Photosensitivity associated with selective serotonin reuptake inhibitors.

Selective serotonin reuptake inhibitors (SSRIs) are a widely prescribed group of antidepressants. We report three cases of photosensitivity induced by fluvoxamine and paroxetine. These photoallergic reactions suggest cross-reactivity between different molecules. Methylation metabolism could explain common photosensitization. Although these drugs are widely prescribed, such photosensitization is rare. Nevertheless, we consider that clinicians and patients should be aware of the risk of photosensitization and these drugs should be stopped before phototherapy or prolonged sun exposure.

[Sheep wool granuloma]. / Granulome à la laine de brebis.

INTRODUCTION: We report the unusual case of cutaneous foreign body granulomas provoked by sheep wool. CASE REPORT: A 45-years old woman presented within one year two episodes of a papular eruption on her neck and limbs. She was working as a farmer's wife and each episode occurred after preparing the ewes for coupling. She had to keep a tight hold on the ewes while the farmer introduced warm and moist compresses in the genitals of the animals. Each diseased skin area was closely related to the tight contact with the sheep's wool and on histological slides each granuloma was centered by a tiny ply of wool. DISCUSSION: This foreign body reaction may be compared to the trichogranulomas of hairdressers. In sheep breeders this occupational practice is very usual and one may wonder why this type of reaction seems so rare.

Photoallergy to hexamidine.

This report details the case of an atopic patient showing a photosensitivity caused by a hexamidine solution. Patch tests were negative but photopatch tests to hexamidine in water solution were positive, after irradiation by ultraviolet A (UVA); all control tests were negative. It is well-known that hexamidine can induce contact allergy but this case was the first reported in which UVA was implicated. This photoallergy can be explained by the structure of the hexamidine molecule, but the question is: why has there never been such a case reported before?

[Severe contact dermatitis caused by Parfenac cream]. / Dermite de contact grave à la crème Parfenac.

Bufexamac is an anti-inflammatory agent used as topical treatment of various pruritic diseases. Since it was put on the market, this product has been blamed for the occurrence of contact dermatitis (eczema, urticaria) and, rarely, severe toxicodermia. We report a case of severe contact dermatitis developed after application of bufexamac (Parfenac) cream. Patch-tests performed two months after the acute phase were positive (+ + +) for both Parfenac cream and bufexamac.

[Association of sarcoidosis and Waldenström's macroglobulinemia]. / Association sarcoïdose et macroglobulinémie de Waldenström.

Sarcoidosis is seldom associated with Waldenström's macroglobulinaemia. We report the case of a 58-year old woman, 7 years after cutaneous and pulmonary sarcoidosis had begun, developed Waldenström's macroglobulinaemia. Chlorambucil was effective on both diseases. The possibility of reactive sarcoidotic granulomas in neoplastic diseases may cast doubts on the reality of the sarcoidosis-malignant haemopathy association. However, most authors consider that such associations are not fortuitous and can be explained by the immunological abnormalities observed in patients with sarcoidosis.