DOCSLIB.ORG

An Update on the Treatment of Rosacea

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
An Update on the Treatment of Rosacea VOLUME 41 : NUMBER 1 : FEBRUARY 2018 ARTICLE An update on the treatment of rosacea Alexis Lara Rivero Clinical research fellow SUMMARY St George Specialist Centre Sydney Rosacea is a common inflammatory skin disorder that can seriously impair quality of life. Margot Whitfeld Treatment starts with general measures which include gentle skin cleansing, photoprotection and Visiting dermatologist avoidance of exacerbating factors such as changes in temperature, ultraviolet light, stress, alcohol St Vincent’s Hospital Sydney and some foods. Senior lecturer For patients with the erythematotelangiectatic form, specific topical treatments include UNSW Sydney metronidazole, azelaic acid, and brimonidine as monotherapy or in combination. Laser therapies may also be beneficial. Keywords For the papulopustular form, consider a combination of topical therapies and oral antibiotics. flushing, rosacea Antibiotics are primarily used for their anti-inflammatory effects. Aust Prescr 2018;41:20-4 For severe or refractory forms, referral to a dermatologist should be considered. Additional https://doi.org/10.18773/ treatment options may include oral isotretinoin, laser therapies or surgery. austprescr.2018.004 Patients should be checked after the first 6–8 weeks of treatment to assess effectiveness and potential adverse effects. Introduction • papules Rosacea is a common chronic relapsing inflammatory • pustules skin condition which mostly affects the central face, • telangiectases. 1 with women being more affected than men. The In addition, at least one of the secondary features pathophysiology is not completely understood, but of burning or stinging, a dry appearance, plaque dysregulation of the immune system, as well as formation, oedema, central facial location, ocular changes in the nervous and the vascular system have manifestations and phymatous changes are been identified. Microbes that are part of the normal considered enough to make the diagnosis accurately skin flora, and specifically in the pilo-sebaceous in most cases. Rosacea usually follows a pre-rosacea unit – including Demodex mites and Staphylococcus stage that involves flushing only. epidermidis – may also play a role as triggers of rosacea.2,3 Symptoms are initially transient. This is followed by Box Differential diagnoses of rosacea persistent erythema due to repeated vasodilation, Common then telangiectasia and skin inflammation in the form Acne vulgaris of papules, pustules, lymphoedema and fibrosis.2,4 Seborrhoeic dermatitis Rosacea can seriously affect a patient’s quality of life. Tinea faciei This should prompt clinicians to diagnose it early and Periorificial dermatitis start treatment.1 Contact dermatitis (irritant or allergic) Diagnosis Steroid-induced acneiform eruption The diagnosis of rosacea is usually made on history Folliculitis and clinical features. If it is not clear, differential Uncommon diagnoses must be considered and ruled out Lupus erythematosus (see Box).1,5,6 Dermatomyositis Clinical manifestations Drug reaction, e.g. isoniazid The presence of at least one of the following primary Sarcoidosis features indicates rosacea: Demodicosis (mange) flushing (transient redness) • Source: References 1, 4, 6 • non-transient redness 20 Full text free online at nps.org.au/australianprescriber VOLUME 41 : NUMBER 1 : FEBRUARY 2018 ARTICLE Rosacea can be classified into four subtypes: Phymatous rosacea erythematotelangiectatic, papulopustular, phymatous Phymatous rosacea is characterised by thickened skin and ocular.1,5 with enlarged pores and irregular surface nodularities. Erythematotelangiectatic rosacea These changes are most commonly found on the nose (rhinophyma), but can occur on the ears, chin and Erythematotelangiectatic rosacea is characterised forehead. This subtype is more common in men than by flushing and persistent central facial erythema. women (Fig. 4). Redness may also involve the peripheral face, ears, neck and upper chest, but periocular skin is typically Ocular rosacea spared. Telangiectases are also common, but are not Ocular rosacea is characterised by a watery required for the diagnosis (Fig. 1). or bloodshot appearance of the eyes, foreign Papulopustular rosacea body sensation, burning or stinging. Blepharitis, Papulopustular