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Keep helmet straps, tight hats, or heavy eyewear off treated areas the first day
Patient 1 stopped metformin and experienced only a 0.1% reduction in HbA1c, while patient 3 started metformin and observed a considerable reduction of 1.3%
Typical pricing Per vial (30 mL): $100-200 from compounding pharmacies Per injection (1 mL from clinic): $25-75 Monthly cost: $100-300 depending on frequency and source Cost factors Compounding pharmacy vs clinic: Getting your own vials and self-injecting is significantly cheaper than clinic-administered injections
ACDR can cause a number of blistering eruptions including: A fixed drug eruption (above) Stevens-Johnson syndrome / Toxic epidermal necrolysis (refer above under serious ACDR) Immunobullous reactions - very uncommon Other possible presentations of ACDR: Acneiform ie acne-like Pustular ie white-yellow pustules - pustules can be localised but are more often generalised and known as acute generalized exanthematous pustulosis (AGEP ) Purpura / cutaneous vasculitis - red-purple palpable lesions most commonly on lower legs, which do not blanch on pressure Erythema nodosum (EN) - painful nodules on the shins Erythema multiforme (EM) - those that are secondary to medication tend to cause more varied and less well-defined target lesions than when due to herpes simplex (antibiotics can be an exception) Skin ulceration and infarction - two of the most commonly associated medications that cause ulceration are hydroxyurea and nicorandil
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