candidal paronychia of his little finger could not be cured by topical ketoconazole and oral terbinafine. The pathogen was identified as Fusarium solani species complex by gene analysis, and was multiple drug resistant. The case eventually resolved by occlusive dressing therapy with 0.5% amorolfine cream for 3 months.     

Inhaled corticosteroid use in HIV‐positive individuals taking protease inhibitors: a review of pharmacokinetics,case reports and clinical management

As a consequence of inhibition of the hepatic cytochrome P450 3A4 isozyme, treatment with HIV protease inhibitors can result in significant drug?drug interactions. One noteworthy interaction is between protease inhibitors and inhaled or intranasal corticosteroids. This interaction can result in adrenal insufficiency and iatrogenic Cushing's syndrome (with symptoms such as rapid weight gain, obesity, facial hirsutism and swelling), as well as hypertension, osteoporosis and decreased CD4 cell count. In this paper, we review and unite pharmacokinetic data, case reports and current research regarding this drug?drug interaction in order to suggest options for the clinical management of HIV‐positive patients requiring treatment with protease inhibitors and inhaled or intranasal corticosteroids.     

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糖皮质激素是临床上皮肤科医生处方最多的外用药物之一,自20世纪50年代问世以来,糖皮质激素极大改善了皮肤病的治疗效果,被誉为皮肤科药物治疗学的"里程碑"。但随着新型外用糖皮质激素不断问世和广泛应用,其在治疗疾病的同时不可避免带来了更多副反应。与抗生素一样,外用糖皮质激素是目前临床上滥用最为严重的药物之一。由于儿童生理和皮肤组织结构特点,外用糖皮     

Patient Blood Management: Use of Topical Hemostatic and Sealant Agents

Patient blood management is the scientific use of safe, effective medical and surgical techniques designed to conserve blood, prevent anemia, decrease bleeding, and optimize coagulation in an effort to improve patient outcomes. Perioperative and primary care nurses play a vital role in promoting and making the best use of patient blood management and can play a key role in implementing effective strategies that decrease or eliminate patient exposure to allogeneic blood. The fast and effective minimization of intraoperative bleeding is integral in an effective blood management program. Topical hemostatic and sealant agents can be used to improve blood conservation, reduce overall procedure time, and contribute to faster patient recovery based on specific clinical situations. The proper selection of hemostatic agents can greatly influence the patient’s clinical outcomes.     

糖皮质激素长疗程间歇疗法治疗神经性皮炎的临床疗效观察

目的探讨外用糖皮质激素长疗程间歇疗法治疗神经性皮炎的疗效、安全性及复发情况,为指导临床用药提供依据。方法采用随机对照开放试验,选取门诊神经性皮炎患者,外用复方氟米松软膏常规疗法短期治疗。将已短期治愈入选的120例患者随机分为2组,试验组外用复方氟米松软膏进行长疗程间歇治疗,2次/d;对照组外用尿素霜（成分：尿素,羊毛脂,白蜡,凡士林）进行治疗,2次/d。2组每周用药2 d,每次间隔3 d用药,疗程8周。在长疗程治疗4周、8周及停药12周时各随访1次,分别比较2组患者的复发率。结果长疗程治疗8周及停药12周时,试验组SCORAD评分均显著低于对照组（P均〈0.05）。长疗程治疗4周、8周及停药12周时,试验组复发率均显著低于对照组（P均〈0.05）。治疗期间不良反应发生率1.67%,无严重不良事件。结论外用糖皮质激素长疗程间歇治疗神经性皮炎,效果好,不良反应少,有预防症状加重、延缓复发的作用。     

雄激素性脱发的外用药治疗

雄激素性脱发外用药物包括血管扩张药物、抗雄激素药物、前列腺素F2α类似物、Wnt/β-连环蛋白途径活化剂及腺苷、褪黑素、Gly-Pro-Ile-Gly-Ser五肽，本文对以上药物的疗效进行综述。     

复发性皮肤坏死性嗜酸性血管炎1例并文献复习

报道1例复发性皮肤坏死性嗜酸性血管炎并对相关文献进行复习。患者，女，64岁，因双下肢痛性皮疹12天就诊。偶有干咳，无哮喘病史。皮肤科查体：双下肢散在紫红色斑片、斑块，胫前数个结节、血疱样损害；右前臂有少量类似损害。外周血嗜酸性粒细胞计数增多。胸部X线提示双肺渗出性改变。皮损组织病理符合皮肤坏死性嗜酸性血管炎。口服强的松45mg/天治疗1周后临床症状明显好转，激素减量过程中曾有复发。