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OBJECTIVE@#To compare the therapeutic effect on bronchial asthma between presence of skin reaction and the absence of skin reaction after acupoint application.@*METHODS@#Sixty-one patients with bronchial asthma were treated with acupoint application during the hottest periods of summer ("dog days"). The acupoints included Dingchuan (EX-B 1), Feishu (BL 13), Xinshu (BL 15), Pishu (BL 20) and Shenshu (BL 23). The treatment was given once every 7 days, with the herbal plaster remained for 6 h each time, and 4 treatments were required totally. According to the local skin reaction after acupoint application, a skin reaction group (30 cases, 2 cases dropped off) and a non-skin reaction group (31 cases) were divided. Separately, before treatment and 1 year after treatment, using chronic disease management platform of asthma, the number of asthma attacks, the score of asthma control test (ACT) and the score of asthma quality of life questionnaire (AQLQ) were recorded online. Besides, the therapeutic effect was observed in the two groups 1 year after treatment.@*RESULTS@#One year after treatment, the number of asthma attacks was reduced as compared with that before treatment in the patients of either group (@*CONCLUSION@#In treatment of acupoint application for bronchial asthma, the clinical therapeutic effect is better in the patients with local skin reaction after acupoint application. The chronic disease management platform of asthma is convenient for online evaluation.
Subject(s)
Humans , Acupuncture Points , Acupuncture Therapy , Asthma/therapy , Disease Management , Quality of LifeABSTRACT
RESUMEN El síndrome de DRESS es una reacción adversa severa a fármacos presentándose más comúnmente con anticonvulsivantes y antibióticos. Se estima que su mortalidad alcanza el 10%; clínicamente se presenta con fiebre, linfadenopatías, erupciones cutáneas morbiliformes y compromiso deórganos terminal. Las reacciones adversas cutáneas medicamentosas se presentan en más de la mitad de los pacientes que están recibiendo medicamentos sistémicos tales como la carbamazepina.
SUMMARY DRESS syndrome is a severe adverse reaction to medicament which is most commonly presentedwith anticonvulsants and antibiotics. It is estimated that the mortality reaches10%;clinically the patients presentit with fever, lymphadenopathies, morbilliform cutaneous eruptions and terminal organ involvement. Adverse skin reactions to medications occur in more than half of patients who have received systemic medications, such as anticonvulsants.
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OBJECTIVE@#To compare the effects of medical ozone oil and urea ointment for prevention and treatment of hand-foot skin reaction (HFSR) caused by sorafenib in patients with hepatocellular carcinoma (HCC).@*METHODS@#A total of 99 patients diagnosed with advanced HCC according to National Comprehensive Cancer Network (NCCN) who were scheduled to receive sorafenib treatment for the first time were enrolled in this study between April, 2018 and January, 2020. The patients were randomized into medical ozone oil group (@*RESULTS@#Eight patients were excluded for poor compliance or protocol violations, leaving a total of 91 patients for analysis, including 44 in medical ozone oil group and 47 in urea ointment group. Sixteen (36.4%) of patients in ozone oil group developed HFSR, a rate significantly lower than that in urea ointment group (57.4%; @*CONCLUSIONS@#Medical ozone oil can significantly reduce the incidence and severity of HFSR to improve the quality of life of HCC patients receiving sorafenib treatment.
