Drug reaction with eosinophilia and systemic symptoms syndrome (DRESS) syndrome associated with azithromycin presenting like septic shock: a case report.

Background Psoriasis (Ps) is a chronic systemic autoimmune disease associated with pruritus in 64–98% of patients. However, few modestly sized studies assess factors associated with psoriatic pruritus. Objective To investigate factors associated with Ps pruritus intensity. Methods Psoriasis patients 18 years or older seen in one of 155 centres in Italy between September 2005 and 2009 were identified from the Italian PsoCare registry. Patients without cutaneous psoriasis and those with missed information on pruritus were excluded. Results We identified 10 802 patients, with a mean age 48.8 ± 14.3 years. Mild itch was present in 33.2% of patients, moderate in 34.4%, severe in 18.7% and very severe in 13.7%. Higher itch intensity was associated with female gender, lower educational attainment compared to university degree, pustular psoriasis, psoriasis on the head, face, palmoplantar areas, folds and genitalia, more severe disease, disease duration <15 years, and no or few prior systemic treatments. Limitations Effects of specific medication on itch were not assessed. Conclusions Pruritus should be evaluated during psoriasis visits, and physicians should be aware of patients at higher risk for itch. Further studies are needed to assess the effects of medications on itch, and establish therapy for psoriasis patients with persistent itch.

background erythema were evident over the nasal bridge, sidewall and ala, clinically in keeping with localized miliaria (Fig. 1), with the differential being an occlusive (infective) folliculitis. Whilst tender on palpation, the area was not overtly cellulitic. Given that the epidermis was intact, and wanting to avoid further compromise to the skin barrier, bacterial swabs were not performed. Dermol â 500 (Dermal Laboratories Ltd, Hertfordshire, UK) lotion was prescribed as an antiseptic soap substitute and emollient. Two weeks later, post-inflammatory hyperpigmentation was apparent in each case, with some residual scaling and dryness. Miliaria, otherwise known as heat rash, is a disorder of eccrine glands due to obstruction and retention of sweat. It is usually associated with immobility, hot/humid environments and improper clothing or bedding which traps heat and perspiration. Within the clinical setting, it is most often seen in febrile inpatients who have been supine for extended periods. There are three subtypesmiliaria crystallina (typically face and trunk), miliaria rubra/pustulosa (most common; typically on the back) and miliaria profunda (rare; trunk and extremities). 5 To our knowledge, this is the first report of a localized facial miliaria secondary to FFP use. It is recognized that epidermal barrier interruption could enhance COVID-19 acquisition 6 and as such, it is fundamental that steps are taken to minimize tissue trauma from PPE use, and to report such cases. Acknowledgement Informed written consent was gained for publication of clinical history and photographs.

Background Knowledge regarding differences in care for psoriatic patients is limited. The aim of this study was to investigate factors influencing prescription of systemic treatments for patients with psoriasis with a special focus on socioeconomic factors.

To date, our study represents the widest experience on the use of biological drugs in elderly psoriatic patients. We found that all biologics for psoriasis showed a great efficacy also in elderly people, and the rate and the type of adverse effects were similar to the younger patients. In conclusion, the age alone should not limit our therapeutic options. Further observational study using multiple data sources is needed to evaluate long-term effectiveness and safety for elderly psoriatic patients.