Bortezomib (Velcade(R)) is proteasome inhibitor that is used as a first-line therapy for multiple myeloma. It can cause gastrointestinal, hematologic, and neuromuscular side effects, and a cutaneous reaction is one of its common adverse reactions. To date, several bortezomib-induced cutaneous adverse reactions have been reported, including folliculitis-like rash, pruriginous rash, purpuric rash, mouth swelling, stomatitis-mucositis, edema in the lower limbs, telogen effluvium, and vasculitis. In the Korean literature, only one case of vasculitis has been reported earlier. Two patients have presented with multiple plaques on the trunk at our clinic. The lesions developed several days after bortezomib chemotherapy, and disappeared spontaneously in about 1 week. Herein, we report bortezomib-induced drug eruption presenting as multiple plaques on the trunk with a review of the relevant literature.
Drug Eruptions* ; Drug Therapy ; Edema ; Exanthema ; Humans ; Lower Extremity ; Mouth ; Multiple Myeloma ; Proteasome Inhibitors ; Vasculitis ; Bortezomib

Adult ; Exanthema ; diagnosis ; drug therapy ; etiology ; physiopathology ; Humans ; Male ; Pruritus ; physiopathology ; Steroids ; administration & dosage ; Treatment Outcome

This article highlights the role of prucalopride in the management of chronic constipation based upon the principles of meta-analysis using data reported in the published randomized, controlled trials. Sixteen randomized, controlled trials on 3943 patients reported the effectiveness of prucalopride in patients with chronic constipation. Prucalopride successfully increased the frequency of spontaneous bowel movements per week in all variable doses of 1 mg (standardized mean difference [SMD], 0.42 [95% CI, 0.18-0.66; P = 0.006]), 2 mg (SMD, 0.34 [95% CI, 0.11-0.56; P = 0.003]), and 4 mg (SMD, 0.33 [95% CI, 0.22-0.44; P = 0.00001]). The risks of adverse events or side effects such as headache, abdominal cramps, excessive flatulence, dizziness, diarrhea, and rash were higher (odds ratio, 1.70 [95% CI, 1.27 to -2.27; P = 0.0004]) in prucalopride group. Prucalopride is clinically a beneficial pharmacotherapy for chronic constipation and its routine use may be considered in patients with chronic simple laxative-resistant constipation.
Colic ; Constipation* ; Diarrhea ; Dizziness ; Drug Therapy ; Exanthema ; Flatulence ; Headache ; Humans ; Laxatives

Hemorrhagic cystitis is potentially life-threatening sequellae of chemotherapy using oxazaphosphorine alkylating agents (cyclophosphamide and ifosfamide). Mesna contains a sulfhydryl group that is believed to bind acrolein within the urinary collecting system and reduce the hemorrhagic cystitis without affecting the chemotherapeutic potential. To date, about thirty cases of hypersensitivity or allergic reactions of the delayed and urticarial type associated with mesna have been reported. We reported two patients with systemic lupus erythematosus who developed facial rash and flushing associated with mesna which imitate malar rash.
Acrolein ; Alkylating Agents ; Cyclophosphamide ; Cystitis ; Drug Therapy ; Exanthema* ; Flushing ; Humans ; Hypersensitivity* ; Lupus Erythematosus, Systemic ; Mesna*

Adalimumab/therapeutic use* ; Antibodies, Monoclonal, Humanized ; Exanthema ; Humans ; Psoriasis/drug therapy*

Child, Preschool ; Emollients ; therapeutic use ; Exanthema ; diagnosis ; drug therapy ; immunology ; virology ; Female ; Histamine Antagonists ; therapeutic use ; Humans

BACKGROUND: In the management of patients whose primary chemotherapy has failed, careful assessment is essential. It is important to find out as accurate a chemotherapy history as possible. Preferably it should contain the drugs which has never used before. The purpose of present study is establishment of retreatment regimen for pulmonary tuberculosis. The present report concerns the results of retreatment of pulmonary tuberculosis patients treated at National Masan Tubersulosis Hospital. METHOD: Retrospective cohort study was made 104 drug-resistant pulmonary tuberculosis patients who were treated by five regimens between Jan. 1994 and Now. 1996. All the patients taken medicine for second anti-tuberculosis regimens for the first time. We separated the patients by three groups(Group l : OFX+PTA+CS+PAS+Aminoglycoside, Group ll : PZA+PTA+CS+PAS+Aminoglycoside, Group lll : PZA+OFX+PTA+PAS+Aminoglycoside). RESULTS: The age distribution was most frequent in fourth decade(36patients, 34.6%) and the mean age was 42.6 year. The sex distribution was most frequent in the males(81patients, 85.7%). There was 31 patients(29.8%) with combined diseaes, 18 patients with complication and 24 patients(27.9%) with family history. Primary chemotherapy regaimens were HERAZ(S or K) in 48 patients (46.2%), HER(S or K) in 41 patients (39.4%) and others in 15 patients(14.4%). Result of drug sensivivity test showed that the resistance to INH and RFP is in 68 patients(65.4%), RFP is in 12 patients(11.5%), INH s in 3 patients(2.9%) and all sensitive to INH and RFP is 3 patients(2.9%). The clinical symptoms on admission were coughing(89.4%), sputum(69.2%), dyspenea on exertion(37.5%), weight loss(33.7%) blood tinged sputum (15.4%) and otheres. The extent of disease on the radiograph was far-advanced in 73 patients (70.2%), moderate in 28 patients(26.9%) and minimal in 3 patients(2.8%). The side effects for drugs were gastrointestinal troubles in 31 patients(29.8%), arthralgai in 22 patients(21.2%), skin rash in 12 patients(11.5%) and others. The negative conversion rate on sputum AFB smear was 85.6%(87.5% in Group l, 80% in Group ll and 90.5% in Group lll). The average negative conversion time on sputum was 4 month(4.0 month in Group l, 4.6 month in Group ll and 3.0 month in Group III). CONCLUSION: In the retreatment of pulmonary tuberculosis, ofloxacin is useful drug for the patients who are not available to use PZA and combination of PZA and OFX can be use effectively substively substituting for CS.
Age Distribution ; Cohort Studies ; Drug Therapy ; Exanthema ; Humans ; Ofloxacin ; Retreatment* ; Retrospective Studies ; Sex Distribution ; Sputum ; Tolnaftate ; Tuberculosis, Pulmonary*

Intravascular lymphomatosis is a rare lymphoma characterized by neoplastic proliferation of malignant cells within the lumen of small blood vessels, usually presenting in the central nervous system or on the skin. Intravascular lymphomatosis is manifested clinically by fever, dementia, cutaneous nodules or plaques, and occasionally, dyspnea. The diagnosis of intravascular lymphomatosis is difficult because of misleading clinical features mimiking vasculitis, infection, stroke, or other neoplasm. We report two cases of intravascular lymphomatosis pesented as fever and skin rash. Those are confirmed by involved tissue biopsy. All cases were treated by combination chemotherapy, but the response was not good. Infectious problems were complicated and disease were progressed.
Biopsy ; Blood Vessels ; Central Nervous System ; Dementia ; Diagnosis ; Drug Therapy, Combination ; Dyspnea ; Exanthema ; Fever ; Lymphoma ; Skin ; Stroke ; Vasculitis

