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Case Report
Pseudoephedrine-induced Fixed Drug Eruption in a Scuba Diver With Recurrent Palmoplantar Exfoliation
Pimpreeya Kajornchaikul, Pattarawat Thantiworasit, Jettanong Klaewsongkram
Received June 24, 2024  Accepted August 1, 2024  Published online August 8, 2024  
DOI: https://doi.org/10.3961/jpmph.24.319    [Accepted]
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AbstractAbstract PDF
Objectives
This report presents a case of pseudoephedrine-induced nonpigmented bullous fixed drug eruption (NBFDE) manifesting as recurrent palmoplantar exfoliation in a scuba diver. It emphasizes the importance of considering drug allergies in the differential diagnosis when divers present with peeling hands and soles.
Methods
A 38-year-old female scuba diver experiencing recurrent palmoplantar exfoliation underwent a clinical evaluation, patch testing, an interferon-gamma enzyme-linked immunospot (ELISpot) assay, and graded drug challenges with pseudoephedrine and phenylephrine.
Results
Patch testing yielded negative results; however, the ELISpot assay indicated a strong immune response to pseudoephedrine. A graded challenge involving pseudoephedrine successfully reproduced the symptoms, confirming a diagnosis of pseudoephedrine-induced NBFDE. Subsequently, a challenge with phenylephrine elicited a milder reaction, suggesting it as a potential alternative medication for the patient.
Conclusions
This case highlights NBFDE as a potential cause of skin peeling in scuba divers who are allergic to pseudoephedrine. It emphasizes the importance of considering drug allergies when diagnosing palmoplantar exfoliation in divers and underscores the need for a thorough evaluation of medication use in this group. Alternative medications and management strategies should be considered for divers with a pseudoephedrine allergy to prevent ear barotrauma while minimizing the risk of adverse skin reactions.
Summary
Original Article
Global Trends in Childhood Sexual Abuse and Bullying Victimization: A Comprehensive Analysis from 1990 to 2019
Nasrin Borumandnia, Mohammadamin Sabbagh Alvani, Payam Fattahi, Mahmood Reza Gohari, Yashar Kheirolahkhani, Hamid Alavimajd
Received January 1, 2024  Accepted June 18, 2024  Published online August 15, 2024  
DOI: https://doi.org/10.3961/jpmph.24.007    [Accepted]
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AbstractAbstract PDF
Objectives
No comprehensive analysis has yet been published regarding global trends in childhood sexual abuse (CSA) and bullying victimization (BV). The present study offers a longitudinal perspective on their prevalence worldwide.
Methods
CSA and BV rates were extracted from the Global Burden of Disease study, spanning the years 1990 to 2019 across 204 countries. Trends by gender, region, and human development index (HDI) were examined.
Results
For both boys and girls, and in both high- and low-HDI countries, CSA rates did not significantly change from 1990 to 2019 (p>0.05). However, BV rates increased significantly in high- and low-HDI countries for both genders (p<0.001). Subsequently, we analyzed trends separately by gender across all countries, without considering development level. In this analysis, CSA rates among girls decreased from 1990 to 2000, followed by an increasing tendency after 2000; overall, an upward trend was evident between 1990 and 2019 (p=0.029). In contrast, no significant pattern was observed for boys. Notably, BV demonstrated an increasing trend across all regions when HDI was not considered (p<0.05), with African populations experiencing the most pronounced rise (p<0.001). Globally, boys consistently exhibited higher BV rates than girls.
Conclusions
Our research indicates that, on a global scale, rates of CSA among girls have been rising. Additionally, BV rates have increased in all regions for both boys and girls. Notably, this trend in BV rates is occurring irrespective of HDI. These findings underscore the necessity for targeted interventions in areas with high rates of CSA and BV.
Summary

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