J Drugs Dermatol
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Post-herpetic neuralgia (PHN) is primarily a disease of the elderly and often refractory to treatment. Randomized and controlled trials have yielded several significant advances in the treatment and prevention of this disease. Treatment advances include the lidocaine patch, opioid analgesics, nortriptyline, amitriptyline, and gabapentin. ⋯ But most adults have already had varicella and are at risk for HZ and PHN as they age. Therefore, a more potent vaccine against varicella has been developed for use in adults. This vaccine offers a new and significant advance in the prevention of HZ and its most noteworthy complication, PHN.
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Varicella-zoster virus is the causal agent of varicella and herpes zoster in humans. Herpes zoster results from reactivation of latent varicella-zoster virus (VZV) within the sensory ganglia. The incidence and severity of herpes zoster increase with advancing age. ⋯ A live attenuated VZV vaccine has been developed and recently approved by the FDA for the prevention of herpes zoster in individuals 60 years of age and older. In a randomized, double-blind, placebo-controlled trial with 38,546 patients 60 years of age or older, the use of the zoster vaccine reduced the burden of illness due to herpes zoster by 61.1% (P < .001), reduced the incidence of postherpetic neuralgia by 66.5% (P < .001), and reduced the incidence of herpes zoster by 51.3% (P < .001). In this review, we will discuss the history of the use of the varicella vaccine in children, and the subsequent development of the new zoster vaccine.
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Oral isotretinoin is an established effective therapy for acne. No published data is available on the efficacy and side effects of this drug in Iranian patients. ⋯ Isotretinoin is an effective and safe treatment for acne in Iranian patients. Starting treatment with a high dose and modifying the length of treatment based on the therapeutic response in each patient, might lead to a rapid and good response rate with minimal side effects.
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Erythema multiforme (EM) is usually an acute and self-limited inflammatory reaction of the skin and mucous membranes. Attacks may be sporadic or recurrent, and generally last for 1 to 3 weeks. ⋯ This continuous and uninterrupted occurrence of typical and atypical lesions is known as persistent EM. We present a case responsive to dapsone.
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Nicolau syndrome or embolia cutis medicamentosa is a very rare, but well recognized complication of intramuscular injections which clinically presents with extensive necrosis of the injected skin area. Intra-arterial or para-arterial injection after unintentional perforation of certain vessels could be the possible mechanisms. We describe 2 cases of Nicolau syndrome resulting from intramuscular injection of Diclofenac. Since irreversible tissue damage may occur within a short duration and, as the there is no definitive treatment for this condition, precautionary measures are emphasized.