patients 1 and 2), trichiasis (patients 2 and 4), and excessive tearing (patient 4). Patient 1 had phimosis that was corrected surgically.Discussion | In our experience using etanercept as treatment for patients with SJS-TEN, including in adults, we have made the following noteworthy observations (although these are only anecdotal). First, we found that a response to treatment with etanercept, namely decreased erythema of existing lesions and halting of progression of new lesions, often occurs 24 to 36 hours after administration. Borrowing from the dosing schedule successfully used in the randomized trial of adults by Wang et al, 5 we recommend considering a second dose in patients who continue to have fevers or notable erythematous and/or edematous skin lesions 36 to 48 hours after the initial dose. Second, patients treated with etanercept demonstrate remarkable time to reepithelialization, which corroborates previous findings comparing etanercept with corticosteroids. 5 Unfortunately this evidence is limited, particularly comparing etanercept with burn-level supportive care. Patient 3 demonstrated a remarkable halting of skin disease. We are not aware of any similar reports of preventing skin denudation in patients with SJS-TEN with early intervention using other immunosuppressive medications. Finally, the lack of adverse events (particularly infections) noted in patients in this series and others is encouraging, although further prospective randomized studies are needed. 4,5

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In the context of a lack of a gold standard for the diagnosis of neurosyphilis due to either nonspecific or nonsensitive tests, we present in this article a new promising tool highly specific for NS diagnosis. This new test involves measuring an intrathecal synthesis index of specific anti- Treponema IgG by ELISA.

Rare or opportunistic fungal infections are mostly described in immunosuppressed patients. We present a case of a cutaneous phaeohyphomycosis that developed on the dorsal foot in an immunosuppressed woman suffering from AIDS, caused by a novel Phialemoniopsis species. It clinically presented as an indurated violaceous plaque, surmounted by nodules exuding a sero-purulent discharge. A filamentous fungus was isolated from pus and cutaneous biopsy. ITS and LSU sequences phylogenetically resolved the fungus as an unknown species of Phialemoniopsis, which is an unresolved family within Sordariomycetes. In this study we describe the new species as Phialemoniopsis limonesiae, which clusters on a single branch clearly separated from its closest phylogenetic neighbours. This new strain showed low MIC to itraconazole, voriconazole and posaconazole.

Introduction: Enzalutamide (Xtandi®) is a new potent inhibitor of the signaling pathway for the androgen receptor with a half-life of 5.8 days. It has been on the market for the treatment of metastatic castration-resistant prostate cancer since November 2013. Objective:We report the first case of acute generalized exanthematous pustulosis (AGEP) induced by enzalutamide.

REVUE MÉDICALE SUISSEWWW.REVMED.CH 10 avril 2019 786Diphtheria is reappearing in a typical cutaneous form where pre-existing skin lesions (wounds or insect bites) become pustular and turn into painful non-healing ulcers. This form is more common among migrants and disadvantaged populations. Lesions can be caused by strains of toxigenic and non-toxigenic Corynebacteria and among them the famous Corynebacterium diphtheriae. In this paper we review diphtheria's clinical presentations and pathogenesis, as well as methods of diagnosis, treatment and prevention. CORYNEBACTERIUM DIPHTHERIAE : UN PATHOGÈNE FORT BIEN CONNUC. diphtheriae est l'agent étiologique de la diphtérie. Le rôle causal de cette bactérie a été découvert en 1883 par Theodor Albrecht Edwin Klebs, assistant de Rudolf Virchow, tandis que l'on doit à Friedrich August Johannes Löffler, assistant de Robert Koch, son isolement par culture en 1884 (d'où

Overlap chronic graft-versus-host disease (GVHD) associates both features of acute and chronic GVHD. Trigger factors for chronic GVHD are unclear. We describe two patients who received allogenic haematopoietic stem-cell transplantation, and who later developed overlap chronic GVHD after sun exposure. Available data from in vivo investigations suggest ultraviolet B radiation (UVB) has a beneficial effect on acute and chronic GVHD. The role of sun irradiation as a trigger for isomorphic cutaneous GVHD has been rarely reported in the literature. Herein, we demonstrate for the first time, using repetitive broadband phototesting, that UVB triggers chronic GVHD.

In systemic lupus erythematosus (SLE), the respiratory system is frequently compromised. One of its uncommon manifestations is the shrinking lungs syndrome (SLS), characterised by dyspnoea, diaphragmatic elevation and a restrictive pattern in the spirometry. We report two cases affected with this rare entity. They presented with different degrees of respiratory involvement and responses to the therapy. At the same time, clinical, physiopathological, prognostic and therapeutic aspects of this syndrome are reviewed.