China
Africa
Explore chapters and articles related to this topic
Cutaneous Phototoxicity
Published in Henry W. Lim, Nicholas A. Soter, Clinical Photomedicine, 2018
For some drugs, the major manifestation of the phototoxic response is the development of hyperpigmentation in sun-exposed areas. Depending on the drug initiating the response, skin discoloration may be caused either by increased amounts of melanin in the skin or by accumulation of the drug or one of its photoproducts. When melanin is responsible for the increased pigmentation, its deposition usually occurs as a consequence of the inflammatory response that precedes it. Almost every drug capable of causing phototoxic erythema has been implicated in producing this type of pigmentary response. Some phototoxic agents also can directly stimulate melanocytes to produce melanin. Phototoxic hyperpigmentation is a common finding in psoralen-induced phytophotodermatitis.
Topical Therapies for Psoriasis
Published in Siba P. Raychaudhuri, Smriti K. Raychaudhuri, Debasis Bagchi, Psoriasis and Psoriatic Arthritis, 2017
Anthralin (cignolin, dithranol) is a synthetically produced derivative of a natural mixture of plant ingredients, which has been used in medicine as early as the eighteenth century [51]. The natural substance chrysarobin is derived from the araroba tree in South America. Anthralin may be used as so-called minutes or short-contact therapy at concentrations of 0.1%–3%, which are applied over weeks for an increasing length of time, starting with a few minutes, to be subsequently rinsed off [52]. Alternatively, anthralin may be applied as long-contact therapy, starting at lower concentrations of 0.01% and left on for 8–12 hours. Mild skin irritation is intended, but may limit its use at delicate locations or with children. However, contact sensitization has not been reported. As it is neither resorbed nor mutagenic or cancerogenic, it may be used in pregnancy and with ample care in children, especially in guttate psoriasis and more superficial psoriasis manifestations. Apart from possible skin irritation, other disadvantages represent dark discoloration of skin, hair, nails, and clothing, as well as sanitary fittings. Skin discoloration may be cosmetically disturbing, but will vanish within 1–2 weeks after stopping the therapy. In addition, Woronoff’s ring or leukoderma psoriaticum may appear as white halos surrounding initial psoriatic lesions. For conservation reasons, 1% salicylic acid is regularly added to the ointment. This should be taken into account when combining with vitamin D analogues, which are sensitive to salicylic acid.
Postherpetic Neuralgia
Published in Gary W. Jay, Practical Guide to Chronic Pain Syndromes, 2016
Rajbala Thakur, Annie G. Philip, Jonathan C. Weeks
Skin discoloration: Skin can be normal in appearance or exhibit areas of hyper-pigmentation, hypopigmentation, or scarring in the affected dermatomes. Affected areas may also exhibit a persistent reddish or brownish hue.
Evaluating safety in hyaluronic acid lip injections
Published in Expert Opinion on Drug Safety, 2021
Tyler Safran, Arthur Swift, Sebastian Cotofana, Andreas Nikolis
Skin discoloration at the injection site was described in few patients both in the case reports and the larger studies. Tyndall effect occurs when filler is placed too superficially in the dermis causing long wavelength blue light to scatter and yield a bluish hue discoloration, described also as Raleigh Scattering. If not treated, superficial product has been shown to stay visible for multiple years [43]. Hylaronidase in this setting can be used multiple times to dissolve HA placed superficially. One technique described is starting with 30 units and then seeing the patient back in 3–4 days for reevaluation. A Q-Switched 1,064 nm laser device or direct incision and drainage are also described treatments [43]. Every patient with non-blanching, Tyndall effect or significant ecchymosis should be followed to rule out an arterial (see arterial injury section) or venous complication.
Dermatomyositis, pembrolizumab, and squamous cell carcinoma of the lung
Published in Baylor University Medical Center Proceedings, 2021
Claire J. Wiggins, Susan Y. Chon
A 74-year-old man with adenocarcinoma of the left lung treated with lobectomy and newly diagnosed squamous cell carcinoma of the lung, recently being treated with pembrolizumab and an interleukin-2 clinical trial, presented with a 3-month history of a rash, periorbital edema, and profound muscle weakness suspicious for a paraneoplastic syndrome. Prior to the unmasking of these symptoms before initiating immunotherapy, the patient reported a nonspecific asymptomatic skin discoloration. Immediately after his infusion with pembrolizumab, the cutaneous symptoms flared, accompanied by new systemic symptoms of severe fatigue, chills, wheezing, and muscle weakness. The violaceous eruption, which began on the abdomen, spread to the chest and then the elbows, medial thighs, and dorsal hands. Neither topical betamethasone nor oral methylprednisolone improved his symptoms after 3 days of use. Due to the severity of these symptoms, the patient’s lung cancer treatment was put on hold.
An evaluation of pixantrone for the treatment of non-Hodgkin’s lymphoma
Published in Expert Opinion on Pharmacotherapy, 2018
In general, pixantrone seems to be safe and manageable. In various trials, there were no unexpected side effects reported and no trials were closed prematurely because of side effects. In an evaluation of 12 clinical trials with pixantrone, the most common side effect (all grades) was hematological toxicity, mainly neutropenia (50% of patients; grade III/IV: 41%), leukopenia (25%), anemia (31%), and thrombocytopenia (21%) [33]. Hematological toxicity was the main reason for a delayed start of subsequent cycles or for omitting the day-15 dose of pixantrone. In the outpatient setting, it is worth considering the use of hematopoietic growth factors. Other side effects included asthenia (23%), pyrexia (23%), and nausea [33]. Most patients experienced reversible skin discoloration.