Ann Dermatol
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Toxic epidermal necrolysis (TEN) is a severe mucocutaneous adverse reaction characterized by extensive necrosis and epidermal detachment involving more than 30% of the body surface area (BSA). It is commonly triggered by antiepileptics, sulfonamide antibiotics, and non-steroidal anti-inflammatory drugs. A 22-year-old female without any underlying medical history presented with painful multiple erythematous bullae and plaques of varied sizes throughout the body for 1 day. ⋯ Although the patient had delirium and additional seizures while in the ICU, her condition improved without any complications after 5 weeks of inpatient treatment. Several complications of TEN such as dehydration, malnutrition, sepsis, and ophthalmic and pulmonary complications have been reported; however, seizures have not been reported yet. Herein, we report a case of seizure in a patient during treatment for TEN.
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Drug survival, defined as the time until discontinuation, is a parameter reflecting real-world therapeutic effectiveness. Few studies have examined the influence of economic factors on the drug survival of biologic agents for psoriasis, particularly in Asian countries. ⋯ The results of our study revealed that the cost of biologics treatment affects the drug survival of ustekinumab and suggested that economic factors affect the drug survival of ustekinumab treatment in Korea.
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Labial melanotic macules (LMMs) are benign pigmented lesions that usually take the shape of flat asymmetrical macules with tan-brown to black color and variable size. Whereas the dermoscopic features of other pigmented skin lesions have been relatively well described, little is known about LMMs. ⋯ Dermoscopy can be useful for the clinical detection of LMMs, and "Landscape painting patterns" may represent a dermoscopic clue for the diagnosis of these lesions.
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Increasing evidence suggests a pivotal role for neuronal inflammation in response to replicating varicella zoster virus in the development of postherpetic neuralgia (PHN). ⋯ In this study, we confirmed that elevated ESR was an independent and significant predictor of PHN in patients with acute HZ. To validate these results, further well-designed, randomized clinical trials are needed.
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Phytophotodermatitis is a condition that occurs by contact with plants containing phototoxic agents such as furocoumarins and psoralens with subsequent ultraviolet exposure. Phytophotodermatitis typically presents as sharply defined erythematous patches with occasional blistering, sometimes accompanied with pain or itching sensation. In some cases, however, sudden appearance of asymptomatic hyperpigmentation can be the only clinical finding of phytophotodermatitis. ⋯ As like these patients, phytophotodermatitis can present with only pigmentation without noticeable inflammation especially in dark skinned people. In such cases, physician can sometimes have difficulty in diagnosis of phytophotodermatitis. Therefore, it is important to consider the possibility of phytophotodermatitis through careful history taking, especially in patients who have abruptly developed well-defined hyperpigmentation on sun-exposed areas, to avoid unnecessary test and treatment.