rosacea subtype includes patients conjunctivitis, dryness, itching, light sensitivity, blurred who develop papules or pustules in a central facial vision and telangiectasia of the conjunctiva or eyelids distribution. In severe cases, these episodes of also occur. Chalazia and styes are more common in inflammation can lead to chronic facial oedema ocular rosacea than other forms. Because there is no (Figs 2 and 3). specific test, the diagnosis relies on the physician’s Fig. 1 Erythematotelangiectatic rosacea Fig. 3 Papules and pustules – close-up Fig. 2 Papulopustular rosacea Fig. 4 Rhinophyma MAKE THESE PHOTOS HIGH RES IN THE FINAL PDF Full text free online at nps.org.au/australianprescriber 21 VOLUME 41 : NUMBER 1 : FEBRUARY 2018 ARTICLE An update on the treatment of rosacea clinical judgment. Ocular involvement is estimated Specific treatments to occur in 6–50% of patients with cutaneous Treatment can be optimised according to the rosacea, and can occur with or without a diagnosis of dominant features.9,13 Topical therapies are 7 cutaneous rosacea. recommended for at least six weeks to effectively Additional tests review the response.5,9 Topical corticosteroids should be avoided.14 If the diagnosis cannot be made clinically, other tests may be necessary. These include skin swabs Treatment for flushing and erythema may involve and scrapings for microbiology studies primarily oral drugs with vasoconstriction properties including to exclude staphylococcal infection. An antinuclear adrenergic antagonists including mirtazapine (alpha antibody test can be useful if photosensitivity is blocker), propranolol (beta blocker) or carvedilol 2 prominent. A skin biopsy is useful when other (both alpha and beta blocker). These are used at low diagnoses such as lupus or chronic folliculitis are doses to avoid adverse effects such as hypotension, being considered.1,8 somnolence, fatigue and bronchospasm. They should be prescribed under specialist supervision, and careful Approach to the patient with rosacea monitoring is required. Educating the patient about rosacea as a chronic Clonidine is an oral alpha2 agonist that has been relapsing skin condition which can be controlled used for flushing. However, topical alpha2 agonists but does not have a traditional ‘cure’ is important. are preferred because they target the skin and carry Warning them that flare-ups can occur even when less risk of systemic adverse effects. Brimonidine is treated properly is also useful and plays a key role in a topical alpha2 agonist which can reduce erythema the patient’s expectations and the role of therapy. for up to 12 hours through direct cutaneous General measures vasoconstriction. Brimonidine 0.33% gel is very useful for some people when not used on a daily basis.6,9 The treatment plan will be adapted to the subtype Post-treatment rebound erythema may occur, and in of rosacea and then realistic expectations are set general telangiectases will not clear. and potential adverse effects discussed. This enables the patient to participate in the choice of therapy Erythematotelangiectatic rosacea appropriate for them and consider the balance Topical treatments for this form of rosacea include between the disease and the treatment.9 metronidazole, azelaic acid and brimonidine. They can Skin care be used alone or in combination. Metronidazole works as an anti-inflammatory drug by altering neutrophil Sun avoidance and photoprotection are an chemotaxis and inactivating reactive oxygen species. important part of management.10 Reducing skin Metronidazole 0.75% has been shown to reduce irritability is also key. Skin care should include a erythema, papules and pustules in multiple trials of gentle facial cleanser and a moisturiser or barrier patients with moderate to severe rosacea. It is usually repair product, as this can adjunctively improve well tolerated with minor local adverse effects such as therapeutic outcomes and reduce skin irritation skin irritation.9,15 in patients undergoing medical therapy. Cosmetic products, especially those with a green tinge, Topical azelaic acid is an over-the-counter preparation may help to cover erythema and may improve the which has anti-inflammatory, anti-keratinising and patient’s self-perception.11 antibacterial effects. A 15% gel and 20% lotion are available and can be applied once or twice daily. Avoiding triggers Adverse effects may include skin irritation, but azelaic Avoiding triggers such as extreme temperatures acid is usually well tolerated and can be used for long (hot or cold), ultraviolet radiation exposure, spicy periods of time.8,16 foods, hot or alcoholic beverages, wind, exercise Laser therapy, including vascular lasers or intense and stress, should be recommended to all patients. pulse light, may help to reduce refractory background Hormonal replacement therapy can be used for erythema and clinically significant telangiectases, but 12 menopausal flushing. will not reduce the frequency of flushing episodes. It is important to ask the patient what medicines they Different laser therapies that target the vessels have are taking as some over-the-counter or prescription been used such as 595 nm pulsed dye laser, Nd:YAG and drugs may worsen rosacea or trigger flushing other vascular lasers, or intense pulsed
Load more

Recommended publications
  • Proper Preop Makes for Easier Toenail Surgery
    April 15, 2007 • www.familypracticenews.com Skin Disorders 25 Proper Preop Makes for Easier Toenail Surgery BY JEFF EVANS sia using a digital block or a distal approach to take ef- Senior Writer fect. Premedication with NSAIDs, codeine, or dextro- propoxyphene also may be appropriate, he said. WASHINGTON — Proper early management of in- To cut away the offending section of nail, an English grown toenails may help to decrease the risk of recur- anvil nail splitter is inserted under the nail plate and the rence whether or not surgery is necessary, Dr. C. Ralph cut is made all the way to the proximal nail fold. The hy- Daniel III said at the annual meeting of the American pertrophic, granulated tissue should be cut away as well. Academy of Dermatology. Many ingrown toenails are recurrent, so Dr. Daniel per- “An ingrown nail is primarily acting as a foreign-body forms a chemical matricectomy in nearly all patients after reaction. That rigid spicule penetrates soft surrounding tis- making sure that the surgical field is dry and bloodless. sue” and produces swelling, granulation tissue, and some- The proximal nail fold can be flared back to expose more times a secondary infection, said Dr. Daniel of the de- of the proximal matrix if necessary. Dr. Daniel inserts a Cal- partments of dermatology at the University of Mississippi, giswab coated with 88% phenol or 10% sodium hydroxide Jackson, and the University of Alabama, Birmingham. and applies the chemical for 30 seconds to the portion of For the early management of stage I ingrown toenails the nail matrix that needs to be destroyed.
    [Show full text]
  • Fungal Infections from Human and Animal Contact
    Journal of Patient-Centered Research and Reviews Volume 4 Issue 2 Article 4 4-25-2017 Fungal Infections From Human and Animal Contact Dennis J. Baumgardner Follow this and additional works at: https://aurora.org/jpcrr Part of the Bacterial Infections and Mycoses Commons, Infectious Disease Commons, and the Skin and Connective Tissue Diseases Commons Recommended Citation Baumgardner DJ. Fungal infections from human and animal contact. J Patient Cent Res Rev. 2017;4:78-89. doi: 10.17294/2330-0698.1418 Published quarterly by Midwest-based health system Advocate Aurora Health and indexed in PubMed Central, the Journal of Patient-Centered Research and Reviews (JPCRR) is an open access, peer-reviewed medical journal focused on disseminating scholarly works devoted to improving patient-centered care practices, health outcomes, and the patient experience. REVIEW Fungal Infections From Human and Animal Contact Dennis J. Baumgardner, MD Aurora University of Wisconsin Medical Group, Aurora Health Care, Milwaukee, WI; Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, WI; Center for Urban Population Health, Milwaukee, WI Abstract Fungal infections in humans resulting from human or animal contact are relatively uncommon, but they include a significant proportion of dermatophyte infections. Some of the most commonly encountered diseases of the integument are dermatomycoses. Human or animal contact may be the source of all types of tinea infections, occasional candidal infections, and some other types of superficial or deep fungal infections. This narrative review focuses on the epidemiology, clinical features, diagnosis and treatment of anthropophilic dermatophyte infections primarily found in North America.
