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Objective: To find out the effects of psychological support intervention on patients with nasopharyngeal carcinoma undergoing radiotherapy. Methods: This was a retrospective study. Sixty six patients with nasopharyngeal carcinoma who received radiotherapy in the Affiliated Hospital of Hebei University from March 2021 to March 2022 were included and randomly divided into the observation group and the control group, with 33 cases in each group. Patients in the control group were given conventional care measures, while those in the observation group were given psychological support intervention on top of conventional care measures. The nursing effects between the two groups were compared. Results: After the intervention, the psychological resilience score of the observation group was significantly higher than that of the control group, with a statistically significant difference (P<0.05). The psychological resilience scores after the intervention were significantly higher in the observation group than before the intervention, and those in the control group were higher than before the intervention, with a statistically significant difference(P<0.05). The overall health score of quality of life in the observation group was significantly higher than that in the control group after the intervention, with a statistically significant difference(P<0.05). Moreover, the skin reaction in the observation group after radiotherapy was significantly better than that of the control group (P<0.01). Conclusion: Psychological support intervention is an effective means to treat patients with nasopharyngeal carcinoma, which results in various benefits such as improving patients’ mental resilience and quality of life and reducing the incidence of adverse reactions after radiotherapy. [ABSTRACT FROM AUTHOR]

Background: Furosemide is a mainstay of treatment in congestive heart failure (CHF) and is widely prescribed to dogs and cats by several formulations, including the subcutaneous one. In canine and human medicine, dermatologic adverse effects to subcutaneous furosemide (SF) have been documented; conversely, no prior case has been published describing skin reactions to this therapeutic protocol in cats. In this report, we describe, for the first time in feline medicine, a suspected dermatologic adverse effect after SF in a cat. Case Description: A 2-year-old domestic shorthair cat was presented for CHF associated with lung edema and pleural effusion. Echocardiography revealed asymmetric left ventricular myocardial thickening and severe left atrial dilation. The cat was hospitalized and initially treated with oxygen, intravenous furosemide and clopidogrel. After discharge, the route of administration of furosemide was switched from intravenous to oral. Within the following 2 weeks, the cat experienced two relapses of lung edema despite the progressive increase of furosemide dose, the addition of spironolactone and adherence to the therapeutic protocol by the owners. The dose of furosemide was further increased and its route of administration at home was switch from oral to parental. As the owner were not able to administrate intramuscular injections, SF was prescribed. This allowed preventing further episodes of lung edema. However, although the cat had never presented skin problems before, multiple well-defined circular, crusted ulcerative cutaneous lesions associated with alopecia developed at the sites of furosemide injections 2 weeks later. After ruling out several differential diagnoses for these lesions, a rare side effect to furosemide, not yet described in cats but already known in canine and human medicine, was strongly suspected as the possible cause. Therefore, the ongoing injectable formulation of furosemide was interrupted and substitute that with an alternative brand, maintaining the same dose and route of administration. Thanks to this change, the dermal ulcerations disappeared within 1 month. Subsequently, the cat experienced neither further skin problems nor recurrence of lung edema. Conclusion: Although SF is sometimes prescribed in small animal practice, it should be noticed that this may lead to dermatologic adverse reactions in the cat. [Open Vet J 2023; 13(8.000): 1027-1031]

Background: Furosemide is a mainstay of treatment in congestive heart failure (CHF) and is widely prescribed to dogs and cats by several formulations, including the subcutaneous one. In canine and human medicine, dermatologic adverse effects of subcutaneous furosemide (SF) have been documented; conversely, no prior case has been published describing skin reactions to this therapeutic protocol in cats. In this report, we describe, for the first time in feline medicine, a suspected dermatologic adverse effect after SF in a cat. Case Description: A 2-year-old domestic shorthair cat was presented for CHF associated with lung edema and pleural effusion. Echocardiography revealed asymmetric left ventricular myocardial thickening and severe left atrial dilation. The cat was hospitalized and initially treated with oxygen, intravenous furosemide, and clopidogrel. After discharge, the route of administration of furosemide was switched from intravenous to oral. Within the following 2 weeks, the cat experienced two relapses of lung edema despite the progressive increase of the furosemide dose, the addition of spironolactone and adherence to the therapeutic protocol by the owners. The dose of furosemide was further increased and its route of administration at home was switched from oral to parental. As the owner was not able to administrate intramuscular injections, SF was prescribed. This allowed the prevention of further episodes of lung edema. However, although the cat had never presented skin problems before, multiple well-defined circular, crusted ulcerative cutaneous lesions associated with alopecia developed at the sites of furosemide injections 2 weeks later. After ruling out several differential diagnoses for these lesions, a rare side effect of furosemide, not yet described in cats but already known in canine and human medicine, was strongly suspected as the possible cause. Therefore, the ongoing injectable formulation of furosemide was interrupted and substituted with an alternative brand, maintaining the same dose and route of administration. Thanks to this change, the dermal ulcerations disappeared within 1 month. Subsequently, the cat experienced neither further skin problems nor a recurrence of lung edema. Conclusion: Although SF is sometimes prescribed in small animal practice, it should be noticed that this may lead to dermatologic adverse reactions in the cat. [ABSTRACT FROM AUTHOR]

