rifampin and Eczema

The 'soak and smear' regimen is a highly effective method for localised topical therapy employed by dermatologists for widespread inflammatory skin conditions. The regimen involves application of topical medication under occlusion after soaking in water. Complications from this treatment method are rare. We present a case of multiple, generalised methicillin-resistant Staphylococcus aureus (MRSA)-positive furuncles arising in a patient as an unexpected consequence of therapy. The case highlights an unanticipated risk of a commonly employed treatment amid an epidemic of MRSA in the community.

Topics: Aged; Anti-Bacterial Agents; Chlorhexidine; Clobetasol; Diagnosis, Differential; Doxycycline; Eczema; Furunculosis; Glucocorticoids; Humans; Male; Methicillin-Resistant Staphylococcus aureus; Mupirocin; Rifampin; Staphylococcal Infections; Staphylococcus aureus; Treatment Outcome; Water

A small percentage of patients with tuberculosis present with cutaneous findings, which may be difficult to diagnose. We present a patient diagnosed with a rare, non-scarring form of cutaneous tuberculosis (CTB), classically termed as lupus vulgaris erythematoides.

Topics: Adrenal Cortex Hormones; Aged, 80 and over; Anti-Bacterial Agents; Antitubercular Agents; Biopsy; Calcineurin Inhibitors; Dermis; Diagnostic Errors; Drug Therapy, Combination; Eczema; Erythema; Facial Dermatoses; Female; Histiocytosis, Langerhans-Cell; Humans; Immunosuppressive Agents; Isoniazid; Lupus Vulgaris; Mycobacterium tuberculosis; Necrosis; Nose Diseases; Pyrazinamide; Rifampin

Multiple drug allergy (MDA) is characterized by hypersensitivity to 2 or more chemically unrelated drugs. Multiple drug allergy from simultaneous use of antituberculosis drugs is a rare phenomenon that mainly presents as an urticarial or maculopapular eruption. This case report describes a 58-year-old man who developed a generalized eczematous eruption during the sixth week of oral therapy with 4 antituberculosis drugs-isoniazid, ethambutol, rifampicin, and morphazinamide-for treatment of suspected pleural tuberculosis. The eruption resolved after treatment with systemic corticosteroids and cessation of isoniazid and ethambutol. During a lesion-free period 6 months after cessation of the corticosteroids, patch testing with serial dilutions of isoniazid and ethambutol revealed positive reactions; irritant patch test reactions were excluded by testing with graded concentrations of each drug. The patient avoided the causative drugs and reported no new eruptions at 1-year follow-up. It is important for dermatologists to consider the value of patch testing in determining the causative drugs in suspected cases of eczematous-type MDA.

Topics: Antitubercular Agents; Drug Eruptions; Drug Therapy, Combination; Eczema; Ethambutol; Follow-Up Studies; Humans; Isoniazid; Male; Middle Aged; Patch Tests; Pyrazines; Rifampin

Topics: Aged; Alcoholism; Bronchial Neoplasms; Chronic Disease; Diabetes Mellitus; Eczema; Evaluation Studies as Topic; Humans; Male; Middle Aged; Radiography; Rifampin; Tuberculosis, Pulmonary

Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Dermatitis, Contact; Eczema; Female; Furunculosis; Humans; Infant; Lupus Vulgaris; Male; Middle Aged; Pyoderma; Rifampin; Skin Diseases; Syphilis, Cutaneous; Tuberculosis, Cutaneous