    [Show full text]
  • Cutaneous Manifestations of HIV Infection Carrie L
    Chapter Title Cutaneous Manifestations of HIV Infection Carrie L. Kovarik, MD Addy Kekitiinwa, MB, ChB Heidi Schwarzwald, MD, MPH Objectives Table 1. Cutaneous manifestations of HIV 1. Review the most common cutaneous Cause Manifestations manifestations of human immunodeficiency Neoplasia Kaposi sarcoma virus (HIV) infection. Lymphoma 2. Describe the methods of diagnosis and treatment Squamous cell carcinoma for each cutaneous disease. Infectious Herpes zoster Herpes simplex virus infections Superficial fungal infections Key Points Angular cheilitis 1. Cutaneous lesions are often the first Chancroid manifestation of HIV noted by patients and Cryptococcus Histoplasmosis health professionals. Human papillomavirus (verruca vulgaris, 2. Cutaneous lesions occur frequently in both adults verruca plana, condyloma) and children infected with HIV. Impetigo 3. Diagnosis of several mucocutaneous diseases Lymphogranuloma venereum in the setting of HIV will allow appropriate Molluscum contagiosum treatment and prevention of complications. Syphilis Furunculosis 4. Prompt diagnosis and treatment of cutaneous Folliculitis manifestations can prevent complications and Pyomyositis improve quality of life for HIV-infected persons. Other Pruritic papular eruption Seborrheic dermatitis Overview Drug eruption Vasculitis Many people with human immunodeficiency virus Psoriasis (HIV) infection develop cutaneous lesions. The risk of Hyperpigmentation developing cutaneous manifestations increases with Photodermatitis disease progression. As immunosuppression increases, Atopic Dermatitis patients may develop multiple skin diseases at once, Hair changes atypical-appearing skin lesions, or diseases that are refractory to standard treatment. Skin conditions that have been associated with HIV infection are listed in Clinical staging is useful in the initial assessment of a Table 1. patient, at the time the patient enters into long-term HIV care, and for monitoring a patient’s disease progression.
    [Show full text]
  • Chronic Paronychia Refers to a Skin Condition, Which Occurs Around the Nails
    Robert E. Kalb, M.D. Buffalo Medical Group, P.C. Phone: (716) 630-1102 Fax: (716) 633-6507 Department of Dermatology 325 Essjay Road Williamsville, New York 14221 PARONYCHIA (CHRONIC) Chronic paronychia refers to a skin condition, which occurs around the nails. The term chronic means that the condition can come and go over time. The word paronychia is a fancy medical term referring to the inflammation, redness and swelling that can occur around the nails. Chronic paronychia occurs most commonly in people whose hands are in a wet environment, for example nurses, bartenders, dishwashers and hairdressers. Repeated cuts and minor trauma of the skin can damage the area around the nail and in the cuticle. This minor damage allows further irritation. There can be overgrowth of various surface germs, which slow the healing process. Symptoms of chronic paronychia include loss of the cuticle, tenderness, redness and swelling. Often the nails can appear changed with rough surfaces or grooves. Sometimes the area around the nail can be colonized with a normal bacteria or yeast on the skin. Because of this, one of the treatments that is often used is a medication, which has antibiotic properties against these types of organisms. In many cases, it is not an actual infection, but simply colonization on the surface of the skin, which impedes the healing. Treatment of chronic paronychia starts by avoiding any chronic irritation or wet environments. Wearing cotton-lined gloves to wash dishes can be helpful if this is an exposure. In most cases, topical medications are used. These often involve two different creams or two different liquids.
