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The New England Journal of Medicine Apr 2021
Topics: Anti-Bacterial Agents; Drug Hypersensitivity; Education, Medical; Electronic Health Records; Erythema; Female; Humans; Infusions, Intravenous; Male; Natural Language Processing; Racism; Syndrome; Terminology as Topic; Vancomycin
PubMed: 33830710
DOI: 10.1056/NEJMp2031891 -
Ophthalmology Oct 2023To evaluate the safety and efficacy of lotilaner ophthalmic solution 0.25% compared with vehicle for the treatment of Demodex blepharitis. (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE
To evaluate the safety and efficacy of lotilaner ophthalmic solution 0.25% compared with vehicle for the treatment of Demodex blepharitis.
DESIGN
Prospective, randomized, double-masked, vehicle-controlled, multicenter, phase 3 clinical trial.
PARTICIPANTS
Four hundred twelve patients with Demodex blepharitis were assigned randomly in a 1:1 ratio to receive either lotilaner ophthalmic solution 0.25% (study group) or vehicle without lotilaner (control group).
METHODS
Patients with Demodex blepharitis treated at 21 United States clinical sites were assigned either to the study group (n = 203) to receive lotilaner ophthalmic solution 0.25% or to the control group (n = 209) to receive vehicle without lotilaner bilaterally twice daily for 6 weeks. Collarettes and erythema were graded for each eyelid at screening and at all visits after baseline. At screening and on days 15, 22, and 43, 4 or more eyelashes were epilated from each eye, and the number of Demodex mites present on the lashes was counted with a microscope. Mite density was calculated as the number of mites per lash.
MAIN OUTCOME MEASURES
Outcome measures included collarette cure (collarette grade 0), clinically meaningful collarette reduction to 10 collarettes or fewer (grade 0 or 1), mite eradication (0 mites/lash), erythema cure (grade 0), composite cure (grade 0 for collarettes as well as erythema), compliance with the drop regimen, drop comfort, and adverse events.
RESULTS
At day 43, the study group achieved a statistically significant (P < 0.0001) higher proportion of patients with collarette cure (56.0% vs. 12.5%), clinically meaningful collarette reduction to 10 collarettes or fewer (89.1% vs. 33.0%), mite eradication (51.8% vs. 14.6%), erythema cure (31.1% vs. 9.0%), and composite cure (19.2% vs. 4.0%) than the control group. High compliance with the drop regimen (mean ± standard deviation, 98.7 ± 5.3%) in the study group was observed, and 90.7% of patients found the drops to be neutral to very comfortable.
CONCLUSIONS
Twice-daily treatment with lotilaner ophthalmic solution 0.25% for 6 weeks generally was safe and well tolerated and met the primary end point and all secondary end points for the treatment of Demodex blepharitis compared with vehicle control.
FINANCIAL DISCLOSURE(S)
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
Topics: Animals; Humans; Mite Infestations; Prospective Studies; Ophthalmic Solutions; Blepharitis; Mites; Eyelashes; Erythema; Eye Infections, Parasitic
PubMed: 37285925
DOI: 10.1016/j.ophtha.2023.05.030 -
International Journal of Molecular... Mar 2020Skin manifestations of systemic disease and malignancy are extremely polymorphous. Clinicians should be familiarized with paraneoplastic dermatoses in order to perform... (Review)
Review
Skin manifestations of systemic disease and malignancy are extremely polymorphous. Clinicians should be familiarized with paraneoplastic dermatoses in order to perform an early diagnosis of the underlying neoplasm. Lack of familiarity with cutaneous clues of internal malignancy may delay diagnosis and treatment of cancer. In this review, we described several paraneoplastic dermatoses and discussed extensively two paradigmatic ones, namely paraneoplastic pemphigus and paraneoplastic dermatomyositis.
Topics: Cytokines; Dermatomyositis; Erythema; Humans; Neoplasms; Paraneoplastic Syndromes; Pemphigus; Pyoderma Gangrenosum; Skin; Skin Diseases; Sweet Syndrome
PubMed: 32245283
DOI: 10.3390/ijms21062178 -
Acta Dermatovenerologica Alpina,... Mar 2020Patients with multiple actinic keratoses are frequently treated with topical agents such as imiquimod, an immune-response modifying agent. Adverse effects associated...
Patients with multiple actinic keratoses are frequently treated with topical agents such as imiquimod, an immune-response modifying agent. Adverse effects associated with imiquimod therapy are mainly limited to the application site and include erythema, crusting, scaling and ulceration. Systemic adverse reactions, such as erythema multiforme are rare. Here we report a case of a 77- years old patient that developed erythema multiforme after treatment of actinic keratoses with imiquimod. Cessation of imiquimod and treatment with local corticosteroids led to rapid regression of erythema multiforme lesions. Residual actinic keratoses were treated with cryotherapy.
