Emergency Dermatology Dr Melissa Barkham

Size: px
Start display at page:

Download "Emergency Dermatology Dr Melissa Barkham"

Transcription

1 Emergency Dermatology Dr Melissa Barkham Spotlight Seminar 30 th September 2010

2 Why is this important? Urgent recognition and treatment of dermatologic emergencies can be life saving and prevent long term morbidity How do you differentiate rare life threatening conditions from the common skin complaints that make up 10-20% of consultations in primary care?

3 Skin structure and function Protective barrier (toxins, microbes, u.v. light, physical injury) Temperature regulation Fluid homeostasis Sensation Immunological function Synthetic (e.g. Vitamin D) Psycho-social

4 Consequences of Skin failure Similar to patients with extensive burns Dehydration Fluid and electrolyte imbalance Hypo - albuminaemia Hypotension Hypothermia Sepsis Other organ failure (e.g. renal, hepatic, CCF)

5 Emergency Dermatology Overview Skin signs a diagnostic clue (to serious underlying disorder) Severe Infections (e.g. meningococcaemia, necrotising facsiitis, staphylococcal scalded skin) Skin disease causing risk of vital organ failure / death Severe adverse drug reactions (e.g. toxic epidermal necrolysis) Acute autoimmune disease (e.g. SLE, systemic vasculitis) Erythroderma (e.g. due to extensive inflammatory skin disease ) Paraneoplastic (e.g. dermatomyositis) Autoimmune Blistering disorders (e.g. pemphigus vulgaris)

6 Team approach GP Accident and emergency On call medical (or paediatric) team Dermatology consultants and specialist nurses ITU Histopathology Microbiology..to name but a few

7 Cutaneous Adverse Drug Reactions Common - severity variable Can be life threatening Potential long term sequelae (e.g. blindness) Think carefully before you prescribe any medicine! Yellow card reporting (MHRA) Over the counter drugs and supplements can be the culprit

8 Cutaneous Adverse Drug Reactions History may not be volunteered Ask about all medications taken in the last 3 months Prescribed and non prescribed (including household remedies, herbal remedies, vitamins and supplements) Beware compound preparations (e.g. cold and flu remedies)

9 Severe Drug reaction - types Exanthemous (morbilliform) Stevens - Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) Drug hypersensitivity syndrome (DHS) Urticaria +/- angioedema

10 Drug reaction - warning signs Facial or mucous membrane involvement Widespread erythema Skin pain Blistering / skin necrosis Fever Lymphadenopathy / arthralgia Features of anaphylaxis Other organ involvement (e.g. hepatic or renal dysfunction)

11 Exanthemous drug reaction - features Commonest type Onset 5-10 days after new drug Morbilliform (measles like) maculopapular rash Usually itchy Sometimes associated with fever / malaise Commoner in patients with infectious mononucleosis, leukaemia or HIV Suspected drug (or drugs) should be discontinued and rash subsides in 1-2 weeks

12 Exanthemous drug eruption - culprits Penicillins Carbamazepine Allopurinol Sulphonamides NSAIDS Phenytoin Isoniazid

13 DHS - clinical features Morbilliform rash with fever and internal organ involvement Toxic erythema Mortality - about 10% Later onset (2-6 weeks) after new drug commenced Fever, lymphadenopathy Eosinophilia (DRESS) in some Hepatic / renal failure Treatment: withdrawal of offending drug(s) and supportive care

14 DHS - culprits Sulphonamides Dapsone Anticonvulsants ACE inhibitors Beta - blockers Allopurinol Minocycline SSRI

15 TEN / SJS - clinical features Rare drug reaction - presents with skin and mucosal loss Variants of the same condition (differentiated by extent of skin involved - TEN >30%, SJS <10%) Mortality - 50% Mucous membrane involvement (eyes, mouth, genitalia) - can scar Tender, blistering skin and necrotic epidermis areas of denuded skin Positive Nikolsky sign (blisters extend with skin pressure)

16 TEN / SJS - culprits More than 100 drugs reported including... Penicillins Sulfonamides NSAIDS (including ibuprofen) Anticonvulsants Allopurinol Antiretrovirals... and even paracetamol Susceptibility factors - HIV, genetic susceptibility

17 TEN / SJS - Differential diagnoses Erythema Multiforme - self limiting reaction triggered by infections e.g. HSV. Typical target lesions especially on acral sites. May involve mucosae. Staphylococcal scalded skin syndrome (SSSS) - a localised infection with a toxigenic strain of S. Aureus triggers fever, redness of skin and easily ruptured blisters. Flexures often affected and mucosae uninvolved. Autoimmune blistering disorders

18 TEN / SJS - investigations Skin biopsy for histology and direct immunofluorescence (DIF) H&E sections - basal or full thickness epidermal keratinocyte necrosis, supepidermal blistering (SSSS - the split is higher) DIF - negative (rules out autoimmune disease)

19 TEN / SJS - management Remove all possible culprit drugs Supportive care in ITU or high dependency setting (skin failure) Careful fluid and electrolyte balance Analgesia Non - adherent dressings / sheets Ophthalmology input Prevention and treatment of secondary infections Consider intravenous immunoglobulin Future avoidance (including 1st degree relatives)

20 Drug induced Urticaria Drug induced urticaria can occur with or without angioedema Up to 3 weeks after first exposure (or minutes on re-challenge) Types - Type 1 hypersensitivity (e.g. penicillin) - can be associated with anaphylaxis Mast cell degranulation on first exposure (e.g. NSAIDS, opiates) Angioedema without urticaria (e.g. ACE inhibitors)

21 Drug Induced Urticaria - culprits NSAIDS Penicillins Cephalosporins Sulphonamides ACE inhibitors Calcium channel inhibitors Vaccinations

22

23 What is Erythroderma? Intense and widespread reddening of the skin (more difficult to detect in asian / black skin) > 90% Body Surface area involement Often associated with exfoliation (exoliative dermatitis / exfoliative erythroderma) Often results from exacerbation of a pre-existing skin disorder

24 Causes of Erythroderma Psoriasis Dermatitis Cutaneous T- Cell lymphoma Drugs (red man syndrome) Idiopathic Paraneoplastic

25 Erythroderma - management Identify underlying cause (biopsy) Consider hospital admission Supportive care (e.g. keep warm, regular emollients, fluid balance, high protein diet) Treat underlying disease (e.g. severe psoriasis - methotrexate or other systemics, dermatitis - topical or oral corticosteroids) Avoid oral corticosteroids in severe psoriasis

