PURPOSE: Treatment targeting immune checkpoint with programmed death-1 (PD-1)/programmed death-ligand 1 (PD-L1) inhibitors has demonstrated efficacy and tolerability in the treatment of metastatic urothelial carcinoma (mUC). We investigated the efficacy and safety of atezolizumab in mUC patients who failed platinum-based chemotherapy. MATERIALS AND METHODS: A retrospective study using the Samsung Medical Center cancer chemotherapy registry was performed on 50 consecutive patients with mUC treated with atezolizumab, regardless of their PD-L1(SP142) status, as salvage therapy after chemotherapy failure between May 2017 and June 2018. Endpoints included overall response rate (RR), progression-free survival (PFS), and safety. RESULTS: Among 50 patients, men constituted 76% and the median age was 68 years (range, 46 to 82 years). Twenty-three patients (46%) received atezolizumab as second-line therapy. PD-L1 (SP142) status IC0/1 and IC2/3 were found in 21 (42%) and 21 (42%) of patients, respectively; in eight patients (16%), PD-L1 (SP142) expression was not available. Atezolizumab was generally well tolerated, with pruritus and fatigue being the most commonly observed toxicities. As a result, partial response was noted in 20 patients (40%), with 12 (24%) stable diseases. RRwas higherin IC2/3 (62%) than in IC0/1 patients (24%, p=0.013). The median PFS was 7.4 months (95% confidence interval, 3.4 to 11.4 months). As expected, PFS also was significantly longer in IC2/3 patients than in IC0/1 (median, 12.7 vs. 2.1 months; p=0.005). PFS was not significantly influenced by age, sex, performance status, number of previous chemotherapy, site of metastases, or any of the baseline laboratory parameters. CONCLUSION: In this retrospective study, atezolizumab demonstrated clinically efficacy and tolerability in unselected mUC patients who failed platinum-based chemotherapy.
Disease-Free Survival ; Drug Therapy ; Fatigue ; Humans ; Male ; Neoplasm Metastasis ; Pruritus ; Retrospective Studies ; Salvage Therapy

PURPOSE: We report six cases of histologically diagnosed conjunctival MALT (mucosa-associated lymphoid tissue)oma. Presenting symptoms were eyelid swelling, foreign body sensation, lid mass, injection and itching sensation. PATIENTS AND METHODS: Six patients with conjunctival MALToma were followed. Clinical progress and biopsy result were reviewed periodically. RESULTS: The conjunctival MALToma seemed to be localized and slowly progressive. Although the conjunctival MALToma is known to be well responsive to radiotherapy, two of three patients who received radiotherapy revealed to have remnant lymphoma cells histologically in conjunctival biopsy. In addition, chemotherapy did not have curative effect in any of the patients. CONCLUSIONS: Therefore, we are doubtful for the necessity of active treatment in MALTomas of the conjunctiva.
Biopsy ; Conjunctiva ; Drug Therapy ; Eyelids ; Foreign Bodies ; Humans ; Lymphoma ; Pruritus ; Radiotherapy ; Sensation

Neutrophilic eccrine hidradenitis(NEH) was originally described in 1982 by Harrist et al. in a patient with myelogenous leukemia receiving chemotherapy. Clinically NEH represents various cutaneous manifestations with or without tenderness and pruritus. Histologic examination demonstrates a neutrophilic infiltrate within and around the eccrine gland and degeneration of the eccrine gland structures. Although the pathogenesis and possible cause of NEH remain unknown, it is probably an unusual cutaneous reaction to chemotherapeutic agents. A few cases of infection associated eccrine hidradenitis are found in the literature. We report three cases of neutrophilic eccrine hidradenitis. Two cases were associated with hematologic malignancy. The third case was associated with an infection of Vibrio vulnificus.
Drug Therapy ; Eccrine Glands ; Hematologic Neoplasms ; Hidradenitis* ; Humans ; Leukemia, Myeloid ; Neutrophils* ; Pruritus ; Vibrio vulnificus

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

Atopic dermatitis(AD),a chronic and relapsing skin disease,is characterized by dry skin and pruritus,severely affecting the quality of patients' life.Accurately grasping the diagnostic criteria and severity assessment is essential and helps to avoid misdiagnosis and missed diagnosis.Moreover,it facilities the development and adjustment of the therapeutic schedule according to the therapeutic reaction and disease control conditions.This article reviews the research advances in the diagnostic criteria and severity assessment of AD.
Humans ; Dermatitis, Atopic/drug therapy* ; Pruritus ; Skin Diseases ; Severity of Illness Index

Skin itching is a subjective sensation that causes the desire to scratch. It is one of the most common clinical symptoms at department of dermatology, even the only complaint of dermatological patients, which seriously affects the quality life of patients. Therefore, based on the software of traditional Chinese medicine inheritance auxiliary platform, association rules and complex system entropy clustering were adopted to collect and analyze Zhang Bing's prescriptions for skin itching, and get the drug use frequency and the relationship between drugs. Based on that, we could conclude the experience for skin itching. A total of 147 prescriptions were collected, 20 drugs with a frequency of 34 or more and 20 high-frequency drug combinations were analyzed, and 14 core combinations and 7 new prescriptions were excavated. The high-frequency drugs included Kochiae Fructus, Dictamni Cortex, Mori Cortex. The high-frequency drug combinations included "Kochiae Fructus-Dictamni Cortex" "Angelicae Dahuricae Radix-Chuanxiong Rhizoma" "Paeoniae Radix Rubra-Paeoniae Radix Alba", and the core combinations included "Schizonepetae Herba-Saposhnikoviae Radix-Cinnamomi Ramulus" "Arctii Fructus-Cicadae Periostracum-Houttuyniae Herba" "Ghrysanthemi Indici Flos-Kochiae Fructus-Dictamni Cortex", and new formulations include "Schizonepetae Herba, Saposhnikoviae Radix, Cinnamomi Ramulus, Clematidis Radix et Rhizoma, Tribuli Fructus, Dictamni Cortex", "Phellodendri Chinensis Coritex, Lonicerae Japonicae Flos, Atractylodis Rhizoma, Ghrysanthemi Indici Flos, Kochiae Fructus, Dictamni Cortex" "Arctii Fructus, Cicadae Periostracum, Houttuyniae Herba, Trichosanthis Fructus". The result of this research shows that Professor Zhang Bing's experience in the treatment of skin itching is mainly to dispelling wind and arresting itching, clearing heat and drying dampness.
Data Mining ; Drug Combinations ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; Pruritus ; drug therapy ; Software

OBJECTIVETo systematically evaluate the efficacy and safety of preoperative administration of cyclooxygenase-2 (COX-2) inhibitor on pain occurring with total knee arthroplasty (TKA).

METHODSWe electronically searched PubMed, Cochrane Library, EMBASE, CNKI, CBM, Wanfang data from inception to March 15, 2014 and manual searched journal of library collection to identify randomized controlled trials (RCTs) about preoperative administration of COX-2 inhibitor on pain occurring with TKA. The methodological quality of the included RCTs was assessed and the data were extracted according to the Cochrane Handbook 5.1.0. Meta-analysis was performed by using RevMan 5.2 software.

RESULTSA total of 6 RCTs involving 228 patients were included. The results of meta-analyses showed that: (1) Efficacy: The visual analog scale (VAS) of post-operation at 12-hour (WMD = -0.60, 95% CI -0.83 to -0.37, P < 0.000 01) and 24-hour (WMD = -0.74, 95% CI -1.29 to - 0.19, P = 0.008) was decreased when COX-2 inhibitor was used before operation. And compared with control group, experimental group decreased the modified numerical pain rating scale (MNPRS) at 24-hour (WMD = -0.50, 95% CI -0.70 to -0.30, P < 0.000 01), 48-hour (WMD = -0.55,95% CI -0.65 to -0.45,P < 0.000 01) under quiescent conditions, and the same result at 24-hour (WMD = -0.82, 95% CI -1.26 to -0.38, P <0.000 01), 48-hour (WMD = -0.71, 95% CI -0.82 to -0.60, P < 0.000 01) under active conditions. The morphine consumption postoperatively were fewer in experimental group at the first day (WMD = - 1.35, 95% CI -1.92 to -0.79, P < 0.000 01) and the second day (WMD = -1.60, 95% CI -2.68 to -0.52, P = 0.004). (2) Safety: COX-2 inhibitor could lessen the incidence of postoperative pruritus (RR = 0.35, 95% CI 0.15 to 0.84, P = 0.02), but not statistically decrease of nausea and vomiting (RR = 0.83, 95% CI 0.54 to 1.28, P = 0.40) and exhaustion (RR = 0.63, 95% CI 0.05 to 7.67, P = 0.72).

CONCLUSIONThe current evidence indicated that preoperative administration of COX-2inhibitor can effectively improve the effect of postoperative analgesia, reduce the consumption of morphine and lessen the incidence of pruritus. Due to the limited quantity of the included studies and the evidence with limited strength,further high-quality RCTs are needed to verify the aforementioned conclusion.

