Purpura of the ears: a distinctive vasculopathy with circulating autoantibodies complicating long-term treatment with levamisole in children.

The cutaneous side-effects of levamisole include non-specific and lichenoid eruptions, fixed drug eruption and, very rarely, cutaneous vasculitis. We describe a distinctive clinical and histological vasculopathy with immunological abnormalities in children with paediatric nephrotic syndrome receiving long-term levamisole treatment. Four boys and one girl were identified. Their average age was 10 years. Levamisole had been used for an average of 24 months. Purpura of the ears was the most common finding corresponding histologically to a vasculopathic reaction pattern ranging from a leucocytoclastic and thrombotic vasculitis to a vascular occlusive disease without true vasculitis but with associated antinuclear, antiphospholipid and anticytoplasmic antibodies. The eruption resolved in all patients 2-3 weeks after the discontinuation of levamisole, but serum autoantibodies persisted for 2-14 months.

Argon laser treatment of cutaneous multiple angiokeratomas.

BACKGROUND: Angiokeratomas are cutaneous vascular lesions with common clinical and histological features: dark red to black papules and ectasia of upper dermis vessels, respectively. Multiple angiokeratomas are difficult to treat because they are often too extensive for surgery and cautery, procedures frequently leading to hemorrhage and scarring. OBJECTIVE: Our report is designed to evaluate the efficacy of argon laser photocoagulation in the treatment of multiple angiokeratomas. METHODS: Two male patients affected by angiokeratoma circumscriptum and angiokeratoma of Fordyce, respectively, were treated using an argon laser under local anesthesia. The laser beam was used as a hemostyptic and to flatten vascular papules by photocoagulation. RESULTS: The cosmetic results of argon laser treatment were good. Posttreatment crusting lasted 2 weeks; 4 months later there was excellent healing without scarring. CONCLUSION: Angiokeratomas respond favorably to argon laser photocoagulation since vascular ectasias are localized in the papillary dermis. Thus, the argon laser offers significant advantages over traditional methods and produces no side effects.

[Splash rash dermatitis. A case]. / Follicolite da idromassagio ("splash rash dermatitis"). Un caso.

The Authors report a case of a folliculitis developed in a woman who used a spa with hydrojet circulation. This dermatitis is due to Pseudomonas aeruginosa, which can colonizes the closed-cycle water systems.

Falsely elevated urinary level of vanillylmandelic acid induced by griseofulvin.

A 6-year-old girl with mild hepatitis was found to have an elevated urinary level of vanillylmandelic acid (VMA), but no cause for the elevation was found. The patient was receiving griseofulvin for treatment of tinea capitis, and this drug was suspected of causing a falsely elevated urinary VMA level. Four other patients receiving griseofulvin were also found to have elevated urinary VMA levels. In one patient, urinary VMA level determined by an alternate method was normal.