• Title/Summary/Keyword: dapsone

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Subcorneal pustular dermatosis in a dog (개에서 발생한 각질하 농포성 피부병 1례)

  • Park, Seong-Jun
    • Korean Journal of Veterinary Research
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    • v.53 no.2
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    • pp.125-127
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    • 2013
  • Canine Subcorneal pustular dermatosis (CSPD) represents a sterile, superficial, pustular skin disease of unknown cause but may be a variant of pemphigus foliaceus. A 7-year-old, intact female, mixed dog presented with 3-month history of pruritic multiple pustules and crusts. Direct smears from intact pustules revealed numerous nondegenerate neutrophils, some acantholytic cells, and bacterial culture was negative. Histologic examination of lesional skin showed subcorneal pustules filled with neutrophils and acantholytic cells. The direct immunofluorescence tests stained with IgG, IgA, IgM, C3 were negative. Oral administration of dapsone (1 mg/kg/q8h) was initiated and it was reduced to 1 mg/kg/q12h with good control of the lesions.

Methylene Blue (메틸렌 블루)

  • You, Ji-Young
    • Journal of The Korean Society of Clinical Toxicology
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    • v.8 no.1
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    • pp.1-6
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    • 2010
  • Methylene blue is a very effective reducer of drug-induced methemoglobinemia. It has dose-dependent oxidation or reduction properties. In most cases, a dose of 1 to 2 mg/kg IV given over 5 minutes and immediately followed by a 15- to 30-mL fluid flush to minimize the local pain is both effective and relatively safe. The onset of action is quite rapid, and the effects are usually seen within 30 minutes. The dose may be repeated after 30 to 60 minutes and then every 2 to 4 hours as needed. The total dose should not exceed 7 mg/kg as a single dose or 15 mg/kg within 24 hours. Repeated treatment may be needed for treating compounds that have prolonged elimination or those compounds that undergo enterohepatic recirculation (e.g., dapsone). Methylene blue can cause dose-related toxicity. At high doses, methylene blue can also induce an acute hemolytic anemia and rebound methemoglobinemia. The reasons for treatment failure with methylene blue include ineffective GI decontamination, the existence of other forms of hemoglobin (e.g., sulfhemoglobin), a low or high dose of methylene blue and the toxicokinetics of some agents, such as aniline, benzocaine or dapsone.

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Advances in management of pediatric chronic immune thrombocytopenia: a narrative review

  • Jae Min Lee
    • Journal of Yeungnam Medical Science
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    • v.40 no.3
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    • pp.241-246
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    • 2023
  • Immune thrombocytopenia (ITP) is a disease in which thrombocytopenia occurs because of immune-mediated platelet destruction and decreased platelet production. Although many pediatric patients with ITP experience spontaneous remission or reach remission within 12 months of first-line therapy, approximately 20% progress to chronic ITP. Patients who do not respond to first-line treatment or experience frequent relapses are of great concern to physicians. This review summarizes recent treatments for second-line treatment of pediatric chronic ITP.

Indoxacarb Pesticide Poisoning with Methemoglobinemia (메트헤모글로빈혈증을 보인 indoxacarb 중독 1례)

  • Shin, Jae-Hoon;Lee, Jae-Kwang;Park, Seong-Soo;Na, Sang-Jun;Park, Joon-Seok
    • Journal of The Korean Society of Clinical Toxicology
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    • v.4 no.2
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    • pp.158-160
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    • 2006
  • Acute methemoglobinemia is induced by various causes, especially ingestion of oxidizing agents such as phenazopyridine, dapsone, and nitrite. Indoxacarb is an oxadiazine insecticide with high insecticidal activity and low mammalian toxicity. It is known to block voltage-gated Na+ channels in insects and mammals, but the mechanism is not yet well understood. We describe a case of a 41-year-old woman with methemoglobinemia that developed following Indoxacarb ingestion, which improved after intravenous injection of methylene blue. This is the first known such case. If signs and symptoms of methemoglobinemia occur after Indoxacarb ingestion, antidotal therapy with methylene blue should be considered as a necessary treatment.