    [Show full text]
  • Cutaneous Adverse Effects of Biologic Medications
    REVIEW CME MOC Selena R. Pasadyn, BA Daniel Knabel, MD Anthony P. Fernandez, MD, PhD Christine B. Warren, MD, MS Cleveland Clinic Lerner College Department of Pathology Co-Medical Director of Continuing Medical Education; Department of Dermatology, Cleveland Clinic; of Medicine of Case Western and Department of Dermatology, W.D. Steck Chair of Clinical Dermatology; Director of Clinical Assistant Professor, Cleveland Clinic Reserve University, Cleveland, OH Cleveland Clinic Medical and Inpatient Dermatology; Departments of Lerner College of Medicine of Case Western Dermatology and Pathology, Cleveland Clinic; Assistant Reserve University, Cleveland, OH Clinical Professor, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH Cutaneous adverse effects of biologic medications ABSTRACT iologic therapy encompasses an expo- B nentially expanding arena of medicine. Biologic therapies have become widely used but often As the name implies, biologic therapies are de- cause cutaneous adverse effects. The authors discuss the rived from living organisms and consist largely cutaneous adverse effects of tumor necrosis factor (TNF) of proteins, sugars, and nucleic acids. A clas- alpha inhibitors, epidermal growth factor receptor (EGFR) sic example of an early biologic medication is inhibitors, small-molecule tyrosine kinase inhibitors insulin. These therapies have revolutionized (TKIs), and cell surface-targeted monoclonal antibodies, medicine and offer targeted therapy for an including how to manage these reactions
    [Show full text]
  • Wrestling Skin Condition Report Form
    IOWA HIGH SCHOOL ATHLETIC ASSOCIATION - WRESTLING SKIN CONDITION REPORT This is the only form a referee will accept as “current, written documentation” that a skin condition is NOT communicable. National Federation wrestling rules state, “If a participant is suspended by the referee or coach of having a communicable skin disease or any other condition that makes participation appear inadvisable, the coach shall provide current written documentation from an appropriate health-care professional, stating that the suspected disease or condition is not communicable and that the athlete’s participation would not be harmful to any opponent.” “COVERING A COMMUNICABLE CONDITION SHALL NOT BE CONSIDERED ACCEPTABLE AND DOES NOT MAKE THE WRESTLER ELIGIBLE TO PARTICIPATE.” This form must be presented to the referee, or opposing head coach, AT THE TIME OF WEIGH INS or the wrestler in question will not be allowed to compete. NFHS rule 4.2.5 states, “A contestant may have documentation from an appropriate health-care professional only, indicating a specific condi- tion such as a birthmark or other non-communicable skin conditions such as psoriasis and eczema, and that documentation is valid for the season. It is valid with the understanding that a chronic condition could become secondarily infected and may require re-evaluation. ________________________________________________ from ____________________________________ High School has Wrestler’s Name (Type or Print Legibly) High School Name (Type or Print Legibly) been examined by me for the following skin condition: ___________________________________________________________ Common name of skin condition here (Note: Wrestling coaches - the most common communicable wrestling skin conditions, and their medical names, are: boils - “furuncles” ; cold sores - “herpes simplex type-1”; impetigo - “pyoderma”; pink eye - “conjunctivitis”; ringworm - “tinea corporis”.) Mark the location(s) of the condition(s) on one of the sihlouettes below.
    [Show full text]
  • Aars Hot Topics Member Newsletter
    AARS HOT TOPICS MEMBER NEWSLETTER American Acne and Rosacea Society 201 Claremont Avenue • Montclair, NJ 07042 (888) 744-DERM (3376) • [email protected] www.acneandrosacea.org Like Our YouTube Page We encourage you to TABLE OF CONTENTS invite your colleagues and patients to get active in AARS in the Community the American Acne & Don’t forget to attend the 14th Annual AARS Networking Reception tonight! ........... 2 Rosacea Society! Visit Our first round of AARS Patient Videos are being finalized now ............................... 2 www.acneandrosacea.org Save the Date for the 8th Annual AARS Scientific Symposium at SID ..................... 2 to become member and Please use the discount code AARS15 for 15% off of registration to SCALE ........... 2 donate now on www.acneandrosacea.org/ Industry News donate to continue to see Ortho Dermatologics launches first cash-pay prescription program in dermatology . 2 a change in acne and Cutera to unveil excel V+ next generation laser platform at AAD Annual Meeting ... 3 rosacea. TARGET PharmaSolutions launches real-world study .............................................. 3 New Medical Research Epidemiology and dermatological comorbidity of seborrhoeic dermatitis ................... 4 A novel moisturizer with high SPF improves cutaneous barrier function .................... 5 Randomized phase 3 evaluation of trifarotene 50 μG/G cream treatment ................. 5 Open-label, investigator-initiated, single site exploratory trial..................................... 6 Erythematotelangiectatic
    [Show full text]
  • Dermatologic Conditions Educational Format Faculty Expertise Required Expertise in the Field of Study
    2019 AAFP FMX Needs Assessment Body System: Integumentary Session Topic: Dermatologic Conditions Educational Format Faculty Expertise Required Expertise in the field of study. Experience teaching in the field of study is desired. Preferred experience with audience Interactive REQUIRED response systems (ARS). Utilizing polling questions and Lecture engaging the learners in Q&A during the final 15 minutes of the session are required. Expertise teaching highly interactive, small group learning environments. Case-based, with experience developing and Problem- teaching case scenarios for simulation labs preferred. Other Based workshop-oriented designs may be accommodated. A typical OPTIONAL Learning PBL room is set for 50-100 participants, with 7-8 each per (PBL) round table. Please describe your interest and plan for teaching a PBL on your proposal form. Learning Objective(s) that will close Outcome Being Professional Practice Gap the gap and meet the need Measured Physicians have knowledge 1. Evaluate the presented skin condition Learners will gaps with regard to and determine differential diagnosis submit written diagnosing and evaluating and the need for further testing or commitment to common skin diseases (e.g. referral. change statements acne, dermatitis, rosacea). 2. Counsel patients on lifestyle on the session Primary care physicians modifications and proper skin care to evaluation, often receive inadequate control flare-ups and avoid outbreaks. indicating how dermatology training in 3. Create a disease management strategy they plan to medical school and for patients with a diagnosed implement residency. dermatologic condition based on the presented practice Patients with skin disease type and severity of the condition. recommendations. often have misconceptions 4.
