• Title/Summary/Keyword: Skin rash

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Secondary adrenal insufficiency caused by sorafenib administration in a patient with hepatocellular carcinoma

  • Jo, Soo Yeon;Ryu, Soo Hyung;Kim, Mi Young;Moon, Jeong Seop;Yoon, Won Jae;Kim, Jin Nam
    • Journal of Yeungnam Medical Science
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    • v.33 no.2
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    • pp.155-158
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    • 2016
  • Sorafenib (Nexavar) has been regarded as a treatment for unresectable hepatocellular carcinoma (HCC), with side effects that include hand-foot skin reaction, diarrhea, rash, fatigue, hypertension, nausea, anorexia, weight loss, and alopecia. Thyroid disorder, such as endocrine side effect, has also been reported. However no case involving adrenal insufficiency has been reported. Here, we report a case of adrenal insufficiency which occurred after taking sorafenib in a patient with HCC. A 56-year-old man visited our hospital due to right upper quadrant abdominal pain and he was diagnosed as multiple disseminated and unresectable HCCs with portal vein invasion; therefore transarterial chemoembolization was performed and sorafenib administration was started. Two months later, he was admitted to the hospital complaining of severe fatigue. The laboratory results showed cortisol of <$0.2{\mu}g/dL$ and adrenocorticotropic hormone of <1.00 pg/mL. The patient had no history of taking steroids or herbal medications. Secondary adrenal insufficiency was diagnosed and prednisolone 10 mg per day was started immediately; as a result, fatigue remarkably improved. This may be the first report indicating a possible association between sorafenib and adrenal insufficiency and it implies that the possibility of adrenal insufficiency should be considered in patients taking sorafenib who complain of severe fatigue.

Essential Fatty Acid Deficiency in Human (인체내(人體內)의 필수지방산(必須脂肪酸)의 결핍(缺乏))

  • Yoon, Tai Heon;Jang, You Kyung
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.12 no.1
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    • pp.51-56
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    • 1983
  • The recent work on symptomatology and therapy of essential fatty acid (EFA) deficience has been reviewed. EFA deficiency is due to an absence of dietary linoleic acid which cannot be synthesized endogenously in man. The diagnosis of EFA deficiency is based on clinical features such as the appearance of scaly skin rash, sparse hair growth or failure to thrive, which occur late in the course of EFA deficiency and biochemical features occurring within two weeks of fat-free diet. The amount of linoleic acid required to prevent EFA deficiency varies with age of the patient and route of fat administration.

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Acute Health Effects of the Hebei Oil Spill on the Residents of Taean, Korea (허베이 스피리트호 유류유출사고 지역주민의 급성건강영향)

  • Lee, Cheol-Heon;Kang, Young-A;Chang, Kyu-Jin;Kim, Chang-Hoon;Hur, Jong-Il;Kim, Jae-Youn;Lee, Jong-Koo
    • Journal of Preventive Medicine and Public Health
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    • v.43 no.2
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    • pp.166-173
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    • 2010
  • Objectives: On December 7, 2007, the Hebei Spirit oil tanker spilled out 12,547 kl of crude oil on the Yellow Sea 10 km away from the cost of Taean Province, Korea. As the coastline has been contaminated, local residents have been exposed to crude oil. Because the residents were showing many symptoms, we investigated the acute health effects of this oil spill on them. Methods: We conducted a cross-sectional study consisting of the heavy and moderately oil soaked area in Taean and the lightly oil soaked area in Seocheon. Ten seashore villages were selected from each area, and 10 male and female adults were selected from each village. We interviewed the subjects using a structured questionnaire on the characteristics of residents, the cleanup activities, the perception of oil hazard, depression and anxiety, and the physical symptoms. The odds ratios and 95% confidence intervals were analyzed using logistic regression analysis. The logistic regression model was adjusted for age, gender, education, smoking, the perception of oil hazard and anxiousness. Results: The more highly contaminated the area, the more likely it was for residents to be engaged in cleanup activities and have a greater chance of exposure to oil. The indexes of anxiety and depression were higher in the heavy and moderately oil soaked areas. The increased risks of headache, nausea, dizziness, fatigue, tingling of limb, hot flushing, sore throat, cough, runny nose, shortness of breath, itchy skin, rash, and sore eyes were significant. Conclusions: The results suggest that exposure to crude oil is associated with various acute physical symptoms. Long-term investigation is required to monitor the residents' health.

