Romina Andino-Navarrete

Eosinophilic annular erythema: complete clinical response with dapsone

dominant pattern have also been reported, and such cases are difficult to differentiate from HBT. The bilateral clinical presentation, presence of telangiectasias, absence of previous trauma, and appearance of the lesions in both twins makes HBT a more likely diagnosis in our two patients. We have found only two reports in the literature of HBT in patients with no family history and none in monochorionic twins.

Skin rash, dyspnea and bone pain: secondary syphilis

A 50-year-old healthy male was seen for a 6-week history of right leg pain, occasional dyspnea and extensive non-pruritic skin rash in trunk and extremities (Fig. 1A). Physical examination revealed tachypnea with normal breath sounds and a non-confluent maculo-papular rash in the trunk and extremities. No adenopathies, mucosal or palmo-plantar lesions were evident. A contrast-enhanced CT scan showed presence of multiple axillary, hilar, and mediastinal lymphadenopathy (Fig. 1B), and bilateral and diffusely distributed pulmonary nodules with ground-glass density (Fig. 1C). Bone scintigraphy showed increased uptake of isotope on the right tibia (Fig. 1D). The Rapid Plasma Reagin test (RPR) was positive in 128 dilutions, with a positive Treponema pallidum microhemagglutination assay. Human immunodeficiency virus and serology of other

Progression of drug exanthemas to serious drug eruptions: A retrospective review identifying early determinants.

Maculo‐papular drug exanthema (MPE) is the most common type of cutaneous adverse drug reaction (CAR). Exanthematous macules and papules may also be the initial presentation of severe CAR (SCAR). We aimed to identify characteristics associated with the diagnosis of SCAR in CAR‐hospitalised patients.

Infección por virus herpes humano 6 en un paciente inmunocompetente con síndrome DRESS secundario a carbamazepina

El sindrome DRESS (drug reaction with eosinophilia and systemic symptoms) constituye una reaccion adversa a farmacos, potencialmente mortal, caracterizada por una erupcion cutanea polimorfa asociada a fiebre, linfadeno-patias y compromiso multiorganico con eosinofilia. Presentamos el caso clinico de un hombre inmunocompetente con un sindrome DRESS secundario a carbamazepina que curso concomitantemente con una meningoencefalitis por virus herpes humano 6 (VHH-6). El rol patogenico del VHH-6 en el sindrome DRESS sigue siendo controversial; sin embargo, dada la importancia diagnostica y eventualmente pronostica de la infeccion por VHH-6, su tamizaje seria recomendable dentro del estudio de estos pacientes.

Experiencia en loxoscelismo cutáneo y cutáneo visceral de manejo hospitalario: clínica, evolución y propuesta terapéutica

BACKGROUND Loxoscelism is a common pathology in our environment with a broad spectrum of differential diagnoses and presentations, with potentially serious complications, even to the point of death. To date, there is no standard treatment for these patients. AIM To describe the clinical manifestations, main complications, therapeutic management, and evolution of loxoscelism in an inpatient setting from a tertiary hospital in Chile. METHODS All patients consulting and hospitalized in the hospital of the Pontificia Universidad Católica de Chile with diagnosis of loxoscelism between 2014 to 2017 and evaluated by dermatologist were included. Review of clinical files, including symptoms, images, laboratory parameters and treatment. RESULTS We evaluated seventeen inpatient with loxoscelism, whose presentation responds to the national epidemiological pattern. Most cases were managed with antibiotics, systemic corticosteroids, antihistamines, and dapsone. From these, 11.8% corresponded to viscerocutaneous loxoscelism, successfully managed with supportive measures, systemic corticosteroids and antihistamines. Fifty-nine percent healed their cutaneous lesions after one month of treatment, with slight residual scarring or post inflammatory hyperpigmentation, without associated mortality in our series. DISCUSSION Most cases of cutaneous loxoscelism presented excellent response and rapid resolution of the disease after combined therapy with systemic corticosteroids, antibiotics and dapsone, suggesting that the use of these therapies could stop the progression of cutaneous necrosis and prevent complications associated with loxoscelism.

Reacciones cutáneas adversas a antimicrobianos sistémicos en pacientes hospitalizados: estudio transversal analítico retrospectivo

INTRODUCTION The reported literature about the types of cutaneous adverse antibiotic reactions (ATB-CAR) and the responsible antimicrobial class is scarce. AIM to describe the clinical and histopathological profile of these reactions, and potential associations between different types of ATB-CAR and causal antibiotic class in a tertiary hospital in Chile. MATERIAL AND METHODS Cross-sectional retrospective study performed at the Hospital of the Pontificia Universidad Católica de Chile. RESULTS A total of 58 patients were included. The most common type of ATB-CAR was morbilliform (n: 37, 63.8%). The antibiotics most frequently involved were the penicillins and cephalosporins (n: 34, 69.3%). The most common histological pattern in all types of ATB-CAR was superficial perivascular dermatitis with or without spongiosis. There was significant association between urticarial, morbilliform, DRESS and PEGA types, with the use of penicillins, cephalosporins, cotrimoxazole, and lincomycin, respectively (n: 4,100%, n: 15, 40.5%, n: 2; 50%, n: 1, 50%, p < 0.05, respectively). DISCUSSION This is the first description of the ATB-CAR patterns in South American hospitalized patients. Both clinical and histopathological patterns of ATB-CAR are similar to other published series, however the types of causal antibiotics are different.