Clinics in dermatology
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The approach to children and adults with atopic dermatitis is similar. In both age groups, failure to respond to conventional therapy should prompt evaluation for complicating factors such as secondary infection and secondary ACD. ⋯ Cutaneous T cell lymphoma (CTCL), cutaneous drug reactions, other spongiotic dermatoses, psoriasis, dermatomycosis, and infestations should be considered in the differential of refractory atopic dermatitis in adults. Systemic therapies prescribed to both children and adults with severe atopic dermatitis include oral corticosteroids, cyclosporine, methotrexate, azathioprine, and mycophenolate mofetil.
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Clinics in dermatology · Sep 2015
Review Case ReportsSystemic drug reactions with skin involvement: Stevens-Johnson syndrome, toxic epidermal necrolysis, and DRESS.
Skin is often affected in adverse drug reactions. Although the majority of cutaneous adverse drug reactions are benign and self-limiting, Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug rash with eosinophilia and systemic symptoms (DRESS), affecting multiple organs and systems, are potentially fatal. Many organs can be affected, including the mucosal membranes, gastrointestinal tract, liver, lungs, kidneys, and eyes. We discuss the causes, pathophysiologic aspects, and main clinical features of SJS, TEN, and DRESS as systemic diseases with skin involvement.
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Clinics in dermatology · Jul 2015
ReviewAcrodermatitis enteropathica and other nutritional diseases of the folds (intertriginous areas).
The appropriate intake and metabolism of vitamins and minerals are critical to maintaining homeostasis. Imbalance in essential nutrients, either through dietary excess or deficiency or disorders in metabolism, can result in a spectrum of dermatologic and systemic manifestations. ⋯ Recognition of these patterns is important, as they can alert the physician to an underlying nutritional disease. We review nutritional diseases involving zinc, biotin, essential fatty acids, vitamin B6 (pyridoxine), and riboflavin that present specifically with intertriginous eruptions.
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Clinics in dermatology · Mar 2015
ReviewRegional anesthesia of the eye, orbit, and periocular skin.
Advances in ophthalmic surgery, together with achieving greater patient safety, have changed the requirements of regional anaesthesia of the eye, orbit, and periocular skin. Patient comfort, safety, and low complication rates are essentials of regional anesthesia, which includes invasive procedures that generate intraoperative and postoperative analgesia, as well as akinesia. ⋯ Local anesthesia is the reversible loss of sensation in certain area of the body to minimize pain and obtain patient comfort. It can be achieved through topical application or injection of anesthetic agents that block the nerve impulses to that tissue.