In the first wave of COVID-19, up to 20% of patients had skin lesions with variable characteristics. There is no clear evidence of the involvement of the SARS-CoV-2 virus in all cases; some of these lesions may be secondary to drug hypersensitivity. To analyze the possible cause of the skin lesions, we performed a complete allergology study on 11 patients. One year after recovery from COVID-19, we performed a lymphocyte transformation test (LTT) and Th1/Th2 cytokine secretion assays for PBMCs. We included five nonallergic patients treated with the same drugs without lesions. Except for one patient who had an immediate reaction to azithromycin, all patients had a positive LTT result for at least one of the drugs tested (azithromycin, clavulanic acid, hydroxychloroquine, lopinavir, and ritonavir). None of the nonallergic patients had a positive LTT result. We found mixed Th1/Th2 cytokine secretion (IL-4, IL-5, IL-13, and IFN-γ) in patients with skin lesions corresponding to mixed drug hypersensitivity type IVa and IVb. In all cases, we identified a candidate drug as the culprit for skin lesions during SARS-CoV-2 infection, although only three patients had a positive drug challenge. Therefore, it would be reasonable to recommend avoiding the drug in question in all cases. [ABSTRACT FROM AUTHOR]

Introduction: Cutaneous Adverse Drug Reaction (cADR) is one of the most common clinical presentation in patients with Acquired Immunodeficiency Syndrome (AIDS). These patients are more prone to get cADR because of various factors like altered drug metabolism, immune dysregulation, genetic predisposition, polypharmacy and oxidative stress. So, a methodical study of cADR, including the risk factors, patterns of drug eruption and prognostic factors is of crucial clinical significance. Aim: To determine the prevalence of cutaneous drug reactions in Human Immunodeficiency Virus (HIV) patients and also study the various patterns of cADRs. Materials and Methods: This cross-sectional study was conducted at the outpatient department of Infectious diseases and Medical Centre, Voluntary health services, Chennai, Tamil Nadu, India, from April 2020 to December 2020. A total of 150 HIV patients above 18 years who were taking Anti-retroviral Therapy (ART) were included in this study. After screening for cADR, it was classified as Morbilliform eruption, Erythema multiforme, Stevens Johnson Syndrome (SJS), Toxic Epidermal Necrolysis (TEN) and Fixed Drug Eruption (FDE) etc., The severity of the reaction was graded based on Modified Hartwig and Siegel severity assessment scale. Pearson Chi-square test and Bivariate Pearson Correlation was performed to statistically analyse the data. Results: Amongst total of 150 HIV patients (87 males and 63 females), mean age of the study population was 41.07 years. There was a male predominance with male:female ratio of 1.3:1. About 44% (n=6) of the study population had opportunistic infection. The prevalence of drug eruption in this study was found to be 6% (n=9). Out of which, 55.6% (n=5) of the population had morbilliform eruption and 22.7% had urticarial (n=2) and pruritus (n=2) respectively. About 56% (n=5) of the drug reaction was caused by Tenofovir/Lamivudine/Efavirenz regimen and the remaining 44% (n=4) of the drug eruption was caused by Abacavir/Lamivudine/Dolutegravir regimen. Conclusion: In this study, the prevalence of drug eruption was 6% and majority of the population had morbilliform eruption [ABSTRACT FROM AUTHOR]

Not available

Abstract Background Genetic variants associated with acute side effects of radiotherapy in nasopharyngeal carcinoma (NPC) remain largely unknown. Methods We performed a two-stage genome-wide association analysis including a total of 1084 patients, where 319 individuals in the discovery stage were genotyped for 688,783 SNPs using whole genome-wide screening microarray. Significant variants were then validated in an independent cohort of 765 patients using the MassARRAY system. Gene mapping, linkage disequilibrium, genome-wide association analysis, and polygenic risk score were conducted or calculated using FUMA, LDBlockShow, PLINK, and PRSice software programs, respectively. Results Five SNPs (rs6711678, rs4848597, rs4848598, rs2091255, and rs584547) showed statistical significance after validation. Radiotherapy toxicity was more serious in mutant minor allele carriers of all five SNPs. Stratified analysis further indicated that rs6711678, rs4848597, rs4848598, and rs2091255 correlated with skin toxicity in patients of EBV positive, late stage (III and IV), receiving both concurrent chemoradiotherapy and induction/adjuvant chemotherapy, and with OR values ranging from 1.92 to 2.66. For rs584547, high occurrence of dysphagia was found in A allele carriers in both the discovery (P = 1.27 × 10− 6, OR = 1.55) and validation (P = 0.002, OR = 4.20) cohorts. Furthermore, prediction models integrating both genetic and clinical factors for skin reaction and dysphagia were established. The area under curve (AUC) value of receiver operating characteristic (ROC) curves were 0.657 (skin reaction) and 0.788 (dysphagia). Conclusions Rs6711678, rs4848597, rs4848598, and rs2091255 on chromosome 2q14.2 and rs584547 were found to be novel risk loci for skin toxicity and dysphagia in NPC patients receiving radiotherapy. Trial registration Chinese Clinical Trial Register (registration number: ChiCTR-OPC-14005257 and CTXY-140007-2).