Topics: Aged; Drug Eruptions; Erythema Multiforme; Humans; Imiquimod; Male
PubMed: 32206824
DOI: No ID Found -
CMAJ : Canadian Medical Association... Mar 2023
Topics: Child; Humans; Erythema; Skin Diseases, Genetic
PubMed: 36972907
DOI: 10.1503/cmaj.221246-f -
Medicina (Kaunas, Lithuania) Aug 2021: Erythema multiforme (EM) is an acute cutaneous eruption often associated with infections and more rarely with drugs. This review aimed to evaluate the association... (Review)
Review
: Erythema multiforme (EM) is an acute cutaneous eruption often associated with infections and more rarely with drugs. This review aimed to evaluate the association between erythema multiforme and coronavirus disease 2019 (COVID-19). : A systematic search of PubMed/MEDLINE, Scimago Scopus, and ISI/Web of Science was performed. Original articles, case series, or case reports were evaluated and selected. : Fourteen articles were selected, describing a total of 70 patients. EM is a cutaneous eruption rarely occurring in COVID-19 and is, in most cases, associated with a hypersensitivity reaction to the virus. In these cases, EM seems to affect patients younger than 30 years or older than 55 years. Infrequently, some drugs used in the management of COVID-19 may induce EM, especially hydroxychloroquine. The three groups of patients seem to have different clinical characteristics and courses. : From these data, it is possible to preliminarily propose that EM or EM-like eruptions linked to COVID-19 might be divided into three types: the virus-related juvenile type (affecting patients <30-year-old), the virus-related older type (affecting patients >55 years), and the drug-induced type. The occurrence of a skin rash does not seem to be related to the severity and clinical course of COVID-19.
Topics: Adult; COVID-19; Erythema Multiforme; Humans; Hydroxychloroquine; SARS-CoV-2
PubMed: 34441034
DOI: 10.3390/medicina57080828 -
Dermatology Online Journal Mar 2021
Topics: Child; Coloring Agents; Depression; Dermatitis; Eosine Yellowish-(YS); Erythema; Female; Humans; Life Change Events
PubMed: 33865294
DOI: No ID Found -
CMAJ : Canadian Medical Association... Jan 2024
Topics: Humans; COVID-19; SARS-CoV-2; Erythema Multiforme
PubMed: 38253367
DOI: 10.1503/cmaj.230926-f -
Acta Gastro-enterologica Belgica 2022We report the case of a 38y old woman who consulted for chronic diffuse abdominal pain related to previous irritable bowel syndrome diagnosis. Physical examination...
QUESTION
We report the case of a 38y old woman who consulted for chronic diffuse abdominal pain related to previous irritable bowel syndrome diagnosis. Physical examination showed nonblanching reddish hyperpigmented reticular peri-umbilical skin patch (figure 1). What's your diagnosis?
ANSWER
The diagnosis of erythema ab igne was made. Additional investigations confirmed repeated use of hot water bottles applied on abdominal wall for 3 weeks overnight for pain relief. Erythema ab igne is a pathognomonic cutaneous presentation of long-lasting exposure to heat sources (1). The pathophysiology of erythema ab igne remains uncertain. It has been suggested that heat exposure damages dermal vascular plexus and subsequent hemosiderin deposition leading to spider's web-like hyperpigmentation. Differential diagnosis of peri -umbilical dermatological manifestations includes digestive-related entities as caput medusae's sign (related to portal hypertension), Cullen's sign or Walzel's sign (related to acute pancreatitis); and non-digestive-related entities such as livedo reticularis (2). Erythema ab igne is well known from the dermatologists, mostly located on the lower limbs due to prolonged close exposition to heaters or on thighs due to laptop batteries (3). Erythema ab igne is usually of benign course, most often self-resolving after heat exposure discontinuation (3). We believe that it is of paramount to take into consideration the patients' pain and to propose an adapted management to avoid self-treatment.
Topics: Acute Disease; Animals; Erythema; Hemosiderin; Humans; Pain; Pancreatitis; Spiders
PubMed: 36198302
DOI: 10.51821/85.3.10418 -
CMAJ : Canadian Medical Association... Oct 2021
Topics: Adult; BCG Vaccine; COVID-19 Vaccines; Cicatrix; Edema; Erythema; Female; Humans; Middle Aged; Remission, Spontaneous
PubMed: 34663612
DOI: 10.1503/cmaj.210696-f