br Discussion According to our findings

Discussion According to our findings, dermatologic SRs are characterized as being massively published in WOS indexed and English language journals, with approximately one half being published in dermatology specialty journals with an average JIF for dermatology specialty, but considered low for general health literature. Importantly, >75% of SRs in dermatology provide enough evidence in order to inform clinical decisions, a fact that is in line with previous analyses. We found that some diseases such as seborreic dermatitis, STA-9090 manifestations of systemic disorders, and urticaria, and some interventions such as immunizations and dietary modifications, were seldom included in SRs, although the vast majority of them are highly prevalent in dermatological practice. It is also possible that there are more dermatological diseases not identified in our search that had never been the subject of SRs. Approximately one half of the analyzed SRs contained a meta-analysis and a third of SRs were randomized controlled trial-based, with approximately 10% of CSG-SRs. Less than 30% SRs were performed with international collaboration. These percentages are similar to those previously reported in other specialties. Surprisingly, not one CSG-SR was among the 10% most cited reviews. This information is remarkable considering the demonstrated fact that CSG-SRs are of higher methodological quality than other reviews. Even though the number of SRs in dermatology is growing at a steady rate, reflecting a general increase in published SRs, all the aforementioned features showed to be constant within the 5 years analyzed.
Introduction Acute generalized exanthematous pustulosis (AGEP) was first described by Baker and Ryan in 1968, and was later identified by Beylot et al as an adverse drug eruption in 1980. AGEP is a rare adverse drug reaction, with the incidence of five cases per million per year. Most common triggers for AGEP are drugs, although it can also be attributed to viral infections or hypersensitivity to mercury. The offending drugs in Europe are different from those in Taiwan according to the Europe severe cutaneous adverse reactions (EuroSCAR) study and a retrospective study by Lee and Chung in Taiwan. Leucomycin, also called kitasamycin, is a 16-member macrolide that binds to bacterial ribosomal RNA and inhibits protein biosynthesis.
Case Report An otherwise healthy 43-year-old man was admitted due to the desquamation of skin on the trunk and four limbs, especially the flexural areas, and some minute nonfollicular pustules on an erythematous background with severe pitting edema of the bilateral lower limbs (Figure 1). Seven days prior to this admission, the patient had an upper respiratory tract infection, and received prophylline 100 mg, procaterol hydrochloride 25 μg, ambroxol hydrochloride 30 mg, and cimetidine 200 mg four times per day for 3 days. Because of persistent symptoms of coughing and nasal congestion, the physician added leucomycin 100 mg four times per day to the patient\'s treatment regimen. Based on the statement from his primary care physician, the patient had previously taken these drugs except for leucomycin. After taking leucomycin 100 mg four times per day for 2 days, generalized exanthems studding with nonfollicular pustules developed and was accompanied by fever up to 38°C. Subsequently, the trunk erythema soon turned into a large area of desquamation, but the fever and legs edema were persistent (Grade 2, depth of 0.25∼0.5 inches). The legs edema resulted in tenderness and difficulty in walking. Thus, he came to our hospital for help. On physical examination, he had a fever (38.3°C) with blood pressure of 120/62 mmHg. The electrocardiogram showed sinus tachycardia (108 beats/min). The blood and chemistry test revealed leukocytosis (15,500 cells/μL) and increasing neutrophils (9145 cells/mm3), but renal, thyroid, and liver function were normal. The echocardiography showed preserved left ventricular systolic function and normal structural heart. The conjunctivae and oral and genital mucosae were intact and the Nikolsky sign was negative. Tzanck smear revealed no multinucleated giant cells; Gram stain, pus cultures, and blood cultures were negative.