    [Show full text]
  • "Skin & Wound Management Under the Wraps"
    SKIN & WOUND MANAGEMENT UNDER THE WRAPS Providing effective treatment and protection beneath compression bandaging is necessary to promote healing. Matthew Livingston, BSN, RN, CWS, ACHRN ound management for patients pustules around hair follicles, occurs and a drier skin surface dressing, such as living with venous insuffi- due to any type of trauma to the fol- cotton batting, will reduce the fungal ciency often involves multiple licle, such as pressure or friction, chemi- outbreak. Be aware that most rashes in W 1 complexities. These variations require cal irritation, or bacterial colonization. venous disease are from stasis dermatitis, providers to consider a spectrum of Milder forms of this skin condition are not candidiasis. strategies. Some require an advanced referred to as superficial folliculitis. This In its milder form, a latex allergy knowledge of skin conditions and dif- is considered self-limiting as long as the caused by compression wraps appears as ferential diagnosis while others are de- source of the injury is reduced. Painful, an itchy rash or hives over the major- pendent on “tricks of the trade” for deep folliculitis warrants a culture to ity of the lower extremity, or just above dressing changes and the understanding isolate the type of bacteria involved, and the knee (with possible systemic effects of different dressing modalities. treatment with systemic antibiotics.1 including puffy face and full-body rash). Fungal infections including candidia- The elastic component of the multilayer The ‘Skinny’ on Skin sis present as groups of small, red open compression dressing can be replaced Several dermatological conditions re- or closed pustules around the moist with a latex-free brand.
    [Show full text]
  • Skin Disease and Disorders
    Sports Dermatology Robert Kiningham, MD, FACSM Department of Family Medicine University of Michigan Health System Disclosures/Conflicts of Interest ◼ None Goals and Objectives ◼ Review skin infections common in athletes ◼ Establish a logical treatment approach to skin infections ◼ Discuss ways to decrease the risk of athlete’s acquiring and spreading skin infections ◼ Discuss disqualification and return-to-play criteria for athletes with skin infections ◼ Recognize and treat non-infectious skin conditions in athletes Skin Infections in Athletes ◼ Bacterial ◼ Herpetic ◼ Fungal Skin Infections in Athletes ◼ Very common – most common cause of practice-loss time in wrestlers ◼ Athletes are susceptible because: – Prone to skin breakdown (abrasions, cuts) – Warm, moist environment – Close contacts Cases 1 -3 ◼ 21 year old male football player with 4 day h/o left axillary pain and tenderness. Two days ago he noticed a tender “bump” that is getting bigger and more tender. ◼ 16 year old football player with 3 day h/o mildly tender lesions on chin. Started as a single lesion, but now has “spread”. Over the past day the lesions have developed a dark yellowish crust. ◼ 19 year old wrestler with a 3 day h/o lesions on right side of face. Noticed “tingling” 4 days ago, small fluid filled lesions then appeared that have now started to crust over. Skin Infections Bacterial Skin Infections ◼ Cellulitis ◼ Erysipelas ◼ Impetigo ◼ Furunculosis ◼ Folliculitis ◼ Paronychea Cellulitis Cellulitis ◼ Diffuse infection of connective tissue with severe inflammation of dermal and subcutaneous layers of the skin – Triad of erythema, edema, and warmth in the absence of underlying foci ◼ S. aureus or S. pyogenes Erysipelas Erysipelas ◼ Superficial infection of the dermis ◼ Distinguished from cellulitis by the intracutaneous edema that produces palpable margins of the skin.
