This review article aims to provide a comprehensive overview of recent epidemiology, pathogenesis, risk factors, and premalignant conditions of gastric cancer. Worldwide, gastric cancer is one of the most common and most fatal cancers. The incidence and mortality remain high in regions such as East Asia and Eastern Europe. Although there is a lower incidence in the United States, it remains a deadly disease. Age, gender, and race are non-modifiable demographic risk factors for developing gastric cancer. There have been several dietary and lifestyle risk factors such as salt preserved foods, N-nitroso compounds containing foods, tobacco smoke, alcohol use, and obesity that have been shown to contribute to the development of gastric cancer. Infections have additionally been shown to have a clear role in the pathogenesis of gastric cancer as Helicobacter pylori eradication has shown a significant reduction in the incidence of gastric cancer as well as other pathogens such as Epstein-Barr virus. There are certain premalignant lesions that increase the risk of developing gastric cancer. These include atrophic gastritis, and intestinal metaplasia amongst others.

The objective of this article is to highlight the clinical features, screening, diagnosis, treatment, and prevention of gastric cancer (GC). Early GC is often asymptomatic leading to frequent delays in diagnosis. Weight loss and persistent abdominal pain are the most common symptoms at initial diagnosis. The diagnosis of GC typically involves a combination of endoscopy, biopsy, and imaging studies. Endoscopic resection techniques are emerging as successful treatment options for early GC. Treatment options for advanced GC include surgery and chemotherapy. The first line chemotherapy for advanced GC consists of doublet therapy with a combination of platinum and fluoropyrimidines. Trastuzumab, a monoclonal antibody, is used in the treatment of human epidermal growth factor 2 positive GCs. Anti-angiogenic agents and immunotherapy are also useful in the treatment of GC. Currently there are no GC screening guidelines in the United States, but they exist in other regions where there is increased prevalence of GC. Prevention strategies for GC include Helicobacter pylori eradication and adoption of a healthy diet consisting of fruits and vegetables.

Acute generalized exanthematous pustulosis (AGEP) is a rare dermatological manifestation of the adverse drug reaction that occurs for a varied duration after the receipt of certain drugs. It manifests as an acute onset of generalized exanthematous pustular reaction with an edematous base. It has a characteristic clinical presentation and rapid resolution soon after the removal of the offending drug. The unique histological finding is that of single-cell necrosis of keratinocytes with edema of papillary dermis accompanied by components of vasculitis and/or exocytosis of eosinophils. Management consists of moist antiseptic dressings, topical steroids, infliximab, the use of systemic steroids if needed, and avoiding antibiotics as much as possible. Here, we present a case of AGEP in a setting of usages of antibiotics like vancomycin, cefepime, and ceftriaxone in a patient with cutaneous lymphoma that resolved after withdrawal of the offending antibiotics.