BACKGROUND & AIMS: :Solid organ transplant patients are well established to be at risk of herpes simplex virus and varicella zoster virus infection and reactivation. We present a case of a 41-year-old woman with a history of pancreas and renal transplant who presented with what appeared to be disseminated herpes simplex virus or varicella zoster virus induced rash, but who was ultimately diagnosed and treated as linear IgA bullous dermatosis. This case alerts physicians to other non-infectious dermatoses as a cause of vesiculobullous rash in solid organ transplant patients.

背景与目标： : 实体器官移植患者有单纯疱疹病毒和水痘带状疱疹病毒和再激活的风险。我们介绍了一例41岁的女性，该女性有胰腺和肾移植史，出现了似乎是播散性单纯疱疹病毒或水痘带状疱疹病毒引起的皮疹，但最终被诊断为线性IgA大疱性皮肤病。该病例提醒医生注意其他非感染性皮肤病是实体器官移植患者中水泡状皮疹的原因。

BACKGROUND & AIMS: :We report a singular clinical condition observed following a short duration treatment with sulphasalazine (SSZ) in a 64-year-old woman affected by psoriatic arthritis. Two weeks after starting treatment, a high degree, subcontinuous fever occurred, together with systemic discomfort, fatigue, headache, and ultimately a moderate wakefulness impairment. Upon admission to the hospital, a malar rash became evident. Modest notes of hepatotoxicity were also evident. All of the symptoms suddenly resolved after SSZ withdrawal. The markers of hepatitis become negative just 2 months later. It is interesting to note that after dismissal, in order to counteract the severe arthritic conditions and the presence of a type 2 diabetes, a combined therapy with methotrexate and cyclosporin had to be used, with no renal or hepatic side effects and remarkable therapeutic effects. No markers of autoimmunity were found in this patient. The chronology and the clinical events here described may confirm the hypothesis of a idiosyncratic reaction to SSZ, closely resembling a rare, sometimes irreversible, condition known as "the 3 week sulphasalazine syndrome".

背景与目标： : 我们报告了在一名受银屑病关节炎影响的64岁女性中，用磺胺嘧啶 (SSZ) 进行短期治疗后观察到的单一临床状况。开始治疗两周后，出现高度持续发热，伴有全身不适、乏力、头痛，最终出现中度清醒障碍。入院后，黄斑皮疹变得明显。适度的肝毒性也很明显。所有症状在SSZ停药后突然消失。仅2个月后，肝炎标志物就变为阴性。有趣的是，在解雇后，为了抵消严重的关节炎疾病和2型糖尿病的存在，必须使用甲氨蝶呤和环孢菌素的联合治疗，没有肾或肝副作用和显着的治疗效果。该患者未发现自身免疫标志物。此处描述的时间顺序和临床事件可能证实了对SSZ的特殊反应的假设，该假设非常类似于一种罕见的，有时是不可逆的，称为 “3周磺胺嘧啶综合征”。

BACKGROUND & AIMS: :Since the eradication of smallpox approximately 39 years ago, monkeypox virus remains the most pathogenic poxvirus, being mainly restricted to Central and West Africa. Before 1970, there were no reports of human monkeypox in Nigeria, while between 1971 and 1978 there were three cases, with none having been reported thereafter. However, in September 2017, a case of contagious skin rash disease, typical of monkeypox, was observed in an 11-year-old boy from the southern part of the country and confirmed to be associated with the monkeypox virus. This large outbreak consisted of 262 suspected, 115 confirmed cases, and 7 mortalities across 26 states and the Federal Capital Territory (FCT), Abuja. The aim of this manuscript is to provide an updated, comprehensive, and timely review of monkeypox, an important emerging infection in Nigeria. Monkeypox is now a major threat to global health security, requiring an urgent multidisciplinary approach involving veterinarians, physicians, virologists, and public health experts to fast-track the development of diagnostic assays, vaccines, antivirals, and other control strategies.

