- Email: [email protected]
FC152 Itraconazole is effective in the treatment of Majocchi's granuloma: A clinical and pharmacokinetic evaluation
Free Communications
periods using of Cyclosporin A, provide encouraging pathway treatment of Pyoderma Gangrenosum. FC150
Cutaneous toxicity associated with high-dose cytosine arabinoside
P. Cetkovska’ , K. Pizinger’, Dermatology; 2Department Charles University Hospital,
P. Skopek2. ‘Department of Haematology Pilsen, Czech
of
and Oncology,
-
dosage schedule of each pulse was 200 mg twice daily for 1 week with 2 weeks off therapy between successive pulses. Two pulses of itraconazole therapy are effective in the treatment of Majocchi’s granuloma. It is also possible that one pulse may be sufficient in some patients. FC153
Republic
High-dose cytosine arabinoside (HiDAC) is used increasingly to treat haematological malignancies. The therapy is associated with various nonhaematological toxicities frequently involving the skin. The purpose of the study was to evaluate the actual occurrence of HiDAC adverse skin reactions. One hundred and eight patients with acute myelogenous leukemia (n = 73) and acute lymphoblastic leukemia (n = 35) between 16 and 71 years of age were treated with 141 post-remission consolidation regimens with HiDAC in combination with standard doses of other cytotoxic drugs (33 patients received 2 courses). The incidence of cutaneous toxicity was 5 1.1% with rashes occurring in 76.6% and 38.3% of subjects having received total doses of 30 and 24 gl sq m, respectively. Surprisingly, the second regimens in 33 patients did not reproduce the reactions in patients suffering from the rash after the first course (46 vs 33%). Morbilliform eruptions over the trunk and extremities and painful erythematous desquamating lesions of palms and soles were most commonly observed, onycholysis developed in occasional cases. The onset ranged from day 8 to day 20 of treatment, the rash generally resolved within 2 weeks. In conclusion, HiDAC induced cutaneous toxicity in 5 1% of patients. These skin changes were dose-related, fully reversible and generally not requiring treatment.
s151
Therapy
The efficacy of oral potassium iodide in the treatment of erythema multiforme
I. Candan, I.E. Aydmoz, T. Mansur. Haydarpaya Hospital,
Istanbul,
Numune
Turkey
Erythema multiforme (EM) is a frequently recurrent but selflimited syndrome characterized by the abrupt onset of symmetrical red papules some of which evolve into distinctive target lesions. The clinical course is variable lasting up to 3 to 4 weeks. In this open trial clinical efficacy of oral potassium iodide (KI) was assessed in 13 patients with a treatment period of 7 days. The therapy was initiated within maximum 7 days after clinical onset in all of our patients. In each patient clinical features were scored on admission and during treatment on the 3rd and 7th days. KI was initially started with a dose of 2 x 200 mg/day and in only 2 patients due to absence of symptomatic relief, it was increased to 3 x 200 mg on the 3rd day. There was a dramatic healing in all of our patients at the end of a week. The average pretreatment score which was 9.07 f 2.36 was found to be reduced to 0.62 f 0.77 which is statistically significant (p < 0.05). Side effects were recorded in 2 patients, which did not necessitate drug cessation. In conclusion, oral KI is found to be an effective alternative drug in the symptomatic treatment of EM reducing disease course with few side effects. FCI 54 A retrospective
FC151
Dermatitis fragellaris as a rare side effect of the Bleomycin included chemotherapy
I. Orojan, L. T&ok, M. Tapai. Dermatology County
Hospital,
Kecskeme’t,
Department,
Hungary
Our 48-year-old non-Hodgkin’s lymphomas female patient has been given operation, irradiation, and chemotherapy since 1978. She was given Bleomycin medication combined treatment in 1997. Within 24 hours sharp-edged, stripe like, protruding, pruritic laesions appeared on her whole body. After the withdrawal of Bleomycin medication the laesions regrediated leaving hyperpigmentation behind. During the chemotherapy containing Bleomycin rarely but recognisable dermatitis fragellaris occurs. FC152
ltraconazole is effective in the treatment of Majocchi’s granuloma: A clinical and pharmacokinetic evaluation
A.K. Gupta ’ , P. De Doncker 2. ’ University 2 Janssen
Research
Foundation,
of Toronto;
Canada
Four patients (age range: 25-66 years) with Majocchi’s granuloma were effectively treated with clinical and mycological cure using itraconazole therapy given as pulse dosing. None of the patients has relapsed over a one year following period. The
study on the clinical presentation and outcome of herpes zoster in a tertiary dermatology outpatient referral clinic
C.L. Goh, L. Khoo. National
Skin Centre,
Singapore
This is a retrospective study on the epidemiology and morbidity of herpes zoster and risk factors for herpes zoster morbidity in Singapore. The mean age of 164 patients with herpes zoster was 48.8 years with a 1:l sex ratio. The common presenting symptoms were pain (90%) followed by feeling helpless/depressed (20%) and flu-like symptoms (12%). The commonest prodrome include pain (41%), itch (27%) and paraesthesia (12%). Prodromal pain was more frequently experienced by patients >50 year (42%) than patients 130 years (25%). The thoracic (45%), followed by the cervical (23%) dermatomes were the commonest affected dermatomes in all age groups. Pain was experienced by 95% patients during the course of their disease. It tends to be more severe in older patients. A higher proportion of old patients (>50 years old) (20%) suffered from the post herpetic neuralgia compared to the younger patient (~30 years old) (7%) (ns). Patients in all age group considered the acute pain (46%) and persistent pain (25%) as their most unbearable symptoms during the course of their herpes zoster. Insomnia was significantly more commonly experienced by patients >50 years old (36%) than those ~30 years old (p = 0.026).