26 Generalised Pustular Psoriasis Rare form of psoriasis (patient presents with widespread sterile pustules on a background of red and tender skin) Many have a background of chronic plaque psoriasis Trigger factors include sudden withdrawal of oral (or potent topical) corticosteroids, infections, irritating topical preparations like tar or dithranol, pregnancy and drugs

27 Generalised Pustular Psoriasis Pustule swab (exclude infectious causes) Consider skin biopsy Admission Fluid balance and supportive care Bland emollients May require systemic therapy (e.g. oral retinoid such as acitretin, Methotrexate or anti- TNF therapy)

28 Pemphigus Vulgaris - clinical features Rare autoimmune blistering disorder The blisters are intra-epidermal (therefore easily ruptured) IgG autoantibodies against a desmosomal protein Usually presents initially with mucosal (oral, genital, conjunctival erosions) - difficulty eating +/- skin erosions / blisters (and positive Nikolsky sign)

29 Pemphigus Vulgaris - treatment Confirm diagnosis with skin biopsy (including direct IF) Fatal before advent of oral corticosteroids Likely to require admission for supportive care Non adherent dressings High dose oral steroids initially (1 mg/kg/day) Prevention / treatment of infection Additional steroid sparing agent usually needed

30 Bullous Pemphigoid - clinical features Autoimmune blistering disorder, commoner in the elderly Split is at the Basement Membrane zone (deeper than in PV) Crops of tense fluid filled blisters, often with surrounding erythema Itchy Can be localised or widespread Oral mucosal involvement less frequent than PV Usually less severe than PV

31 Bullous Pemphigoid -treatment Confirm diagnosis with skin biopsy (including direct and indirect IF) Biopsy confirmation less probable if patient already on oral corticosteroids Admission not always necessary Treatment usually oral +/- topical corticosteroids (reducing course commencing around 0.5 mg/kg/day) Attention to dressings May need steroid sparing agent (e.g. dapsone, azathioprine)

32 Eczema herpeticum Herpes simplex infections can be more severe and extensive in patients with underlying skin disease (e.g. eczema) Systemic antivirals +/- antibiotics needed May need admission Ophthalmology input if eyelids involved or eyes feel gritty

33 Learning points Pause before you prescribe is this drug really necessary? Warning signs in severe drug reaction (e.g. fever, mucosal involvement, blistering, tenderness) Caution with oral corticosteroids in psoriasis (abrupt withdrawal can precipitate generalised pustular psoriasis)

34 When you need us... On call team (via switchboard on ) if admission needed Call dermatology (particularly if admission avoidable but urgent treatment needed) SPH Ashford

35 and a happy ending Any questions?

Emergency Dermatology. Emergency Dermatology

Emergency Dermatology. Emergency Dermatology Emergency Dermatology These are rapidly progressive skin conditions and some are potentially lifethreatening. Early recognition is important to implement prompt supportive care and therapy. Some are drug

More information

Drug Allergy A Guide to Diagnosis and Management

Drug Allergy A Guide to Diagnosis and Management Drug Allergy A Guide to Diagnosis and Management (Version 1 April 2015 updated April 2018) Author: Jed Hewitt Chief Pharmacist, Governance & Professional Practice Date of Preparation: April 2015 Updated:

More information

DERMATOLOGICAL EMERGENCIES. DR. Ian Hoyle MBBS DIP IMC RCS (Ed), DA (UK),FRACGP,FACRRM,DIP DERM(Wales) TASMANIAN SKIN AND BODY CENTRE

DERMATOLOGICAL EMERGENCIES. DR. Ian Hoyle MBBS DIP IMC RCS (Ed), DA (UK),FRACGP,FACRRM,DIP DERM(Wales) TASMANIAN SKIN AND BODY CENTRE DERMATOLOGICAL EMERGENCIES DR. Ian Hoyle MBBS DIP IMC RCS (Ed), DA (UK),FRACGP,FACRRM,DIP DERM(Wales) TASMANIAN SKIN AND BODY CENTRE Dermatological Emergencies INFECTIONS ERYTHRODERMA DRUG ERUPTIONS STEVENS-JOHNSON

More information

Cutaneous Drug Reactions

Cutaneous Drug Reactions Cutaneous Drug Reactions Andrei Metelitsa, MD, FRCPC, FAAD Co-Director, Institute for Skin Advancement Clinical Associate Professor, Dermatology University of Calgary, Canada Copyright 2017 by Sea Courses

More information

Skin Manifestations of Drug Reactions

Skin Manifestations of Drug Reactions Skin Manifestations of Drug Reactions Dr Carol Hlela, Division of Dermatology Department of Medicine, University of Cape Town and Red Cross Children s Hospital What are the Skin Manifestations of Drug

More information

They are updated regularly as new NICE guidance is published. To view the latest version of this NICE Pathway see:

They are updated regularly as new NICE guidance is published. To view the latest version of this NICE Pathway see: bring together everything NICE says on a topic in an interactive flowchart. are interactive and designed to be used online. They are updated regularly as new NICE guidance is published. To view the latest

More information

Five things not to miss in Dermatology. Dr Judy Wismer Associate Clinical Professor Michael G DeGroote School of Medicine

Five things not to miss in Dermatology. Dr Judy Wismer Associate Clinical Professor Michael G DeGroote School of Medicine Five things not to miss in Dermatology Dr Judy Wismer Associate Clinical Professor Michael G DeGroote School of Medicine Key Descriptives Fever, skin pain Purpura, necrosis Bullae, Mucosal, Skin sloughing

More information

Rashes Not To Be Missed In Children

Rashes Not To Be Missed In Children May 2016 Rashes Not To Be Missed In Children Dr Chan Yuin Chew Dermatologist Dermatology Associates Gleneagles Medical Centre Scope of presentation Focus on rashes May lead to significant morbidity if

More information

PedsCases Podcast Scripts

PedsCases Podcast Scripts PedsCases Podcast Scripts This is a text version of a podcast from Pedscases.com on Drug Allergy. These podcasts are designed to give medical students an overview of key topics in pediatrics. The audio

More information

Pediatric Dermatology

Pediatric Dermatology Pediatric Dermatology --------- Emergencies & Urgencies Nicholas V. Nguyen, M.D. Director, Pediatric Dermatology Disclosures In the past 12 months, I have had the following financial relationships with

More information

An unpredictable, dose-independent adverse drug reaction which is immunologically or IgEmediated.

An unpredictable, dose-independent adverse drug reaction which is immunologically or IgEmediated. R H E U M A T I S M D I S O R D E R S A N D A L L E R G I E S APPROACH TO DRUG ALLERGY Dr Bernard Thong DEFINITION OF DRUG ALLERGY An unpredictable, dose-independent adverse drug reaction which is immunologically

More information

Herbal and homeopathic products, often considered natural and non-toxic, can also cause adverse drug reactions.

Herbal and homeopathic products, often considered natural and non-toxic, can also cause adverse drug reactions. Idiosyncratic and potentially serious cutaneous adverse drug reactions (CADRs), although relatively rare, account for significant morbidity and mortality. RANNAKOE J LEHLOENYA, BSc, MB ChB, FCDerm (SA)

More information

Vulval dermatoses. Dr Fiona Lewis, Consultant Dermatologist St John s Institute of Dermatology, London & Heatherwood & Wexham Park Hospital, Slough

Vulval dermatoses. Dr Fiona Lewis, Consultant Dermatologist St John s Institute of Dermatology, London & Heatherwood & Wexham Park Hospital, Slough Vulval dermatoses Dr Fiona Lewis, Consultant Dermatologist St John s Institute of Dermatology, London & Heatherwood & Wexham Park Hospital, Slough Pigmentation Vulvodynia Ulcers Genetic Pruritus VULVAL

More information

REGISTRY OF SEVERE CUTANEOUS ADVERSE REACTIONS TO DRUGS AND COLLECTION OF BIOLOGICAL SAMPLES. R e g i S C A R PATIENT'S DATA. Age country of birth

REGISTRY OF SEVERE CUTANEOUS ADVERSE REACTIONS TO DRUGS AND COLLECTION OF BIOLOGICAL SAMPLES. R e g i S C A R PATIENT'S DATA. Age country of birth REGISTRY OF SEVERE CUTANEOUS ADVERSE REACTIONS TO DRUGS AND COLLECTION OF BIOLOGICAL SAMPLES R e g i S C A R PATIENT'S DATA Initials of the patient date of birth Age country of birth Gender male female

More information

GOOD MORNING! AUGUST 5, 2014

GOOD MORNING! AUGUST 5, 2014 GOOD MORNING! AUGUST 5, 2014 PREP QUESTION During the health supervision visit of a term newborn boy, his mother relates that a cousins child died at age 4 months from sudden infant death syndrome. She

More information

A. Erythema multiforme and related diseases

A. Erythema multiforme and related diseases Go Back to the Top To Order, Visit the Purchasing Page for Details Chapter Erythema, Erythroderma (Exfoliative Dermatitis) Erythema is caused by telangiectasia or hyperemia in the papillary and reticular

More information

Dilantin (phenytoin) ROBERT A. SCHWARTZ

Dilantin (phenytoin) ROBERT A. SCHWARTZ Dilantin (phenytoin) ROBERT A. SCHWARTZ Bailey & Galyen Attorney in Charge, Mass Tort Litigation Managing Attorney, Houston 18333 Egret Bay Blvd., Suite 120 Houston, Texas 77058 Toll Free: (866) 715-1529

More information

Cutaneous Adverse Drug Reactions in Domestic Animals. Katherine Doerr, DVM, Dip. ACVD. Veterinary Dermatology Center

Cutaneous Adverse Drug Reactions in Domestic Animals. Katherine Doerr, DVM, Dip. ACVD. Veterinary Dermatology Center Cutaneous Adverse Drug Reactions in Domestic Animals Katherine Doerr, DVM, Dip. ACVD Veterinary Dermatology Center Maitland, Rockledge, Waterford Lakes, FL Not highly studied in veterinary medicine Unknown

More information

If a drug trigger is suspected, stop the offending drug as this may reduce the risk of relapse.

If a drug trigger is suspected, stop the offending drug as this may reduce the risk of relapse. There is so much we don't know in medicine that could make a difference, and often we focus on the big things, and the little things get forgotten. To highlight some smaller but important issues, we've

More information

Dermatology GP Referral Guidelines

Dermatology GP Referral Guidelines Austin Health Dermatology Department holds 5 Clinic sessions to discuss and plan the treatment of with Dermatology conditions. Department of Health clinical urgency categories for specialist clinics Urgent:

More information

DERMATOLOGIC EMERGENCIES. Mary Evers D.O., F.A.O.C.D. Georgetown, Texas

DERMATOLOGIC EMERGENCIES. Mary Evers D.O., F.A.O.C.D. Georgetown, Texas DERMATOLOGIC EMERGENCIES Mary Evers D.O., F.A.O.C.D. Georgetown, Texas SKIN EMERGENCIES??? Subclassifications: Autoimmune (Anaphylaxis, Vasculitis, Pemphigus) Erythroderma (AGEP, DRESS, SJS, TEN) Infectious

More information

Dermergency! An Approach to Identification and Management of Life-Threatening Rashes

Dermergency! An Approach to Identification and Management of Life-Threatening Rashes Dermergency! An Approach to Identification and Management of Life-Threatening Rashes Gabby Anderson, PharmD PGY2 Emergency Medicine Pharmacy Resident anderson.gabrielle@mayo.edu Pharmacy Grand Rounds January

More information

SKIN REACTIONS WITH PSYCHOTROPICS: A SYSTEMATIC REVIEW

SKIN REACTIONS WITH PSYCHOTROPICS: A SYSTEMATIC REVIEW SKIN REACTIONS WITH PSYCHOTROPICS: A SYSTEMATIC REVIEW *Anderson Isaac, PharmD Candidate, 2019 Pooja Patel, PharmD Candidate, 2019 Katelyn Thomasson, PharmD Candidate, 2019 Erika Tillery, PharmD, BCPP,

More information

New product information wording Extracts from PRAC recommendations on signals

New product information wording Extracts from PRAC recommendations on signals 12 October 2017 EMA/PRAC/610988/2017 Pharmacovigilance Risk Assessment Committee (PRAC) New product information wording Extracts from PRAC recommendations on signals Adopted at the 25-29 September 2017

More information

Correspondence should be addressed to Wanjarus Roongpisuthipong; rr

Correspondence should be addressed to Wanjarus Roongpisuthipong; rr Dermatology Research and Practice, Article ID 237821, 5 pages http://dx.doi.org/10.1155/2014/237821 Research Article Retrospective Analysis of Corticosteroid Treatment in Stevens-Johnson Syndrome and/or