背景与目标： : 自从大约39年前消灭天花以来，猴痘病毒仍然是最具致病性的痘病毒，主要限于中部和西部非洲。1970年之前，尼日利亚没有人猴痘的报告，而1971年和1978则有3例，此后没有报告。然而，在2017年9月，在该国南部的一名11岁男孩中观察到传染性皮疹疾病，典型的猴痘，并证实与猴痘病毒有关。这次大规模爆发包括26个州和阿布贾联邦首都地区 (FCT) 的262个疑似病例，115个确诊病例和7个死亡病例。本手稿的目的是提供对猴痘 (尼日利亚一种重要的新兴感染) 的最新，全面和及时的回顾。猴痘现在是对全球健康安全的主要威胁，需要采取紧急的多学科方法，涉及兽医，医生，病毒学家和公共卫生专家，以快速跟踪诊断分析，疫苗，抗病毒药和其他控制策略的开发。

BACKGROUND & AIMS: :Negative urgency (NU: tendency to act rashly when distressed) is the facet of impulsive personality that has been most predictive of binge eating, but less is known about the relative role of positive urgency (PU: tendency to act rashly in response to positive emotions). In addition, most studies have exclusively focused on women and the examination of pathological eating outcomes, using a dimensional symptom approach, has been somewhat limited. This study aimed to replicate and extend upon prior work. We examined the extent to which NU and/or PU are uniquely associated with dysregulated eating, using a latent factor comprised of dimensional symptoms, and directly tested whether effects differ by sex. Two independent cross-sectional samples of women and men were used (Sample 1: Midwestern university, 437 females, 348 males; Sample 2: Southwestern university, 301 females, 236 males). NU and PU were assessed with the UPPS-P Impulsive Behavior Scale, and dysregulated eating symptoms (i.e., binge eating, loss of control eating, eating concerns) were assessed with well-validated self-report questionnaires. Although both NU and PU showed significant positive associations with dysregulated eating, NU showed the strongest unique relationship with dysregulated eating in both samples. The relative role of PU was weakened in Sample 1 and completely attenuated in Sample 2 once its shared variance with NU was accounted for. All results were similar in men and women. Overall, findings continue to suggest that NU is the form of impulsivity that is most relevant to dysregulated eating in both men and women.

背景与目标： : 消极紧迫感 (NU: 苦恼时轻率行事的倾向) 是冲动性人格的一个方面，它最能预测暴饮暴食，但对积极紧迫感的相对作用知之甚少 (PU: 对积极情绪做出反应时轻率行事的倾向)。此外，大多数研究都只针对女性，使用维度症状方法对病理性饮食结果的检查受到一定程度的限制。本研究旨在复制和扩展先前的工作。我们使用由维度症状组成的潜在因素检查了NU和/或PU与饮食失调的独特程度，并直接测试了效果是否因性别而异。使用了两个独立的女性和男性横截面样本 (样本1: 中西部大学，437名女性，348名男性; 样本2: 西南大学，301名女性，236名男性)。使用UPPS-P冲动行为量表评估NU和PU，并使用经过验证的自我报告问卷评估饮食失调的症状 (即暴饮暴食，饮食失控，饮食问题)。尽管NU和PU与饮食失调均显示出显着的正相关，但NU在两个样本中与饮食失调均显示出最强的独特关系。考虑到PU与NU的共同方差，PU的相对作用在样本1中减弱，而在样本2中完全减弱。所有结果在男性和女性中相似。总体而言，研究结果继续表明，NU是一种冲动形式，与男性和女性饮食失调最相关。

BACKGROUND & AIMS: :Cladribine is an approved drug for the treatment of highly active multiple sclerosis. We report a 28-years-old man with a poor response to previous treatments, elected to treatment with Cladribine. He developed a lichenoid rash two weeks after taking the first and second treatment cycles. This symptom regressed with specific therapy. A lichenoid drug eruption is a rare side effect which can occur following the administration of several different medications, but it has never been described after treatment with oral Cladribine.

背景与目标： : 克拉屈滨是一种被批准用于治疗高度活跃的多发性硬化症的药物。我们报告了一名28岁的男性，对先前的治疗反应不佳，选择接受克拉屈滨治疗。他在接受第一和第二个治疗周期后两周出现了苔藓样皮疹。这种症状在特定治疗后会消退。地衣样药疹是一种罕见的副作用，可以在服用几种不同的药物后发生，但在口服克拉屈滨治疗后从未描述过。