Arthroplasty, Replacement, Knee ; Cyclooxygenase 2 Inhibitors ; therapeutic use ; Humans ; Pain, Postoperative ; drug therapy ; Postoperative Complications ; prevention & control ; Pruritus ; prevention & control

Radiation recall dermatitis is a rare skin reaction, occurring subsequent to drug administration, and has all the clinical signs of inflammation, which develop in a previously irradiated area, days to years after exposure to ionizing radiation. A 41-year-old woman was diagnosed with Kaposi sarcoma. The patient was treated by radiotherapy, followed by a 1st chemotherapy session with doxorubicin and ifosfamide, 20 days after the radiotherapy. However, the patient developed erythema of the skin, accompanied by pruritus and pain in the previously irradiated area, 3 to 4 days after the chemotherapy. The erythema resolved almost completely after systemic and topical steroid therapy. The patient received a 2nd chemotherapy session with the same regimen, but there was no recurrence of radiation recall dermatitis. We report a case of an uncommon skin reaction after chemotherapy in a patient with kaposi sarcoma, which was identified as radiation recall dermatitis.
Adult ; Doxorubicin ; Drug Therapy ; Erythema ; Female ; Humans ; Ifosfamide ; Inflammation ; Pruritus ; Radiation, Ionizing ; Radiodermatitis* ; Radiotherapy ; Recurrence ; Sarcoma, Kaposi* ; Skin

Radiation recall dermatitis is a rare skin reaction, occurring subsequent to drug administration, and has all the clinical signs of inflammation, which develop in a previously irradiated area, days to years after exposure to ionizing radiation. A 41-year-old woman was diagnosed with Kaposi sarcoma. The patient was treated by radiotherapy, followed by a 1st chemotherapy session with doxorubicin and ifosfamide, 20 days after the radiotherapy. However, the patient developed erythema of the skin, accompanied by pruritus and pain in the previously irradiated area, 3 to 4 days after the chemotherapy. The erythema resolved almost completely after systemic and topical steroid therapy. The patient received a 2nd chemotherapy session with the same regimen, but there was no recurrence of radiation recall dermatitis. We report a case of an uncommon skin reaction after chemotherapy in a patient with kaposi sarcoma, which was identified as radiation recall dermatitis.
Adult ; Doxorubicin ; Drug Therapy ; Erythema ; Female ; Humans ; Ifosfamide ; Inflammation ; Pruritus ; Radiation, Ionizing ; Radiodermatitis* ; Radiotherapy ; Recurrence ; Sarcoma, Kaposi* ; Skin

The purpose of this study was to identify side effects of the vesicant chemotherapy. The study was designed to be a descriptive survey. The subjects of this study were 88 patients with various types of cancer, primary lung cancer(25.0%), advanced gastric cancer(25.0%), breast cancer(20.5%), etc. The mean age was 44.8 years old(range: 16-68). The questionnaire was completed by nurses of the outpatient unit and chemotherapy ward, and intravenous nurse specialist. The results of the study were as follows: 1) Chemotherapy was administered with a 23G scalp needle and 24G insyte. Injection site was dorsum of hands (64.7%), cephalic vein(19.3%). Successful rate for the first attempt was 88.6%. The first & second cycle chemotherapy was 29.5% each.. Mainly used drugs were Navelbine(34.1%), Adriamycin(20.5%). 2) Venous problems after chemotherapy were pain(13.6%) incurred by venous, mainly due to the administration of Navelbine; redness at the inravenous site(12.5%) and itching sense 2.3%. Non-venous problems were nausea (18.2%), dullness(14.8%), vomiting(8.0%), facial flushing(6.8%), anxiety(5.7%). Subjective discomforts after chemotherapy were generalized arm pain at the injection side(14.8%), dizziness(6.8%), weakness(5.7%) and general bodyache (5.7%). Systemic anaphylactic reaction and extravasation did not occur. 3) Non-venous problem after chemotherapy were nausea, vomiting & anorexia. Frequency of chemotherapy related to side effects were itching, facial flushing, and nausea(p<0.05). Day of chemothe-rapy related to side effects were nausea & vomiting(p<0.05). Site of chemothe- rapy related to side effects were redness(p<0.05). Frequency of venipuncture related to side effects were redness(p<0.05). Conclusively, cancer chemotherapy patients have had some venous problem. They need appropriate venous access devices for chemotherapy. And other non-venous problem will be managed appropriately. Further research was required to identify the rate of venous complication or side effects of vesicant chemotherapy.
Anaphylaxis ; Anorexia ; Arm ; Breast ; Drug Therapy* ; Flushing ; Hand ; Humans ; Lung ; Nausea ; Needles ; Outpatients ; Phlebotomy ; Pruritus ; Surveys and Questionnaires ; Scalp ; Specialization ; Vomiting