Dermatologic therapy
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Cellulitis is an acute infection of the dermal and subcutaneous layers of the skin, often occurring after a local skin trauma. It is a common diagnosis in both inpatient and outpatient dermatology, as well as in the primary care setting. Cellulitis classically presents with erythema, swelling, warmth, and tenderness over the affected area. ⋯ Some of the most common mimics of cellulitis include venous stasis dermatitis, contact dermatitis, deep vein thrombosis, and panniculitis. History, local characteristics of the affected area, systemic signs, laboratory tests, and, in some cases, skin biopsy can be helpful in confirming the correct diagnosis. Most patients can be treated as an outpatient with oral antibiotics, with dicloxacillin or cephalexin being the oral therapy of choice when methicillin-resistant Staphylococcus aureus is not a concern.
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Dermatologic therapy · Mar 2011
ReviewDiagnosis and treatment of the neutrophilic dermatoses (pyoderma gangrenosum, Sweet's syndrome).
Neutrophilic dermatoses include a spectrum of disorders with similar histologic appearance and pathologic processes. Clinically, however, they have different physical manifestations and associations. ⋯ The previously reported diagnostic criteria, physical descriptions, differential diagnosis, workup, and treatment options are reviewed. A practical approach to pyoderma gangrenosum and Sweet's syndrome for the provider is described.
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Dermatologic therapy · Sep 2010
Case ReportsTherapeutic hotline. Infliximab for treatment of resistant pyoderma gangrenosum associated with ulcerative colitis and psoriasis. A case report.
Pyoderma gangrenosum (PG) is a rare, noninfectious, neutrophilic dermatosis of unknown origin that is associated with systemic diseases in 50% of cases. The authors present a case of a 54-year-old man patient with refractory to conventional treatment PG associated with ulcerative colitis and psoriasis, which showed a successful response to treatment with infliximab, a chimeric monoclonal antibody that inhibits tumor necrosis factor alpha (TNF-α). This case report shows the frequent difficulty in the therapeutic approach of PG, especially if associated with underlying disease, and necessity to apply new agents, such as a novel application of the TNF-α inhibitors, in relationship to the recent pathogenic knowledge.
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When assessing women with chronic vulvar pain, women's health physical therapists search for comorbid mechanical components (including musculoskeletal, fascial, and visceral) and other disorders that may contribute to or be caused by chronic vulvar pain (CVP). Pelvic floor hypertonicity is a key perpetuating factor for CVP. ⋯ Normalization of pelvic floor muscle function contributes to the reduction of CVP. Successful treatment includes the identification and treatment of co-existing physical abnormalities throughout the trunk and pelvis.
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Oral lichenoid reactions represent a common end point in response to extrinsic agents (drugs, allergens), altered self-antigens, or superantigens. Oral lichen planus, a common and under-recognized inflammatory disorder, shares many clinical and histopathological features with oral lichenoid drug reaction and oral lichenoid contact reaction. Clinical presentation can vary from asymptomatic white reticular striae to painful erythema and erosions. ⋯ Delay in diagnosis of extraoral mucocutaneous lichen planus (LP) results in conjunctival scarring; vaginal stenosis; vulvar destruction; and stricture of the esophagus, urethra, and external auditory meatus. Although the etiology of LP is idiopathic, oral lichenoid reactions may be caused by medications or exogenous agents such as cinnamates and other flavorings. The clinical features, evaluation, and management of these oral lichenoid reactions are discussed.