Dermatoscope for the diagnosis of erythema with purpura induced by lidocaine/prilocaine cream:A case report

BACKGROUND Lidocaine/prilocaine(EMLA)cream is a local anesthetic that is applied to the skin or mucosa during painful therapeutic procedures with few reported side effects.CASE SUMMARY Here,we report the use of dermatoscopy to identify a case of erythema with purpura,a rare side effect,after the application of 5%EMLA cream.CONCLUSION We conclude that erythema with purpura is caused by irritation and toxicity associated with EMLA,but the specific mechanism by which the toxic substance affects skin blood vessels is unclear.In response to this situation and for cosmetic needs,we recommend tranexamic acid,in addition to routine therapy,to prevent changes in pigmentation in patients with dermatitis.

Phase III study of TAC and TP regimens as neoadjuvant chemotherapy in patients withtriple-negative breast cancer

Objective： This study aimed to compare the efficacy and safety of neoadjuvant chemotherapy with TAC and TP regimens of triple negative breast cancer （TNBC）. Methods： A total of 102 patients with TNBC were confirmed by histopathology. They were divided into TAC group （52 cases） and TP group （50 cases）. Group TAC： Docetaxel 75 mg/m2 or paclitaxel （taxol liposome） 135 mg/m2 on all, pirarubicin 40 mg/m2 or epirubicin 75 mg/m2 on d2, cyclophosphamide 600 mg/m2 on dl; Group TP： Docetaxe175 mg/m2 or paclitaxel （taxol liposome） 135 mg/m2 on dl, cisplatin 30 mg/m2 on d2-d4, with 21 days as a cycle. All patients underwent operation after 2-4 cycles of chemotherapy. The short-term effects and toxic and adverse effects were evaluated. Results： In TAC group, 5 cases （9.6%） had pathological complete release （pCR）, 35 cases （67.3%） partial release （PR）, 9 cases （17.3%） stable disease （SD）, and the response rate （RR） was 76.9%. In TP group, 4 cases （8%） had pCR, 32 cases （64%） PR, 5 cases （10%） SD, and RR was 72%. In 102 patients, 12 patients with tumor progression after 2 cycles of chemotherapy, included 3 cases in TAC group, 9 cases in TP group. In TAC group, 2 cases occurred atrial premature contraction; while 3 cases developed grade 2 renal injury in TP group. In TAC group, grade 3-4 hematologic toxicity and alopecia was significantly higher than that in TP group, but grade 3-4 gastrointestinal reaction rate in TP group was significantly higher than TAC group. Conclusion： TAC and TP regimens all had certain efficacy in the neoadjuvant chemotherapy for TNBC, and the toxicity reactions can be tolerated.

Clinical observation of nedaplatin concurrent with radiotherapy for mid-advanced nasopharyngeal carcinoma and esophageal carcinoma

Objective: The aim of our study was to evaluate the short-term efficacy and the toxic reaction of nedaplatin concurrent with radiotherapy for mid-advanced nasopharyngeal carcinoma and esophageal carcinoma. Methods: Thirty-four patients were confirmed diagnosis with cancer by pathologic results. All patients were given 6MV X-ray for radiotherapy, Dt 66-70 Gy/33-35 f/6-7 w, concurrently administrated nedaplatin (30 mg/m2) once a week (6 times). Results: A total 34 patients were enrolled, of whom 33 patients were available for objective response, 1 patient of esophageal cancer quit for allergic reaction. The response rate (RR) of nedaplatin-contained therapy for nasopharyngeal carcinoma and esophageal carcinoma were 90.0% and 76.9%, respectively. The major toxic reaction was bone marrow suppression observed in 25 patients (73.5%), in which grade III aleukocytosis was observed in 3 patients (8.8%), grade III + IV thrombocytopenia in 3 patients (8.8%). And 6 patients (17.6%) showed gastrointestinal tract reaction. There were 4 patients with radiation esophagitis in the 13 patients with esophageal carcinoma. Conclusion: Nedaplatin can increase the therapeutic effect of radiation. Its incidence rate of bone marrow suppression is high, but the gastrointestinal tract reaction and renal toxicity is low and mild.