V ambulanci praktického lékaře pro děti a dorost se každoročně v jarních měsících setkáváme s nárůstem exantémových infekčních nemocí, zejména pátou a šestou dětskou nemocí a planými neštovicemi. Tyto nemoci se léčí v naprosté většině pouze symptomaticky. V ambulanci PLDD u dětí s typickými projevy těchto nemocí klasickou léčbu doplňuji homeopatiky, která pomáhají imunitnímu systému a rychlejší úzdravě.
Every year in the spring months, general paediatricians encounter an increased number of exanthematous infectious diseases, particularly the fifth disease and sixth disease and chickenpox. The treatment of these diseases is only symptomatic in the vast majority of cases. In children with typical manifestations of these diseases, I supplement the classic treatment with homeopathics which are beneficial for the immune system and a more rapid recovery.
- MeSH
- Child MeSH
- Exanthema * therapy MeSH
- Homeopathy * methods MeSH
- Humans MeSH
- Materia Medica pharmacology therapeutic use MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Publication type
- Review MeSH
OBJECTIVES: To compare clinical characteristics, including the frequency of cutaneous, extramuscular manifestations and malignancy, between adults with anti-synthetase syndrome (ASyS) and DM. METHODS: Using data regarding adults from the MYONET registry, a cohort of DM patients with anti-Mi2/-TIF1γ/-NXP2/-SAE/-MDA5 autoantibodies, and a cohort of ASyS patients with anti-tRNA synthetase autoantibodies (anti-Jo1/-PL7/-PL12/-OJ/-EJ/-Zo/-KS) were identified. Patients with DM sine dermatitis or with discordant dual autoantibody specificities were excluded. Sub-cohorts of patients with ASyS with or without skin involvement were defined based on presence of DM-type rashes (heliotrope rash, Gottron's papules/sign, violaceous rash, shawl sign, V-sign, erythroderma, and/or periorbital rash). RESULTS: In total 1054 patients were included (DM, n = 405; ASyS, n = 649). In the ASyS cohort, 31% (n = 203) had DM-type skin involvement (ASyS-DMskin). A higher frequency of extramuscular manifestations, including Mechanic's hands, Raynaud's phenomenon, arthritis, interstitial lung disease and cardiac involvement differentiated ASyS-DMskin from DM (all P < 0.001), whereas higher frequency of any of four DM-type rashes-heliotrope rash (n = 248, 61% vs n = 90, 44%), violaceous rash (n = 166, 41% vs n = 57, 9%), V-sign (n = 124, 31% vs n = 28, 4%), and shawl sign (n = 133, 33% vs n = 18, 3%)-differentiated DM from ASyS-DMskin (all P < 0.005). Cancer-associated myositis (CAM) was more frequent in DM (n = 67, 17%) compared with ASyS (n = 21, 3%) and ASyS-DMskin (n = 7, 3%) cohorts (both P < 0.001). CONCLUSION: DM-type rashes are frequent in patients with ASyS; however, distinct clinical manifestations differentiate these patients from classical DM. Skin involvement in ASyS does not necessitate increased malignancy surveillance. These findings will inform future ASyS classification criteria and patient management.
