trimethoprim--sulfamethoxazole-drug-combination and Facial-Dermatoses

A case of rapidly relapsing pyoderma gangrenosum (PG) of the left preauricular area with no undermined borders is described. This might be considered a case of malignant pyoderma (PM), a rare variety of PG. Five months after complete healing obtained with systemic corticosteroids, the preauricular lesion of PG relapsed. As retreatment with oral methylprednisolone induced glucose intolerance and high arterial pressure, sulfa drugs were initially employed with a transitory recovery of the skin lesion. A successive prolonged course with minocycline induced a new complete resolution. To date, at six months' follow-up, the patient is relapse-free. This case confirms that sulfa drugs and minocycline may also be considered alternative therapies in PM. PM is a variety of PG characterized by specific morphological features, a higher tendency to relapse, and poor responsiveness to treatment.

Topics: Adrenal Cortex Hormones; Anti-Bacterial Agents; Anti-Infective Agents; Facial Dermatoses; Humans; Male; Middle Aged; Minocycline; Pyoderma Gangrenosum; Secondary Prevention; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Anti-Bacterial Agents; Diagnosis, Differential; Exanthema; Face; Facial Dermatoses; Female; Fever; Humans; Stevens-Johnson Syndrome; Trimethoprim, Sulfamethoxazole Drug Combination; Young Adult

A total of 105 patients with established fixed drug eruption (FDE) by oral provocation were evaluated with regard to a drug-related site involvement. Cotrimoxazole was the leading causative agent (63.8%), followed by naproxen sodium (23.8%), dipyrone (5.7%), oxicams (4.8%) and other rare causes (1.9%). Cotrimoxazole most frequently induced lesions on genital mucosa; naproxen and oxicams on lips; and dipyrone on trunk and extremities. Isolated FDE on male genitalia (n = 16) was exclusively because of cotrimoxazole. A highly significant association could be established between naproxen and FDE on lips (chi-square = 28.3; corrected P =.000002). As this study represents the largest series of patients with naproxen-induced FDE, we would suggest that naproxen should be considered as an important potential cause of FDE on lips.

Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Dipyrone; Drug Eruptions; Facial Dermatoses; Female; Foot Dermatoses; Genital Diseases, Male; Hand Dermatoses; Humans; Lip Diseases; Male; Middle Aged; Naproxen; Trimethoprim, Sulfamethoxazole Drug Combination

We describe a 64-year-old man with an actinomycetoma of the frontal region of the head caused simultaneously by two aetiological agents, Nocardia brasiliensis and N. asteroides. This case is presented due to the unusual body site affected and, above all, because two aetiological agents were isolated.

Topics: Actinomycetales Infections; Anti-Bacterial Agents; Anti-Inflammatory Agents, Non-Steroidal; Dapsone; Drug Therapy, Combination; Facial Dermatoses; Humans; Male; Middle Aged; Naproxen; Nocardia; Nocardia asteroides; Treatment Refusal; Trimethoprim, Sulfamethoxazole Drug Combination

Two cases of cutaneous nocardial infection are reported. The Nocardia species are gram-positive, partially acid-fast bacteria. Cutaneous involvement may develop as one of four types: (1) mycetoma, (2) lymphocutaneous (sporotrichoid) infection, (3) superficial skin infection, or (4) systemic disease with cutaneous involvement. A review of each of these types of infection is included, as well as potential clues that may suggest the diagnosis of nocardiosis.

Topics: Abscess; Aged; Amikacin; Drug Combinations; Facial Dermatoses; Humans; Lymphangitis; Male; Minocycline; Mycetoma; Nocardia; Nocardia asteroides; Nocardia Infections; Skin Diseases, Infectious; Skin Ulcer; Sulfamethoxazole; Sulfonamides; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination