amoxicillin-potassium-clavulanate-combination and Erythema

Topics: Adult; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Erythema; Female; Humans; Keratosis; Male; Middle Aged

Hyperkeratotic flexural erythema (HKFE), also termed granular parakeratosis (GP), is a rare skin condition thought to be linked to a skin barrier dysfunction process, however the exact cause of this is yet to be determined. Management options are varied, with no consensus on treatment. Several previous reports have recorded successful treatment with amoxycillin-clavulanic acid combination. We propose the use of oral doxycycline in addition to topical coconut oil compound as a treatment option in therapy resistant HKFE.

Topics: Amoxicillin-Potassium Clavulanate Combination; Doxycycline; Erythema; Humans; Parakeratosis; Rare Diseases

Toxic shock syndrome (TSS) was first described by Todd in 1978. The relevant Lancet publication reported 7 cases of children with fever, exanthema, hypotension and diarrhoea associated with multiple organ failure. An association between TSS and use of hyper-absorbent tampons in menstruating women was discovered in the 1980s. Following the market withdrawal of such tampons, TSS virtually disappeared. Herein we report a new case of TSS in a 15-year-old girl.. A 15-year-old patient was admitted to intensive care for severe sepsis and impaired consciousness associated with diffuse abdominal pain. Dermatological examination revealed diffuse macular exanthema. Laboratory tests showed hepatic cytolysis (ASAT 101 U/L, ALAT 167 U/L, total bilirubin 68μmol/L) and an inflammatory syndrome. Lumbar puncture and blood cultures were sterile while thoraco-abdomino-pelvic and brain scans were normal. The patient was menstruating and had been using a tampon over the previous 24hours. Vaginal sampling and tampon culture revealed TSST-1 toxin-producing S. aureus. Management consisted of intensive care measures and treatment with amoxicillin-clavulanic acid and clindamycin for 10 days.. In case of septic shock associated with diffuse macular exanthema a diagnosis of TSS must be envisaged, particularly in menstruating women.

Topics: Abdominal Pain; Adolescent; Amoxicillin-Potassium Clavulanate Combination; Bacterial Toxins; Clindamycin; Critical Care; Diagnosis, Differential; Drug Therapy, Combination; Enterotoxins; Erythema; Female; Fever of Unknown Origin; Humans; Menstrual Hygiene Products; Shock; Shock, Septic; Staphylococcus aureus; Superantigens

Hyperkeratotic eruptions in the flexures, especially in the inguinal region, often pose a diagnostic and therapeutic dilemma. Inguinal keratotic eruptions may be caused by various infections, inflammatory dermatoses, vesico-bullous dermatoses, nutrient deficiencies, medication allergies and other miscellaneous causes such as granular parakeratosis. We hereby report four patients who presented with idiopathic hyperkeratotic erythematous eruptions with a migratory nature involving the inguinal region and occasionally showing the histopathologic features of granular parakeratosis. All four patients showed a dramatic therapeutic response to amoxicillin-clavulanic acid combination. We suggest that 'granular parakeratosis' should be considered as a histopathologic feature rather than the diagnosis. We would prefer to label our cases as 'Hyperkeratotic Flexural Erythema'. We recommend that detailed study of skin microbiome may help identify a possible alteration in skin microbiome contributing to the pathogenesis. We briefly review strategies on characterising the skin microbiome and the latest knowledge surrounding how alterations to the skin microbial populations can contribute to some diseases.

Topics: Adult; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Buttocks; Erythema; Female; Groin; Humans; Keratosis; Male; Middle Aged

Topics: Abdomen; Amoxicillin-Potassium Clavulanate Combination; Anti-Inflammatory Agents; Benzimidazoles; Carnitine; Clobetasol; Dermatitis; Edema; Erythema; Female; Humans; Injections, Subcutaneous; Keratosis; Lipolysis; Mesotherapy; Middle Aged; Peptides; Phosphatidylcholines; Piperidines; Prednisone; Subcutaneous Fat; Thigh

Topics: Aged; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Drug Eruptions; Erythema; Fingers; Hand Dermatoses; Humans; Male