Lack of efficacy of phenytoin in recessive dystrophic epidermolysis bullosa

Article Abstract:

Phenytoin may not be an effective treatment for patients with recessive dystrophic epidermolysis bullosa, a rare genetic disorder characterized by blistering and scarring of the unusually fragile skin. Twenty-two patients with this disease were treated for five to seven months with either phenytoin or a placebo (an inactive substance). The treatments were then reversed, after a two-month break. Disease activity did not decrease during treatment with phenytoin, compared to treatment with a placebo. An average 7% decrease occurred in the number of blisters and erosions over the entire body during treatment with phenytoin, compared to an average 6% increase during treatment with a placebo. The size of three plaques, or specific areas containing blisters and erosions, decreased an average of 0.4% during phenytoin treatment and increased an average 0.2% during the placebo treatment. The number of blisters and erosions within each of the three plaques declined an average of 12% during treatment with phenytoin, compared to an average 31% increase during treatment with the placebo. These differences were not significant.

Evaluation, Drug therapy, Skin diseases, Phenytoin, Epidermolysis bullosa

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Nonmelanoma cancers of the skin

Article Abstract:

Basal-cell cancers and squamous-cell cancers are both nonmelanoma skin cancers accounting for more than a third of cancer cases in the US. Nonmelanoma cancers primarily affect whites and are caused mainly by radiation from the sun. The most effective way to prevent these types of cancer is to avoid sun exposure, especially during the middle of the day, and to use sunscreen and wear protective clothing when outdoors. About 80% of basal-cell carcinomas appear on the head and neck and 80% of squamous-cell carcinomas caused by the sun appear on the arms, head and neck. About 50% of all nonmelanoma patients will develop a new skin cancer within five years of the first diagnosis. Several types of surgery, chemotherapy and radiotherapy are used to treat nonmelanoma. Early detection of these cancers is the most important factor in reducing both the severity and the cost of treatment.

Care and treatment, Squamous cell carcinoma, Basal cell carcinoma

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Medication use and the risk of Stevens-Johnson syndrome or toxic epidermal necrolysis

Article Abstract:

Stevens-Johnson syndrome and toxic epidermal necrolysis are serious skin conditions often caused by reaction to drugs, with antibacterial sulfonamides associated most strongly. Researchers studied 245 patients who were diagnosed with the rare but potentially fatal diseases of Stevens-Johnson syndrome and toxic epidermal necrolysis in France, Germany, Italy, and Portugal. Each case patient was compared to three controls at the same hospital whose conditions were not related to drug use. The use of antibacterial sulfonamides, anticonvulsant agents, allopurinol, oxicam NSAIDS, chlormezanone, and corticosteroids were closely linked to the the development of these diseases, although the extra risk was not greater than five cases per million users a week. One or more of the drugs suspected of causing these diseases was used by 59% of case patients and 15% of controls.

Complications and side effects, Risk factors, Toxic epidermal necrolysis, Corticosteroids, Adrenocortical hormones, Nonsteroidal anti-inflammatory drugs, Nonsteroidal anti-inflammatory agents, Antibacterial agents, Allopurinol, Stevens-Johnson syndrome

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