Introduction: Cutaneous Adverse Drug Reaction (cADR) is one of the most common clinical presentation in patients with Acquired Immunodeficiency Syndrome (AIDS). These patients are more prone to get cADR because of various factors like altered drug metabolism, immune dysregulation, genetic predisposition, polypharmacy and oxidative stress. So, a methodical study of cADR, including the risk factors, patterns of drug eruption and prognostic factors is of crucial clinical significance. Aim: To determine the prevalence of cutaneous drug reactions in Human Immunodeficiency Virus (HIV) patients and also study the various patterns of cADRs. Materials and Methods: This cross-sectional study was conducted at the outpatient department of Infectious diseases and Medical Centre, Voluntary health services, Chennai, Tamil Nadu, India, from April 2020 to December 2020. A total of 150 HIV patients above 18 years who were taking Anti-retroviral Therapy (ART) were included in this study. After screening for cADR, it was classified as Morbilliform eruption, Erythema multiforme, Stevens Johnson Syndrome (SJS), Toxic Epidermal Necrolysis (TEN) and Fixed Drug Eruption (FDE) etc., The severity of the reaction was graded based on Modified Hartwig and Siegel severity assessment scale. Pearson Chi‑square test and Bivariate Pearson Correlation was performed to statistically analyse the data. Results: Amongst total of 150 HIV patients (87 males and 63 females), mean age of the study population was 41.07 years. There was a male predominance with male:female ratio of 1.3:1. About 44% (n=6) of the study population had opportunistic infection. The prevalence of drug eruption in this study was found to be 6% (n=9). Out of which, 55.6% (n=5) of the population had morbilliform eruption and 22.7% had urticarial (n=2) and pruritus (n=2) respectively. About 56% (n=5) of the drug reaction was caused by Tenofovir/Lamivudine/Efavirenz regimen and the remaining 44% (n=4) of the drug eruption was caused by Abacavir/Lamivudine/Dolutegravir regimen. Conclusion: In this study, the prevalence of drug eruption was 6% and majority of the population had morbilliform eruption.

Objective This study aimed to compare the adhesion of CATHEREEPLUS TM Pad (CPSP; NICHIBAN Co., Ltd., Tokyo, Japan) and Tegaderm TM +Pad (TGMP; 3M, Maplewood, MN, USA) film dressings on the forearm skin of healthy participants over a four-day application period. Methods Twenty-six randomly assigned participants received CPSP dressing on one arm and TGMP on the other. The primary endpoint was adhesion to the skin after four days of dermal application. Secondary endpoints were adhesion and itchiness during the application period, pain experienced during dressing removal, skin maceration, adhesive residue immediately post-dressing removal, and skin reactions at one and 24 hours post-dressing removal. All endpoints were evaluated using a five- or six-point scoring system. Results Following four days of dressing application, 77% of participants in the CPSP group and 73% of those in the TGMP group scored 4 (most) or 5 (complete) for adhesion. No clinically significant problems such as itchiness, pain, skin maceration, adhesive residue, or skin reactions were observed in either group. No statistically significant differences in any of the endpoints were observed between the two groups. Conclusion Both CPSP and TGMP dressings showed good adhesion to the skin during four days of dermal application in healthy participants, with no significant difference in adhesion observed between the two groups., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Shiba Palace Clinic issued approval 152395-35242. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: This study was funded by NICHIBAN Co., Ltd., the manufacturer of CATHEREEPLUS PAD. SS, YK, EN, and TK are employees of NICHIBAN Co., Ltd. The honesty of the study was not traded for any monetary benefit. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Sakurai et al.)

Background: The deadly COVID-19 pandemic has swept the globe since December 2019. Due to the significant risk of infection, frontline health workers had to use Personal Protective Equipment and hand hygiene products, to help prevent transmission of infection. The present study aims to compare the adverse skin responses between healthcare workers (HCW) and non-healthcare workers (NHCW). Materials and methods: A descriptive, cross-sectional study of HCW and NHCW throughout the country wa executed. A self-structured questionnaire was utilized to gather data from 404 HCWs and 826 NHCWs during a two-month period using multistage sampling. STATA (v16) was used to analyse the data. Results: 41.87% of the study participants experienced adverse skin reactions, which were more prevalent amongs HCW (65.10%) than NHCW (30.51%). The most frequently reported skin condition was skin dryness (34.39%), followed by skin peeling (11.71%). Users of alcohol-based hand sanitizers (ABHS) were more likely to get itch (8.13%), whereas soap water users were more likely to suffer from skin peeling (35.74%) and rash (7.46%). There was a significant (p < 0.001) association between occupation and adverse skin responses, with HCW being 3.5 times more likely to have adverse skin manifestations than NHCW. Conclusion: The research showed that healthcare workers were at a greater risk to developing skin reactions than the overall population with frequent use of hand hygiene measures being a significant risk factor.

This article, published in Dermatology Reports, discusses a case of an acquired ichthyosiform eruption induced by the drug apalutamide in a 69-year-old man with metastatic castration-sensitive prostate cancer. The patient developed a pruritic, scaly rash after starting treatment with apalutamide. Skin examination revealed dry, rough skin with prominent scaling. The rash improved with topical therapy, and the patient was able to continue his anticancer treatment. The article also mentions that skin rash is a known adverse effect of apalutamide, and Japanese patients may be more prone to developing cutaneous adverse events. Further research is needed to confirm the causal connection and underlying mechanisms. [Extracted from the article]

Background: Genetic variants associated with acute side effects of radiotherapy in nasopharyngeal carcinoma (NPC) remain largely unknown. Methods: We performed a two-stage genome-wide association analysis including a total of 1084 patients, where 319 individuals in the discovery stage were genotyped for 688,783 SNPs using whole genome-wide screening microarray. Significant variants were then validated in an independent cohort of 765 patients using the MassARRAY system. Gene mapping, linkage disequilibrium, genome-wide association analysis, and polygenic risk score were conducted or calculated using FUMA, LDBlockShow, PLINK, and PRSice software programs, respectively. Results: Five SNPs (rs6711678, rs4848597, rs4848598, rs2091255, and rs584547) showed statistical significance after validation. Radiotherapy toxicity was more serious in mutant minor allele carriers of all five SNPs. Stratified analysis further indicated that rs6711678, rs4848597, rs4848598, and rs2091255 correlated with skin toxicity in patients of EBV positive, late stage (III and IV), receiving both concurrent chemoradiotherapy and induction/adjuvant chemotherapy, and with OR values ranging from 1.92 to 2.66. For rs584547, high occurrence of dysphagia was found in A allele carriers in both the discovery (P = 1.27 × 10− 6, OR = 1.55) and validation (P = 0.002, OR = 4.20) cohorts. Furthermore, prediction models integrating both genetic and clinical factors for skin reaction and dysphagia were established. The area under curve (AUC) value of receiver operating characteristic (ROC) curves were 0.657 (skin reaction) and 0.788 (dysphagia). Conclusions: Rs6711678, rs4848597, rs4848598, and rs2091255 on chromosome 2q14.2 and rs584547 were found to be novel risk loci for skin toxicity and dysphagia in NPC patients receiving radiotherapy. Trial registration: Chinese Clinical Trial Register (registration number: ChiCTR-OPC-14005257 and CTXY-140007-2). [ABSTRACT FROM AUTHOR]