    [Show full text]
  • Jemds.Com Original Research Article
    Jemds.com Original Research Article DERMATOLOGICAL ADVERSE EFFECTS OF CHEMOTHERAPEUTIC AGENTS: EXPERIENCE FROM A TERTIARY CENTRE Parvaiz Anwar Rather1, M. Hussain Mir2, Sandeep Kaul3, Vikas Roshan4, Jilu Mathews5, Bandu Sharma6 1Lecturer, Department of Dermatology, GMC, Jammu, Jammu & Kashmir, India. 2Consultant, Department of Oncology, Narayana Superspeciality Hospital, Katra, Jammu, Jammu & Kashmir, India. 3Consultant, Department of Surgical Oncology, Narayana Superspeciality Hospital, Katra, Jammu, Jammu & Kashmir, India. 4Consultant, Department of Radiation Oncology, Narayana Superspeciality Hospital, Katra, Jammu, Jammu & Kashmir, India. 5Senior Nursing In Charge, Department of Oncology, Narayana Superspeciality Hospital, Katra, Jammu, Jammu & Kashmir, India. 6Senior Nursing In Charge, Department of Oncology, Narayana Superspeciality Hospital, Katra, Jammu, Jammu & Kashmir, India. ABSTRACT BACKGROUND Chemotherapeutic agents, both conventional and new targeted therapy, are known to cause diverse side effects related to skin, hair, mucous membranes and nails, collectively called `dermatological adverse effects`. But such association in literature is mostly confined to case reports/case series and small number of published papers. The aim of this study is to look for dermatological adverse effects and the most common culprit agents, with the objective that the oncologist and dermatologist team remain vigilant and adopt rational management protocol in their management to circumvent the morbidity and long-term toxicity as it involves the cosmetic appearance of long-term cancer survivor. MATERIALS AND METHODS This prospective hospital-based descriptive study was conducted jointly by the dermatologist and oncology team over a period of more than one year in a specialised tertiary centre on oncology patients, who developed dermatological side effects after initiation of anti-cancer drugs. RESULTS Out of 125 patients studied, dermatological adverse effects of varying duration were noticed in 27 patients (21.6%), with overall 45 side effects manifestation.
    [Show full text]
  • Drug-Induced Acneiform Eruptions
    View metadata, citation and similar papers at core.ac.uk brought to you by CORE We are IntechOpen, provided by IntechOpen the world’s leading publisher of Open Access books Built by scientists, for scientists 4,800 122,000 135M Open access books available International authors and editors Downloads Our authors are among the 154 TOP 1% 12.2% Countries delivered to most cited scientists Contributors from top 500 universities Selection of our books indexed in the Book Citation Index in Web of Science™ Core Collection (BKCI) Interested in publishing with us? Contact [email protected] Numbers displayed above are based on latest data collected. For more information visit www.intechopen.com Chapter 5 Drug-Induced Acneiform Eruptions Emin Özlü and Ayşe Serap Karadağ EminAdditional Özlü information and Ayşe is available Serap at Karadağ the end of the chapter Additional information is available at the end of the chapter http://dx.doi.org/10.5772/65634 Abstract Acne vulgaris is a chronic skin disease that develops as a result of inflammation of the pilosebaceous unit and its clinical course is accompanied by comedones, papules, pus- tules, and nodules. A different group of disease, which is clinically similar to acne vul- garis but with a different etiopathogenesis, is called “acneiform eruptions.” In clinical practice, acneiform eruptions are generally the answer of the question “What is it if it is not an acne?” Although there are many subgroups of acneiform eruptions, drugs are common cause of acneiform eruptions, and this clinical picture is called “drug-induced acneiform eruptions.” There are many drugs related to drug-induced acneiform erup- tions.
    [Show full text]