- MeSH
- Amino Acyl-tRNA Synthetases immunology MeSH
- Autoantibodies * blood immunology MeSH
- Dermatomyositis * immunology complications MeSH
- Adult MeSH
- Exanthema etiology MeSH
- Lung Diseases, Interstitial immunology etiology MeSH
- Middle Aged MeSH
- Humans MeSH
- Myositis * immunology complications MeSH
- Neoplasms complications MeSH
- Registries * MeSH
- Aged MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Comparative Study MeSH
- Keywords
- blueberry muffin,
- MeSH
- Diagnosis, Differential MeSH
- Exanthema * diagnosis etiology pathology MeSH
- Hematologic Neoplasms pathology congenital MeSH
- Infections pathology MeSH
- Humans MeSH
- Vascular Diseases pathology MeSH
- Infant, Newborn MeSH
- Check Tag
- Humans MeSH
- Infant, Newborn MeSH
- Publication type
- Review MeSH
- Keywords
- kód diagnozy B08,
- MeSH
- Data Analysis MeSH
- Child MeSH
- Epidemiological Monitoring MeSH
- Erythema Infectiosum etiology MeSH
- Exanthema * epidemiology etiology classification MeSH
- Exanthema Subitum etiology complications MeSH
- Herpangina etiology MeSH
- Skin Diseases * diagnosis etiology virology MeSH
- Cowpox MeSH
- Humans MeSH
- Molluscum Contagiosum MeSH
- Hand, Foot and Mouth Disease diagnosis etiology complications MeSH
- Foot-and-Mouth Disease etiology MeSH
- Mouth Mucosa pathology MeSH
- Yatapoxvirus MeSH
- Animals MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Animals MeSH
- Geographicals
- Czech Republic MeSH
Systémová terapie maligního melanomu prošla v posledních deseti letech velkým vývojem způsobeným objevením nových léčiv ze skupin imunoterapeutik a cílených léků. Tyto látky signifikantně zvyšují četnost remisí a prodlužují celkové přežití pacientů s metastazujícím melanomem. Vedle prokázaného protinádorového efektu ale mají řadu specifických nežádoucích účinků, které mohou ovlivnit průběh a účinnost onkologické léčby, a mohou být pro pacienta potenciálně život ohrožující. Tyto vedlejší reakce se velmi často projeví na kůži. Kožní toxicita je zpravidla méně závažná a ve většině případů nevyžaduje přerušení léčby. Nicméně může mít významný vliv na kvalitu života pacientů a tím i na jejich adherenci k léčbě. V případě imunoterapie se jedná především o vznik nespecifického makulopapulózního exantému, vitiliga a pruritu, u cílené léčby pak o rozvoj fotosenzitivity, vznik spinaliomů či o tvorbu bolestivých hyperkeratóz. Cílem článku je podat stručný přehled o kožních nežádoucích účincích systémové léčby spolu s nástinem základních možností jejich terapeutického ovlivnění.
The systemic therapy of malignant melanoma has undergone great development in the last ten years due to the discovery of new drugs from the groups of immunotherapeutics and targeted drugs. These substances significantly increase the frequency of remissions and prolong the overall survival of patients with metastatic melanoma. In addition to the proven anti-tumor effect, however, they have a number of specific side effects that can affect the course and effectiveness of oncological treatment, and can be potentially life-threatening for the patient. These side effects are very often manifested on the skin. Skin toxicity is usually less severe and in most cases does not require treatment interruption. However, it can have a significant impact on patients' quality of life and thus on their adherence to treatment. In the case of immunotherapy, it is primarily the development of a non-specific maculopapular exanthema, vitiligo and pruritus, while with targeted treatment, the development of photosensitivity, the development of squamous cell carcinoma or the formation of painful hyperkeratoses. The aim of the article is a brief overview of the skin side effects of systemic treatment together with an outline of the basic possibilities of their therapeutic influence.
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- MeSH
- Diagnosis, Differential MeSH
- Child MeSH
- Exanthema * diagnosis etiology drug therapy MeSH
- Drug Eruptions diagnosis drug therapy MeSH
- Humans MeSH
- Virus Diseases MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Publication type
- Review MeSH
Unilaterálny exantém najčastejšie s postihnutím laterálnej časti hrudníka (ULTE), axily a priľahlej hornej končatiny, známy aj ako asymetrický periflexulárny exantém (APEC), je ochorenie neznámej etiológie. Boli však referované prípady asociované s vírusovou infekciou Epsteina-Barrovej, parvovirusom 19, ako aj vírusom SARS-CoV-2. Exantém je charakterizovaný tvorbou erytematóznych mierne svrbivých makulopapúl, najčastejšie sa vyskytujúcich v detskom veku, typicky spontánne zregreduje s podpornou symptomatickou liečbou v priebehu 2 - 6 týždňov. Autori prezentujú kazuistiku prípadu 10-ročného pacienta s prejavmi ULTE, doplnenú histologickým vyšetrením z kožných prejavov.