Simple Summary: Our study with 139 breast cancer patients treated with intraoperative radiotherapy reports favorable data on the cosmetic outcome as well as the acute and early long-term side effects. Our oncologic control rates are comparable to the previous literature. Background/Aims: Due to its favorable dose distribution and targeting of the region at highest risk of recurrence due to direct visualization of tumor bed, intraoperative electron radiation therapy (IOERT) is used as part of a breast-conserving treatment approach. The aim of this study was to analyze tumor control and survival, as well as the toxicity profile, and cosmetic outcomes in patients irradiated with an IOERT boost for breast cancer. Materials and Methods: 139 Patients treated at our institution between January 2010 and January 2015 with a single boost dose of 10 Gy to the tumor bed during breast-conserving surgery followed by whole-breast irradiation were retrospectively analyzed. Results: 139 patients were included in this analysis. The median age was 54 years (range 28–83 years). The preferred surgical strategy was segmental resection with sentinel lymphonodectomy (66.5%) or axillary dissection (23.1%). Regarding adjuvant radiotherapy, the vast majority received 5 × 1.8 Gy to 50.4 Gy. At a median follow-up of 33.6 months, recurrence-free and overall survival were 95.5% and 94.9%, respectively. No patient developed an in-field recurrence. Seven patients (5.0%) died during the follow-up period, including two patients due to disease recurrence (non-in-field). High-grade (CTCAE > 2) perioperative adverse events attributable to IOERT included wound healing disorder (N = 1) and hematoma (N = 1). High-grade late adverse events (LENT-SOMA grade III) were reported only in one patient with fat necrosis. Low-grade late adverse events (LENT-SOMA grade I-II) included pain (18.0%), edema (10.5%), fibrosis (21%), telangiectasia (4.5%) and pigmentation change (23.0%). The mean breast retraction assessment score was 1.66 (0–6). Both patients and specialists rated the cosmetic result "excellent/good" in 84.8% and 87.9%, respectively. Conclusion: Our study reports favorable data on the cosmetic outcome as well as the acute and early long-term tolerability for patients treated with an IOERT boost. Our oncologic control rates are comparable to the previous literature. However, prospective investigations on the role of IOERT in comparison to other boost procedures would be desirable. [ABSTRACT FROM AUTHOR]

Background: Skin reaction is a common side-effect of radiotherapy and often only assessed as clinician-reported outcome (CRO). The aim was to examine and compare patient-reported outcome (PRO) of skin reactions with CRO for signs of acute skin reactions for patients with primary brain tumour receiving proton beam radiotherapy (PBT). A further aim was to explore patients’ experiences of the skin reactions. Methods: Acute skin reactions were assessed one week after start of treatment, mid-treatment and end of treatment among 253 patients with primary brain tumour who underwent PBT. PRO skin reactions were assessed with the RSAS and CRO according to the RTOG scale. Fleiss’ kappa was performed to measure the inter-rater agreement of the assessments of skin reactions. Results: The results showed a discrepancy between PRO and CRO acute skin reactions. Radiation dose was associated with increased skin reactions, but no correlations were seen for age, gender, education, occupation, other treatment or smoking. There was a poor agreement between patients and clinicians (κ = −0.016) one week after the start of PBT, poor (κ = −0.045) to (κ = 0.396) moderate agreement at mid treatment and poor (κ = −0.010) to (κ = 0.296) moderate agreement at end of treatment. Generally, patients’ symptom distress toward skin reactions was low at all time points. Conclusion: The poor agreement between PRO and CRO shows that the patient needs to be involved in assessments of skin reactions for a more complete understanding of skin reactions due to PBT. This may also improve patient experience regarding involvement in their own care.

Keywords: coronavirus; COVID-19; foreign body reaction; polyacrylamide filler; skin reaction EN coronavirus COVID-19 foreign body reaction polyacrylamide filler skin reaction 1694 1696 3 05/03/23 20230501 NES 230501 To the Editor, Aquafilling® (BIOTRH, spol, s.r.o., Czech Republic) is a kind of synthetic nonbiodegradable hydrophilic gel, which is employed around the world for breast augmentation to correct mild undesirable results after silicone implants.[1] It is composed of 98% physiological saline and 2% poly (acrylamide-co-N, N0-methylene-bis-acrylamide). Coronavirus, COVID-19, polyacrylamide filler, foreign body reaction, skin reaction Foreign body reaction to polyacrylamide filler (Aquafilling®) injected nine years previously: A complication of SARS-CoV-2 infection or merely a coincidence?. [Extracted from the article]

Drug-induced skin reactions are familiar with older epileptic drugs such as phenytoin, lamotrigine, and carbamazepine (CBZ); the newer antiepileptic drugs are less likely to cause. Oxcarbazepine (OXC), the successor of CBZ, has a better safety profile with respect to side effects and adverse drug reactions (ADRs). The StevensJohnson syndrome (SJS), an ADR, is less common with OXC, and there are few case reports in the literature. Here, we report a case of OXC-induced SJS/toxic epidermal necrolysis overlap in line with CARE guidelines.

