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Tafazzul H Mahmud
393 posts
Tafazzul H Mahmud
@thmahmud
Lead Consultant Rheumatologist Crescent Clinic Jail Road Lahore Former Head, Div of Med Founder Head Professor Dept of Rheumatology and Immunology SZ FPGMI
Lahore Pakistan Katılım Şubat 2013
272 Takip Edilen266 Takipçiler
Tafazzul H Mahmud retweetledi
Diagnosis: Vancomycin-induced linear IgA bullous dermatosis (LABD).
LABD is a rare autoimmune subepidermal blistering disorder characterized by linear IgA deposition along the basement membrane zone; vancomycin is the most common drug trigger. In this case, recurrent vancomycin exposure was followed by a rapidly progressive eruption that evolved from diffuse erythematous patches to tense bullae, superficial erosions (>15% BSA), and targetoid palmar lesions.
The initial presentation mimicked SJS/TEN, but the absence of mucosal involvement, -ve Nikolsky/Asboe-Hansen signs, and subsequent biopsy findings favored LABD. Histopath showed a subepidermal blister with neutrophilic infiltrate/microabscesses, and direct immunofluorescence confirmed linear IgA at the dermoepidermal junction.
Vancomycin was discontinued. Because of severe sepsis, systemic corticosteroids were avoided. The patient was treated empirically with etanercept plus topical clobetasol, with rapid cessation of new blistering and progressive healing.
Scott C. Howard@schowardjd
A man in his 60s w/ CAD s/p ICD, prior ischemic CVA, aFib w/ recent PE/DVT, & low-risk GIST was hospitalized for acute ischemic stroke complicated by severe sepsis requiring broad-spectrum abx. He had received vancomycin on 3 occasions; an initial loading dose & later a 4-day course were tolerated. ~2 wks after the second course, he developed a progressive erythematous eruption of the trunk/extremities. Vancomycin was subsequently restarted for polymicrobial infection. On day 5 of rash (during active infusion) showed widespread nonblanching erythematous patches of the face, trunk, & extremities w/out mucosal involvement. Topical mometasone started, & vanco stopped the next day. W/in 24 hrs, the eruption progressed to tense bullae & superficial erosions involving >15% BSA, w/ targetoid palmar macules. Ocular/oral/genital mucosae were spared. Nikolsky and Asboe-Hansen signs were -ve. What’s your DDx❓
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@Janetbirdope @DennisGodsmark Honeycomb in muscle.
Muscular cysticercosis??
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@DennisGodsmark Can yo provide answer of multicystic synovial findings
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43 year old female diagnosed with systemic lupus erythematosus who presented with pain and swelling in the right shoulder. What do you see?
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@Gemma_2210 Daughter. Then both can try saving wife and mother.
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Answer is not "6" Then what is the answer??
Difficulty, "Hard"
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No word starts with “T” and ends with “T.”
Prove me wrong—no Google allowed.
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If you solve this, your IQ is high 🔥
What should come instead of ?
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Janet Pope sharing her wisdom with Rheumatologists in Pakistan.
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DIFFICULTY- HARD
SO FAR NO ONE HAS FOUND THE NUMBER ON THE BOX
Correct answer deserves another $3200
Ends in 48hrs
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