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A Case Report Of IgA Dermatitis Herpetiformis (IgA 疱疹狀 皮膚炎의 治驗 1例 報告)

  • Park, Se-Bong;Youn, Fa-Jeng;;Ko, Woo-Shin
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.14 no.2
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    • pp.35-38
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    • 2001
  • Dermatitis herpetiformis (DH) is a chronic disease of the skin marked by groups of watery, itch blisters. It is characterized by urticarial plaques and blisters on the elbows, buttocks, and knees, although other sites may also be involved. The ingestion of gluten (the proteins gliadin and prolamin contained in wheat, rye, oats, and barley) triggers an immune system reponse that deposits a substance, IgA (immonuglobin A), under the top layer of skin. IgA is present in affected as well as unaffected skin. DH is a hereditary autoimmune disease linked with celiac disease. Treatment for DH is twofold. (1) Remove the cause: gluten. (2) Suppress the skin response with drugs such as Dapsone or some other sulphones. The latter is the most common treatment used as it is rapidly relieves the itch. However there are some side effects associated with these medications and they need to be taken under medical monitoring with blood tests to detect side effects. Recently, we experienced a DH and that was successfully treated by the herbal medication and external therapy. The medications taken by the patient were yongdamsagantanggami and external therapy were gosam and gumunhwa. So we report this case with a bief review of the oriental medical and medical literatures.

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Acute methemoglobinemia after a normal diet (일상적인 음식 섭취 후 발생한 급성 메트헤모글로빈혈증)

  • Lee, Sung Kgun;Kang, Jeong Ho
    • Journal of Medicine and Life Science
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    • v.18 no.1
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    • pp.20-23
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    • 2021
  • Methemoglobin is generated by the oxidation of ferrous iron to ferric iron within a hemoglobin molecule. Methemoglobin is unable to bind and transport oxygen, resulting in methemoglobinemia, which can lead to fatal tissue hypoxia. The most common cause of methemoglobinemia is poisoning by oxidizing agents such as dapsone, benzocaine, and primaquine. However, methemoglobinemia can also be caused by normal dietary sources. We present two cases of methemoglobinemia that developed after a normal diet in two male patients. In this case report, the patients suddenly developed dyspnea and cyanosis after eating the same meal. They had no history of suspected poisoning, such as the use of drugs, exposure to chemicals, or gas inhalation. Their symptoms did not improve even after a high dose of oxygen was administered; further, an abnormal 'oxygen saturation gap' was observed. Because of CO-oximetry, the methemoglobin levels of the patients were 50.0% and 46.6%, respectively. We administered methylene blue (1 mg/kg), and the patients recovered completely without any complications. Emergency physicians should, therefore, be aware that methemoglobinemia can also be caused by normal dietary sources. In addition, if the source and route of contamination are unclear, an epidemiological investigation should be conducted.

Clinical Experience with Continuous Renal Replacement Therapy as a Method of Extracorporeal Elimination and as performed by Emergency Room Physicians for Patients with Poisoning (체외제거가 필요한 중독환자에서 응급의학과 의사에 의해 시행된 지속적신대체요법에 대한 임상적 고찰)

  • Ahn, Jung-Hwan;Choi, Sang-Cheon;Jung, Yoon-Seok;Min, Young-Gi
    • Journal of The Korean Society of Clinical Toxicology
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    • v.7 no.2
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    • pp.150-155
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    • 2009
  • Purpose: Extracorporeal elimination of drugs is a critical part of managing poisonings, although the indications and optimal method remain a matter of debate. The aim of this study is to report our clinical experiences with continuous renal replacement therapy (CRRT), as performed by emergency room physicians, as method of extracorporeal drug elimination in patients with poisoning. Methods: This study was a retrospective study of the consecutive patients who underwent CRRT, as performed by an emergency room physician, for acute poisoning. The patient characteristics, the kinds of drugs and the method of extracorporeal elimination were analyzed by reviewing the patients' charts. Results: During eleven months, 26 patients with acute poisoning underwent extracorporeal elimination (2 patients; intermittent hemodialysis, 24 patients; CRRT). The mean time from the decision to performing extracorporeal elimination was $206.0{\pm}36.8$ minutes for intermittent hemodialysis, $62.9{\pm}8.5$ minutes for continuous venoveno-hemodiafiltration (CVVHDF) and $56.6{\pm}6.8$ minutes for charcoal hemoperfusion. For the patients with CRRT, CVVHDF was conducted in 10 patients (3 patients; valproic acid, 2 patients; Lithium, 1 patient; salicylates, 1 patient; methanol) and charcoal hemoperfusion by using CRRT was done in 14 patients (13 patients; paraquat, 1 patient; dapsone). For the 12 patients who required hemodialysis due to severe poisoning, 7 patients underwent CRRT because of their unstable vital signs. Conclusion: CRRT was an effective method of extracorporeal drug elimination in patients with acute poisoning, and especially for the cases with unstable vital sign and for those patients who required an early start of extracorporeal elimination according to the characteristics of the drug. (ED note: the writing of the abstract was not clear. Check it carefully.)