More information

Future of Pediatrics: Blisters, Hives and Other Tales from the Emergency Room June 14 th, 2016

Future of Pediatrics: Blisters, Hives and Other Tales from the Emergency Room June 14 th, 2016 A. Yasmine Kirkorian MD Assistant Professor of Dermatology & Pediatrics Children s National Health System George Washington University School of Medicine & Health Sciences Future of Pediatrics: Blisters,

More information

Bacterial Infections in Pediatric Dermatology. Patrick McMahon, MD Children s Hospital of Philadelphia

Bacterial Infections in Pediatric Dermatology. Patrick McMahon, MD Children s Hospital of Philadelphia Bacterial Infections in Pediatric Dermatology Patrick McMahon, MD Children s Hospital of Philadelphia Fill In The Blank When you see on the skin, you think of a bacterial skin infection SEND SWABS VIRAL

More information

Big rashes in little patients:

Big rashes in little patients: ! Big rashes in little patients: Severe drug eruptions and cutaneous infections!! Marcia Hogeling, MD, FAAD Assistant Clinical Professor Director, Pediatric Dermatology Division of Dermatology David Geffen

More information

Some skin conditions

Some skin conditions Some skin conditions Some skin conditions Acute Inflammatory Dermatoses Chronic Inflammatory Dermatoses Blistering (Bullous) Diseases Panniculitis Disorders of Epidermal Appendages -Urticaria -Acute eczematous

More information

Concentrate on Descriptors. An Approach to Skin Diseases in the ER

Concentrate on Descriptors. An Approach to Skin Diseases in the ER Concentrate on Descriptors An Approach to Skin Diseases in the ER Toby Maurer, MD University of California, San Francisco Vasculitis-leaky blood vessels Targetoid lesions-round lesions with blue or red

More information

Classification: 1. Infective: 2. Traumatic: 3. Idiopathic: Recurrent Aphthous Stomatitis (RAS) 4. Associated with systemic disease:

Classification: 1. Infective: 2. Traumatic: 3. Idiopathic: Recurrent Aphthous Stomatitis (RAS) 4. Associated with systemic disease: Classification: 1. Infective: 2. Traumatic: 3. Idiopathic: Recurrent Aphthous Stomatitis (RAS) 4. Associated with systemic disease: Hematological GIT Behcet s HIV 5. Associated with dermatological diseases:

More information

Hospital-based Dermatopathology. Janis M. Taube, MD Director of Dermatopathology Johns Hopkins University SOM

Hospital-based Dermatopathology. Janis M. Taube, MD Director of Dermatopathology Johns Hopkins University SOM Hospital-based Dermatopathology Janis M. Taube, MD Director of Dermatopathology Johns Hopkins University SOM Overview Drug-eruptions Erythroderma Manifestations of renal disease Blistering disorders Vasculitis/Vasculopathy

More information

50 microgram/g Calcipotriol and 500 microgram/g betamethasone (as dipropionate).

50 microgram/g Calcipotriol and 500 microgram/g betamethasone (as dipropionate). DUPISOR Composition Gel 50 microgram/g Calcipotriol and 500 microgram/g betamethasone (as dipropionate). Action Calcipotriol is a non-steroidal antipsoriatic agent, derived from vitamin D. Calcipotriol

More information

New product information wording Extracts from PRAC recommendations on signals

New product information wording Extracts from PRAC recommendations on signals 20 July 2017 EMA/PRAC/406976/2017 Pharmacovigilance Risk Assessment Committee (PRAC) New product information wording Extracts from PRAC recommendations on signals Adopted at the 3-6 July 2017 PRAC The

More information

B. Autoimmune blistering diseases

B. Autoimmune blistering diseases Go Back to the Top To Order, Visit the Purchasing Page for Details formation immediately above the basal layer. The dermal papillae, which are covered by basal cells in the single layer that is left in

More information

Autoimmune Diseases with Oral Manifestations

Autoimmune Diseases with Oral Manifestations Autoimmune Diseases with Oral Manifestations Martin S. Greenberg DDS, FDS RCSEd Professor Emeritus Department of Oral Medicine University of Pennsylvania Disclosure Statement I have no actual or potential

More information

Adverse Drug Reactions (ADRs) Outline

Adverse Drug Reactions (ADRs) Outline Adverse Drug Reactions (ADRs) Outline 1. What are Adverse Drug Reactions (ADRs)? WHAT WHY HOW 2. How important are ADRs and are they preventable? 3. What are the classifications and mechanisms of ADRs?

More information

ERYTHRODERMA. ASAPA 2018 Fall Conference Tucson, AZ 10/12/2018. Andrew Newman, DO Pgy-3, Affiliated Dermatology/Honor Health

ERYTHRODERMA. ASAPA 2018 Fall Conference Tucson, AZ 10/12/2018. Andrew Newman, DO Pgy-3, Affiliated Dermatology/Honor Health ERYTHRODERMA ASAPA 2018 Fall Conference Tucson, AZ 10/12/2018 Andrew Newman, DO Pgy-3, Affiliated Dermatology/Honor Health OBJECTIVES Define Erythroderma Name common diseases and medications that cause

More information

Mark A. Bechtel, MD Clinical Associate Professor Division Director, Dermatology Ohio State University Medical Center

Mark A. Bechtel, MD Clinical Associate Professor Division Director, Dermatology Ohio State University Medical Center Dermatologic Emergencies Mark A. Bechtel, MD Clinical Associate Professor Division Director, Dermatology Ohio State University Medical Center Clinical Features of SJS/TEN Initial symptoms Fever, stinging

More information

Patient Group Direction for Doxycycline (Tetracycline) Version: 01 Start Date: October 2015 Expiry Date: October 2018

Patient Group Direction for Doxycycline (Tetracycline) Version: 01 Start Date: October 2015 Expiry Date: October 2018 THIS PATIENT GROUP DIRECTION HAS BEEN AGREED BY THE FOLLOWING ORGANISATIONS: CLINICAL COMMISSIONING GROUP: Doncaster CCG Lancashire North CCG Fylde & Wyre CCG East Lancashire CCG Change history Version

More information

Undergraduate Dermatology Curriculum July 2016

Undergraduate Dermatology Curriculum July 2016 Undergraduate Dermatology Curriculum July 2016 British Association of Dermatologists Introduction This document is the 2016 revised dermatology undergraduate curriculum (UK) from the British Association

