Sole dermatitis in children: patch testing revisited.

Although dermatoses affecting the soles of the feet in children are regularly encountered in dermatology clinics, the relationship with allergic contact dermatitis affecting this part of the foot is not well established. The aim of this study was to evaluate the relevance of patch testing children with sole dermatoses. We reviewed the results of all patch tests performed in children (<18 years) presenting with dermatoses involving the soles between 1997 and 2009 from our departmental patch test database. Forty-one children were identified: 27 children with an inflammatory dermatitis affecting the sole and 14 children with juvenile plantar dermatosis (JPD). Seventeen (41%) children had at least one clinically relevant positive patch test reaction. Rubber additives and potassium dichromate were the most frequent allergens identified. Forty-eight percent of children with inflammatory dermatitis affecting the sole and 29% of children with JPD had at least one relevant reaction. Of the children with relevant reactions, 76% had a personal or family history of atopy. Our results demonstrate the importance of patch testing children with dermatoses affecting the soles and indicate that a history of atopy or a diagnosis of JPD should not deter investigation.

Terbinafine-induced subacute cutaneous lupus erythematosus.

Oral terbinafine is licensed for use in onychomycosis after positive confirmation of infection. We describe five cases of subacute cutaneous lupus erythematosus associated with terbinafine therapy. All cases had positive antibodies to extractable nuclear antigens, predominantly anti-Ro, and several had a history of pre-existing autoimmune disease. Terbinafine should only be prescribed after confirmation of infection by microscopy or culture.