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Acute generalized exanthematous pustulosis (AGEP) is a sudden-onset, severe and rare adverse skin reaction characterized by nonfollicular sterile pustules tending to intertriginous localization. Lesions develop on erythematous and edematous skin. It is often triggered by drugs. This article presents a case diagnosed with AGEP due to etodolac. To the best of our knowledge, this is the second case of AGEP due to etodolac in the literature. A 47-year-old female patient presented with diffuse erythema on the extremities, a purple purpuric rash on the extensor face of both legs, and millimetric pustules on an erythematous base on the inner surface of the left arm. She stated that the reaction developed after taking 3 medications, including etodolac tablets, and gargling the throat with povidone-iodine. The patient was diagnosed with AGEP and her EuroSCAR AGEP Validation Score was calculated as 9 suggesting a definitive diagnosis of AGEP. All of the suspected drugs were discontinued. Methylprednisolone 16 mg/day, a local corticosteroid, and an oral antihistamine were started. Her symptoms resolved and laboratory abnormalities returned to normal within 2 weeks. Patch tests were performed 3 months after the reaction with the suspected drugs. The patch testing showed that only 10% etodolac at 48-, 72- and 96-hour readings were positive (++). The patient was diagnosed with AGEP due to etodolac. AGEP is often secondary reaction to drugs. The most frequent causative drugs are diltiazem, aminopenicillins, pristinamycin, terbinafine, sulphonamides, quinolones, and hydroxychloroquine. AGEP secondary to NSAIDs is very rare. Only one previous case of AGEP due to etodolac was reported in 2011. [ABSTRACT FROM AUTHOR]

Although cases of late-onset localized rash after bee sting and localized cold urticaria after insect sting have been rarely reported, lateonset localized urticaria or recall urticaria after a wasp sting has not previously been reported as far as we are aware. A 24-year-old male patient was stung once in the neck by a wasp in October 2018. After 15 minutes, the patient developed dizziness, fainting, flushing and dyspnea that resolved in a few hours with the treatment administered in the emergency room. One week after this event, a wasp stung his right arm and he fainted within 5-10 minutes. The patient vomited and recovered in a few hours with the treatment provided in the emergency room. Approximately one month after the last wasp sting, skin lesions that were localized only to the right forearm and consistent with urticaria developed. There were no skin lesions in other parts of the body. While this complaint of the patient was under control with cetirizine 10 mg/day, it recurred every day if he did not use an antihistamine. This situation was not related to any trigger (cold, heat, drug use, etc.). The Vespula spp. (10 mcg/mL) skin prick test was positive and the wasp-specific IgE level was found to be 56.2 IU/mL (class5). Vespula spp. subcutaneous immunotherapy was started and the patient has been on maintenance therapy for two years. No side effects related to immunotherapy have been observed so far. However, localized urticaria on the right forearm still persists in the absence of antihistamine use. A very rare case of late onset chronic localized urticaria after a wasp sting is presented. Past history of wasp or bee stings should be questioned in cases of localized urticaria. [ABSTRACT FROM AUTHOR]

Background: Immunosuppression at the feto-maternal interface is crucial for a successful pregnancy outcome. Human leukocyte antigen-G (HLA-G) seems to be a major contributor to fetal tolerance. The HLA-G expression is seen in cytotrophoblasts and in maternal blood. Fetal HLA-G acts on decidual antigen-presenting cells (APCs), natural killers (NKs) and T cells. Recent findings revealed that defects in placentation and their consequences are associated with maternal HLA-G variants and their expression levels., Objectives: The objective of this article is to investigate the relationship between fetal HLA-G alleles and miscarriage, which has not been investigated to date., Material and Methods: The present study includes 204 recurrent miscarriage (RM) cases who were admitted to our clinic between 2012 and 2016. Twenty-eight miscarriage products without maternal cell contamination and any known pathology were analyzed by HLA-G typing. In addition, 3' untranslated region (UTR) 14-base pair (bp) insertion/deletion polymorphism was also investigated by Sanger sequencing., Results: For our population, the most frequent HLA-G type was G*01:01, both in the study group (30.3%) and in the control group (47%). The study revealed that the G*01:04 allele was significantly associated with miscarriage (p = 0.007). The 3' UTR 14bp deletion was more frequent in the miscarriage group, but there was no significant correlation., Conclusions: HLA-G alleles seem to be related with miscarriage and should be considered in RM cases.