More information

Package leaflet: Information for the user

Package leaflet: Information for the user Package leaflet: Information for the user Dalacin C 150mg Capsules clindamycin hydrochloride PFIZER Read all of this leaflet carefully before you start taking this medicine because it contains important

More information

0BCore Safety Profile. Pharmaceutical form(s)/strength: Cream 1% DK/H/PSUR/0009/005 Date of FAR:

0BCore Safety Profile. Pharmaceutical form(s)/strength: Cream 1% DK/H/PSUR/0009/005 Date of FAR: 0BCore Safety Profile Active substance: Pimecrolimus Pharmaceutical form(s)/strength: Cream 1% P-RMS: DK/H/PSUR/0009/005 Date of FAR: 06.06.2013 4.3 Contraindications Hypersensitivity to pimecrolimus,

More information

NEOFEN 60 mg suppository

NEOFEN 60 mg suppository PACKAGE LEAFLET: INFORMATION FOR THE USER NEOFEN 60 mg suppository IBUPROFEN This leaflet is a copy of the Summary of Product Characteristics and Patient Information Leaflet for a medicine, which outlines

More information

Stevens-Johnson s Syndrome / Toxic Epidermal Necrolysis: An update

Stevens-Johnson s Syndrome / Toxic Epidermal Necrolysis: An update Stevens-Johnson s Syndrome / Toxic Epidermal Necrolysis: An update Robert G. Micheletti, MD Assistant Professor of Dermatology and Medicine Director, Cutaneous Vasculitis Clinic, Penn Vasculitis Center

More information

To update the use of IVIG and CORTICOIDS IN management of SJS/ TEN To remind Doctors being careful when giving

To update the use of IVIG and CORTICOIDS IN management of SJS/ TEN To remind Doctors being careful when giving Present : Dr Pham Thi Minh Rang Internal Department No2-Hospital for children No2 AIMS To update the use of IVIG and CORTICOIDS IN management of SJS/ TEN To remind Doctors being careful when giving To

More information

Effective Shared Care Agreement (ESCA)

Effective Shared Care Agreement (ESCA) Effective Shared Care Agreement (ESCA) Azathioprine (either alone or more usually in combination with corticosteroids and/or other drugs and procedures) ESCA: For the treatment of systemic lupus erythematosus

More information

An Approach to Common and not so Common Rashes in the Office FMF 2014 Christie Freeman MD, CCFP, DipPDerm, MSc

An Approach to Common and not so Common Rashes in the Office FMF 2014 Christie Freeman MD, CCFP, DipPDerm, MSc An Approach to Common and not so Common Rashes in the Office FMF 2014 Christie Freeman MD, CCFP, DipPDerm, MSc 1 Common Rashes Tinea Corporis: Annular- this is not the only criteria Advancing erythematous

More information

Common Dermatological Conditions in Adults in Ghana. Margaret Lartey FWACP

Common Dermatological Conditions in Adults in Ghana. Margaret Lartey FWACP Common Dermatological Conditions in Adults in Ghana Margaret Lartey FWACP Outline Introduction Two Common disorders Discussion Case 1 34 yr old female C/o pruritus of 2 months duration First episode Seen

More information

SJS/TEN spectrum. Stevens-Johnson syndrome (SJS) /Toxic Epidermal Necrolysis (TEN) 10/7/2016

SJS/TEN spectrum. Stevens-Johnson syndrome (SJS) /Toxic Epidermal Necrolysis (TEN) 10/7/2016 Jesse Keller MD Assistant Professor Oregon Health & Science University Stevens-Johnson syndrome (SJS) /Toxic Epidermal Necrolysis (TEN) Drug induced dermemergencies that exist on a spectrum Delayed reaction:

More information

Diagnosis and Management of Drug-induced Stevens-Johnson Syndrome: Report of Two Cases

Diagnosis and Management of Drug-induced Stevens-Johnson Syndrome: Report of Two Cases 10.5005/jp-journals-10011-1189 CASE REPORT JIAOMR Diagnosis and Management of Drug-induced Stevens-Johnson Syndrome: Report of Two Cases 1 M Venkateshwarlu, 2 B Radhika 1 Professor and Head, Department

More information

Pharmacologyonline 1: 1-6 (2010) Case Report Ravishankar and Hiremath CIPROFLOXACIN INDUCED BULLOUS PEMPHIGOID: A CASE REPORT

Pharmacologyonline 1: 1-6 (2010) Case Report Ravishankar and Hiremath CIPROFLOXACIN INDUCED BULLOUS PEMPHIGOID: A CASE REPORT CIPROFLOXACIN INDUCED BULLOUS PEMPHIGOID: A CASE REPORT Ravishankar AC 1*, Hiremath SV 1 1 Dept of Pharmacology and Pharmacotherapeutics, JN Medical College, Belgaum, India. Summary Bullous pemphigoid

More information

A Case Report on Amoxicillin Induced Stevens- Johnson Syndrome

A Case Report on Amoxicillin Induced Stevens- Johnson Syndrome Open Journal of Clinical & Medical Case Reports Volume 2 (2016) Issue 11 A Case Report on Amoxicillin Induced Stevens- Johnson Syndrome Rajendra Singh Airee*; Aastha Rawal; Binu Mathew; H. Doddayya Abstract

More information

Vasculitis local: systemic

Vasculitis local: systemic Vasculitis Inflammation of the vessel wall. Signs and symptoms: 1- local: according to the involved tissue 2- systemic:(fever, myalgia, arthralgias, and malaise) Pathogenesis 1- immune-mediated 2- infectious

More information

Drug allergy and Skin Disorders. Timothy Craig, DO, FACOI Professor of Medicine and Pediatrics Distinguished Educator Penn State University, Hershey

Drug allergy and Skin Disorders. Timothy Craig, DO, FACOI Professor of Medicine and Pediatrics Distinguished Educator Penn State University, Hershey Drug allergy and Skin Disorders Timothy Craig, DO, FACOI Professor of Medicine and Pediatrics Distinguished Educator Penn State University, Hershey The best screening test for anaphylaxis is? A. histamine

More information

VI.2 Elements for a public summary. VI.2.1 Overview of disease epidemiology

VI.2 Elements for a public summary. VI.2.1 Overview of disease epidemiology VI.2 Elements for a public summary VI.2.1 Overview of disease epidemiology Sinus infection (Acute bacterial sinusitis) Sinus infection (upper respiratory infection) is short-lived infection of the sinuses,

More information

Drug induced allergy and hypersensitivity

Drug induced allergy and hypersensitivity Drug induced allergy and hypersensitivity Yunita Sari Pane, Aznan Lelo Dept. Pharmacology & Therapeutic School of Medicine Universitas Sumatera Utara 13 Mei 2009, KBK-FK USU, Medan Drug Allergy Adverse

More information

Address for correspondence: Dr. Patel Raksha M. R-3, Doctor s Quarters, Jail Road, Vadodara- 01, Gujarat, India.

