In addition to drugs other

In addition to drugs, other factors have also been implicated in the development of AGEP, including acute infections with enterovirus, and hypersensitivity to mercury. Similarly, other pathogen infections have been known to contribute to the development of drug hypersensitivity, and infectious pathogen-related AGEP has been reported previously, with known causative agents including enterovirus, cytomegalovirus, EBV, hepatitis B virus, parvovirus B19, Escherichia coli, Chlamydia pneumonia, Echinococcus granulosus, and Mycoplasma. In this study, we identified three AGEP patients without drug causality showing recent infections of EBV, Coxsackie virus, and mycoplasma. All our patients of AGEP without drug causality denied insect bite history. As for other infectious pathogens, we did not survey all of them except patients with prodrome or a recent history of suspected viral infections and EBV, HSV, or mycoplasma which are of our routine works for severe drug reactions.
Recently, Hotz et al reported systemic involvement of AGEP in a retrospective study of 58 patients. Systemic involvement, including liver, kidney, bone marrow, and lungs, was observed in 17.2% of their AGEP cases. Comparably, in this study, we found that 23.5% of AGEP cases had systemic involvement, indicating that physicians should be educated and aware of the potential risk of systemic involvement in AGEP.

Introduction
In the recent years, various therapeutic benefits of lactic purchase Regorafenib bacteria (LAB) and bifidobacteria have been studied extensively, but their application in dermatology remains new. Staphylococcus aureus is Gram-positive cocci that have been identified to be most virulent among all staphylococcal species to cause skin and soft tissue infections, surgical site infections, and hospital-acquired bloodstream infections. In some infections, survival, dissemination, and pathogenesis of staphylococci are supported by the formation of a biofilm. Treating infections in which biofilms are involved is very difficult, and due to the emergence of methicillin-resistant S. aureus, alternative natural antibacterial therapies have gained much attention.
LAB and bifidobacteria are useful for a variety of applications due to their therapeutic effects; these microorganisms are, in general, nonpathogenic, and thus have been assigned a “generally recognized as safe” status. These microorganisms have been highlighted for their ability to treat acute infectious diarrhea, antibiotic-associated diarrhea, viral infections of the respiratory tract, inflammatory bowel disease, and cholesterol lowering. In recent studies, beneficial effects of LAB and bifidobacteria that extend beyond the gut were uncovered, as these bacteria also demonstrated their potential in promoting dermal health and exerting cellular immunity response required for in skin defence. Bioactive compounds that were found to be useful in dermatological applications included hyaluronic acid, peptidoglycan, lipoteichoic acid, and sphingomyelinase. These compounds were produced by LAB at an effective concentration to inhibit pathogens causing dermal illness.
Findings of extensive studies on these beneficial bacteria suggest that the therapeutic effects exhibited by these microorganisms are due to the secretion of various inhibitory compounds, particularly LAB, which can produce growth-inhibitive compounds such as lactic acid, acetic acid, bacteriocin, hydrogen peroxide, and diacetyl. The unique ability of LAB and bifidobacteria to produce organic acids not only empower bacteria with the ability to preserve food, but also to inhibit pathogenic microorganisms by penetrating the targeted bacterial membranes and interfering with the essential metabolic functions. Bacteriocins are another group of interesting natural antimicrobial compounds produced by LAB, which resemble antibiotics; they work by adhering to specific receptors on targeted bacterial cytoplasmic membrane and affect the metabolic activity within cells.