Multi-target anticancer drugs have a more comprehensive and extensive range of action,and there is an uncertain risk in the combination of two drugs.A case of acute toxicity induced by erlotinib combined with cabozantinib is reported in this article.
Anilides ; adverse effects ; Drug Eruptions ; etiology ; Drug Therapy, Combination ; adverse effects ; Erlotinib Hydrochloride ; adverse effects ; Humans ; Myocardial Infarction ; chemically induced ; Pyridines ; adverse effects

No abstract available.
Aged, 80 and over ; Anti-Bacterial Agents/*adverse effects ; Ciprofloxacin/*adverse effects ; Drug Eruptions/diagnosis/*etiology ; Female ; Humans ; Skin/*drug effects/pathology

Aged ; Drug Eruptions ; etiology ; Female ; Humans ; Lupus Erythematosus, Cutaneous ; chemically induced ; Nifedipine ; adverse effects ; Vasodilator Agents ; adverse effects

Trimethoprim-sulfamethoxazole (TMP-SMZ) is a commonly used antibiotic that has been associated with drug rash with eosinophilia and systemic symptoms (DRESS) syndrome. DRESS syndrome is characterised by fever, rash, lymphadenopathy, eosinophilia and one or more major organ involvement. Although rare, TMP-SMZ is a recognised cause of fulminant hepatic failure. We report a 17-year-old Chinese male adolescent who presented with fever, myalgia, generalised maculopapular rash and lymphadenopathy after taking TMP-SMZ for acne vulgaris. He subsequently developed hepatic encephalopathy and was worked up for urgent liver transplantation. He responded well to extracorporeal liver dialysis (originally intended as a bridging therapy) and subsequently recovered without the need for liver transplantation. This case report highlights the importance of early recognition of TMP-SMZ-induced DRESS syndrome and the need for early discontinuation of the drug in the affected patient. Extracorporeal liver dialysis and transplantation should be considered in the management of TMP-SMZ-induced fulminant hepatic failure.
Acne Vulgaris ; complications ; drug therapy ; Adolescent ; Anti-Infective Agents ; adverse effects ; Biopsy ; Drug Eruptions ; etiology ; Drug Hypersensitivity Syndrome ; diagnosis ; etiology ; Fever ; etiology ; Humans ; Liver Failure, Acute ; etiology ; therapy ; Lymphatic Diseases ; etiology ; Male ; Myalgia ; etiology ; Renal Dialysis ; methods ; Skin ; pathology ; Treatment Outcome ; Trimethoprim, Sulfamethoxazole Drug Combination ; adverse effects

Anticonvulsants ; adverse effects ; Asian Continental Ancestry Group ; genetics ; Carbamazepine ; adverse effects ; China ; epidemiology ; Drug Eruptions ; epidemiology ; ethnology ; genetics ; Genetic Predisposition to Disease ; genetics ; HLA-B Antigens ; genetics ; HLA-B15 Antigen ; genetics ; Humans ; Risk Factors ; Severity of Illness Index ; Skin ; pathology ; Stevens-Johnson Syndrome ; epidemiology ; etiology ; genetics

Drug Combinations ; Drug Eruptions ; diagnosis ; etiology ; Humans ; Hypolipidemic Agents ; adverse effects ; Indoles ; adverse effects ; Male ; Middle Aged ; Niacin ; adverse effects ; Skin Diseases, Vesiculobullous ; chemically induced ; diagnosis

Adult ; Carbamazepine ; adverse effects ; therapeutic use ; Drug Eruptions ; etiology ; Female ; Humans ; Tinnitus ; drug therapy

Albendazole ; adverse effects ; Child, Preschool ; Drug Eruptions ; etiology ; Humans ; Tablets

OBJECTIVETo study the effects of trichloroethylene (TCE) to lymphocyte subsets among exposed workers, and explore the early immunological effect biomarkers for prevention of hypersensitivity dermatitis induced by TCE.

METHODSTwenty-eight patients with TCE-induced hypersensitivity dermatitis, 56 healthy TCE-exposed workers from the same workshops with patients, and 28 comparable unexposed controls were recruited in this study. The total lymphocyte count and the major lymphocyte subsets including T cell, CD4(+) T cell, CD8(+) T cell, B cell, NK cell in peripheral blood were measured by Flow Cytometer analysis and Standard blood count analysis.

RESULTSThe total lymphocyte count and T cell, CD4(+) T cell, CD8(+) T cell among patients (median at 2810.00, 1846.17, 831.87, 904.05 cell counts/µl blood) were significantly increased compared with TCE-exposed workers (median at 2101.00, 1218.59, 643.87, 482.81 cell counts/µl blood, Z = -3.19, -4.96, -3.22, -4.99, P < 0.001) and unexposed controls (median at 1900.00, 1223.60, 558.60, 325.80 cell counts/µl blood, Z = -3.30, -4.46, -3.45, -5.03, P < 0.001), the NK cell and CD3(+)CD4(+)/CD3(+)CD8(+) ratio among patients (median at 255.50 cell counts/µl blood and 1.11) were significantly decreased compared with the unexposed controls (median at 642.60 cell counts/µl blood and 1.96, Z = -3.56 and -3.11, P < 0.01). Meanwhile, for the exposed workers, the CD8(+) T cell (median at 482.81 cell counts/µl blood) was significantly increased and the NK cell and CD3(+)CD4(+)/CD3(+)CD8(+) ratio (median at 318.76 cell counts/µl blood and 1.27) were significantly decreased compared with unexposed controls (median at 325.80 and 642.60 cell counts/µl blood and 1.96, Z = -2.63, -3.52, -2.29, P < 0.05).

CONCLUSIONOccupational exposure to TCE could affect the lymphocyte subsets, especially T cell and NK cell. The total lymphocyte count, T cell and CD4(+) T cell might be effect biomarkers for subjects with hypersensitivity dermatitis among TCE-exposed workers.

Adolescent ; Adult ; Dermatitis, Occupational ; blood ; immunology ; Drug Eruptions ; blood ; etiology ; immunology ; Female ; Humans ; Lymphocyte Count ; Lymphocyte Subsets ; Male ; Middle Aged ; Trichloroethylene ; adverse effects ; Young Adult

PURPOSETo review the current progress in epidemiology, etiology, clinical manifestation, and pathophysiology of severe cutaneous adverse drug reactions (SCADRs).

DATA SOURCESData were acquired by using Blackwell-Synergy, PubMed, original articles published in the main Chinese journals and related medical textbooks materials. Study selection and data extraction Throughout the literature review 49 articles were selected.

RESULTSSCADRs cases are rare, however, the implication is life threatening with significant mortality rates. Epidemiology studies have shown various incidences from different regions, gender, age, race and concurrent illness. There are typical signs and symptoms for each type of SCADRs, but this is not always so. Drugs associated with inducing SCADRs are anticonvulsants, antibiotics, NSAIDs and antirheumatic drugs. In some countries, especially in Asia, traditional drugs are often the cause of SCADRs. Genetic polymorphisms and viral infections are predisposition factors of SCADRs. Patients with certain genetic alleles and underlying diseases are vulnerable to SCADRs. The exact pathogenesis of SCADRs is not well defined. Nonetheless, recent study showed that reactive metabolites and immunological processes have a significant role in SCADRs.

CONCLUSIONSThe different SCADRs reactions are attributed by different intrinsic factors, such as genetic polymorphisms, gender, age and race as well as extrinsic factors, such as underlying diseases. Different regions and culprit drugs also play a role in the various types of SCADRs.

Adult ; Drug Eruptions ; complications ; epidemiology ; etiology ; Female ; Humans ; Male ; Middle Aged