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Prophylactic and therapeutic studies on intestinal giant-cystic disease of the Israel carp caused by Thelophanellus kitauei II. Effects of physical and chemical factors on T. kitauei spores in vitro (향어의 장포자충(Thelohanellus kitauei)증의 예방 및 치료에 관한 기초적 연구 II. 물리화학적 요인이 장포자충 포자에 미치는 영향)

  • Lee, Jae-Gu;Kim, Jong-O;Park, Bae-Geun
    • Parasites, Hosts and Diseases
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    • v.28 no.4
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    • pp.241-252
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    • 1990
  • In a basic attempt to develop the prophylactic and therapeutic measures on intestinal giantcystic disease of the Israel carp, C), prinks carpio nudum, the effects of physical and chemical factors on viability or survival of the spores of Thelchcnellus kiteuei were checked in vitro by means of extrusion test on the polar filament. When the fresh spores suspended with 0.45% and 0.9% scdium chloride solution and distilled water were laid at $5^{\circ}C$ and $28^{\circ}C$ for short terms, the extrusion rates increased until the 3rd day, meanwhile when son;e of them were suspended with Tyrode's solution at $-70^{\circ}C$ the rates increased gradually until the 8th day. Viabilities of the spores suspended with 0.9% saline and added antibiotics to the suspension at $5^{\circ}C$ for long terms lasted for 997 days and 1, 256 days (presumed values) at maximum, respectively. The spores suspended with distilled water at $28^{\circ}C$ for long terms survived 152.4 days, but the spores suspended with Tyrode's solution at $-70^{\circ}C$ for long terms showed almost the same viable pattern as early freezing stages up to 780 days. The spores suspended with Tyrode's solution, frozen at $-70^{\circ}C$ and thawed at $5^{\circ}C$, showed the highest rate of extrusion of the polar filament. In the case of frozen spores, the extrusion rates during heating tend to become higher in accordance with the increase of frozen period, and the critical points of 180 day-frozen spores to be killed were generally 78.5 hr. at $60^{\circ}C$, 23.4 hr. at $70^{\circ}C$, 189.1 min. at $80^{\circ}C$ or 10.5 min. at $90^{\circ}C$. The longer the spores were frozen, the more time was needed for the death of spores after thawing; 20 days-17.4 days, 100 days-33.2 days, and 400 days-37.8 days. The longer the spores were frozen, the more time was needed for the death of spores at a conventional when they were dried air drying condition, 540 days-23.5 days, 160 days-21.0 days, and 20 days-14.4 days. On the other hand, the longer the spores were frozen, the more spores were dead rapidly when they were irradiated with 10W UV-ray; 100 days-26.0 hr, 300 days-21.9 hr, and 540 days-13.9 hr. The time needed for killing 200 days-frozen spores by various disinfectants at 1, 000 ppd was 5.2 min. by calcium oxide, 10.4 min. by potassium permanganate, 27.8 min. by malachite green and 14.3 hr. by formalin. Transient inhibitory effects of the extrusion of the polar filament were observed by various antiprotozoal and antifungal agents in the descending order of ketoconazole. metronidasole and dapsone. The above results presume that full drying, followed by spraying CaO and maintaining sunny condition for a few days on the concrete bottoms of knish farm may be an effective method for the prevention of intestinal giant.cystic disease.

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