OBJECTIVE: To determine the clinical characteristics, culprit drugs and outcome of patients with AGEP.
METHODS: A retrospective note review of all AGEP patients seen from 2001-2015.
RESULTS: Among 21 AGEP patients, 76% were Malays, 9.5% Chinese, 9.5% Indians, and 5% Iban. Sixteen were females and 5 were males. Median age of patients was 40 years (IQR: 26). The main culprit drug was amoxicillin (10 cases), followed by cloxacillin (three cases), phenytoin (two cases) and one case each of carbamazepine, sulphasalazine, allopurinol, cephalexin, ceftriaxone, celecoxib and herbal product. The median time from drug initiation to onset of AGEP was 3 days (IQR: 5.5). Fever was documented in 52.4 %, mucosal involvement 9.5%, purpura 4.7% and blisters 4.7%. Neutrophilia was observed in 63.6% of patients and eosinophilia in 28.5%. While most patients required admission (67%), all achieved complete recovery within 15 days without any sequela.
CONCLUSIONS: AGEP predominantly affects Malay females in this study. The most common culprit drug was amoxicillin. Our patients exhibited the classic clinical manifestations of AGEP and confirmed the generally benign nature of this reaction upon drug withdrawal. Although the overall prognosis is good, prompt diagnosis of AGEP is important because drug withdrawal is the mainstay therapy.
METHODS: Mice were initiated with single dose of 7,12-dimethylbenz[α]anthracene (DMBA) (390 nmol/100 μL) followed by, in subsequent week, repeated promotion (twice weekly; 22 weeks) with 12-O-tetradecanoylphorbol-13-acetate (TPA) (1.7 nmol/100 μL). Annonacin (85 nM) and curcumin (10 mg/kg; reference) were, respectively, applied topically to DMBA/TPA-induced mice 30 min before each TPA application for 22 weeks. Upon termination, histopathological examination of skin, liver and kidney as well as genes and proteins expression analysis were conducted to elucidate the potential mechanism of annonacin.
RESULTS: With comparison to the carcinogen control, Annonacin significantly increased the tumor latency period and reduced the tumor incidence, tumor burden and tumor volume, respectively. In addition, it also suppressed tumorigenesis manifested by significant reduction of hyperkeratosis, dermal papillae and number of keratin pearls on skin tissues. Annonacin also appeared to be non-toxic to liver and kidney. Significant modulation of both AKT, ERK, mTOR, p38, PTEN and Src genes and proteins were also observed in annonacin-targeted signaling pathway(s) against tumorigenesis.
CONCLUSIONS: Collectively, results of this study indicate that annonacin is a potential therapeutic compound targeting tumor promoting stage in skin tumorigenesis by modulating multiple gene and protein in cancer signaling pathways without apparent toxicity.
OBJECTIVES: To describe clinical and epidemiological aspects of canine and feline screw-worm myiasis.
ANIMALS: Naturally infested dogs and cats, presented to five veterinary clinics in four Malaysian states from September 2017 to February 2018.
METHODS AND MATERIALS: Cutaneous screw-worm myiasis was diagnosed based on clinical signs and visual examination of burrowing larvae within lesion. Age, breed, gender, anatomical site of infestation and suspected underlying predisposing causes were investigated.
RESULTS: A total of 55 dogs and 21 cats were included in the study. Intact male mixed breed dogs (mean age 58 months) and intact male domestic short hair cats (mean age 24 months) with suspected fight-related wounds were most commonly presented with exudative and ulcerative lesions associated with screw-worm myiasis. The most common anatomical sites of infestation in the dogs were the external ear canals, followed by the perineum and medial canthus. For the cats, the most commonly affected areas were paws and tail. Five cats with screw-worm myiasis were concurrently infected with sporotrichosis.
CONCLUSION AND CLINICAL RELEVANCE: Aggression between unneutered animals is a likely underlying cause for cutaneous screw-worm myiasis in both cats and dogs. Sporotrichosis was also a potential predisposing cause for screw-worm myiasis in cats.