RESUMEN
Hydroxyzine is commonly used to treat pruritic skin lesions. Although rare, hydroxyzine can sometimes be linked to worsening dermatitis in patients who have sensitivities to phenothiazines and/or ethylenediamines. Herein we describe a patient who developed papulovesicular eruptions following the use of topical neomycin. Our patient's contact dermatitis initially improved after the use of oral steroids. However, the patient's skin condition was exacerbated by the continued use of hydroxyzine to treat her pruritus. Patch testing was positive at 48 hours for neomycin sulfate, ethylenediamine dihydrochloride, and p-phenylenediamine. Given the suspected cross-reactivity between hydroxyzine and ethylenediamine, hydroxyzine was discontinued and the patient's cutaneous symptoms improved. In summary, physicians must be aware that oral hydroxyzine can worsen contact dermatitis in ethylenediamine-sensitive patients.
Asunto(s)
Antibacterianos/efectos adversos , Antipruriginosos/efectos adversos , Dermatitis por Contacto/tratamiento farmacológico , Hipersensibilidad a las Drogas/diagnóstico , Hidroxizina/efectos adversos , Neomicina/efectos adversos , Administración Cutánea , Administración Oral , Adulto , Antipruriginosos/administración & dosificación , Etilenodiaminas/efectos adversos , Femenino , Humanos , Hidroxizina/administración & dosificaciónRESUMEN
BACKGROUND: Asthma exacerbation patterns are cyclic in nature and often correlate with air particle concentrations. OBJECTIVE: To examine the relationship between asthma-related emergency department (ED) visits and outdoor air quality for pediatric and adult patients in a high asthma prevalence area, the New York City borough of the Bronx. METHODS: Numbers of daily asthma-related adult and pediatric ED visits during one complete year (1999) were obtained from the seven major Bronx hospitals. Daily values of nitrogen oxides (NO(x)), ozone (O(3)), sulfur dioxide (SO(2)), and pollen counts were acquired. RESULTS: Asthma-related ED visit numbers were highest in December-January and lowest in July. There were three distinct peaks of increased asthma ED visits: winter (December-January), spring (late April-May), and fall (October). The spring peak was the most striking and coincided with high tree pollen counts (tree pollen: r = 0.90, p = .03). We observed a positive correlation between asthma ED visits in the winter and SO(2) and NO(x) levels. Winter peaks of SO(2) and NO(x) in early December appeared to precede the winter asthma peak. CONCLUSIONS: The spring asthma peak is closely associated with increased tree pollen counts, and the asthma increase at this time is likely due to allergic reactions to pollen. No significant associations could be established with the fall peak. The winter peak correlates with elevated SO(2) and NO(x) levels.
Asunto(s)
Contaminación del Aire/efectos adversos , Asma/epidemiología , Progresión de la Enfermedad , Servicio de Urgencia en Hospital/estadística & datos numéricos , Polen/efectos adversos , Adolescente , Adulto , Distribución por Edad , Contaminación del Aire/estadística & datos numéricos , Asma/diagnóstico , Asma/terapia , Niño , Preescolar , Estudios de Cohortes , Monitoreo del Ambiente , Monitoreo Epidemiológico , Femenino , Humanos , Incidencia , Masculino , Ciudad de Nueva York/epidemiología , Óxido Nítrico/análisis , Ozono/análisis , Polen/inmunología , Factores de Riesgo , Estaciones del Año , Distribución por Sexo , Dióxido de Azufre/análisis , Árboles , Población Urbana , Adulto JovenAsunto(s)
Alérgenos/inmunología , Desensibilización Inmunológica , Infecciones por VIH/inmunología , VIH/fisiología , Rinitis Alérgica Perenne/inmunología , Rinitis Alérgica Estacional/inmunología , Adulto , Alérgenos/uso terapéutico , Recuento de Linfocito CD4 , Enfermedad Crónica , Femenino , VIH/patogenicidad , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/patología , Infecciones por VIH/fisiopatología , Humanos , Inyecciones Subcutáneas , Masculino , Persona de Mediana Edad , Rinitis Alérgica Perenne/tratamiento farmacológico , Rinitis Alérgica Perenne/patología , Rinitis Alérgica Perenne/fisiopatología , Rinitis Alérgica Estacional/tratamiento farmacológico , Rinitis Alérgica Estacional/patología , Rinitis Alérgica Estacional/fisiopatología , Medición de Riesgo , Sinusitis , Estornudo , Carga Viral/efectos de los fármacosAsunto(s)
Eosinofilia/diagnóstico , Enfermedades Parasitarias/diagnóstico , Strongyloides , Estrongiloidiasis/diagnóstico , Anciano , Animales , Enfermedad Crónica , Colonoscopía/métodos , Heces , Estudios de Seguimiento , Humanos , Ivermectina/uso terapéutico , Masculino , Enfermedades Parasitarias/complicaciones , Enfermedades Parasitarias/tratamiento farmacológico , Prurito/diagnóstico , Prurito/etiología , Medición de Riesgo , Índice de Severidad de la Enfermedad , Enfermedades Cutáneas Parasitarias/diagnóstico , Enfermedades Cutáneas Parasitarias/tratamiento farmacológico , Estrongiloidiasis/tratamiento farmacológico , Resultado del TratamientoRESUMEN
BACKGROUND: Despite the existence of numerous dermatology-specific quality-of-life questionnaires, there exists a need for a well-validated instrument to evaluate and monitor patients with chronic urticaria. OBJECTIVE: To develop and validate a novel chronic urticaria-specific questionnaire, the Urticaria Severity Score (USS). METHODS: The USS was developed with 12 questions and 7 response options per question included in the final questionnaire. The USS was pilot tested on 28 patients with symptomatic chronic urticaria, and a modified version was tested in 80 patients. In this latter group, the USS was compared with the previously validated Dermatology Life Quality Index (DLQI). Patients completed both questionnaires at baseline and at follow-up (median, 2 weeks). Spearman rank correlation tests were used to compare the USS with the DLQI. At a subsequent visit, 9 additional patients completed the USS to evaluate test-retest reliability. RESULTS: There was a positive correlation between the USS and DLQI at baseline (r = 0.64) and follow-up (r = 0.69). The test-retest reliability correlation for the USS was adequate (r = 0.96) (P = .001). The USS was more sensitive in detecting symptom improvement than the DLQI. The mean (SD) "raw score" change from baseline to follow-up for the USS was 9.95 (12.80), whereas the mean (SD) change from baseline to follow-up for the DLQI was 2.25 (4.87). CONCLUSIONS: The USS is a valid and reliable instrument for monitoring urticaria severity. The USS is more sensitive than the DLQI for quantifying urticaria severity and may be moreapplicable in the evaluation of urticaria-specific treatment efficacy.