[Asteatotic eczema as paraneoplastic syndrome]. / Asteatotisch eczeem als paraneoplastisch verschijnsel.

BACKGROUND: Asteatotic eczema is rarely associated with an underlying malignancy. The condition as paraneoplastic syndrome is characterised by glucocorticoid resistance. CASE DESCRIPTION: A 66-year old woman came to the emergency room with symptoms of dehydration resulting from diarrhoea due to cyclosporine therapy for treatment-resistant eczema. CT scan of thorax and abdomen showed multiple, pathologically enlarged lymph nodes. Histological examination of a lymph node biopsy from the right axilla showed an ALK-negative, anaplastic large T-cell lymphoma. CONCLUSION: Asteatotic eczema is usually innocuous but may also be linked to malignancy. A careful physical examination and early referral to second-line care are needed for rapid diagnosis and treatment of the underlying condition.

Treatment of vitiligo with khellin liposomes, ultraviolet light and blister roof transplantation.

BACKGROUND: Various surgical and non-surgical methods are available to treat vitiligo. Surgical techniques such as epidermal blister graft transplantation may be effective for the re-pigmentation of stable, but refractory vitiligo areas. Khellin has phototherapeutic properties that are similar to those of the psoralens, but with substantially lower phototoxic effects and DNA mutation effects. Its penetration into the hair follicles is enhanced by encapsulating it into liposomes. Subsequent activation of the khellin with UV light stimulates the melanocytes in the hair follicles. OBJECTIVE: The first objective was to evaluate the additional value of combining blister roof transplantation (BRT) with khellin in liposomes and ultraviolet light (KLUV) in the treatment of recalcitrant vitiligo patches. The second objective was to assess patients' satisfaction. MATERIALS AND METHODS: Nineteen patients with vitiligo lesions which did not respond to KLUV treatment for at least a year were treated with BRT followed by KLUV. The transplantation was performed by creating blisters with a suction device, preparing the target site with Erbium laser ablation and the actual transplantation. Locations where randomly assigned. A blinded observer established the results. RESULTS: Seventy-five percent of the patients were satisfied with the cosmetic result. All of the patients would recommend the treatment to other vitiligo patients. More than 75% re-pigmentation of the vitiligo areas was noted in 47% of the patients according to the blinded evaluation of photographs taken before and after the treatment.