Since the beginning of the covid-vaccine campaign, a lot of local and systemic dermatologic reactions happening after the administration of Coronavirus disease 2019 (COVID-19) vaccines have been described, even if their exact biological mechanism is still debated. In this paper we report 4 cases of cutaneous manifestations arose within ten days after the first dose of messenger RNA (mRNA)-based COVID-19 vaccination: one case of giant urticaria, one case of head and neck redness and two cases of Erythema Multiforme (EM). In our experience these reactions were mild, transient and all of them resolved, not recurring after the second dose, so these manifestations shouldn’t be considered as an absolute contraindication to the second dose of vaccine, that to date is fundamental.

Background: Intravenous immunoglobulin (IVIG) treatment in Guillain-Barré syndrome (GBS) is relatively easy to administer and safe due to infrequent, non-severe side effects. Adverse effects can include skin reactions, the causes of which have not been fully elucidated. In this study, we investigated skin reactions following IVIG treatment for acute inflammatory neuropathy. We examined the relationship between the clinical results in the neuropathy and the clinical profile of skin reactions. Methods: We retrospectively analyzed patients with skin reactions that developed after IVIG treatment in acute immune-mediated or inflammatory neuropathy [GBS or Miller Fisher syndrome (MFS)] based on the dermatologic evaluation. Results: Ninety-six patients with acute inflammatory neuropathy were treated with IVIG during the study period. Thirteen cases (13.5%), with age at onset ranging from 22-69 years (mean, 50.3 years), developed skin reactions after IVIG treatment. The features accompanying skin reactions were hand eczema, including pompholyx (9/13, 82%), generalized eczematous eruption (2/13, 15.4%), and contact dermatitis, including folliculitis. The electrophysiological classification of 11 patients with classical GBS showed that nine patients (81.8 %) had axonal neuropathy, and one (9.1 %) had acute inflammatory demyelinating polyradiculoneuropathy. Conclusions: Eczematous skin reactions or pompholyx are the most common skin reactions following IVIG treatment in axonal GBS. These reactions were relatively minor and recovered well. Although adverse skin reactions to IVIG were usually benign and the precise mechanism of this cutaneous eruption remains unknown, its occurrence within days of IVIG treatment can be managed effectively if recognized by neurologists. [ABSTRACT FROM AUTHOR]

Because of the increasing emergence of cutaneous reactions from COVID-19 vaccines worldwide, we investigated the published reports of these complications. We searched the PubMed, Google Scholar, and Scopus databases and the preprint server bioRxiv for articles on cutaneous complications linked to mRNA-1273 (Moderna), BNT162b2 (Pfizer–BioNTech), and AZD1222 (AstraZeneca–Oxford University) vaccines published until 30 September 2021. Eighty studies describing a total of 1415 reactions were included. Cutaneous reactions were more prevalent in females (81.6%). Delayed large local reactions were the most common complication (40.4%), followed by local injection site reactions (16.5%), zoster (9.5%), and urticarial eruptions (9.0%). Injection site and delayed large local reactions were predominantly caused by the mRNA-1273 vaccine (79.5% and 72.0%, respectively). BNT162b2 vaccination was more closely linked to distant reactions (50.1%) than mRNA-1273 (30.0%). Zoster was the most common distant reaction. Of reactions with adequate information for both vaccine doses, 58.3% occurred after the first dose only, 26.9% after the second dose only, and 14.8% after both doses. Overall, a large spectrum of cutaneous reaction patterns occurred following the COVID-19 vaccination. Most were mild and without long-term health implications. Therefore, the occurrence of such dermatologic complications does not contraindicate subsequent vaccination. [ABSTRACT FROM AUTHOR]

Abstract Some drugs cause phototoxicity in humans when exposed to light, thus there is a need for an in vivo phototoxicity test to evaluate them. However, an in vivo phototoxicity test method to evaluate this has not been established. This study aimed to establish an in vivo phototoxicity test method for transdermally administered drugs. For this, we evaluated the phototoxicity using Sprague-Dawley (SD) rats for transdermal administered drugs and we studied the appropriate UVA dose using 8-methoxypsalen, which is a well-known phototoxic drug. We found that a UVA dose of 15 J/cm2 was dose and time dependent response compared to other UVA doses. We performed the Minimum Erythema Dose (MED) test because UVB can cause skin irritation by itself and selected 0.01 J/cm2 as an appropriate dose of UVB. Using the selected UVA and UVB doses, we performed a phototoxicity study of 6 pharmaceutical drugs, which included phototoxic and non-phototoxic drugs. As a result of the phototoxicity test, 100% accuracy was obtained when compared with previous studies. In addition, we performed histopathology to confirm the new findings. We found that histopathology can be used as an additional indicator of phototoxicity test for transdermally administered drugs.

