We analyzed the efficacy of this metronidazole therapy by first evaluating the patients' symptoms, which included erythema, papules, pustules, plaques, telangiectasia and burning, stinging or itchy sensations. We then compared the therapeutic effects observed in patients treated with the topical metronidazole alone with those in patients whose treatment consisted of a combination of the topical metronidazole and oral antibiotics. Eighteen of the patients with erythematotelangiectatic rosacea were treated with the metronidazole alone, and 15 (83.3%) showed a positive response. In comparison, 7 patients were treated with the metronidazole and oral antibiotics, and 6 (85.7%) showed a positive response. Two of the four patients with papulopustular rosacea (50.0%) treated with the metronidazole alone showed a positive response. In the 6 papulopustular patients treated with both metronidazole and antibiotics, 5 (83.3%) showed a positive response. There were no significant differences in clinical efficacy between the groups treated with the metronidazole and those receiving the combination of the metronidazole and oral antibiotics. In patients suffering from papulopustular rosacea, the topical metronidazole was most effective in relieving the cutaneous and perceptive symptoms. However, it had little effect on the telangiectasia or dryness. We were able to decrease or discontinue oral antibiotics in eight patients (41.2%); they were successfully treated with the topical metronidazole alone. Our data demonstrated that the metronidazole 1% ointment is effective and reduces the need to prescribe antibiotics in the treatment of rosacea.
We performed preemptive interventions against skin disorders with anti-EGFR antibody chemotherapy to treat 43 cases of colorectal cancer and head and neck cancer at the Niigata Cancer Center Hospital from November of 2011 through November 2013, and examined the effects of these interventions and the relationship between the grade of skin disorders and life prognosis. These interventions were effective in reducing the incidence rate and extending the period of the expression of the skin disorders. None of the patients discontinued chemotherapy because of the skin disorders. The skin disorder diagnoscd as grade 2 or more significantly prolonged survival in 36 colon cancer cases. We discussed the significance of preemptive interventions proactively performed by dermatologists.
We report a familial case of repetitive furunculosis due to Community-associated MRSA (CA-MRSA), disseminating from a male case to his wife, his son and his mother-in-law. Screening of samples from furuncles of the four cases showed methicillin-resistant Staphylococcus aureus (MRSA). The results of PCR showed that all the isolates showed an identical antimicrobial susceptibility profile, carried type V SCCmec, and harbored the pvl gene. In addition, the clonal relationship determined by pulsed field gel electrophoresis using Sma I enzyme for genomic DNA digestion showed that isolates from all four cases displayed indistinguishable electrophoretic patterns. The cases were diagnosed as repetitive furunculosis due to CA-MRSA on the basis of the drug sensitivity pattern of MRSA isolated from the four cases and the positivity to Panton-Valentine leukocidine (PVL). In the two cases with atopic dermatitis, furunculosis due to CA-MRSA recurred despite long-term oral administration of trimethoprim-sulfamethoxazole.