Address for correspondence: Dr. Patel Raksha M. R-3, Doctor s Quarters, Jail Road, Vadodara- 01, Gujarat, India. Clinical study of cutaneous drug eruptions in 200 patients Raksha M. Patel, Y. S. Marfatia Department of Skin and V.D, Medical College, Vadodara, Gujarat, India Address for correspondence: Dr. Patel Raksha

More information

Analysis of causation of Stevens Johnson Syndrome in a patient of rheumatoid arthritis with increased dose of methotrexate

Analysis of causation of Stevens Johnson Syndrome in a patient of rheumatoid arthritis with increased dose of methotrexate Original Research Article Analysis of causation of Stevens Johnson Syndrome in a patient of rheumatoid arthritis with increased dose of methotrexate Manab Nandy 1, Sangeeta De 2*, Mustafa Asad 2, Nirmal

More information

Discoid Lupus Erythematosus. DLE Treatment. Tacrolimus (Protopic ) DLE Treatment. Uses for Tacrolimus (Protopic ) 9/7/2016

Discoid Lupus Erythematosus. DLE Treatment. Tacrolimus (Protopic ) DLE Treatment. Uses for Tacrolimus (Protopic ) 9/7/2016 Common Immune mediated Dermatoses William H. Miller, Jr VMD Professor of Dermatology College of Veterinary Medicine Cornell University Ithaca, NY 14853 Discoid Lupus Erythematosus Most common autoimmune

More information

Goals of this talk. Morbilliform. Common Morphologies in the Hospital 11/7/2017. Hospital Based Dermatology: Common and Tough Consult Cases

Goals of this talk. Morbilliform. Common Morphologies in the Hospital 11/7/2017. Hospital Based Dermatology: Common and Tough Consult Cases Hospital Based Dermatology: Common and Tough Consult Cases Lindy P. Fox MD Associate Professor of Clinical Dermatology Director, Hospital Consultation Service University of California, San Francisco lindy.fox@ucsf.edu

More information

Cutaneous drug reactions

Cutaneous drug reactions Maintenance of Certification clinical management series Series editor: James T. Li, MD, PhD Cutaneous drug reactions David A. Khan, MD Dallas, Tex INSTRUCTIONS Credit can now be obtained, free for a limited

More information

PACKAGE LEAFLET: INFORMATION FOR THE USER. Flutarzole 0,05% w/w cream, Fluticasone propionate

PACKAGE LEAFLET: INFORMATION FOR THE USER. Flutarzole 0,05% w/w cream, Fluticasone propionate PACKAGE LEAFLET: INFORMATION FOR THE USER Flutarzole 0,05% w/w cream, Fluticasone propionate 1. IDENTIFICATION OF THE MEDICINAL PRODUCT 1.1. Trade name Flutarzole 1.2. Composition Active substance: Fluticasone

More information

EU RISK MANAGEMENT PLAN (EU RMP)

EU RISK MANAGEMENT PLAN (EU RMP) EU RISK MANAGEMENT PLAN (EU RMP) Active substance(s) (INN or common name): Esomeprazole Pharmaco-therapeutic group (ATC Code): A02B C05 Name of Marketing Authorisation Holder or Applicant: Strength and

More information

건강한성인에서의오진하기쉬운포도구균성열상피부증후군의치험례. Staphylococcal Scalded Skin Syndrome in a Healthy Adult: Easy to Misdiagnose

건강한성인에서의오진하기쉬운포도구균성열상피부증후군의치험례. Staphylococcal Scalded Skin Syndrome in a Healthy Adult: Easy to Misdiagnose Archives of Hand and Microsurgery Arch Hand Microsurg 2018;23(4):271-276. https://doi.org/10.12790/ahm.2018.23.4.271 pissn 2586-3290 eissn 2586-3533 Case Report 건강한성인에서의오진하기쉬운포도구균성열상피부증후군의치험례 김홍일ㆍ곽찬이ㆍ박언주

More information

Shared Care Protocol Oral methotrexate 2.5mg tablets in dermatology/gastroenterology/rheumatology patients

Shared Care Protocol Oral methotrexate 2.5mg tablets in dermatology/gastroenterology/rheumatology patients Shared Care Protocol Oral methotrexate 2.5mg tablets in dermatology/gastroenterology/rheumatology patients Specialist Details Name: Patient Identifier (please include NHS number as minimum) Location: Telephone

More information

PACKAGE LEAFLET: INFORMATION FOR THE USER

PACKAGE LEAFLET: INFORMATION FOR THE USER PACKAGE LEAFLET: INFORMATION FOR THE USER Fucidin 250 mg Tablets sodium fusidate Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.

More information

Summary of Product Characteristics

Summary of Product Characteristics 1 NAME OF THE MEDICINAL PRODUCT Feldene 5mg/g Gel Summary of Product Characteristics 2 QUALITATIVE AND QUANTITATIVE COMPOSITION Each gram contains 5 mg piroxicam (0.5% w/w). Excipient with known effect:

More information

Elements for a public summary

Elements for a public summary VI.2 Elements for a public summary VI.2.1 Overview of disease epidemiology Nevirapine is used for antiretroviral combination therapy of Human Immunodeficiency Virus (HIV) infection. Human immunodeficiency

More information

Clinical profile of skin diseases in accident and emergency department attenders

Clinical profile of skin diseases in accident and emergency department attenders Hong Kong J. Dermatol. Venereol. (2007) 15, 4-9 Original Article Clinical profile of skin diseases in accident and emergency department attenders CY Chan, KL Kam, CA Graham, TH Rainer, NM Luk Skin problems

More information

Department of Dermatology, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo , Japan 2

Department of Dermatology, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo , Japan 2 Dermatology Research and Practice Volume 2010, Article ID 931340, 5 pages doi:10.1155/2010/931340 Case Report Paraneoplastic Pemphigus Presenting as Mild Cutaneous Features of Pemphigus Foliaceus and Lichenoid

