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Introduction: Tianeptine is a tricyclic antidepressant (TCA) without FDA-approval that acts on dopamine and norepinephrine. It has opioid agonist activity and is increasingly being used for recreational purposes to achieve an opioid-like anxiolytic effect. This can lead to clinical addiction with subsequent withdrawal symptoms resembling symptoms of opioid withdrawal. There are limited cases detailing the management of tianeptine withdrawal. Case Summary: We present the case of a 38-year-old male with chronic tianeptine use admitted to the Intensive Care Unit for treatment of encephalopathy and vital sign changes due to intake of multiple substances and suspected tianeptine withdrawal. He reported 8 to 20 g daily use of tianeptine. He was initially managed with buprenorphine/naloxone and supportive care and reported improvement in withdrawal symptoms within three days of admission. We trialed transitioning to methadone, given possible long-term benefit due to TCA-like properties, but this was discontinued due to difficulty with access on discharge. He was provided with a bridge prescription for buprenorphine/naloxone to cover until his outpatient follow-up visit and was subsequently discharged home. Conclusion: This case demonstrates management of tianeptine withdrawal in a hospitalized patient presenting with significant daily use not reported previously in the literature. [ABSTRACT FROM AUTHOR]

The article focuses on the diagnosis of a 28-year-old woman who presented with tender burning lesions in her left axillary and vaginal skin. It mentions she had a history of hidradenitis suppurativa and pulmonary Langerhans cell histiocytosis, which had been resolved after smoking cessation. It describes the diagnostic process, which led to a diagnosis of cutaneous Langerhans cell histiocytosis with a background of hidradenitis suppurativa.

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a hypersensitivity reaction often requiring hospitalization, and severe cases may result in death.[[1], [3]] Hematologic abnormalities, which include cytopenias, are a well-documented finding in DRESS patients,[[4]] but the relationship with patient characteristics is unknown. Significance testing was performed by combining all cytopenic patients into one group ( I N i = 46) and comparing them to patients with normal counts ( I N i = 19), as some patients met the criteria for multiple groups (Table 2). [Extracted from the article]

A study published in the International Journal of Dermatology examined the outcomes of patients with Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome, a rare and potentially fatal drug reaction. The study focused on the differences in outcomes between African American and White patients. The study found that African American patients had a higher mortality rate within 30 days of discharge compared to White patients. The study suggests that social determinants of health, access to resources, disease severity, and comorbidities may contribute to the observed disparities. The study acknowledges the limitations of a small sample size and recommends further research to validate the findings and explore the causes of race-specific survival differences in DRESS syndrome patients. [Extracted from the article]

With this patient's multiple sebaceous nodules and DNA mismatch mutation on histology, extensive malignancy workup was started. A 60-year-old man with a history of basal cell carcinoma (BCC) on his forehead excised 10 years ago presented to the dermatology clinic with an enlarging red bump on his back for the past few months. To date, computed tomography (CT) revealed a multicystic pancreatic tail lesion and multiple metastatic lesions to the liver, with plans to conduct further colonoscopy and upper gastrointestinal (GI) imaging. [Extracted from the article]

This study was conducted with the hypothesis that sepsis patients who suffer from DEs would have longer lengths of stay than sepsis patients without a DE during hospitalization. Keywords: drug eruption; sepsis; medical dermatology; hospitalization outcomes EN drug eruption sepsis medical dermatology hospitalization outcomes e319 e320 2 04/20/23 20230501 NES 230501 Sepsis patients have high mortality rates and frequently suffer persistent long-term health outcomes.[[1]] Sepsis patients are often placed on broad-spectrum antibiotics, the most frequent cause of cutaneous drug eruptions (DEs).[[3]] However, there is little research on DE impact on hospitalization length of stay or mortality in sepsis. [Extracted from the article]