Subject(s)
Humans , Antineoplastic Agents/therapeutic use , Carcinoma, Hepatocellular/drug therapy , Hand-Foot Syndrome/prevention & control , Liver Neoplasms/drug therapy , Niacinamide/therapeutic use , Ozone/therapeutic use , Phenylurea Compounds/adverse effects , Quality of Life , Sorafenib/therapeutic useABSTRACT
Apatinib mesylate is a novel small molecule monoclonal antibody. Its mechanism of action is through highly selective com-petition for intracellular vascular endothelial growth factor receptor-2 (VEGFR-2) ATP binding sites and blocking downstream signal transduction thereby inhibiting neovascularization of tumor tissue. Hand-foot skin reaction (HFSR) is one of the common adverse reac-tions of apatinib, and it often affects the quality of life of patients; this leads to a reduction in the use of targeted drugs , which nega-tively affects the efficacy of anti-tumor therapy. The conventional western medicine treatment for HFSR comprises urea and glucocorti-coid topical preparations. Clinical treatment is often based on redness, ulceration, scab, and other skin manifestations; a combination of Chinese and western medicines can improve clinical outcomes. This article reviews apatinib-related HFSR and the relevant progress in treatment strategies in order to provide a clinical reference.
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Objective To investigate associate chief physician the clinical effects of Jiawei Jinhuang powder with fumigation -washing on hand -foot skin reaction(HFSR)caused by sorafenib.Methods 48 patients who received sorafenib were randomly divided into two groups.24 patients in the treatment group were administered Jiawei Jinhuang powder with fumigation -washing,and another 24 patients in the control group were given VitB6 orally.After 8 weeks,the incidence and grade of HFSR were statistically studied between the two groups.Results There was significant differences of hand -foot reaction between the treatment group and the control group (incidence rate:29.17% vs 70.83%,χ2 =8.375,P <0.05;The incidence rate of Ⅱ -Ⅲ:12.50% vs 33.33%,P <0.05 ). Conclusion Jiawei Jinhuang powder with fumigation -washing could remarkably reduce the incidence rate of HFSR caused by sorafenib.
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<p><b>OBJECTIVE</b>To examine the variations in the prevalence of skin reactions and the association between skin reactions and efficacy of summer acupoint application treatment (SAAT) on chronic pulmonary disease (CPD).</p><p><b>METHODS</b>A total of 2,038 patients with CPD were enrolled at 3 independent hospitals (defined as Groups A, B and C, respectively) in China. All patients were treated by SAAT, as applying a herbal paste onto the acupoints of Fengmen (BL 12) and Feishu (BL 13) on the dog days of summer, according to the lunar calendar, in 2008. Ten days after treatment, skin reaction data (no reaction, itching, stinging, blistering, and infection) were obtained via face-to-face interviews. Patients were retreated in the same hospital one year later, thereby allowing doctors to assess treatment efficacy based on the patients' symptoms, the severity of the spirometric abnormalities, and the concomitant medications used.</p><p><b>RESULTS</b>A large number of patients (85.3%) displayed reactive symptoms; however, the marked associations between reactive symptoms and age or gender were not observed. An increased number of patients from Group B (99.3%) and Group C (76.5%) displayed reactive symptoms due to the increased mass of crude Semen Sinapis Albae. The effective rate of SAAT was as high as 90.4% for patients of Group B, which was followed by Group A (70.9%) and Group C (42.2%). Using stratified analyses, a convincing association between reactive symptoms and therapeutic efficacy was observed for patients with asthma [itching: odds ratio (OR)=2.17, 95% confidence interval (CI): 1.49 to 3.14; blistering: OR=0.43, 95% CI: 0.25 to 0.73; and no reaction: OR=0.56, 95% CI: 0.35 to 0.90]. However, the same tendency was not observed for patients with chronic bronchitis and chronic obstructive pulmonary disease.</p><p><b>CONCLUSIONS</b>SAAT can induce very mild skin reactions for patients with CPD, among which patients with asthma displayed a strong association between skin reactions and therapeutic efficacy. The skin reactions may be induced by the crude Semen Sinapis Albae.</p>
Subject(s)
Adult , Aged , Child , Female , Humans , Male , Acupuncture Points , Blister , Follow-Up Studies , Prospective Studies , Pruritus , Pulmonary Disease, Chronic Obstructive , Therapeutics , Skin , Pathology , Treatment OutcomeABSTRACT
Midazolam is one of the most commonly used drugs for sedation in Emergency Department (ED). This was a retrospective study conducted on 380 patients from December 2012 to May 2014 in ED of Universiti Kebangsaan Malaysia Medical Centre (UKMMC). The objective was to elicit the frequency of side effects and correlation to various factors i.e. socio-demography, co-morbidities, age groups and underlying illnesses. Out of 380 patients, 35 patients experienced side effects (20 patients with midazolam alone, 15 patients with combination of drugs). The average age was 42 years and the average dose of midazolam was 3.5mg. The most common other drug combined was fentanyl. The overall complication rate for midazolam was 5.3%. The most common side effect recorded was excessive somnolence (1.6%). Other side effects included local skin reactions (1.1%), vomiting (0.8%), headache (0.8%) and hypotension (0.5%). There was no significant association between the socio-demographic factors and drugs combination with the side effects of midazolam on patients. It was concluded that midazolam was a safe drug due to absence of any life-threatening side effects. There are possibilities that most side effects recorded could be caused by other comfounding factors e.g. underlying injuries or disease and combination with other drugs.
