The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform

P Haeusermann - One of the best experts on this subject based on the ideXlab platform.

  • acute generalized exanthematous pustulosis induced by the antifungal terbinafine case report and review of the literature
    British Journal of Dermatology, 2005
    Co-Authors: H S Beltraminelli, Marianne Lerch, A Arnold, Andreas J Bircher, P Haeusermann
    Abstract:

    Cutaneous drug reactions occur with a frequency of 1-8% and can be higher for certain classes of drugs. They can range from mild Morbilliform eruptions to more severe forms such as drug-hypersensitivity syndrome, toxic epidermal necrolysis or anaphylaxis. Acute generalized exanthematous pustulosis (AGEP) is considered to be a clinical reaction pattern, which is induced in over 90% of the cases by systemic drugs. It is a rare presentation of an adverse drug reaction most frequently triggered by anti-infectious drugs. A high proportion of these cases have been attributed to aminopenicillins and macrolides. We report a terbinafine-induced AGEP in a 68-year-old male confirmed by lymphocyte stimulation in vitro, and review the published cases induced by antimycotic drugs with special emphasis on terbinafine-triggered cases.

William T Kent - One of the best experts on this subject based on the ideXlab platform.

  • antibiotic impregnated intramedullary cement nail induced acute generalized exanthematous pustulosis and septic shock a case report
    Journal of Bone and Joint Surgery American Volume, 2020
    Co-Authors: Brendon C Mitchell, Paul J Girard, William T Kent
    Abstract:

    CASE A 28-year-old woman with an infected proximal femur nonunion was treated with an antibiotic-coated intramedullary nail. Shortly after discharge, the patient presented to the emergency department and was readmitted with a Morbilliform rash sparing the left lower extremity. She became hemodynamically unstable, despite cessation of intravenous antibiotics, requiring transfer to the intensive care unit and urgent removal of her antibiotic nail. She improved after surgery, and biopsy results from the rash confirmed acute generalized examthematous pustulosis. CONCLUSION Acute generalized exanthematous pustulosis is a rare, dermatologic crisis that can be precipitated by antibiotics, even in the form of antibiotic cement.

David A. Cooper - One of the best experts on this subject based on the ideXlab platform.

  • Immunohistological assessment of cutaneous drug hypersensitivity in patients with HIV infection
    Clinical and experimental immunology, 2008
    Co-Authors: Andrew Carr, E Vasak, V Munro, Ronald Penny, David A. Cooper
    Abstract:

    The pathogenesis of drug hypersensitivity in patients with HIV infection is unknown. To study further the nature of hypersensitivity, the histopathological features of Morbilliform drug hypersensitivity reactions were examined in a group of HIV-infected patients. Skin sections from 23 HIV-infected subjects with Morbilliform drug hypersensitivity reactions were examined by light microscopy, direct immunofluorescence and immunohistochemistry, to determine the nature of the inflammatory infiltrate and the role of immunoglobulin, complement and cytokines. The principal light microscopic findings were spongiosis, hydropic generation of the basal layer, civatte bodies, an epidermal lymphocytic infiltrate (48%), and a perivascular dermal infiltrate of lymphocytes (87%) and macrophages (52%). Two patients had findings consistent with toxic epidermal necrolysis. Immunohistochemistry demonstrated that the lymphocytic infiltrate consisted of CD8+, HLA-DR+ T lymphocytes (some of which also stained for CD38), a marked depletion of epidermal Langerhans cells (90%), and strong cytoplasmic staining of keratinocytes for IL-6 (60%), IL-1 beta (50%), tumour necrosis factor-alpha (TNF-alpha) (45%) and to a lesser degree, interferon-gamma (IFN-gamma) (35%). Immunofluorescence did not demonstrate any significant deposition of immunoglobulin or complement. The histological findings were independent of the responsible drug, the duration of either therapy or the rash, and of peripheral blood CD4+ and CD8+ cell counts. These findings suggest that activated CD8+ lymphocytes and perhaps epidermal production of cytokines are involved in the pathogenesis of cutaneous drug hypersensitivity in HIV-infected patients. The common histological features, regardless of the causative drug, suggest a common pathogenesis.

