Sorafenib a multikinase inhibitor has been approved by the FDA for the treatment of thyroid, hepatocellular and renal cell carcinoma. Hand-foot syndrome / palmar -plantar erythrodysesthesia causes redness, swelling and pain on the palms of the hands and / or the soles of the feet. Sometimes blisters also appear. Here, we report a post right hepatectomy hepatocellular carcinoma patient who developed hand and foot syndrome after a dose with sorafenib.
Lichenplanus is a chronic inflammatory disorder with remissions and relapses. The pathogenesis is likely to be autoimmune, with T Lymphocytes targeting the basal keratinocytes. The clinical presentation is violaceous papules and plaques in skin, mucous membranes and nails. The aim of this study is to analyse the clinical and pathological profile of Cutaneous Lichen planus of all patients diagnosed with Lichen planus attending our hospital from 2016 to 2019.All cases diagnosed as Lichen planus clinically and confirmed histopathologically are analysed for age, sex, location, duration, associated comorbid conditions, type of Lichen Planus, histopathological features and for malignant transformation.Of the 91 patients diagnosed, 83 (91%) were classical Lichen Planus, 6 (6.5%) hypertrophic Lichen Planus, 2 (2.5%) lichenplanopilaris. The median age was 38 years and the mean age 40 years. Majority were in the age group of 20 to 40 years. Male : Female ratio was 1.1 :1. 10 (10.98%) patients were in paediatric age group. 7 (8%) had skin and oral involvement. 40 patients had violaceous plaques & papules, 46 pigmented and violaceous plaques and papules, 5 hypertrophic pigmented plaques. No nail or genital involvement was seen in any of our patients.The predominant type was classical Lichen planus. Few patients had Hypertension, diabetes Mellitus, diabetes mellitus and hypertension seemed to be age related. No malignant transformation was observed.
Steven Johnson Syndrome (SJS) is an acute systemic disorder presenting as severe mucosal erosions with erythematous , cutaneous macules or atypical targets.Here we discussed a case of 39 year old women who developed drug induced steven Johnson syndrome (SJS). she was on Amoxicillin -Clavulanic acid(penicillin antibiotic) and Paracetamol for the management of fever and cough. Later she developed peeling of skin over lips ,painful reddish lesions over 75% of her skin surface including back of trunk, front of chest , hands ,legs ,palms and soles. Her eyes, mouth and genital organs were also affected.Blood investigations revealed LFT was elevated herpes simplex virus IgM was borderline and IgG HSV was elevated( 5.5). her blood cultures were negative .Patients symptoms started to develop on 2 nd day of treatment with amoxicillin/clavulanic acid( Augmentin) 625mg OD . adverse reaction was managed with IV steroids ,oral cyclosporine and other conservative measures . After 2 weeks her lesions subsided and steroids were tapered. During her discharge ,she was haemodynamically stable ,LFT was improved and her lesions were exfoliating.Health care providers must be careful regarding the adverse effects of the drugs especially the one is the Stevens-Johnson syndrome (SJS) which is a potentially fatal condition with mortality rate below 5 percent .This reaction is of shorter duration and with rechallenge. The most commonly and widely prescribed drug regimens should also be used judiciously and continuously monitored to prevent such a fatal adverse drug reactions. ABS042
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