Subject(s)
MidazolamABSTRACT
Objective To observe the acute skin and mucous membrane reactions in patients treated with concurrent radiochemotherapy for nasopharyngeal carcinoma,and to analyze the influencing factors.Methods A total of 85 nasopharyngeal carcinoma cases treated with concurrent radiochemotherapy were enrolled in the study.Fifteen clinical and laboratory indexes,including BMI,radiation dose,degree of acute oral mucous and skin reactions and blood routine test were observed weekly.Univariate and multivariate regression analysis were performed to assess the factors,and screen the independent factors.Results Multiple-factor analysis showed that the risk factors cloesly related with acute radioactive oral mucosa reactions were smoking history(OR =3.467,P ＜ 0.05),single-dose of gross tumor volume (GTV) ＞2.15 Gy(OR =3.393,P ＜ 0.05),while those with acute radiation skin reactions were diabetes history(OR =87.859,P ＜ 0.05) and hemoglobin values 1 week before radiotherapy ＞ 130 g/L (OR =21.404,P ＜ 0.05).Conclusions In the patients treated with concurrent radiochemotherapy for nasopharyngeal carcinoma,smoking history and single-dose of GTVnx is the independent risk factors of acute radiation oral mucosa reactions,while diabetes history and hemoglobin values I week before radiotherapy are the independent factors of acute skin reactions.
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Background: Preparation for surgery has traditionally included the routine removal of body hair from the intended surgical wound site. Hair is removed as its presence can interfere with the exposure of the incision and subsequent wound, the suturing of the incision and the application of adhesive drapes and wound dressings. Hair is also perceived to be associated with a lack of cleanliness and hair removal is thought to reduce the risk of surgical site infections (SSIs). SSIs are experienced by around 10% of patients in the UK each year and can result in delayed wound healing, increased hospital stays, unnecessary pain and in extreme cases the death of the patient. Three methods of hair removal are currently used: shaving, clipping and chemical depilation. When a surgical operation is to be conducted through a hair bearing part of the body, hair removal is often performed. Aims & Objective: This study aimed to evaluate the relationship of two methods (shaving and depilation cream) of preoperative hair removal to adequacy of hair removal, skin injury and reaction during hair removal, postoperative wound infection in a developing country where razor shaving is very popular. Material and Methods: Consecutive consenting patients scheduled to have such operations were randomized into two groups. One group had hair removal by shaving with a razor blade while the other had hair removed by depilatory cream. Adequacy of hair removal and presence of skin injuries and/or reactions were noted preoperatively. Details of the procedures were recorded and patients were then assessed for postoperative wound infection. Results: A total 215 patients were studied. Of the 103 patients who had hair removal by depilatory cream, hair was completely removed in 93 (91%) compared to 69 (62%) of the 112 patients who had razor hair shaving. Skin injuries were noted in 32 (29%) of the razor group and 4 (4%) of patients who had depilatory cream. 18 patients (8%) had postoperative wound infection including 3 (3%) in the depilatory cream group and 15 (13%) of the razor group. A significant association was found between preoperative skin injuries and postoperative wound infections. Conclusion: Preoperative hair removal with razor shaving predisposes to skin injuries which in turn significantly influence postoperative wound infection rates. Such injuries and resultant wound infection are fewer when depilatory cream is used for hair removal.
