rifampin and Cicatrix

Buruli ulcer (BU) denotes a cutaneous infection by Mycobacterium ulcerans endemic in certain tropical and subtropical regions. Treatment may be either medical and surgical or else purely medical for early lesions. The literature contains reports of several cases of transient aggravation of BU following initiation of medical treatment. We report a case observed in the Ivory Coast, one of the areas with the highest prevalence of BU worldwide. The distinguishing features of our case are the early onset of this paradoxical reaction and the multiple cephalic site of lesions.. A 4-year-old child with no prior medical history was referred for two painless ulcerative cutaneous nodules. Incubation of samples from the edges of these lesions revealed the presence of acid-alcohol resistant bacilli (AARB), which were shown by PCR to be M. ulcerans, the causative agent in BU. Treatment consisted of levofloxacin (100mg/d) and rifampicin (150mg/d) for 8weeks. After 7days of medical treatment, seven painless nodules appeared on the patient's scalp. Further PCR for these lesions confirmed the presence of M. ulcerans. The same medical therapy was maintained and after 54days of treatment, all lesions had been healed.. The originality of this case rests on two features: the bifocal aspect of the lesions, which is uncommon, and the early development of cephalic predominance that occurred after the start of drug treatment. While cases of lesions secondary to initiation of medical therapy have already been described, such lesions generally occurred after at least 2months of treatment and did not involve the head.

Topics: Anti-Bacterial Agents; Buruli Ulcer; Child, Preschool; Chin; Cicatrix; Cote d'Ivoire; Drug Therapy, Combination; Endemic Diseases; Facial Dermatoses; Female; Humans; Leg; Levofloxacin; Mycobacterium ulcerans; Ofloxacin; Rifampin; Scalp Dermatoses; Time Factors

Topics: Cicatrix; Clarithromycin; Debridement; Diabetes Mellitus, Type 2; Disease Susceptibility; Femoral Fractures; Fracture Fixation, Internal; Fractures, Closed; Humans; Male; Middle Aged; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria; Osteomyelitis; Osteotomy; Ribotyping; Rifampin; Surgical Wound Infection; Vancomycin

Hidradenitis suppurativa (HS) may be associated with face and back lesions which are considered as acne.. To describe the skin lesions of a group of patients with HS.. Twelve patients were selected from a series of 648 patients on the basis of their specific skin lesions.. The patients (mostly male) had typical hidradenitis. On their face or back they had one or several of the following skin lesions which are not seen in acne: hypertrophic rope-like bridged scars, raised plaques with multiple carbuncle-like openings or with ulcerations, 'worm-eaten scars' and coalescent nodules with round ulcerations. All patients had deep round scars. Several had a pilonidal cyst or large epidermal cysts. Isotretinoin had been used by 7 patients with no effect.. Some HS patients have specific lesions of the face and back which are not acne and have to be treated differently.

Topics: Acne Vulgaris; Adult; Back; Cicatrix; Clindamycin; Dermatologic Agents; Epidermal Cyst; Face; Female; Hidradenitis Suppurativa; Humans; Isotretinoin; Male; Middle Aged; Pilonidal Sinus; Rifampin; Skin Ulcer; Treatment Outcome; Young Adult

Folliculitis decalvans is a rare follicular inflammatory disease of the scalp. It is characterized by initial perifollicular inflammatory changes followed by peripheral extension and eventual circumscribed patches of cicatricial alopecia. The disease is known for its resistance to treatment, resulting in an unfavorable prognosis. The cause of the disease is unknown, although a bacterial etiology is postulated. We report a classic case that was temporized with various antibiotics and only subsequently resolved after ten weeks of therapy with rifampin. The patient has remained free of disease for more than one year. We present a brief review of the cicatricial alopecias and discuss rifampin therapy for this condition.

Topics: Adult; Alopecia; Cicatrix; Female; Folliculitis; Humans; Rifampin