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Poison Ivy/Oak/Sumac
Published in Charles Theisler, Adjuvant Medical Care, 2023
In poison oak and sumac there is itching initially, followed by a rash. Painfully itchy bumps may form and eventually turn into blisters that ooze liquid. The rash usually peaks in severity about a week after exposure and lasts 5 to 12 days. In some cases, it can last a month or more.
Introduction to dermatological treatment
Published in Richard Ashton, Barbara Leppard, Differential Diagnosis in Dermatology, 2021
Richard Ashton, Barbara Leppard
Treatment of acute rashes. Resting the skin is important in any acute or extensive skin disease. Going to bed is a helpful treatment in its own right. It is the basis for most in-patient treatments but can often be done just as well at home (by this we mean actually going to bed and not just lying down on the sofa, as the latter will not stop the patient from pottering about). Sedating antihistamines (promethazine or alimemazine) may be needed to keep the patient resting in bed. Localised acute rashes should also be rested. If the patient has an acute blistering rash on the feet, it will not get better unless he stops walking around. A patient with an acute hand eczema is unlikely to get better while continuing to do the washing up. The more acute the rash, the more bland the treatment needs to be. If in doubt, white soft paraffin is unlikely to do any harm and will keep the patient comfortable.
Adverse Reactions to Antibiotics in the Critical Care Unit
Published in Cheston B. Cunha, Burke A. Cunha, Infectious Diseases and Antimicrobial Stewardship in Critical Care Medicine, 2020
Diane M. Parente, Cheston B. Cunha, Michael Lorenzo
In CCU patients, rashes are common and their etiology can be a challenge to determine. Additionally, skin abnormalities in these CCU patients may vary from mild to life threatening. The cause of rash may be due to disease, pressure, or medications. Identifying an offending agent may be difficult because of the large number of medications administered to CCU patients and the difficulties in temporally associating the rash with the initiation of any single agent [7]. Any antimicrobial agent has the potential to cause an allergic rash, but this problem occurs most commonly with β-lactams, sulfonamides, and fluoroquinolones [28].
The differential effects of upadacitinib treatment on skin rashes of four anatomical sites in patients with atopic dermatitis
Published in Journal of Dermatological Treatment, 2023
Teppei Hagino, Hidehisa Saeki, Eita Fujimoto, Naoko Kanda
This study has several limitations. We could not compare the treatment responses to upadacitinib among individual features of rash, erythema, induration/papulation, excoriation, and lichenification. The differential treatment responses among different features of rash should be examined in further studies. Second, this study evaluated only the therapeutic effects of 15 mg/day of upadacitinib, and not of 30 mg/day, which should be examined in further studies. Third, there is a lack of information on the dose and rank of topical corticosteroids used for different anatomical sites. Treatment responsiveness might be affected by the dose and rank of corticosteroids, which might influence the anatomical site-dependent differences in treatment responsiveness. For instance, it is common to apply less potent corticosteroids to the face, which may result in the lower treatment response of the head and neck rash compared to that of the other sites. Therefore, future studies should record the detailed information about the topical corticosteroids for individual anatomical sites.
Psoriasis complicated with metabolic disorder is associated with traditional Chinese medicine syndrome types: a hospital-based retrospective case–control study
Published in Current Medical Research and Opinion, 2023
Xiaoying Sun, Huaibo Zhao, Ruiping Wang, Hongjin Li, Yong Wu, Kan Ze, Yonghua Su, Bin Li, Xin Li
Based on the dialectical standard of TCM in the 2018 Chinese psoriasis diagnosis and treatment guide6, the patients were divided into blood-heat, blood-stasis, and non-blood-heat or blood-stasis syndrome groups based on the main symptoms, related symptoms, tongue coating, and pulse manifestation obtained by observing, hearing, questioning, and feeling the pulse.Blood-heat syndrome is mainly observed in the progressive stages of drip or plaque psoriasis. The primary symptoms include bright red skin lesions and increasing or rapidly expanding new rashes; secondary symptoms include perturbed and irritable deep-colored urine, red or crimson tongue, wiry, and slippery or thready pulse.Blood-stasis syndrome: mainly seen in the static stage of drip or plaque psoriasis The main symptoms were dark red skin lesions, thickened, infiltrated, and long-lasting rash, while the secondary symptoms include squamous and dry skin, darkish complexion or cyanotic lips and nails, menstruation with dark color or blood clots for women, purplish dark or ecchymosed tongue, sluggish or fine, and slow pulse.Non-blood-heat or blood-stasis syndrome is considered to be an “other” syndrome that does not meet the diagnostic criteria of the above two syndrome types.
Cost-effectiveness analysis of sintilimab + chemotherapy versus camrelizumab + chemotherapy for the treatment of first-line locally advanced or metastatic nonsquamous NSCLC in China
Published in Journal of Medical Economics, 2022
Mingjun Rui, Zhengyang Fei, Yingcheng Wang, Xueke Zhang, Aixia Ma, Haikui Sun, Hongchao Li
The base case PFS and OS HRs of sintilimab plus chemotherapy after adjustment by the MAIC method were both higher than those of camrelizumab plus chemotherapy, but the confidence intervals of the two groups were large, which indicated that the difference between the effects was not obvious. The HR was also included in the PSA for analysis, and the results showed that, after 5,000 Monte Carlo simulations, the average difference in QALYs in the lifetime horizon was 0.2, which meant that the efficacy of sintilimab plus chemotherapy was slightly better than that of camrelizumab plus chemotherapy. Therefore, costs would be the main driver in determining the conclusion, which was also verified in the DSA tornado diagram, especially in scenarios 1 and 2. In addition, it should be mentioned that camrelizumab has a serious adverse event, RCCEP. According to relevant literature25, this symptom is different from a rash and has a high incidence, so it may incur great disutility for patients. According to experts’ opinions, the incidence of RCCEP in the real world is much higher than that in the CameL trial. However, due to the lack of relevant studies on the disutility of RCCEP and long-term follow-up real-world evidence, this study still estimated the incidence of RCCEP based on the expert opinions, which might underestimate the cost-effectiveness of sintilimab plus chemotherapy to some extent.