D Brown - One of the best experts on this subject based on the ideXlab platform.

  • ORIGINAL ARTICLE Causes of Morbilliform rash in a highly immunised
    2016
    Co-Authors: English Population, M Ramsay, M Reacher, R Buttery, F Hadden, B Cohen, W Knowles, T Wreghitt, D Brown
    Abstract:

    Aims: To determine the causes of Morbilliform rash and fever in a population with high vaccination coverage for measles and rubella. Methods: Comprehensive laboratory investigation additional to routine oral fluid testing of children presenting to primary care physicians in East Anglia, England. Results: Laboratory confirmation of infection was obtained in 93 (48%) of 195 children: parvovirus B19 in 34 (17%); group A streptococcus in 30 (15%); human herpesvirus type 6 in 11 (6%); enterovi-rus in nine (5%); adenovirus in seven (4%); and group C streptococcus in six (3%) (four individuals tested positive for two agents). None had measles or rubella. Conclusions: Oral fluid testing to cover infections additional to measles and rubella aids clinical man-agement and is likely to maintain uptake of testing, which is essential for measles and rubella surveil-lance in highly immunised low incidence populations. The infectious causes of Morbilliform rash and fever inchildhood are varied and include measles virus, rubellavirus, group A streptococci (GAS)—the cause of scarlet fever, parvovirus B19, non-polio enteroviruses, adenoviruses, and human herpesvirus type 6 (HHV6).1 Laboratory investiga-tion is therefore necessary for accurate diagnosis. In popula

  • causes of Morbilliform rash in a highly immunised english population
    Archives of Disease in Childhood, 2002
    Co-Authors: M Ramsay, M Reacher, R Buttery, F Hadden, W Knowles, T Wreghitt, C Oflynn, B J Cohen, D Brown
    Abstract:

    Aims: To determine the causes of Morbilliform rash and fever in a population with high vaccination coverage for measles and rubella. Methods: Comprehensive laboratory investigation additional to routine oral fluid testing of children presenting to primary care physicians in East Anglia, England. Results: Laboratory confirmation of infection was obtained in 93 (48%) of 195 children: parvovirus B19 in 34 (17%); group A streptococcus in 30 (15%); human herpesvirus type 6 in 11 (6%); enterovirus in nine (5%); adenovirus in seven (4%); and group C streptococcus in six (3%) (four individuals tested positive for two agents). None had measles or rubella. Conclusions: Oral fluid testing to cover infections additional to measles and rubella aids clinical management and is likely to maintain uptake of testing, which is essential for measles and rubella surveillance in highly immunised low incidence populations.

W J Pichler - One of the best experts on this subject based on the ideXlab platform.

  • skin and laboratory tests in amoxicillin and penicillin induced Morbilliform skin eruption
    Clinical & Experimental Allergy, 2000
    Co-Authors: B Schnyder, W J Pichler
    Abstract:

    Background Cutaneous amoxicillin- and penicillin-mediated reactions can be classified as immediate and delayed-type reactions. Immediate reactions are thought to involve IgE antibodies and have been studied extensively. In contrast only few data exist about delayed reactions such as Morbilliform or maculopapular rash. Objective To assess the predictive value of immediate skin tests, skin-patch tests, specific IgE and lymphocyte transformation tests with regard to the diagnosis of delayed skin eruptions. Methods Skin and in vitro tests were performed in 18 subjects. Twelve subjects had penicillin- or amoxicillin-induced Morbilliform exanthema and six were controls without hypersensitivity reaction, tested before and after exposure. Results Specific IgE to penicillin and immediate penicillin skin tests were negative in amoxicillin- or penicillin-induced delayed skin eruptions. In contrast, skin-patch testing and LTT were positive in 9/12 or 10/12, respectively, but negative in all six controls. Conclusion These findings substantiate a T-cell-mediated immune pathomechanism in the majority of penicillin-induced delayed skin reaction. Moreover, they underline the necessity to adapt the test procedures to underlying pathomechanisms and support the diagnostic value of skin-patch testing and LTT in delayed cutaneous reactions to penicillins.