摘要：Toxic epidermal necrolysis (TEN) is a rare condition that was described by Lyell in 1956. It is a severe, acute, adverse, primarily drug-induced, potentially fatal, cutaneous reaction that is characterized by large areas of skin desquamation and sloughing, similar in many aspects to second-degree burns. The treatment of cutaneous drug reactions rests essentially on immediate diagnosis and recognition of the disease process, accurate history, thorough physical examination, prompt discontinuation of the offending drug, and supportive care. TEN patients are best managed in specialized burn units. Nevertheless, the management remains very much individualized, based on the clinical setting. Topical wound care remains an essential factor in the treatment of burn-like syndromes and is a main determining parameter for morbidity and mortality. As the value of moist environment in wound healing is being fully appreciated, we report on the use of a newly introduced ointment, the Moist Exposed Burn Ointment (Julphar; Gulf Pharmaceutical industries, Ras El-Khaymah, United Arab of Emirutes), a moisture-retentive ointment, in the successful management of a case of TEN.

摘要：BACKGROUND Aplasia cutis congenita (ACC) in newborns is a condition in which congenital defects or hypoplasia is present in part of the epidermis, dermis and even subcutaneous tissue (including muscle and bones). First reported by Cordon in 1767, ACC is a rare disease with a low incidence of 1/100000 to 3/10000. Currently, there are 500 cases reported worldwide. ACC can be accompanied by other malformations. The onset mechanism of the disease remains unknown but is thought to be correlated to factors such as genetics, narrow uterus, foetal skin and amniotic membrane adhesion, use of teratogenic drugs in early pregnancy and viral infection. CASE SUMMARY In August 2018, we treated a newborn with ACC on the left lower limbs using a combination of ionic silver dressing and moist exposed burn ointment (MEBO) and achieved a satisfactory treatment outcome. The skin defects were observed on the external genitals and on areas from the left foot to 3/4 of the upper left side. Subcutaneous tissue and blood vessels were observed in the regions with skin defects. The following treatments were provided. First, the wound was rinsed with 0.9% sodium chloride solution followed by disinfection with povidone-iodine twice. And then MEBO was applied to the wound at a thickness of approximately 1 mm. After applying ionic silver dressing, the wound was covered with sterile gauze. The wound dressing was replaced every 2-3 d. At the 4-mo follow-up, the treatment outcome was satisfactory. There was minimal scar tissue formation, and limb function was not impaired. CONCLUSION The combination of ionic silver dressing and MEBO to ACC is helpful.

摘要：Topical treatment for facial burns, Review question, We reviewed the evidence about the effects of topical (applied to the surface of the skin) treatments for healing burn wounds on the face or neck. We wanted to find out which treatments were most effective at healing these wounds and improving the appearance of scars, which is a particularly important issue in relation to facial burn injuries. We also wanted to find out how topical treatments affected the risk of complications such as infection and pain, and how they impacted on peoples' quality of life., Background, Burn injuries are an important health problem, and a major global cause of disability and disfigurement in both adults and children. Women and children in low‐income countries are at particular risk. Burns pose particular problems when they occur on the head or neck. The face is central to a person's identity and plays a vital role in communication. Other basic functions such as hearing, smell and breathing may become affected as a direct result of a facial burn. Topical treatments such as (non) antimicrobial creams and skin substitutes, are most commonly used to treat facial burns. We wanted to compare the effectiveness of these treatments to evaluate their benefits and harms., Study characteristics, In December 2019, we searched for randomised controlled trials (RCTs) investigating topical treatments for facial burns. RCTs are medical studies where the treatment or care people receive is chosen at random. This type of study design provides the most reliable health evidence about whether different approaches to treatment or care can make a difference. We found 12 studies that were suitable for inclusion in this review update, with 507 participants with mean ages ranging from 5.3 to 41.9 years. Three studies compared antimicrobials with non‐antimicrobials agents, two studies compared different antimicrobials, four studies compared skin substitutes with antimicrobials, while four studies compared a variety of topical treatments. One study contributed to two comparisons. Eight studies were small (fewer than 40 participants) and almost all studies were at high risk of bias due to lack of blinding (where participants and evaluators may have known which group the participants were allocated to and interpreted effects differently)., Key results, Overall, there is mainly low to very low‐certainty evidence on the effects of any topical intervention on wound healing or infection in people with facial burns. In addition, there is low to very low‐certainty evidence on the effects of the included interventions on need for surgery, pain, scar quality, patient satisfaction, length of hospital stay and side effects., All results were at high risk of bias and varied, which may have exaggerated the effects., Certainty of the evidence, Overall, the certainty of the evidence about the effectiveness of topical treatments for facial burns is low to very low. There is insufficient reliable evidence as to whether topical treatments improve outcomes for people with facial burns including improving wound healing, or rates of infection. Better trial design and reporting of these studies is required to contribute to evidence‐based burn care., How up to date is this review?, We searched for studies that had been published up to December 2019.

摘要：Moist exposed burn ointment (MEBO) is an oil-based herbal paste, purported to be efficacious in managing burn wounds and more commonly used in Asia and the Middle East. A PRISMA-compliant systematic review was performed to analyse the evidence for the use of MEBO on burn wounds. Wound healing rate was the primary outcome of interest. PubMed-listed randomised controlled trials (RCTs) comparing the efficacy of MEBO with placebo, standard care or other therapies in the treatment of partial thickness burns in adults and children were eligible for inclusion (November 2019). Six RCTs were eligible. The majority of trials comparing wound healing between MEBO and SSD favoured MEBO (two of three). There may be improved healing in MEBO-treated wounds vs. those treated with povidone-iodine + bepanthenol cream. There was no difference between MEBO and Acquacel Ag, but Helix Aspersa had faster healing rates than MEBO. However, all evidence was from moderately to poorly reported trials with a high risk of bias, thereby limiting the strength of this evidence. In conclusion, the evidence for MEBO in English-language literature was poor and inconsistent with respect to wound healing rate and analgesis compared to 1% SSD, Acquacel Ag, Helix aspersa cream and povidone-iodine + bepanthenol cream. Blinded RCTs comparing MEBO to both placebo and other common topical treatments may further improve the confidence in concluding their analysis. There is some evidence that MEBO is as safe as its comparators as shown by the low complication rate.