Background: This pharmacovigilance study was conducted in Amravati region of central India to identify the nature and prevalence of adverse drug reactions, which will be helpful for better drug prescription practice and management of diseases. Materials and Methods: Adverse drug reaction reporting forms from April 2016 to March 2019, were collected from the pharmacovigilance center, which include details of demographics, investigations, concomitant drug history, and details of present complaints including reaction details, onset, recovery, drug information, hospitalization, management, and assessment. Results: A total of 19 cases were reported. Approximately 47.4% male and 52.6% female experienced the reactions with age-group ranging from 15 to 75 years. The most common adverse drug reactions were caused by antimicrobial agents (47.6%) followed by other group of drugs (37%) and nonsteroidal anti-inflammatory drugs (15.9%). Polypharmacy was the most common cause (31.6%) with the most common route being intravenous (42.1%). Skin reactions were the most common (84.2%). Antitubercular drugs were more commonly responsible for exfoliative lesions, whereas paracetamol and unknown drugs were responsible for multiple ulcerative lesions. Reactions to antitubercular drugs were considered as possible (15.8%), whereas with other drugs (63.2%), it was probable. Conclusion: It is a tip of the iceberg, which provides important demographic details in which adverse drug reactions were reported. Cutaneous reactions due to common drugs are responsible for hospitalization of the patients. There is an urgent need of training for health-care providers so that reporting can be improved and better picture can emerge.

Objective: To find out the effects of psychological support intervention on patients with nasopharyngeal carcinoma undergoing radiotherapy., Methods: This was a retrospective study. Sixty six patients with nasopharyngeal carcinoma who received radiotherapy in the Affiliated Hospital of Hebei University from March 2021 to March 2022 were included and randomly divided into the observation group and the control group, with 33 cases in each group. Patients in the control group were given conventional care measures, while those in the observation group were given psychological support intervention on top of conventional care measures. The nursing effects between the two groups were compared., Results: After the intervention, the psychological resilience score of the observation group was significantly higher than that of the control group, with a statistically significant difference (P<0.05). The psychological resilience scores after the intervention were significantly higher in the observation group than before the intervention, and those in the control group were higher than before the intervention, with a statistically significant difference(P<0.05). The overall health score of quality of life in the observation group was significantly higher than that in the control group after the intervention, with a statistically significant difference(P<0.05). Moreover, the skin reaction in the observation group after radiotherapy was significantly better than that of the control group (P<0.01)., Conclusion: Psychological support intervention is an effective means to treat patients with nasopharyngeal carcinoma, which results in various benefits such as improving patients' mental resilience and quality of life and reducing the incidence of adverse reactions after radiotherapy., Competing Interests: Conflicts of interest: None., (Copyright: © Pakistan Journal of Medical Sciences.)

A 52-year-old woman presented with erythema, papules, pain, and itching on the buttocks and trunk that had persisted for 1 week. Twenty-two days before admission, the patient received three intramuscular injections of vitamin K1 in the gluteal muscles. Two weeks after the last intramuscular injection edematous hard erythema developed bilaterally on the gluteal muscles, accompanied by itching, pain, and a burning sensation. Afterward, the erythema and papules gradually spread to the trunk, with notable itching. Dermatological examination revealed a large area of well-defined edematous hard erythema, and blisters around the injection sites on both hips. The skin temperature was high, with mild tenderness. Dense distributions of edematous erythema and papules were observed on the trunk, some of which were fused into pieces. The patient received a diagnosis of a skin reaction induced by intramuscular injections of vitamin K1. Therefore, she was administered glycyrrhizin, calcium, vitamin C, antihistamines, topical polysulfonic mucopolysaccharide cream, and glucocorticoid cream, and the lesions subsided after 2 weeks. [ABSTRACT FROM AUTHOR]

Abstract Many exaggerated skin reactions after insect bites have been described and due to global warming the incidence of these cases will increase. This clinical video promotes its recognition by showing an unusual cutaneous phenomenon after an insect bite.

Abstract This case report presents an acute painful skin reaction several years after injection of site‐enhancing oils (SEO) induced by chemotherapy. This case exemplifies the long‐term dangerous side effects of the use of SEO, however treatable with prednisolone.

Drug-induced skin reactions are familiar with older epileptic drugs such as phenytoin, lamotrigine, and carbamazepine (CBZ); the newer antiepileptic drugs are less likely to cause. Oxcarbazepine (OXC), the successor of CBZ, has a better safety profile with respect to side effects and adverse drug reactions (ADRs). The StevensJohnson syndrome (SJS), an ADR, is less common with OXC, and there are few case reports in the literature. Here, we report a case of OXC-induced SJS/toxic epidermal necrolysis overlap in line with CARE guidelines. [ABSTRACT FROM AUTHOR]

The vast majority of patients treated with radiotherapy develop dermatological side effects. Acute radiation dermatitis or chronic skin fibrosis are well known sequels of radiation, but there are also other infrequent skin toxicities following external radiotherapy we should be aware of. We present a case of a rare form of delayed radiation dermatitis consisting of a localized acneiform eruption, confirmed by skin biopsy, in the irradiated fields in a woman with breast cancer. We review the clinical characteristics and risk factors available in the literature about this unusual adverse effect of radiotherapy. It is important for dermatologists to recognize this rare adverse effect, owing to the important impact on physical and psychosocial health of the patients and because it may delay the surgical reconstruction.

Introduction Skin and subcutaneus tissue disorders are common type of adverse drug reactions reported with a wide variety of both typical and atypical antipsychotics. Aripiprazole is a quinolinone antipsychotic that is a partial agonist at the D2 and 5-HT1A receptors and antagonist at the 5-HT2A receptors. We report a case of rosacea that developed after starting aripiprazole in a patient with schizophrenia and which remitted after the drug was stopped. Objectives To present a case of rosacea that developed in a schizophrenic patient after starting aripiprazole. Review of literature and search for the total number of cases reported in the european database of suspected adverse drug reactions (EudraVigilance). Methods We carried out a literature review in Pubmed electing those articles focused on skin ad subcutaneous skin disorders in those patients that have been taking aripiprazole. Review number of cases of skin reactions reported by the European database of suspected adverse drug reactions. Results A 43-year-old man previously diagnosed with schizophrenia with low adherence to different treatments. He came to our service seeking for help in order to decrease delusions with a treatment with minimun adverse reactions. We started aripirazole 10 mg every day and, after 7 days appeared signs of rosacea in his face. After discontinuation of aripiprazol, after 5 days, rosacea remitted. Conclusions Rosacea in our case posibly point aripiprazole as the agent that produced the skin reaction. After stopping the treatment the signs disapeared. Awareness of skins manifestations produced by aripiprazole is essential to prevents worse skin reactions.