More information

DESCRIPTIONS FOR MED 3 ROTATIONS Dermatology A3S

DESCRIPTIONS FOR MED 3 ROTATIONS Dermatology A3S Regardless of your future field of practice, you will be exposed to a considerable amount of dermatology and this rotation provides you the chance to see a range of skin diseases. You will have the opportunity

More information

The mechanisms of common drug hypersensitivities and implications for testing

The mechanisms of common drug hypersensitivities and implications for testing The mechanisms of common drug hypersensitivities and implications for testing R J Heddle 17 May 2016 Adverse Drug Reactions (ADR) Type A 85-90% of ADR Any individual, given sufficient dose & exposure Predictable

More information

CARBAMAZEPINE INDUCED STEVENS JOHNSON SYNDROME- A CASE STUDY

CARBAMAZEPINE INDUCED STEVENS JOHNSON SYNDROME- A CASE STUDY WORLD JOURNAL OF PHARMACY AND PHARMACEUTICAL SCIENCES Ragesh SJIF Impact Factor 2.786 Volume 3, Issue 6, 1599-1604. Case Study ISSN 2278 4357 CARBAMAZEPINE INDUCED STEVENS JOHNSON SYNDROME- A CASE STUDY

More information

DEFINITION Impetigo vulgaris is a highly contagious, superficial bacterial infection of the skin.

DEFINITION Impetigo vulgaris is a highly contagious, superficial bacterial infection of the skin. DEFINITION Impetigo vulgaris is a highly contagious, superficial bacterial infection of the skin. Nonbullous impetigo Formation of vesiculopustules that ruptures, leading to crusting with a characteristic

More information

Prescribing Information

Prescribing Information Prescribing Information Pr DERMOVATE Cream (clobetasol propionate cream, USP) Pr DERMOVATE Ointment (clobetasol propionate ointment, USP) Topical corticosteroid TaroPharma Preparation Date: A Division

More information

A Retrospective Study of Spectrum of Nevirapine Induced Cutaneous Drug Reactions in HIV Positive Patients

A Retrospective Study of Spectrum of Nevirapine Induced Cutaneous Drug Reactions in HIV Positive Patients Journal of US-China Medical Science 12 (2015) 85-89 doi: 10.17265/1548-6648/2015.02.008 D DAVID PUBLISHING A Retrospective Study of Spectrum of Nevirapine Induced Cutaneous Drug Reactions in HIV Positive

More information

CUTANEOUS DRUG REACTIONS OR I WOULDN T HAVE SEEN IT, IF I HADN T BELIEVED IT Edmund J. Rosser Jr., DVM, DACVD

CUTANEOUS DRUG REACTIONS OR I WOULDN T HAVE SEEN IT, IF I HADN T BELIEVED IT Edmund J. Rosser Jr., DVM, DACVD CUTANEOUS DRUG REACTIONS OR I WOULDN T HAVE SEEN IT, IF I HADN T BELIEVED IT Edmund J. Rosser Jr., DVM, DACVD DERMATOLOGY Pathogenesis Immunologic: can involve Type I, II, III, IV hypersensitivity reactions.

More information

Psoriasis. What is Psoriasis? What causes psoriasis? Medical Topics Psoriasis

Psoriasis. What is Psoriasis? What causes psoriasis? Medical Topics Psoriasis 1 Psoriasis What is Psoriasis? Psoriasis is a long standing inflammatory non-contagious skin disease which waxes and wanes with triggering factors. There is a genetic predisposition in psoriasis. Internationally,

More information

Objectives. Routine to Rare: Complex Wound and Skin Conditions 8/29/2017

Objectives. Routine to Rare: Complex Wound and Skin Conditions 8/29/2017 Routine to Rare: Complex Wound and Skin Conditions Debbie Harrell RN, MSN Objectives Describe various pediatric complex wound and skin conditions. Identify the root causes of complex wound and skin conditions

More information

Stevens Johnson Syndrome: How Diagnosis Impacts Disease Course

Stevens Johnson Syndrome: How Diagnosis Impacts Disease Course Southern Adventist Univeristy KnowledgeExchange@Southern Graduate Research Projects Nursing 12-4-2015 Stevens Johnson Syndrome: How Diagnosis Impacts Disease Course Sharon K. Hart Southern Adventist University,

More information

Learning Objectives. History 8/1/2016. An Approach to Pediatric Rashes

Learning Objectives. History 8/1/2016. An Approach to Pediatric Rashes An Approach to Pediatric Rashes Neethi Patel, D.O. Learning Objectives 1.To identify common features of rashes seen in the pediatric population as well as pathognomonic features of certain pathologies

More information

Immodium / loprarmide

Immodium / loprarmide Immodium / loprarmide IMODIUM (loperamide hydrochloride) is indicated for the control and symptomatic relief of acute nonspecific diarrhea and of chronic diarrhea associated with inflammatory bowel disease.

More information

PACKAGE LEAFLET: INFORMATION FOR THE USER

PACKAGE LEAFLET: INFORMATION FOR THE USER PACKAGE LEAFLET: INFORMATION FOR THE USER Fucidin 250 mg/5 ml Oral Suspension fusidic acid Read all of this leaflet carefully before you start taking this medicine because it contains important information

More information

Cutanous Manifestation of Lupus Erythematosus. Presented By: Dr. Naif S. Al Shahrani Salman Bin Abdaziz university

Cutanous Manifestation of Lupus Erythematosus. Presented By: Dr. Naif S. Al Shahrani Salman Bin Abdaziz university Cutanous Manifestation of Lupus Erythematosus Presented By: Dr. Naif S. Al Shahrani Salman Bin Abdaziz university A 50-year old lady, who is otherwise healthy, presented to the dermatology clinic with

More information

An Evidenced-Based Approach to the Adult with a Morbilliform Eruption

An Evidenced-Based Approach to the Adult with a Morbilliform Eruption Relatively An Evidenced-Based Approach to the Adult with a Morbilliform Eruption Ben Kaffenberger, MD Assistant Professor, Dermatology Director, Inpatient Dermatology Consult Service Ohio State University

More information

Syndrome de Lyell Approche diagnostique. seminaires iris. Veronique del Marmol Alexandre Chamoun Service de Dermatologie Hôpital Erasme.

