ABSTRACT
Crospovidone, a polymer of poly N-vinyl-2-pyrrolidone, is an inert insoluble disintegrant found in pharmaceutical tablets. This material has been encountered in the lungs of intravenous drug users and embolized with other components such as talc and microcrystalline cellulose. More recently, crospovidone has also been described in the gastrointestinal tract. We present 2 cases of cutaneous crospovidone deposition resulting from subcutaneous injection of crushed tablets, commonly known as "skin popping." Clinical presentation includes painful, inflamed papules, nodules, or ulcers with overlying eschar. Crospovidone has a distinct and reproducible histochemical staining profile. Histologic recognition of this material is important because it can guide clinicians in their diagnosis and management decisions.
Subject(s)
Analgesics, Opioid/adverse effects , Foreign Bodies/etiology , Opioid-Related Disorders/complications , Pharmaceutic Aids/adverse effects , Povidone/adverse effects , Skin/chemistry , Substance Abuse, Intravenous/complications , Adult , Analgesics, Opioid/analysis , Drug Compounding , Female , Foreign Bodies/pathology , Humans , Injections, Subcutaneous , Pharmaceutic Aids/analysis , Povidone/analysis , Skin/pathology , TabletsABSTRACT
Erythema multiforme (EM) is an immune-mediated hypersensitivity reaction often related to viral infection or medications. Infection-induced EM is typically self-limited and commonly caused by herpes simplex virus (HSV) or Mycoplasma pneumoniae (MP); recurrent EM is almost always associated with HSV. We present a concise overview of diagnostic techniques for HSV and MP, as repeatedly elevated MP titers in our case led to a delayed diagnosis of HSV-induced EM.
Subject(s)
Erythema Multiforme/diagnosis , Herpes Simplex/complications , Pneumonia, Mycoplasma/complications , Adolescent , Delayed Diagnosis , Erythema Multiforme/microbiology , Erythema Multiforme/virology , Herpes Simplex/diagnosis , Humans , Male , Mycoplasma pneumoniae/isolation & purification , Pneumonia, Mycoplasma/diagnosis , Recurrence , Simplexvirus/isolation & purificationABSTRACT
BACKGROUND: The impact of skin disease on heath-related quality of life (QoL) is often underrecognized, and there is little research about health-related QoL in patch-tested populations. OBJECTIVE: A pilot study to assess baseline QoL in dermatitis patients referred to a specialized center for patch testing. METHODS: A convenience sample of patients presenting for patch testing (n = 107) completed a survey, Skindex-16+5, which measures QoL in four domains: symptoms, emotions, functioning, and occupational. RESULTS: Responses were indexed from 0 (never bothered) to 100 (always bothered). Emotions (mean, 67; SD +/- 27) and symptoms (mean, 60; SD +/- 27) demonstrated the lowest QoL. Patients with hand involvement had a worse QoL in all areas, including the occupational domain, compared to patients without hand involvement. Limitations of the study included the referral clinic population and convenience sample. Survey questions added to Skindex-16 regarding the occupational domain have not been validated. CONCLUSIONS: Patients referred for patch testing endorse a highly negative impact of the disease on their emotional QoL and are also greatly bothered by symptoms. Patch-tested patients with hand dermatitis had a significantly lower QoL across all areas as compared to tested patients without hand involvement. Facial involvement, duration of skin problem, atopic history, occupation relationship, or positive patch-test results were not correlated with QoL.