Background/Aim: In this study, a new method to create a customized three-dimensional (3D) bolus by accurately considering the anatomy of an individual patient is demonstrated. Patients and Methods: A 3D bolus structure was created from an extended planning target volume (PTV) to reduce an inevitable skin reaction. In addition, during computed tomography simulation in patients with oral cavity cancers, a balloon was inserted into the mouth of a patient to secure space, and then the area surrounding the balloon was designed into a 3D bolus structure. Results: For patients with head and neck cancers, a customized 3D bolus can reduce the unnecessary skin dose by 14.4% compared to a commercial bolus. For patients with oral cavity cancer, the PTV and tongue doses were 93.8% and 8% of the prescribed dose, respectively. Conclusion: The customized 3D bolus enables effective skin sparing and full coverage of the target area. [ABSTRACT FROM AUTHOR]

Because of the increasing emergence of cutaneous reactions from COVID-19 vaccines worldwide, we investigated the published reports of these complications. We searched the PubMed, Google Scholar, and Scopus databases and the preprint server bioRxiv for articles on cutaneous complications linked to mRNA-1273 (Moderna), BNT162b2 (Pfizer–BioNTech), and AZD1222 (AstraZeneca–Oxford University) vaccines published until 30 September 2021. Eighty studies describing a total of 1415 reactions were included. Cutaneous reactions were more prevalent in females (81.6%). Delayed large local reactions were the most common complication (40.4%), followed by local injection site reactions (16.5%), zoster (9.5%), and urticarial eruptions (9.0%). Injection site and delayed large local reactions were predominantly caused by the mRNA-1273 vaccine (79.5% and 72.0%, respectively). BNT162b2 vaccination was more closely linked to distant reactions (50.1%) than mRNA-1273 (30.0%). Zoster was the most common distant reaction. Of reactions with adequate information for both vaccine doses, 58.3% occurred after the first dose only, 26.9% after the second dose only, and 14.8% after both doses. Overall, a large spectrum of cutaneous reaction patterns occurred following the COVID-19 vaccination. Most were mild and without long-term health implications. Therefore, the occurrence of such dermatologic complications does not contraindicate subsequent vaccination.

It has become important to be careful in terms of side effects with the increased lenalidomide use. The most commonly reported adverse events with the use of lenalidomide were hematologic toxicities and less frequently peripheral edema, infections, gastrointestinal disorders, fatigue, and muscle cramps. In particular, the nonserious rash is the most common cause of permanent discontinuation of lenalidomide. Although morbilliform, urticarial, or acneiform rashes have been observed with lenalidomide, malar rash-like lesions have not been described previously. Our aim is to present here 71-year-old female myelodysplastic syndrome patient with deletion of 5q abnormality who should be discontinued lenalidomide due to recurrent skin reaction like a malar rash.

Skin reactions have been reported with various antipsychotic drugs in scientific literature. It is important that clinicians be watchful of skin reactions in the elderly with antipsychotic medication, which can be an uncommon occurrence. It has been documented that the elderly are more prone to skin reactions with various forms of medication. We herewith report a case of skin reaction with risperidone in an elderly female patient.

Background: This pharmacovigilance study was conducted in Amravati region of central India to identify the nature and prevalence of adverse drug reactions, which will be helpful for better drug prescription practice and management of diseases. Materials and Methods: Adverse drug reaction reporting forms from April 2016 to March 2019, were collected from the pharmacovigilance center, which include details of demographics, investigations, concomitant drug history, and details of present complaints including reaction details, onset, recovery, drug information, hospitalization, management, and assessment. Results: A total of 19 cases were reported. Approximately 47.4% male and 52.6% female experienced the reactions with age-group ranging from 15 to 75 years. The most common adverse drug reactions were caused by antimicrobial agents (47.6%) followed by other group of drugs (37%) and nonsteroidal anti-inflammatory drugs (15.9%). Polypharmacy was the most common cause (31.6%) with the most common route being intravenous (42.1%). Skin reactions were the most common (84.2%). Antitubercular drugs were more commonly responsible for exfoliative lesions, whereas paracetamol and unknown drugs were responsible for multiple ulcerative lesions. Reactions to antitubercular drugs were considered as possible (15.8%), whereas with other drugs (63.2%), it was probable. Conclusion: It is a tip of the iceberg, which provides important demographic details in which adverse drug reactions were reported. Cutaneous reactions due to common drugs are responsible for hospitalization of the patients. There is an urgent need of training for health-care providers so that reporting can be improved and better picture can emerge. [ABSTRACT FROM AUTHOR]