Syndrome de Lyell Approche diagnostique. seminaires iris. Veronique del Marmol Alexandre Chamoun Service de Dermatologie Hôpital Erasme. Syndrome de Lyell Approche diagnostique Veronique del Marmol Alexandre Chamoun Service de Dermatologie Hôpital Erasme Serge Jennes Hôpital Militaire Rash benign Pustulose exanthematique Aigue et généralisée

More information

LESIONS OF THE ORAL CAVITY ORAL CAVITY. Oral Cavity Subsites 4/10/2013 LIPS TEETH GINGIVA ORAL MUCOUS MEMBRANES PALATE TONGUE ORAL LYMPHOID TISSUES

LESIONS OF THE ORAL CAVITY ORAL CAVITY. Oral Cavity Subsites 4/10/2013 LIPS TEETH GINGIVA ORAL MUCOUS MEMBRANES PALATE TONGUE ORAL LYMPHOID TISSUES LESIONS OF THE ORAL CAVITY David I. Kutler, MD, FACS Associate Professor Division of Head and Neck Surgery Department of Otolaryngology HNS Weill Cornell Medical Center ORAL CAVITY LIPS TEETH GINGIVA ORAL

More information

Dermatology Pearls for Inpatient Medicine. Dr Peter J Green MD FRCPC Professor, Division of Dermatology Dalhousie University

Dermatology Pearls for Inpatient Medicine. Dr Peter J Green MD FRCPC Professor, Division of Dermatology Dalhousie University Dermatology Pearls for Inpatient Medicine Dr Peter J Green MD FRCPC Professor, Division of Dermatology Dalhousie University Objectives 1. Review spectrum of cutaneous manifestations seen with inpatient

More information

9/9/17. Disclosures" Dermatology in Primary Care: Recognition and treatment of common disorders of the skin" A preview" Classic skin infections"

9/9/17. Disclosures Dermatology in Primary Care: Recognition and treatment of common disorders of the skin A preview Classic skin infections Disclosures Dermatology in Primary Care: Recognition and treatment of common disorders of the skin I have no conflicts of interest to disclose. I may discuss off-label use of treatments for cutaneous disease.

More information

Paediatric Eczema. Dr Manjeet Joshi Consultant Dermatologist 16 th May 2012

Paediatric Eczema. Dr Manjeet Joshi Consultant Dermatologist 16 th May 2012 Paediatric Eczema Dr Manjeet Joshi Consultant Dermatologist 16 th May 2012 Classification of the principal forms of eczema EXOGENOUS ENDOGENOUS Irritant Allergic contact Photoallergic contact Eczematous

More information

Package leaflet: Information for the patient UNITED KINGDOM Feldene 5mg/g Gel piroxicam

Package leaflet: Information for the patient UNITED KINGDOM Feldene 5mg/g Gel piroxicam Package leaflet: Information for the patient UNITED KINGDOM Feldene 5mg/g Gel piroxicam Read all of this leaflet carefully before you start using this medicine because it contains important information

More information

Objectives. Terminology. Recognize common pediatric dermatologic conditions. Review treatment plans Identify skin manifestations of systemic disease

Objectives. Terminology. Recognize common pediatric dermatologic conditions. Review treatment plans Identify skin manifestations of systemic disease Pediatric Visual Dermatological Diagnosis Fernando Vega, M.D. Objectives Recognize common pediatric dermatologic conditions Expand differential diagnosis Review treatment plans Identify skin manifestations

More information

Department of Dermatology, Christian Medical College and Hospital, Ludhiana, Punjab, India.

Department of Dermatology, Christian Medical College and Hospital, Ludhiana, Punjab, India. Bullous pemphigoid mimicking granulomatous inflammation Abhilasha Williams, Emy Abi Thomas. Department of Dermatology, Christian Medical College and Hospital, Ludhiana, Punjab, India. Egyptian Dermatology

More information

SUMMARY OF PRODUCT CHARACTERISTICS 1 NAME OF THE MEDICINAL PRODUCT

SUMMARY OF PRODUCT CHARACTERISTICS 1 NAME OF THE MEDICINAL PRODUCT SUMMARY OF PRODUCT CHARACTERISTICS 1 NAME OF THE MEDICINAL PRODUCT Haelan Tape Fludroxycortide 4 micrograms per square centimetre Tape 2. QUALITATIVE AND QUANTITATIVE COMPOSITION The tape is impregnated

More information

Index. derm.theclinics.com. Note: Page numbers of article titles are in boldface type.

Index. derm.theclinics.com. Note: Page numbers of article titles are in boldface type. Note: Page numbers of article titles are in boldface type. A Abatacept for DLE, 493 for SLE, 497 Ablative therapies, localized, for cutaneous T-cell lymphoma, 502 506. See also Cutaneous T-cell lymphoma,

More information

Personalized Medical Care:Recognition, Management, and Maybe Prevention of Cutaneous Hypersensitivity Reactions

Personalized Medical Care:Recognition, Management, and Maybe Prevention of Cutaneous Hypersensitivity Reactions Personalized Medical Care:Recognition, Management, and Maybe Prevention of Cutaneous Hypersensitivity Reactions Bernard A. Cohen, M.D. Johns Hopkins Children s Center Baltimore, Maryland (NO disclosures)

More information

פורמט עלון זה נקבע ע"י משרד הבריאות ותוכנו נבדק ואושר SUMMARY OF PRODUCT CHARACTERISTICS

פורמט עלון זה נקבע עי משרד הבריאות ותוכנו נבדק ואושר SUMMARY OF PRODUCT CHARACTERISTICS פורמט עלון זה נקבע ע"י משרד הבריאות ותוכנו נבדק ואושר SUMMARY OF PRODUCT CHARACTERISTICS 1. NAME OF THE MEDICINAL PRODUCT FELDENE GEL 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Each gram contains 5mg

More information

RABEPRAZOL 10mg and 20mg Gastro-resistant Tablets

RABEPRAZOL 10mg and 20mg Gastro-resistant Tablets PACKAGE LEAFLET: INFORMATION FOR THE USER RABEPRAZOL 10mg and 20mg Gastro-resistant Tablets RABEPRAZOLE This leaflet is a copy of the Summary of Product Characteristics and Patient Information Leaflet

More information

Drug Allergy: A Rash ionale for Treatment

Drug Allergy: A Rash ionale for Treatment Drug Allergy: A Rash ionale for Treatment Heather A. Powell, PharmD, BCPS Assistant Professor of Clinical Sciences Roosevelt University College of Pharmacy Jordan O. Powell, PharmD Clinical Pharmacist

More information