BACKGROUND: Epidermal growth factor receptor (EGFR) and cellular-mesenchymal to epithelial transition factor (c-Met) are widely expressed on cancer cells. There is a synergistic effect of EGFR and HGF/c-Met pathways on proliferation, downstream activation of signal transduction and an additive effect. Studies show that combination of both signaling pathways could potentially be targeted in a synergistic fashion. Amivantamab, a bispecific monoclonal antibody targeting EGFR and c-Met, yielded robust and durable responses in a variety of clinicals trials. However, few researches have reported its efficacy in Chinese non-small cell lung cancer (NSCLC) patients. This study was conducted to evaluate the effectiveness and tolerance of Amivantamab in NSCLC patients with EGFR/MET gene abnormalities at Peking University Cancer Hospital. METHODS: The study enrolled NSCLC patients who received Amivantamab in our hospital between August 2020 and December 2021, and analyzed the response, survival, and treatment-related adverse events. RESULTS: Fifteen patients were enrolled in this research, and six of them received Amivantamab treatment and the other nine patients received Amivantamab plus Lazertinib treatment. The rates of partial response (PR), stable disease (SD), and progressive disease (PD) were 46.7% (7/15), 46.7% (7/15) and 6.7% (1/15), respectively. The overall response rate (ORR) and disease control rate (DCR) were 28.6% (2/7) and 100.0% (7/7) in seven patients with EGFR exon 20 insertion, respectively. The ORR and DCR were 40.0% (2/5) and 100.0% (5/5) in five post-osimertinib EGFR-mutant patients, respectively. After a median follow-up of 8.7 months, the median progression-free survival and overall survival were not reached. The most common treatment-related adverse events were rash (86.7%), paronychia (80.0%), and infusion-related reactions (60.0%), and most of them were graded as 1 to 2. Grade 3 to 4 adverse events included rash (33.3%), alanine aminotransferase elevation (13.3%), gamma-glutamyl transpeptidase elevation (13.3%), peripheral edema (6.7%), thromboembolism (6.7%), interstitial lung disease (6.7%), and thrombocytopenia (6.7%). CONCLUSIONS Amivantamab was effective in Chinese NSCLC patients with EGFR exon 20 insertion and post-Osimertinib EGFR-mutant patients, similar to the results of clinical trials conducted in western countries. Amivantamab was well tolerated and emphases should be put on adverse events such as rash, paronychia, and infusion-related reactions.
Antibodies, Bispecific ; Carcinoma, Non-Small-Cell Lung/genetics* ; ErbB Receptors/genetics* ; Exanthema/drug therapy* ; Humans ; Lung Neoplasms/genetics* ; Mutation ; Paronychia/drug therapy* ; Protein Kinase Inhibitors/therapeutic use*

OBJECTIVETo describe the etiology, clinical features and treatment of childhood acute generalized exanthematous pustulosis (AGEP).

METHODSClinical data from 20 cases of childhood acute generalized exanthematous pustulosis from 1990 to 2008 were retrospectively reviewed.

RESULTSEighteen cases had a history of medication, including the use of penicillin (n=6), cephalosporins (n=3), sulphonamides (n=2), algopyrin (n=2), vaccines (n=2 ) and anti-cold drugs (n=3). Fever and generalized erythematous pustules were observed in all 20 cases. Histopathologic examination revealed spongiform superficial pustules and papillary edema. The patients were asked to stop taking suspected sensitizing drugs and received glucocorticoid treatment (1-2 mg/kg daily). After 3-5 days of the treatment, symptoms were improved and the dosage of glucocorticoid was gradually reduced. All patients were healed within 20 days after treatment.

CONCLUSIONSThe cause of AGEP is mainly attributed to the use of antibiotics, sulphonamides, antipyretic analgesics and vaccines in children. AGEP is characterized by fever and widespread pustular eruption of the skin. Removal of sensitizing factors and glucocorticoid administration is important in the treatment of AGEP in children.

Child ; Child, Preschool ; Drug Eruptions ; diagnosis ; etiology ; therapy ; Exanthema ; diagnosis ; etiology ; therapy ; Female ; Humans ; Male ; Prognosis ; Retrospective Studies ; Skin Diseases, Vesiculobullous ; diagnosis ; etiology ; therapy