Background: Anti‐programmed cell death 1 antibody is a standard therapy for advanced non‐small cell lung cancer (NSCLC). However, immune‐related adverse events (irAEs), such as skin reactions, are frequently observed. Although skin reactions are associated with clinical efficacy in melanoma, this association in advanced NSCLC and predictors of irAEs remain unclear. Accordingly, this study identified potential correlations of skin reactions with clinical efficacy and clinical predictors of development of skin reactions. Subjects, Materials, and Methods: We retrospectively surveyed patients with advanced NSCLC who received nivolumab or pembrolizumab monotherapy at Sendai Kousei Hospital (n = 155) during January 2016 to April 2018. Treatment efficacy was evaluated in patients with and without skin reactions, and associated predictive markers were determined. A 6‐week landmark analysis was conducted to assess the clinical benefit of early skin reactions. Results: Skin reactions were observed in 51 patients with a median time to onset of 6.4 weeks. The overall response rate (ORR) was significantly higher in patients with skin reactions (57% vs. 19%, p <.001). Median progression‐free survival (PFS) durations of 12.9 and 3.5 months and overall survival durations of not reached and 11.4 months were observed in patients with and without skin reactions, respectively. In the 6‐week landmark analysis, the ORR was significantly higher in patients with skin reactions, and skin reactions were significantly associated with increased PFS. A multivariate analysis identified pre‐existing rheumatoid factor (RF) as an independent predictor of skin reactions. Conclusion: Skin reactions appeared beneficial in patients treated with nivolumab/pembrolizumab for advanced NSCLC and could be predicted by pre‐existing RF. Further large‐scale validations studies are warranted. Implications for Practice: This single‐institutional medical record review that included 155 patients with advanced non‐small cell lung cancer who were treated with nivolumab or pembrolizumab monotherapy revealed that overall response rate and progression‐free survival were significantly better in patients with skin reactions. Pre‐existing rheumatoid factor was an independent predictor of skin reactions. Skin reactions are common immune‐related adverse events associated with PD‐1 therapy. This study investigated the association between the development of skin reactions and clinical benefit of skin reaction, as well as associated predictive markers, in patients with advanced non‐small cell lung cancer who were treated with nivolumab or pembrolizumab monotherapy. [ABSTRACT FROM AUTHOR]

Tissue adhesives are commonly used for skin closure in both surgical and nonsurgical specialties. Although they are very well tolerated, tissue adhesives can induce a localized allergic response in 0.5% to 14% of patients. Allergic response can result in wound dehiscence, patient discomfort, increased healing time, and suboptimal esthetic results. We present two cases of allergic reaction to anterior neck incisions following topical application of tissue adhesives. The patients were managed with local wound care, steroid administration, and one with subsequent revision surgery. Clinicians who routinely use tissue adhesives should understand the incidence, risk factors, and management of allergic reaction to these products. [ABSTRACT FROM AUTHOR]

This case report presents an acute painful skin reaction several years after injection of site‐enhancing oils (SEO) induced by chemotherapy. This case exemplifies the long‐term dangerous side effects of the use of SEO, however treatable with prednisolone. [ABSTRACT FROM AUTHOR]

Sorafenib has been established as one of the standard treatment for unresectable hepatocellular carcinoma, but the prognosis for this disease remains poor. Therefore, other treatment modalities such as local radiation therapywere widely investigated in many trials. As a result, the combination of Sorafenib and radiation therapy offered some promising results, but the distinct adverse effects of targeted therapeutics combined with radiation therapywere also observed. An undefined and rarely-reported skin reaction was observed in 2 elder patients with advanced hepatocellular carcinoma who underwent concurrent Sorafenib and radiation therapy.We describe this phenomenon as Sorafenib induced radiation in-field skin (SIRIS) reaction, and the clinical course and radiation dosimetry of these patients were reviewed. The development of SIRIS reaction was primarily limited within the radiation treatment fields, and it occurred at a relatively low dose during the courses of RT. The SIRIS reaction progressed in a radiation dose-dependent manner and was recovered spontaneously after 3-4 weeks of radiation therapy. The SIRIS reaction implicates a unique phenomenon that systemic skin reaction of targeted therapeutics, such as sorafenib, might be limited or exacerbated in specific regions by local radiation therapy. [ABSTRACT FROM AUTHOR]

Background: Respiratory viruses like coronavirus disease (COVID-19) spread when mucus or droplets containing the virus get into your body through your eyes, nose or throat. Most often, this happens through your hands. Hands also are one among the foremost common ways in which the virus spreads from one person to subsequent. During a worldwide pandemic, one among the most cost-effective, easiest, and most vital ways to stop the spread of an epidemic is to scrub your hands frequently with soap and water1. But there may be mild to moderate skin reactions related to hand hygiene. Objective: To find out the consequences of repeated washing of hands to protect against coronavirus (COVID-19). Methods: 106 candidates were asked by questionnaire to fill 20 different questions related to time, duration, frequency and consequences of hand wash they are feeling. Result: The result of this study supports that 56% of people who are washing their hands at least 25-100 times a day are suffering from skin dryness. Conclusion: study suggests that repeated or frequent washing of hands can cause dryness and crack skin of hands even in individuals with no history of skin diseases [ABSTRACT FROM AUTHOR]

Skin rashes have been reported after the start of various antipsychotic drugs in the scientific literature. It is important that psychiatrists be aware of antipsychotic-induced skin reactions in patients on antipsychotic medication which can be an uncommon yet possible occurrence. Patients with psychiatric problems may be prone to skin reactions and may not report the same as they may not be aware of the same. We herewith report a case of skin reaction with Olanzapine in a patient with schizophrenia.

Liraglutide is an antidiabetic drug given subcutaneously for weight reduction. We report a 35-year-old woman who presented with a rash after starting liraglutide. The rash consisted of erythematous well-defined plaques surrounded by ecchymotic patches on extensor aspects of the thighs at the sites of liraglutide injection with gradual onset and progressive course. The exact cause of the reaction is unknown. The eruption resolved after discontinuation of treatment.