Idiopathic Mixed Cryoglobulinemia: A Diagnostic Challenge.

Mixed cryoglobulinemia (MC) is commonly associated with chronic hepatitis C infection. Symptoms usually present as a clinical triad of purpuric rash, arthralgia, and generalized weakness. There have been several case reports establishing the relationship between hepatitis C and MC.

Linezolid-induced lactic acidosis corrected with sustained low-efficiency dialysis: a case report.

Linezolid, an oxazolidinone antibiotic, has been reported to increase the risk of lactic acidosis and peripheral neuropathy because it disrupts mitochondrial function. This case report describes the development of lactic acidosis in a 63-year-old man who had received 3 months of treatment with intravenous linezolid for pulmonary nocardiasis, and correction of the acidotic state with sustained low-efficiency dialysis. This case demonstrates that renal replacement therapy can be an alternative to discontinuation alone for rapid reversal of linezolid-induced lactic acidosis.

Dyshomeostasis of serum sodium concentration in congestive heart failure.

Congestive heart failure (CHF) is the most common discharge diagnosis in the United States and accounts for greater than 1 million hospital discharges annually. CHF is associated with many serum electrolyte abnormalities, the most common and perhaps most significant of which is hyponatremia. CHF with hyponatremia makes the already high morbidity and mortality of CHF even more unfavorable.

Eruptive keratoacanthoma-type squamous cell carcinomas in patients taking sorafenib for the treatment of solid tumors.

Background: Protein kinases (PKs) are indispensable for most cellular processes, and deregulation of PKs can lead to activation of oncogenic and anti-apoptotic pathways and immune dysregulation.

Objective: To report the development of keratoacanthoma (KA)-type squamous cell carcinomas (SCCs) in patients treated with the multikinase inhibitor sorafenib for the treatment of solid tumors, to present the possible mechanisms for induction of these SCCs, and to discuss the implications for discontinuation of therapy and possible cotherapies to decrease this side effect.

Participants: Fifteen patients taking the multikinase inhibitor sorafenib for the treatment of solid tumors who developed multiple KA-type SCCs, which continued to develop while the patients were undergoing therapy but stopped with discontinuation of sorafenib.

The use of 40% urea cream in the treatment of moccasin tinea pedis.

Moccasin tinea pedis is a chronic dermatophyte infection of the foot that is recalcitrant to topical antifungal therapy. Furthermore, most patients with moccasin tinea pedis also have onychomycosis, thus adding to the recalcitrant nature of the infection. The topical antifungals used as sole therapy are generally ineffective because the scale on the plantar surface impedes or limits the absorption of the antifungal agent.

Onychotillomania: 2 case reports.

Onychotillomania is an uncommon condition characterized by self-destruction of the fingernails and/or toenails by compulsive manipulation. We report 2 cases of onychotillomania with differing presentations in a young man and in an older man. Onychotillomania may be a form of obsessive-compulsive disorder (OCD), and we discuss the psychologic factors and current treatments for this condition.