periods using of Cyclosporin A, provide encouraging pathway treatment of Pyoderma Gangrenosum. FC150
Cutaneous toxicity associated with high-dose cytosine arabinoside
P. Cetkovska’ , K. Pizinger’, Dermatology; 2Department Charles University Hospital,
P. Skopek2. ‘Department of Haematology Pilsen, Czech
of
and Oncology,
-
dosage schedule of each pulse was 200 mg twice daily for 1 week with 2 weeks off therapy between successive pulses. Two pulses of itraconazole therapy are effective in the treatment of Majocchi’s granuloma. It is also possible that one pulse may be sufficient in some patients. FC153
Republic
High-dose cytosine arabinoside (HiDAC) is used increasingly to treat haematological malignancies. The therapy is associated with various nonhaematological toxicities frequently involving the skin. The purpose of the study was to evaluate the actual occurrence of HiDAC adverse skin reactions. One hundred and eight patients with acute myelogenous leukemia (n = 73) and acute lymphoblastic leukemia (n = 35) between 16 and 71 years of age were treated with 141 post-remission consolidation regimens with HiDAC in combination with standard doses of other cytotoxic drugs (33 patients received 2 courses). The incidence of cutaneous toxicity was 5 1.1% with rashes occurring in 76.6% and 38.3% of subjects having received total doses of 30 and 24 gl sq m, respectively. Surprisingly, the second regimens in 33 patients did not reproduce the reactions in patients suffering from the rash after the first course (46 vs 33%). Morbilliform eruptions over the trunk and extremities and painful erythematous desquamating lesions of palms and soles were most commonly observed, onycholysis developed in occasional cases. The onset ranged from day 8 to day 20 of treatment, the rash generally resolved within 2 weeks. In conclusion, HiDAC induced cutaneous toxicity in 5 1% of patients. These skin changes were dose-related, fully reversible and generally not requiring treatment.
s151
Therapy
The efficacy of oral potassium iodide in the treatment of erythema multiforme
I. Candan, I.E. Aydmoz, T. Mansur. Haydarpaya Hospital,
Istanbul,
Numune
Turkey
Erythema multiforme (EM) is a frequently recurrent but selflimited syndrome characterized by the abrupt onset of symmetrical red papules some of which evolve into distinctive target lesions. The clinical course is variable lasting up to 3 to 4 weeks. In this open trial clinical efficacy of oral potassium iodide (KI) was assessed in 13 patients with a treatment period of 7 days. The therapy was initiated within maximum 7 days after clinical onset in all of our patients. In each patient clinical features were scored on admission and during treatment on the 3rd and 7th days. KI was initially started with a dose of 2 x 200 mg/day and in only 2 patients due to absence of symptomatic relief, it was increased to 3 x 200 mg on the 3rd day. There was a dramatic healing in all of our patients at the end of a week. The average pretreatment score which was 9.07 f 2.36 was found to be reduced to 0.62 f 0.77 which is statistically significant (p < 0.05). Side effects were recorded in 2 patients, which did not necessitate drug cessation. In conclusion, oral KI is found to be an effective alternative drug in the symptomatic treatment of EM reducing disease course with few side effects. FCI 54 A retrospective
FC151
Dermatitis fragellaris as a rare side effect of the Bleomycin included chemotherapy
I. Orojan, L. T&ok, M. Tapai. Dermatology County
Hospital,
Kecskeme’t,
Department,
Hungary
Our 48-year-old non-Hodgkin’s lymphomas female patient has been given operation, irradiation, and chemotherapy since 1978. She was given Bleomycin medication combined treatment in 1997. Within 24 hours sharp-edged, stripe like, protruding, pruritic laesions appeared on her whole body. After the withdrawal of Bleomycin medication the laesions regrediated leaving hyperpigmentation behind. During the chemotherapy containing Bleomycin rarely but recognisable dermatitis fragellaris occurs. FC152
ltraconazole is effective in the treatment of Majocchi’s granuloma: A clinical and pharmacokinetic evaluation
A.K. Gupta ’ , P. De Doncker 2. ’ University 2 Janssen
Research
Foundation,
of Toronto;
Canada
Four patients (age range: 25-66 years) with Majocchi’s granuloma were effectively treated with clinical and mycological cure using itraconazole therapy given as pulse dosing. None of the patients has relapsed over a one year following period. The
study on the clinical presentation and outcome of herpes zoster in a tertiary dermatology outpatient referral clinic
C.L. Goh, L. Khoo. National
Skin Centre,
Singapore
This is a retrospective study on the epidemiology and morbidity of herpes zoster and risk factors for herpes zoster morbidity in Singapore. The mean age of 164 patients with herpes zoster was 48.8 years with a 1:l sex ratio. The common presenting symptoms were pain (90%) followed by feeling helpless/depressed (20%) and flu-like symptoms (12%). The commonest prodrome include pain (41%), itch (27%) and paraesthesia (12%). Prodromal pain was more frequently experienced by patients >50 year (42%) than patients 130 years (25%). The thoracic (45%), followed by the cervical (23%) dermatomes were the commonest affected dermatomes in all age groups. Pain was experienced by 95% patients during the course of their disease. It tends to be more severe in older patients. A higher proportion of old patients (>50 years old) (20%) suffered from the post herpetic neuralgia compared to the younger patient (~30 years old) (7%) (ns). Patients in all age group considered the acute pain (46%) and persistent pain (25%) as their most unbearable symptoms during the course of their herpes zoster. Insomnia was significantly more commonly experienced by patients >50 years old (36%) than those ~30 years old (p = 0.026).