BACKGROUND & AIMS: :Rationale: Kawasaki disease (KD) is an acute vasculitis of small and medium vessels; whereas systemic lupus erythematosus (SLE) is a chronic systemic autoimmune disease. Their presentation is varied and not always straightforward, leading to misdiagnosis. There have been case reports of lupus onset mimicking KD and KD presenting as lupus-like. Coexistence of both diseases is also possible. Patient concerns: We present three adolescents, one with fever, rash, arthritis, nephritis, lymphopenia, and coronary aneurysms, a second patient with rash, fever, aseptic meningitis, and seizures, and a third patient with fever, rash, and pleural effusion. Diagnoses: The first patient was finally diagnosed with SLE and KD, the second patient initially diagnosed as KD but eventually SLE and the third patient was diagnosed at onset as lupus but finally diagnosed as KD. Interventions: The first patient was treated with IVIG, corticosteroids, aspirin, coumadin and mycophenolate mofetil. The second patient was treated with IVIG, corticosteroids and methotrexate and the third patient with IVIG, aspirin and corticosteroids. Lessons: Both diseases may mimic each other's clinical presentation. KD in adolescence presents with atypical signs, incomplete presentation, and develop coronary complications more commonly. An adolescent with fever and rash should include KD and SLE in the differential diagnosis.

背景与目标： : 原理: 川崎病 (KD) 是中小血管的急性血管炎; 而系统性红斑狼疮 (SLE) 是一种慢性全身性自身免疫性疾病。他们的介绍多种多样，并不总是直截了当，导致误诊。有病例报告称狼疮发作模仿KD和KD表现为狼疮样。两种疾病并存也是可能的。患者关注: 我们介绍了三名青少年，一名发热，皮疹，关节炎，肾炎，淋巴细胞减少和冠状动脉瘤，第二名患有皮疹，发热，无菌性脑膜炎和癫痫发作，第三名发热，皮疹和胸腔积液。诊断: 第一例患者最终被诊断为SLE和KD，第二例患者最初被诊断为KD，但最终被诊断为SLE，第三例患者在发病时被诊断为狼疮，但最终被诊断为KD。干预措施: 第一位患者接受IVIG，皮质类固醇，阿司匹林，香豆素和霉酚酸酯治疗。第二例患者接受IVIG，皮质类固醇和甲氨蝶呤治疗，第三例患者接受IVIG，阿司匹林和皮质类固醇治疗。经验教训: 两种疾病都可能模仿彼此的临床表现。青春期的KD表现为非典型体征，表现不完全，并更常见发生冠状动脉并发症。发热和皮疹的青少年应在鉴别诊断疾病中包括KD和SLE。

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BACKGROUND & AIMS: :Chronic Infantile Neurological Cutaneous and Articular (CINCA) syndrome, also called Neonatal Onset Multisystemic Inflammatory Disease (NOMID) is characterised by the triad of cutaneous rash, chronic meningitis and arthropathy. It is a chronic inflammatory illness that starts most often at birth and persists for the whole lifespan of the patient. Attempts at therapy have been disappointing. The long-term prognosis is poor, with progressive deafness and visual impairment, and worsening of the central nervous system manifestations. Some cases of death have been reported secondary to infection, vasculitis and amyloidosis. Usually observed as sporadic cases, some familial association is recognised.

背景与目标： : 慢性婴儿神经性皮肤和关节 (CINCA) 综合征，也称为新生儿发作的多系统炎性疾病 (NOMID)，其特征是皮疹，慢性脑膜炎和关节病的三联征。它是一种慢性炎症性疾病，最常在出生时开始，并持续到患者的整个生命周期。治疗的尝试令人失望。远期预后差，伴进行性耳聋和视力损害，中枢神经系统表现恶化。据报道，一些死亡病例是继发于感染，血管炎和淀粉样变性的。通常观察为零星病例，一些家族关联被认可。

BACKGROUND & AIMS: :Temozolomide is an oral alkylating agent used in the treatment of metastatic melanoma. Commonly reported adverse effects of the drug include nausea and vomiting, constipation, headache, and fatigue, as well as myelosuppression, which may be dose limiting. Few reports have described dermatologic adverse effects such as rash and pruritus, and, to our knowledge, none have discussed the seriousness or extensiveness of the rash. We describe a 37-year-old woman who was receiving temozolomide for treatment of metastatic melanoma. After 6 weeks of therapy, the patient developed an unexplained fever. The drug was discontinued, and the fever resolved within 2 days. Temozolomide was restarted 2 months later; the patient again developed a fever. This time the fever was accompanied by a diffuse erythematous skin rash that progressed to an extensive, full-body, desquamative skin rash. The rash was treated with moisturizing cream along with intravenous and topical corticosteroids and antibiotics. Due to the severity of the rash, temozolomide was permanently discontinued. Even after its discontinuation, the patient experienced the rash on a long-term basis, with periodic exacerbations. However, none were as severe as the first rash. The patient's metastatic disease remained stable for the next 2 years. According to the Naranjo adverse drug reaction probability scale, the likelihood that temozolomide was responsible for the adverse drug reaction of fever was probable (score of 6). Clinicians should be aware that an erythematous and exfoliative rash may be induced by temozolomide, and be familiar with the pharmacologic and supportive measures necessary for its treatment.

