Therapeutic guidelines for the treatment of generalized pustular psoriasis (GPP) based on a proposed classification of disease severity.

Generalized pustular psoriasis (GPP) is a rare but notoriously recalcitrant cutaneous diseases. Therefore, there have been few reports of more than ten patients with GPP who were treated at the same institution. The severity of this disease and its response to each therapeutic modality vary among patients. In some GPP is life-threatening, but in others it may show a benign, chronic course for a long period of time. Before starting treatment, a knowledge of the therapeutic efficacy and side effects of each drug used in the treatment of GPP is necessary. In our multicenter study, we compared the effectiveness of and adverse reactions to several systemically administered drugs. Following the development of a unique classification of the disease severity based on scoring the clinical symptoms and the laboratory findings, we propose here therapeutic guidelines for the treatment of GPP.

[Antibacterial activity of various antibacterial agents against methicillin-resistant Staphylococcus aureus, and difference in antibacterial activity between aminoglycosides by coagulase type. Comparison of isolates obtained in the period from 1982 to 1986 and isolates in recent 6 months].

The sensitivity of methicillin-resistant Staphylococcus aureus (MRSA) isolated in our hospital during the period from November 1988 through April 1989 to various antibacterial agents was examined. Isolates were obtained from blood (4 isolates), sputum (40), bile (1), ascites (1) and urine (4). All isolated MRSA were resistant to cefazolin, cefmetazole, cefuzonam, flomoxef, and tobramycin. More than 80% of the isolates were resistant to fosfomycin and amikacin. 60% were resistant to ofloxacin (OFLX). 46% were sensitive to minocycline. 50% or more of the isolates were sensitive to gentamicin (GM), dibekacin (DKB) and astromicin (ASTM). 88% were sensitive to netilmicin. All the isolates were sensitive to vancomycin and arbekacin. The incidence of OFLX-resistant isolates was increased compared with the results of the previous study. Most of the isolates were coagulase type II. GM, ASTM and DKB were less active against type IV isolates, but they had sufficient antibacterial activity against the type II isolates.