• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
• /
• v.18 no.2
• /
• pp.104-108
• /
• 2005

Drug eruption refers to an adverse effect which is unintentionally given rise to by dosage, injection, inhalation, suppository and ointment, etc. Maculopapular, urticarial, morbilliform, papulosquamous, pustular, and bullous morphologies may be encountered. Adverse drug reactions also can cause pruritus or dysesthesia unaccompanied by rash. We treated a patient suffered from maculopapular rash and pruritus with acupuncture, herb medication and wet dressing. After treatment we observed the improvement. Based on this study, it is considered that oriental medical treatment can be applied to the management of drug eruption.

• Clinical and Experimental Pediatrics
• /
• v.51 no.11
• /
• pp.1228-1231
• /
• 2008

Drug hypersensitivity syndrome (DHS) has rarely been reported in association with vancomycin treatment. Here, we describe an 11-year-old girl who developed fever and a maculopapular rash on day 18 of intravenous vancomycin for treatment of infective endocarditis. The patient presented with fever, a maculopapular skin rash, hepatitis, and acute renal failure caused by vancomycin-induced DHS. The symptoms resolved in less than 24 h after withdrawal of vancomycin and treatment with corticosteroids. We present this case of DHS associated with vancomycin.

• Clinical and Experimental Pediatrics
• /
• v.50 no.2
• /
• pp.132-137
• /
• 2007

Patients with febrile illness and skin rashes need full and immediate attention. In general, these diseases show mild manifestations and good prognosis. However, causalities of some diseases with fever and rash may be life threatening or trivial. So, the differential diagnosis for those patients is extensive. A through history, a careful physical examination and close observation of clinical progress are very helpful and essential to confirming the diagnosis. Histories of recent travel, drug or specific food ingestion, exposure to human or an animal source of infection may be useful to discover the cause. Although laboratory tests can be useful in making the diagnosis, laboratory results usually are not available immediately. Knowledge and experiences of such diseases may be helpful to reduce the differential diagnosis to a few major possibilities. Rashes can be categorized as petechial, maculopapular, vesicular, urticarial and erythematous. Potential causes include infectious pathogens such as virus, bacteria, rickettsiae, spirohetes, connective tissue diseases, allergic diseases and heamto-oncologic diseases. Because the severity of these diseases can vary mild to life threatening, physicians must perform prompt management decisions regarding empirical therapies. In this article, the differential etiological diagnosis of each type rash is reviewed and discussed, and with emphasis on intensive care of life threatening febrile diseases with rashes that are seen in our country.

• Tuberculosis and Respiratory Diseases
• /
• v.61 no.4
• /
• pp.389-393
• /
• 2006

Tsutstugamushi disease is a major febrile disease that generally occurs in the fall in Korea with hemorrhagic fever with renal syndrome and leptospirosis. This disease is often accompanied by interstitial pneumonia, acute renal failure and liver failure. The causative agent, namely Orientia tsutsugamushi, is transmitted to humans through the bite of a laval trombiculid mite, which is commonly known as a chigger. A 78 year old man was admitted in October 2004 with intractable fever and a drowsy mentality. Two weeks earlier, he visited a private clinic complaining of a simple skin rash. He was treated with antihistamine and steroid, but his symptoms were aggravated and he was referred to our hospital. His physical examination and laboratory findings showed a septic shock status. The maculopapular rash had spread over his face, chest, abdomen and extremities. Eschar was observed in lower back area but it was too difficult to distinguish it from other skin rashes. His chest X-ray appeared as diffuse nodular patchy consolidations in the bilateral lung parenchyme. He was treated with a mechanical ventilator and doxycycline under th suspicion of Tsutstugamushi disease. However, he suffered multiorgan failure accompanied by acute respiratory distress syndrome, acute renal failure and acute hepatitis. He was treated in the intensive care unit for approximately 12 weeks and his general condition was recovered.

• Pediatric Infection and Vaccine
• /
• v.11 no.2
• /
• pp.192-197
• /
• 2004

A 9-year-old boy who was confirmed measles by clinical manifestations and serum measles IgM antibody presented with bilateral visual loss 12 days after the onset of maculopapular rash. Complete ophthalmic and neurologic examinations, radiologic studies, and lumbar puncture were performed. Visual acuities were counting fingers in both eyes, with mild bilateral optic disk hyperemia and swelling noted. Neurologic examination was unremarkable, however, a magnetic resonance imaging of the brain showed high signals on basal ganglia, and periventricular white matter. The cerebrospinal fluid was devoid of white cells. Intravenous methylprednisolone and high dose immunoglobulins were administered, and clinical findings resolved completely within 6 months.