背景与目标： : 替莫唑胺是一种口服烷化剂，用于治疗转移性黑色素瘤。通常报道的药物的不良反应包括恶心和呕吐，便秘，头痛和乏力，以及骨髓抑制，这可能是剂量限制。很少有报道描述皮肤不良反应，例如皮疹和瘙痒，据我们所知，没有报道讨论皮疹的严重性或广泛性。我们描述了一名37岁的女性，她正在接受替莫唑胺治疗转移性黑色素瘤。治疗6周后，患者出现不明原因的发热。停药，2天内退烧。2个月后重新开始替莫唑胺治疗; 患者再次出现发热。这次发热伴有弥漫性红斑性皮疹，发展为广泛的全身脱屑性皮疹。皮疹用保湿霜以及静脉和局部皮质类固醇和抗生素治疗。由于皮疹的严重程度，替莫唑胺被永久停用。即使在停药后，患者仍长期出现皮疹，并定期发作。但是，没有一个像第一次皮疹那样严重。患者的转移性疾病在接下来的2年内保持稳定。根据Naranjo药物不良反应概率量表，替莫唑胺可能导致发热药物不良反应 (得分为6)。临床医生应注意，替莫唑胺可能会诱发红斑和剥脱性皮疹，并熟悉其治疗所需的药理和支持措施。

BACKGROUND & AIMS: PURPOSE:Cutaneous adverse reactions from antiepileptic drugs (AEDs) are common, but have received little scientific attention from a clinical point of view. We wanted to study the incidence of skin reactions of current AEDs and to explore their relation to clinical parameters such as gender, age, and learning disability. METHODS:Consecutive patients with epilepsy were studied retrospectively. A detailed survey of medical records concerning all treatment with AEDs was performed. RESULTS:A total of 663 patients were included with altogether 2,567 exposures to 15 different AEDs. Skin reactions were found in 14% of the patients and in 5% of the exposures. Ninety-seven percent of the reactions occurred to either carbamazepine (CBZ, 11%), phenytoin (PHT, 8%), lamotrigine (LTG, 8%), oxcarbazepine (8%), or phenobarbital (2%). Skin reactions developed significantly more often in females than in males (19% vs. 8%), and significantly less often in patients with learning disability than in other patients (7% vs. 16%). These differences were significant for CBZ, PHT, and LTG when analyzed separately. Females displayed higher rash frequency during the reproductive years, while men experienced less frequent rash in the same phase of life. CONCLUSIONS:Fertile females have a higher risk for skin reactions compared to males, probably due to hormonal factors. Patients with learning disability appeared to have a lower risk than other patients in this study. Hygiene factors may possibly be underlying.

背景与目标：

BACKGROUND & AIMS: :Rash and other cutaneous adverse events are class-effect toxicities seen with therapeutic agents such as the small-molecule tyrosine kinase inhibitors erlotinib and gefitinib and monoclonal antibodies cetuximab and panitumumab, targeting the epidermal growth factor receptor (EGFR) in the treatment of cancer. Rash has been reported in approximately two thirds of patients treated with these agents in phase II/III clinical trials in different tumor types. The rash that occurs with EGFR-targeted agents is generally mild to moderate; severe (grade 3/4) rash is rare (< 15% in non-small-cell lung carcinoma trials). In a number of clinical trials, the association of the incidence and severity of rash with response and survival after treatment with erlotinib or gefitinib has been analyzed. Although the significance of the association is yet to be determined, in most studies, a positive correlation between rash and clinical outcomes with EGFR-targeted therapy has been demonstrated. Therefore, the potential of using rash as a surrogate marker for efficacy of EGFR inhibitors in lung cancer therapy exists and needs to be further explored. This article provides a review of the data evaluating the association between rash and treatment outcomes and summarizes the current knowledge regarding the significance of this association. Understanding the biology/etiology of the rash resulting from EGFR inhibitors and assessing its correlation with treatment outcomes in large, prospective trials will help define the role of rash as a surrogate marker for efficacy of EGFR-targeted therapy.

