Idiopathic elastosis perforans serpiginosa with satisfactory response after 5-ALA photodynamic therapy.

Photodynamic therapy (PDT) involves the use of photochemical reactions mediated through the interaction of photosensitizing agents, light, and oxygen for the treatment of malignant or benign diseases. Topical photosensitizers employed in dermatology are 5-aminolevulinic acid (5 ALA) and methyl aminolevulinate, classically used for the treatment of superficial non-melanoma skin cancer and their precursors. Recently the efficacy of PDT has been introduced in other benign diseases. Elastosis perforans serpiginosa (EPS) is a rare skin disorder characterized by transepidermal elimination of abnormal elastic fibers. Management of this condition is complicated, various methods have been used but with limited success. We report a case of EPS in a 30-yeard-old woman treated with 5 ALA-PDT. After 4 sessions the lesions have almost completely disappeared with no residual side effects. Therefore we present an effective and safe alternative for the treatment of EPS.

[Non-Mediterranean lymphoma producing heavy alpha chains]. / Linfoma no mediterráneo productor de cadenas pesadas alfa.

At the present, immunoproliferative small intestinal disease (IPSID) is considered a fairly homogeneous entity. Isolated heavy chain production is so closely related with IPSID that has been considered as a natural biologic marker for it. By contrast, we report here the case of a 63-year-old female that developed a multinodular small bowel lymphoma without clinical malabsorption symptoms. The main tumour mass was located in proximal jejunum and the neighbour intestinal mucosa did not show neoplastic cell infiltrates. Immunohistochemical methods demonstrated restrictive presence of IgA1 subclass in the neoplastic cells without presence of light chains. Cases as present are extremely infrequent and their potential relationship with IPSID has not been completely outlined, being useful in trying to understand the spectrum of gut lymphomas.