• Clinical and Experimental Pediatrics
• /
• v.62 no.2
• /
• pp.75-78
• /
• 2019

Although rare, antihistamines can cause adverse effects, including drug-induced eruptions or anaphylaxis. A 4-year-old child visited the pediatric department of a hospital for skin eruptions after administration of antihistamines, (e.g., ucerax [hydroxyzine] or leptizine [levocetirizine]), for cholinergic rashes; he did not have pruritus. Skin prick, intradermal, and drug provocation tests were performed to determine the relationship between the antihistamines and eruptions. Levocetirizine induced wheals in the skin prick test and a rash in the oral drug provocation test. In contrast, ketotifen induced no reaction in the skin prick test but showed a positive reaction in the oral provocation test. Our case report highlights that children can experience the same types of adverse reactions as seen in adults, and cross-reactivity between various antihistamines can occur.

• The Journal of Internal Korean Medicine
• /
• v.45 no.2
• /
• pp.278-286
• /
• 2024

A cutaneous adverse drug reaction (CADR) refers to an unexpected skin and mucosal reaction caused by drug administration. In the present case, a 65-year-old male presented with generalized itching and a maculopapular rash after taking Western medication, including anticonvulsants and a nonsteroidal anti-inflammatory drug (NSAID). He was treated with Gamiseungmagalgeun-tang, a traditional Korean herbal medicine. After treatment, the patient's symptoms improved, without recurrence. Based on this experience, traditional Korean herbal medicine, including Gamiseungmagalgeun-tang, may be beneficial for improving symptoms of CADRs.

• Clinical and Experimental Pediatrics
• /
• v.52 no.4
• /
• pp.499-503
• /
• 2009

Iodinated contrast media (CM) can cause immediate and late reactions. We treated a patient with a recurrent generalized maculopapular rash and a fever that occurred within two days of exposure to iodinated CM, iopromide ($Ultravist^{(R)}$), for chest computed tomography. We performed skin testing including prick tests, intradermal tests, and patch tests. Our findings indicated a late skin reaction to $Ultravist^{(R)}$in addition to cross-reactions to other iodinated CM such as ioversol ($Optiray^{(R)}$), iohexol ($Iobrix^{(R)}$), and iobitridol ($Xenetix^{(R)}$). In this study, we report the case of a patient diagnosed with a late adverse reaction to $Ultravist^{(R)}$in addition to cross-reactions to other iodinated CM.

• Journal of Yeungnam Medical Science
• /
• v.27 no.1
• /
• pp.78-84
• /
• 2010

Adult-onset Still's disease (AOSD) is an inflammatory disorder that's characterized by daily, spiking high fever, arthritis and an evanescent, salmon-pink rash. AOSD is diagnosed purely on the basis of the typical clinical features of the illness. The symptoms commonly include swelling of the lymph nodes, enlargement of the spleen and liver, and a sore throat. AOSD is difficult to differentiate from systemic lupus erythematosus (SLE) due to the similar clinical manifestations. We report here on a case of a 16-year-old female patient with autism and epilepsy and who complained of daily spiking fever for 20 days. The patient had maculopapular skin rashes on the face and whole body and lymphadenopathy. The liver function tests were elevated mildly. The initial rheumatoid factor (RF) and antinuclear antibody (ANA) tests were negative. We diagnosed her as having adult-onset Still's disease according to the criteria of Yamaguchi. We successfully treated her with oral prednisolone. But her antinuclear antibody test was changed to positive after discharge. So we finally diagnosed her as having SLE.

• Pediatric Infection and Vaccine
• /
• v.8 no.1
• /
• pp.101-106
• /
• 2001

Purpose : The outbreaks of measles in infants and school children have been reported recently, but there are no specific treatment of these patients except symptomatic therapy. This study was performed to evaluate the effectiveness of intravenous gammaglobulin(IVGG) therapy in acute febrile phase of measles. Methods : The 68 cases in measles were treated with single dose of IVGG(400~500 mg/kg), and 44 cases were treated with only symptomatic treatment during the periods of 14 months from Jan. 2000 to Feb. 2001. They were compared to duration of fever, rash, the levels of CRP and days of admission on both groups after treatment. Results : The results obtained follows. The average of age was $7.9{\pm}3.6$ year old, and male to female was 1.0 : 1.6. The duration of fever after admission was $2.4{\pm}1.2$ days in treated group and $5.7{\pm}2.4$ days in control group. The period of disappearance of systemic erythematous maculopapular rash was $4.5{\pm}1.3$ days in treated group, and $6.9{\pm}2.4$ days in control group. The durations of admission day were also shown significantly shorter duration of period in treated group(P<0.05). The levels of CRP were no significant difference between two groups before treatment. However, treated group was significantly shown by improved within 5 days after IVGG therapy(P<0.05). Conclusions : The single dose of IVGG(400~500 mg/kg) therapy is one of rapid and effective therapy for clinical symptoms and signs in acute high febrile phase of measles.