A Case of Pyomyositis and Toxic Shock Syndrome Caused by Methicillin Resistant Staphylococcus aureus (독성 쇼크 증후군을 동반한 Methicillin 저항성 황색 포도알균 화농성 근염 1례)

  • Kim, Yang Kyong;Kim, Dal Hyon;Kim, Soon Ki;Son, Byong Kwan;Hong, Young Jin
    • Clinical and Experimental Pediatrics
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    • v.48 no.1
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    • pp.88-92
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    • 2005
  • Pyomysitis is a primary acute bacterial infection of large skeletal muscule, usually occuring in the absence of specific cause of infection. Pyomyositis has been reported mainly in tropical countries and was rare in temperate climates. but it has been recognized with increasing frequency. Toxic shock syndrome(TSS) is an acute mutisystemic disease characterized by high fever, hypotension, multisystem dysfunction and erythematous rash followed by skin desquamation 8-12 days after onset. Especially, TSS and pyomyositis are rare conditions in the pediatric population. We experienced one case in a healthy 13-year-girl who developed pyomyositis of the right ileac and gluteal muscles associated with TSS caused by methicillin resistant Staphylococcus aureus. We reports a case of acute pyomyositis with TSS, in which the diagnosis was difficult because of the relative rare incidence in temperate climates and its vague symptoms. To our knowledge, this is the first reported case of pyomyositis with TSS in Korean pediatric population.

Discrimination of Kawasaki disease with concomitant adenoviral detection differentiating from isolated adenoviral infection

  • Kim, Jong Han;Kang, Hye Ree;Kim, Su Yeong;Ban, Ji-Eun
    • Clinical and Experimental Pediatrics
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    • v.61 no.2
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    • pp.43-48
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    • 2018
  • Purpose: Human adenovirus infection mimics Kawasaki disease (KD) but can be detected in KD patients. The aim of this study was to determine the clinical differences between KD with adenovirus infection and only adenoviral infection and to identify biomarkers for prediction of adenovirus-positive KD from isolated adenoviral infection. Methods: A total of 147 patients with isolated adenovirus were identified by quantitative polymerase chain reaction. In addition, 11 patients having KD with adenovirus, who were treated with intravenous immunoglobulin therapy during the acute phase of KD were also evaluated. Results: Compared with the adenoviral infection group, the KD with adenovirus group was significantly associated with frequent lip and tongue changes, skin rash and changes in the extremities. In the laboratory parameters, higher C-reactive protein (CRP) level and presence of hypoalbuminemia and sterile pyuria were significantly associated with the KD group. In the multivariate analysis, lip and tongue changes (odds ratio [OR], 1.416; 95% confidence interval [CI], 1.151-1.741; P=0.001), high CRP level (OR, 1.039; 95% CI 1.743-1.454; P= 0.021) and sterile pyuria (OR 1.052; 95% CI 0.861-1.286; P=0.041) were the significant predictive factors of KD. In addition, the cutoff CRP level related to KD with adenoviral detection was 56 mg/L, with a sensitivity of 81.8% and a specificity of 75.9%. Conclusion: Lip and tongue changes, higher serum CRP level and sterile pyuria were significantly correlated with adenovirus-positive KD.

Ether-Aspirin Topical Application for Herpetic Neuralgia (대상포진성 신경통에 대한 에테르-아스피린 도포요법)

  • Moon, Won-Bae;Kim, Hae-Kyu;Back, Seong-Wan;Kim, Inn-Se;Chung, Kyoo-Sub
    • The Korean Journal of Pain
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    • v.3 no.1
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    • pp.40-43
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    • 1990
  • Herpes zoster is a common, usually self-limited disease distinguished by pain and a characteristic vesicular rash. The clinical onset of herpes zoster is heralded by pain in the area of the affected segment. So herpetic neuralgia is a major complaint from patients visiting the pain clinic. There are several methods for the treatment of herpetic neuralgia, but there is no method that results in complete remission. In 1988, King introduced the chloroform-aspirin topical application method. This method is known to be a very simple and effective treatment of acute herpetic neuralgia and postherpetic neuralgia. We used diethyl ether instead of chloroform as the solvent and treated 12 patients; 7 patients with herpetic neuralgia and 5 patients with postherpetic neuralgia. The results were follows, 1) The treatment has proved to be highly effective in relieving pain in acute herpetic neuralgia. 2) The application was very simple and safe to use and treatment tolerance has been excellent. 3) There were no effective results in postherpetic neuralgia. 4) The topical treatment seemed to promote the healing of the herpetic skin lesion.

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Earlier treatment improves the chances of complete relief from postherpetic neuralgia

  • Kang, Dong Hee;Kim, Su Young;Kim, Hyuck Goo;Park, Jung Hyun;Kim, Tae Kyun;Kim, Kyung Hoon
    • The Korean Journal of Pain
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    • v.30 no.3
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    • pp.214-219
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    • 2017
  • Background: As herpes zoster progresses via postherpetic neuralgia (PHN) to well-established PHN, it presents its recalcitrant nature to the treatment. At this point, the well-established PHN is fixed as a non-treatable, but manageable chronic painful neuropathic disorder. This study evaluated the incidence of complete relief from PHN according to PHN duration at their first visit, and the other factors influencing it. Methods: A retrospective chart review was performed on patients with PHN at a university-based pain clinic over 7 years. The responders were defined as patients who had complete relief from pain after 1 year of active treatment. Age, sex, PHN duration at their first visit, dermatomal distribution, and underlying disorders were compared in the responder and non-responder groups. Responders were also compared according to these factors. Results: Among 117 PHN patients (M/F = 48/69), 35 patients (29.9%) had complete relief from PHN. Mean ages were $64.3{\pm}10.6$ and $66.9{\pm}10.7$ years, numbers of male to female patients were 11/24 and 37/45, and mean durations of PHN at their first visit were $8.5{\pm}6.3$ and $15.3{\pm}10.7$ months in the responder and non- responder groups, respectively. In addition, PHN patients who visited the clinic before 9 months showed a better result. Dermatomal distribution and underlying disorders did not show significant differences. Conclusions: Almost 30% of PHN patients received complete relief. Those who sought treatment in a pain clinic before 9 months received a better result.

