Iatrogenic Cushing's syndrome in a dog from owner's topical corticosteroid.
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Biomedical subjects
Publications and source records attributed to H B Ridgway.
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Generalized eruptions following radiation therapy are rare. Most reported cases involve deep x-ray therapy for underlying cancer. We report a patient who experienced Stevens-Johnson syndrome following radiation therapy and present a review of the literature.
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Relapsing polychondritis is a rare disease of undetermined cause. The most frequently seen symptom is redness and swelling of the cartilaginous ear, followed by cartilage inflammation elsewhere in the body. Our five cases had neurologic symptoms that posed diagnostic difficulties. Because vasculitis is not uncommon in relapsing polychondritis, it was difficult to determine whether these neurologic symptoms were attributable to relapsing polychondritis or to other unrelated causes. In our cases, specific neurologic complaints were caused by a concomitant but unrelated disease, rather than by relapsing polychondritis. We add five additional documented cases to the medical literature and confirm the therapeutic efficacy of dapsone in the treatment of this unusual disease.
An elderly man with Hodgkin's disease who was receiving multiple drug chemotherapy became septic and a wide spread bullous eruption developed. Intraepidermal cleavage on skin biopsy supported a diagnosis of the staphylococcal scalded skin syndrome (SSSS) type of toxic epidermal necrolysis. Blood cultures confirmed a staphylococcal septicemia. Occurrence of this syndrome in an adult is unusual. A review of the literature on SSSS indicates an increased mortality when adults are compared with children with this syndrome.
Nonspecific dermatologic problems occasionally associated with malignant disease include pruritus, reactive erythemas and skin infections. Frequently associated with internal neoplasms are acanthosis nigricans, dermatomyositis, rapid development of multiple seborrheic keratoses, hypertrichosis lanuginosa and other syndromes. Skin metastases may be the first signs of internal cancer. The most common visceral primaries are the lung and colon in men and the breast, colon and ovary in women. Recognizing these lesions can lead to early diagnosis and improved prognosis.
Precipitation of generalized pustular psoriasis was manifested in a patient with previously stable psoriasis vulgaris following lithium carbonate therapy for manic-depressive psychosis. Methotrexate toxicity was observed during the acute stage of the illness, and photochemotherapy was the successful treatment. Further pustulation occurred when lithium carbonate therapy was reintroduced.
Fifty normal control volunteers were patch tested to 20% neomycin as well as tobramycin 1%, 10%, 20% and 30% in white petrolatum. Tobramycin is a new aminoglycoside antibiotic for prescription ophthalmologic use in the United States. There were no reactions on any of the control volunteers. Twenty known and proven neomycin-allergic patients were then tested to tobramycin 10% and 20% in white petrolatum, as well as to neomycin 20% aqueous and 20% in white petrolatum. All 20 reacted with a 2+ or greater response to the neomycin patch tests. Twelve out of the 20 or 60% of the neomycin-allergic patients reacted to the 10% tobramycin in white petrolatum. Thirteen out of 20 or 65% reacted to 20% tobramycin in white petrolatum. From these data, tobramycin (ophthalmic) should not be used to treat known neomycin-allergic patients without first patch testing the patient with 20% tobramycin in white petrolatum. It appears probable that 65% of neomycin-allergic patients would react with a dermatitic response to such therapy.