背景与目标： : 皮疹和其他皮肤不良事件是治疗剂 (例如小分子酪氨酸激酶抑制剂厄洛替尼和吉非替尼) 以及单克隆抗体西妥昔单抗和帕尼单抗 (靶向表皮生长因子受体 (EGFR)) 治疗的类效应毒性癌症。在不同肿瘤类型的II/III期临床试验中，大约3分之2的用这些药物治疗的患者中报道了皮疹。EGFR靶向药物发生的皮疹通常为轻度至中度; 严重 (3/4级) 皮疹很少见 (在非小细胞肺癌试验中 <15%)。在许多临床试验中，已经分析了用厄洛替尼或吉非替尼治疗后皮疹的发生率和严重程度与反应和生存率的关系。尽管该关联的重要性尚未确定，但在大多数研究中，已经证明了皮疹与EGFR靶向治疗的临床结果之间的正相关。因此，使用皮疹作为EGFR抑制剂在肺癌治疗中疗效的替代标志物的潜力存在，需要进一步探索。本文回顾了评估皮疹与治疗结果之间关联的数据，并总结了有关这种关联重要性的当前知识。了解由EGFR抑制剂引起的皮疹的生物学/病因学，并在大型前瞻性试验中评估其与治疗结果的相关性，将有助于确定皮疹作为EGFR靶向治疗疗效的替代标志物的作用。

BACKGROUND & AIMS: :Primary care practitioners in the pediatric setting treat children for numerous skin complaints. The most frequently seen dermatologic conditions are those that are persistent and cause children discomfort, such as atopic, contact seborrheic dermatitis and tinea infections. Familiarity with the presentation, pathophysiology, and treatment of these common skin conditions enables the practitioner to successfully manage these rashes.

背景与目标： : 儿科医生为儿童治疗许多皮肤不适。最常见的皮肤病是那些持续存在并引起儿童不适的疾病，例如特应性，接触性脂溢性皮炎和癣感染。熟悉这些常见皮肤病的表现，病理生理学和治疗，使医生能够成功地处理这些皮疹。

BACKGROUND & AIMS: :Boceprevir and telaprevir are 2 specific inhibitors of the hepatitis C (HCV) serine protease 3. Cutaneous side effects have been reported with high frequency, essentially rash, and dry skin. We report a case of drug rash with eosinophilia and systemic symptoms (DRESS) due to boceprevir. A 56-year-old African woman with chronic hepatitis C complicated with cirrhosis and cryoglobulinemia received pegylated interferon alfa-2a (PegIFN) and ribavirin (RBV) for 4 weeks and then boceprevir was added. She was also co-infected with HIV state A2. Eight weeks after adding boceprevir she developed a generalized maculopapular exanthema with fever, facial oedema, apparition of lymph node and alteration of the general state. She presented an eosinophilia (up to 3.0 × 10(9)cells/L), no biological inflammatory syndrome. The computed tomography revealed several lymph nodes located in the abdominal and inguinal areas. The cutaneous biopsy was consistent with a drug rash reaction. The HCV treatment was stopped and the patient was treated with topical steroids. Cutaneous and systemic symptoms disappeared in few weeks. Boceprevir was considered the culprit drug. We report to our knowledge the first case of DRESS due to boceprevir.

背景与目标： : Boceprevir和telaprevir是丙型肝炎 (HCV) 丝氨酸蛋白酶3的2种特异性抑制剂。据报道，皮肤副作用高频率，基本上是皮疹和皮肤干燥。我们报告了一例因boceprevir引起的嗜酸性粒细胞增多和全身症状 (DRESS) 的药疹。一名56岁的慢性丙型肝炎并发肝硬化和冷球蛋白血症的非洲妇女接受聚乙二醇化干扰素alfa-2a (PegIFN) 和利巴韦林 (RBV) 治疗4周，然后加入boceprevir。她还与HIV状态a2共同感染。添加boceprevir八周后，她出现了广泛性斑丘疹，发热，面部水肿，淋巴结出现和一般状态改变。患者出现嗜酸性粒细胞增多 (最多3.0 × 10(9) 个细胞/L)，无生物性炎症综合征。计算机断层扫描显示位于腹部和腹股沟区域的几个淋巴结。皮肤活检与药疹反应一致。HCV治疗停止，患者接受局部类固醇治疗。皮肤和全身症状在几周内消失。Boceprevir被认为是罪魁祸首。据我们所知，由于boceprevir，我们报告了第一例着装。