A Case of Hughes-Stovin Syndrome (Hughes-Stovin Syndrome 1예)

  • Kim, Joo-In;Lee, Young-Min;Yum, Ho-Kee;Choi, Soo-Jeon;Choi, Seok-Jin;Yang, Young-Il;Sung, Kyu-Bo;Kim, Dong-Soon;Lee, Bong-Choon
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.1
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    • pp.96-101
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    • 1996
  • Hughes-Stovin Syndrome is an exceedingly rare combination of distal pulmonary arterial aneurysm and deep vein thrombosis, mostly found in young patients. There are striking similarities between the vascular manifestation of Behçet's disease and Hughes-Stovin Syndrome. It has been suggested that they may have a similar pathogenesis. Most patients died of massive hemoptysis due to rupture of aneurysm. Recently we have experienced the first case of Hughes-Stovin Syndrome in Korea. A 37 year old male patient was admitted because of recurrent hemoptysis and intermittent fever. He had a history of recurrent aphthous ulcers and erythema nodosum-like skin rash, But no other findings of Behcet's disease was found. Angiography showed multiple pulmonary arterial aneurysm and deep vein thrombosis in Right lower extremity. Histologic examination of specimens of open lung biopsy revealed leukocytoclastic angiitis. Pulmonary arterial aneurysms were successfully treated by coil embolization and he is in good condition with corticosteroid and cyclophosphamide therapy.

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Prevalence Related Characteristics and Management Status in Children with Atopic Dermatitis in Ulsan (울산 일 지역 영유아 및 학령기 아동의 아토피 피부염의 유병관련특성 및 관리실태)

  • Kim, Myoung-Soo;Kim, Yun-Hee;Kim, Jeong-Soo;Yoo, Youn-Ja;Kim, Soo-Ok;Won, Dae-Young;Sung, Mal-Sun;Park, Jung-Ha
    • Journal of Korean Biological Nursing Science
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    • v.13 no.3
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    • pp.220-228
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    • 2011
  • Purpose: This study was performed to investigate prevalence related characteristics and management status in children with atopic dermatitis(AD) for developing health promotion strategies led by community. Methods: Data were collected from 6,562 children with AD in preschool and elementary schools in a district of Ulsan city. Results: The majority of children(44.4%) were onset in less than 2 years after the birth. Seventy six point seven percent of subjects had skin rash and the pathologic lesion of them were flexion of upper extremities and extension of lower extremities. The prevalence rate of the respondents was 30.3%. In bathing, the children in AD group had used soap more frequently than children in normal group. The most preference type of complementary therapy in frequency order were aloe, aroma oil and Pasture. Conclusion: More effective management strategy for alleviating symptom and preventing advanced disease such as asthma and allergic rhinitis should be developed. And also scientific evidence for using complementary therapy is necessary to be provided.

A Study on Food Allergy Occurrence and Parental Perceptions of Food Allergen Labeling System in School Food Service (식품알레르기 발생실태 및 학교급식 알레르기 유발식품 표시제에 대한 학부모 인식에 관한 연구)

  • Lee, Eun-Joo;Ryu, Ho Kyung
    • The Korean Journal of Community Living Science
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    • v.27 no.3
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    • pp.521-531
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    • 2016
  • This study was conducted to measure the prevalence of food allergies among kindergarten and elementary school children and their parents' perceptions of the Food Allergen Labeling System in school food service (FALSSFS). The surveys were conducted by the parents of children in Yangsan-si, Gyeongsangnam-do, Korea. According to the results, the prevalence of food allergies among the children was 21.9% (current group 8.1% and experienced group 13.8%). The features of the food allergy of the children were as follows : The onset time of allergy was at 1-2 years for 59 children (40.7%), at 3-4 years for 41 children (28.3%), and the main symptoms of allergy were 'rash and skin hives' (47.1%) and 'itching' (30.2%). In terms of the family history, the prevalence of allergies among the mothers was the highest with a value of 31.9%. The allergenic foods were egg (14.7%), pork (11.6%), and milk (8.9%) in the order. Most of the parents had a low perception of the FALSSFS. 26.2% of the parents requested preventive education related to food allergies at school, making this the most requested item, followed by "helping students understand students with food allergies" with a value of 20.2%. The benefit of the FALSSFS was to increase the safety of school food and promote the emotional health of children with allergies.