Toxic epidermal necrolyis after vancomycin use: a case report and discussion of management.

Vancomycin is a commonly used antibiotic for severe Gram-positive bacterial infections, especially for methicillin-resistant Staphylococcus Aureus and coagulase-negative staphylococci infections. Nevertheless, only few cases of toxic epidermal necrolysis have been reported since the introduction of Vancomycin into clinical practice. We report a case of a 35-year-old man who presented with multiple facial abscesses and methicillin-resistant Staphylococcus Aureus bactermia and who was started on Vancomycin and later developed toxic epidermal necrolysis.

Eccrine porocarcinoma of the lower extremity: a case report and review of literature.

Eccrine porocarcinoma is a rare malignancy of the eccrine sweat gland. It is usually found frequently on the lower extremities, and it affects both sexes equally usually in the sixth to seventh decade. In our case, we present a 42-year-old male patient with a recurring exophytic tumor on the right lower extremity without local extension. The initial tumor was biopsied, excised and diagnosed as an eccrine poroma. The tumor then recurred 6 years later, was re-excised, reconstructed with a soleus muscle flap and diagnosed as an eccrine porocarcinoma.

A counting strategy for estimating plasma cell number in CD138-stained bone marrow core biopsy sections.

Plasma cells are readily identified microscopically after immunostaining for the CD138 antigen, and CD138-stained bone marrow core biopsy sections have proved superior to Giemsa-stained aspirate smears and hematoxylineosin (H&E) sections for determining plasma cell percentages in marrow. The CD138-stained plasma cell percentage is generally obtained by visual estimation, after viewing the entire section. We propose an alternative method, in which the microscopist initially views the immunostained section under low- and medium-power magnification, then selects a single high-power field in which the relative concentration of plasma cells appears most representative of the section as a whole, and performs a manual differential count of plasma cells in that field. On 44 CD138-stained core biopsy specimens from patients with plasma cell myeloma, selected area counting provided plasma cell percentage values that were more closely correlated with total section plasma cell area, determined by computerized image cytometry, than were visual estimates. This simple method requires only slightly more time than visual appraisal, does not require extensive training or experience, and appears to provide a more accurate estimate of the plasma cell population within the entire specimen.