Unilatheral Laterothoracic Exnthema (ULTE), also known as asymetrical periflexular exanthema of childhood (APEC), is a disorder of unknown aetiology. However, it has been associated with viral infections, such as Epstein-Barr virus, parvovirus 19 and SARS-CoV-2 infection. It is characterized by unilateral papular exanthema with mild pruritus, that is prevalent in children. Treatment is symptomatic with resolution at 2-6 weeks. The authors present case report of a 10-year-old patient with symptoms of ULTE, supplemented by histology examination of skin manifestations.
- Keywords
- asymetrický periflexulární exantém,
- MeSH
- Diagnosis, Differential MeSH
- Child MeSH
- Exanthema * diagnosis drug therapy MeSH
- Upper Extremity pathology MeSH
- Humans MeSH
- Torso pathology MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Case Reports MeSH
DRESS syndrome is an idiosyncratic drug reaction and potentially life-threatening. The authors report a case of this syndrome presenting with fever, rash, mucosal involvement, liver and muscle involvement associated with moxifloxacin treatment.
- MeSH
- Eosinophilia * chemically induced diagnosis MeSH
- Exanthema * chemically induced diagnosis MeSH
- Liver MeSH
- Drug Hypersensitivity Syndrome * diagnosis etiology MeSH
- Humans MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Case Reports MeSH
- MeSH
- Epinephrine pharmacology therapeutic use MeSH
- Anaphylaxis * etiology drug therapy MeSH
- Histamine Antagonists pharmacology therapeutic use MeSH
- Diabetes Mellitus, Type 1 * diagnosis drug therapy MeSH
- Child MeSH
- Exanthema etiology drug therapy MeSH
- Glucocorticoids pharmacology therapeutic use MeSH
- Insulin pharmacology therapeutic use MeSH
- Humans MeSH
- Treatment Outcome MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Case Reports MeSH
Autori popisujú prípad 90-ročného pacienta s výsevom vzniknutým niekoľko hodín po podaní amoxicilín klavulanátu. Na základe prítomnosti charakteristických klinických prejavov bola stanovená diagnóza symetrický liekmi navodený intertriginózny a flexurálny exantém. Prípad bol z diferenciálne-diagnostického hľadiska komplikovaný aj koexistenciou arteficiálne vzniknutého edému dolnej končatiny. Autori uvádzajú prehľad súčasných poznatkov o diagnostických a terapeutických možnostiach v manažmente tejto zriedkavej klinickej entity.Autori popisujú prípad 90-ročného pacienta s výsevom vzniknutým niekoľko hodín po podaní amoxicilín klavulanátu. Na základe prítomnosti charakteristických klinických prejavov bola stanovená diagnóza symetrický liekmi navodený intertriginózny a flexurálny exantém. Prípad bol z diferenciálne-diagnostického hľadiska komplikovaný aj koexistenciou arteficiálne vzniknutého edému dolnej končatiny. Autori uvádzajú prehľad súčasných poznatkov o diagnostických a terapeutických možnostiach v manažmente tejto zriedkavej klinickej entity.
The authors describe a case of a 90-year-old patient with a rash that appeared a few hours after administration of amoxicillin clavulanate. Based on the presence of characteristic clinical features, a diagnosis of symmetrical drug- -related intertriginous and flexural exanthema was established. From the differential diagnosis point of view, the case was also complicated by the coexistence of artificially induced edema of the lower limb. The authors present an overview of current knowledge on diagnostic and therapeutic options in the management of this rare clinical entity.
- Keywords
- SDRIFE,
- MeSH
- Amoxicillin * administration & dosage adverse effects therapeutic use MeSH
- Anti-Bacterial Agents administration & dosage adverse effects therapeutic use MeSH
- Lower Extremity pathology MeSH
- Edema MeSH
- Exanthema chemically induced drug therapy MeSH
- Glucocorticoids administration & dosage therapeutic use MeSH
- Hemarthrosis therapy MeSH
- Drug Eruptions * diagnosis etiology physiopathology MeSH
- Humans MeSH
- Aged, 80 and over MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Publication type
- Case Reports MeSH