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Sorafenib (Nexavar(R), BAY 43-9006) is a novel, orally administered multi-kinase inhibitor that has recently been approved for the treatment of metastatic renal cell carcinoma. It is also used to delay disease progression in patients with advanced solid organ malignancies and metastatic melanoma. Sorafenib is associated with a relatively high incidence of dermatologic adverse events. The commonly occurring dermatologic adverse events associated with sorafenib include hand-foot skin reaction, facial erythema, splinter subungual hemorrhages, alopecia, pruritus and xerosis. We report here on a case of a 50-year-old man who was diagnosed with metastatic hepatocellular carcinoma. He developed both facial erythema and hand-foot skin reaction after the administration of sorafenib.
Subject(s)
Humans , Middle Aged , Alopecia , Bays , Carcinoma, Hepatocellular , Carcinoma, Renal Cell , Disease Progression , Erythema , Hemorrhage , Incidence , Melanoma , Niacinamide , Phenylurea Compounds , Pruritus , SkinABSTRACT
PURPOSE: Various treatment techniques have been attempted for the radiotherapy of anal cancer because of acute side effects such as perineal skin reactions. This study was performed to investigate an optimal radiotherapy technique in anal cancer. MATERIALS AND METHODS: The study subjects included 35 patients who underwent definitive concurrent chemoradiotherapy for anal cancer in Yonsei Cancer Center between 1990 and 2007. The patients' clinical data, including irradiation technique, were reviewed retrospectively. The primary lesion, regional lymph nodes, and both inguinal lymph nodes were irradiated by 41.4~45 Gy with a conventional schedule, followed by a boost does to the primary lesion or metastatic lymph nodes. The radiotherapy technique was classified into four categories according to the irradiation field and number of portals. In turn, acute skin reactions associated with the treatment interruption period were investigated according to each of the four techniques. RESULTS: 28 patients (80.0%) had grade 2 radiation dermatitis or greater, whereas 10 patients (28.6%) had grade 3 radiation dermatitis or greater during radiotherapy. Radiation dermatitis and the treatment interruption period were relatively lower in patients belonging to the posterior-right-left 3 x-ray field with inguinal electron boost and in patients belonging to electron thunderbird techniques. The interruption periods were 8.2+/-10.2 and 5.7+/-7.7 for the two technique groups, respectively. Twenty-seven patients (77.1%) went into complete remission at 1 month after radiotherapy and the overall 5 year survival rates were 67.7%. CONCLUSION: Field size and beam arrangement can affect patients' compliance in anal cancer radiotherapy, whereas a small x-ray field for the perineum seems to be helpful by decreasing severe radiation dermatitis.
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Chemoradiotherapy , Neoplasm MetastasisABSTRACT
Honeybee sting is an important problem because of their high incidence and ability to produce fatal anaphylactic reactions. They can also produce erythema and edema at the site of a sting in non-allergic individuals and extensive local reactions in allergic patients. Bee venom acupuncture has been widely used in Oriental medicine as pain control, however, its side effects are not well known. Only a few cases of anaphylaxis by bee venom acupuncture have been reported, but there is no case report of its delayed type skin reaction. We report a case of persistent delayed type skin reaction due to bee venom acupuncture.
