Erroneous diagnosis of genital lichen planus

Clinical case of 62 year old patient complaining of rash on the glans of the penis is reported. It was known from the case history that genital rashes first appeared in spring 2020 in the form of two “red dots” associated with no subjective sensations. During the initial visit to dermatology clinic (in London) in June 2020 no diagnosis was established; antibiotics and application of topical emollient were prescribed. The patient did not take treatment as prescribed. During the repeat visit to dermatologist (in Moscow) lichen planus was diagnosed; application of alclometasone dipropionate cream on the rashes 2 times a day was prescribed. Rashes resolved completely in 10 days with treatment.

Foundation therapy in canine atopic dermatitis

Therapy in canine atopic dermatitis should be multimodal and should be individualised for each patient. Therapies can be described as foundation or supplementary. In all but the mildest cases, dogs require a foundation therapy for the control of their atopic dermatitis. These include allergen-specific immunotherapy, ciclosporin, glucocorticoids, lokivetmab or oclacitinib. All of these five therapeutic options have a strong evidence base to recommend their use in canine atopic dermatitis. Supplementary therapies, which include drugs such as antihistamines, essential fatty acids, topical emollient and antiseptics, help in treatment to improve barrier function and correct skin biome dysbiosis, but can rarely control canine atopic dermatitis in isolation. When combined with foundation therapy they can reduce the risk of relapse and the level of foundation therapy that is required. https://doi.org/10.12968/coan.2019.0020

A possible case of exfoliative dermatitis due to ibuprofen in an Eleven-month-old infant

Ibuprofen is a NSAID belonging to the class of propionic acid derivatives which is widely used for its analgesic, antipyretic and anti-inflammatory action. Well-known adverse effects of ibuprofen include gastric irritability leading to nausea and vomiting as well as allergic manifestations such as urticaria and skin rashes. Severe ADRs include renal papillary necrosis, SJS/TEN, and thrombotic events leading to myocardial infarction and stroke. Authors present a case of exfoliative dermatitis in an 11-month-old infant possibly due to ibuprofen. An 11-month-old infant was prescribed syrup ibuprofen by a local medical practitioner for unclear reasons. Three days after ibuprofen therapy, the infant developed erythematous, crusting exfoliative lesions predominantly over the face with a few lesions over the lower abdomen. Subsequently, the infant was admitted to Kempegowda Institute of Medical Sciences and Research Center Hospital, Bangalore. A diagnosis of drug-induced exfoliative dermatitis was made after ruling out other causes. Treatment was initiated with intravenous and topical dexamethasone along with saline compressions and amoxicillin + clavulanic acid for secondary bacterial infection as well as topical emollient cream applied over the affected areas. The lesions improved significantly with the above management and the infant recovered enough to be discharged from the hospital after 3 days. The reaction was assessed to be “possible” as per Naranjo and WHO-UMC causality assessment scales, “moderately severe” on modified Hartwig’s severity assessment scale and “not preventable” according to Schumock and Thornton criteria. Severe and serious reactions such as exfoliative dermatitis can be caused by commonly used drugs like ibuprofen.