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Humans , Acupuncture , Anaphylaxis , Bee Venoms , Bees , Bites and Stings , Edema , Erythema , Incidence , Medicine, East Asian Traditional , SkinABSTRACT
Sea urchin granuloma is a chronic granulomatous skin lesion caused by injury with sea urchin. Two types of sea urchin reaction have been noted: immediated and delayed. It has been known to form granuloma in most cases of delayed reaction histopathologically. However, 30% of cases are non-granulomatous inflammation. We describe two cases of delayed skin reaction by sea urchin. One showed a predominant inflammatory reaction with features of non-specific chronic inflammation. We recommend to use other name for delayed reaction of sea urchin rather than 'sea urchin granuloma'.
Subject(s)
Granuloma , Inflammation , Sea Urchins , SkinABSTRACT
PURPOSE: Ginkgo biloba extract (GBE) is known to increase the peripheral blood circulation. This study was designed to evaluate the effect of GBE on the acute normal tissue radiation reaction. MATERIALS AND METHODS: C3H mice were divided into two groups, radiation alone and two doses GBE plus radiation, for both acute skin reaction and jejunal crypt assay. GBE was given i.p. one hour before irradiation with priming dose given one day earlier. Thirty to Fifty Gy for acute skin reaction and 11 to 14 Gy for jejunal crypt were irradiated to right hind leg and whole body, respectively. RESULTS: Radiation doses (RD50) for peak skin score of 2.0 were 44.2Gy (40.6-48.2Gy) for radiation alone and 44.4Gy (41.6-47.4Gy) for two doses GBE plus radiation, showing no effect of GBE on acute radiation skin damage. The numbers of regenerating jejunal crypts per circumference were also almost the same for each radiation dose level (p=0.57-0.94), and the mean lethal doses (Do) were 1.80Gy (1.57-2.09Gy) for radiation alone and 1.88Gy (1.65-2.18Gy) for two doses GBE plus radiation, indicating no effect of GBE on jejunal crypt cell survival after radiation. CONCLUSION: GBE doesn't increase acute normal tissue radiation reaction in this model system. As GBE was verified to enhance radiation effect on tumor, high therapeutic gain is expected when GBE is combined with radiation therapy.
Subject(s)
Animals , Mice , Blood Circulation , Cell Survival , Ginkgo biloba , Leg , Mice, Inbred C3H , Radiation Effects , Radiation Tolerance , SkinABSTRACT
PURPOSE: Ginkgo biloba extract (GBE) is known to increase the peripheral blood circulation. This study was designed to evaluate the effect of GBE on the acute normal tissue radiation reaction. MATERIALS AND METHODS: C3H mice were divided into two groups, radiation alone and two doses GBE plus radiation, for both acute skin reaction and jejunal crypt assay. GBE was given i.p. one hour before irradiation with priming dose given one day earlier. Thirty to Fifty Gy for acute skin reaction and 11 to 14 Gy for jejunal crypt were irradiated to right hind leg and whole body, respectively. RESULTS: Radiation doses (RD50) for peak skin score of 2.0 were 44.2Gy (40.6-48.2Gy) for radiation alone and 44.4Gy (41.6-47.4Gy) for two doses GBE plus radiation, showing no effect of GBE on acute radiation skin damage. The numbers of regenerating jejunal crypts per circumference were also almost the same for each radiation dose level (p=0.57-0.94), and the mean lethal doses (Do) were 1.80Gy (1.57-2.09Gy) for radiation alone and 1.88Gy (1.65-2.18Gy) for two doses GBE plus radiation, indicating no effect of GBE on jejunal crypt cell survival after radiation. CONCLUSION: GBE doesn't increase acute normal tissue radiation reaction in this model system. As GBE was verified to enhance radiation effect on tumor, high therapeutic gain is expected when GBE is combined with radiation therapy.
Subject(s)
Animals , Mice , Blood Circulation , Cell Survival , Ginkgo biloba , Leg , Mice, Inbred C3H , Radiation Effects , Radiation Tolerance , SkinABSTRACT
To evaluate the in vivo effect of autologous serum including antibodies to house dust mite in atopic individuals, we observed the immediate (15 mins) and late (6 hours) skin reactions (ISR, LSR) on intradermal (ID) test of serially diluted Dermatophagoides farinae antigens (DFa, Allergopharma, Germany) mixed with autologous sera (DFa-S) and diluent alone (DFa-D). We tested 34 DFa-skin reactive atopic individuals including 12 asthmatics (BA), 8 asthmatics on immunotherapy with DFa (IT), and 14 healthy atopic controls (AC). We observed complete inhibition of ISR in the lowest allergen dose of DFa-S in 7 (58.3%) of 12 BA, 3 (37.5%) of 8 IT, and 2 (14.3%) of 14 AC. In BA, the inhibition of ISR was more frequent than AC (p or = 1.5 X size; accentuation of LSR). Accentuation of LSR were shown more frequently by DFa mixed with larger amount of serum (25% in 1:1 mix; 80% in 1:3 mix, p< 0.05). But there were no differences of DFa-specific IgE and IgG subclass antibodies regardless of the inhibition of ISR or the accentuation of LSR. In conclusion, some autologous sera from DFa-sensitive individuals showed the inhibition of ISR and the accentuation of LSR on DFa-ID test.
Subject(s)
Humans , Animals , Blood Physiological Phenomena , Dermatitis, Atopic/blood , Hypersensitivity, Delayed/immunology , Hypersensitivity, Immediate/immunology , Immunoglobulin E/metabolism , Immunoglobulin G/metabolism , Intradermal Tests , Mites/immunology , Skin/immunologyABSTRACT
Investigations were carried out into the time-and dose-related changes in acute skin reaction following graded single dose (20, 30 and 40 Gy) of x-ray irradiation in Wistar rats, in order to evaluate the radioprotective effect of Diethon on skin. For the duration of skin response over 1. 5 score in dose of 40 Gy, the Diethone group of 24.7 days was significantly different (p<0.02) from that of control (29.8 days) and vaseline (29.2 days) groups, it was 17.1% diminution of skin response period compared with that of control group. By the averaging daily scores for 10 days during peak skin reaction the mean scores were obtained. Mean score of Diethone group (2.43+/-0.22) was significantly different (p<0.01) from that of control (2.91+/-0.23) and vaseline (2.81+/-0.18) groups of 40 Gy dose. By iso-effect dose obtained at level of 2.5 score the dose reduction factor(DRF) was 1.41 which reduced radiation dose of 41% by radioprotective effect of Diethone. From this experimental data, it may be possible to give higher radiation dose to large and/or radioresistant tumor mass rather than conventional treatment doses for improving therapeutic ratio by using topical application of skin radioprotector.
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Animals , Rats , Petrolatum , Rats, Wistar , SkinABSTRACT
Objective:To observe the changes of cellular immunity after the therapy and investigate the effect of the treatment of recurrent spontaneous abortion by active immunotherapy.Methods:32 cases with RSA were treated by their husbands' lymphocyte and were observed the local skin reaction.The changes of the serum CD 4,CD 8 cell and the ratio of CD 4/CD 8 before and after the active immunotherapy were observed simultaneously.Results:The local skin reactions were gradually alleviated by the active immunotherapy.The skin reaction area of the last therapy were remarkablely different from that of the first therpy time ( P 0.05),but the percentage of CD 8 cell was higher significantly ( P
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A study under laboratory control was conducted for 3 months to investigate the dynamic changes of local skin reaction and histopathology in guinea pigs exposed to the continuous and repeated bites of mosquitoes (Aedes albopictus)at 1, 6, and 24h after biting.Histopathologically, there were massive cumulations of basophils in the upper dermis of the infected skin, which coincided well with the degree of skin reaction. It would seem reasonable to suggest that hypersensitive guinea pigs show both immediate reaction and cutaneous basophil hypersensitivity.The occurrence of basophils in Skin reaction to mosquito biting, or to other blood-sucking dipterous biting has not previously been reported.