Extragenital lichen sclerosus arising in tattooed skin.

Lichen sclerosus (LSc) is a chronic inflammatory condition commonly affecting the anogenital area, with extragenital involvement seen in less than 1%-20% of cases. Concomitant extragenital and genital LSc is extremely rare in male patients. The Koebner phenomenon is a recognised feature of LSc; here we present a rare case of extragenital LSc occurring in tattooed skin.

Babchi oil-induced phytophotodermatitis mimicking burn injury.

Babchi (Psorylea corylifolia) is occasionally used by patients as a herbal treatment in conditions such as psoriasis and vitiligo, due to its anti-inflammatory, anti-oxidant and immune-modulatory properties (Shrestha et al., 2018; Chopra et al., 2013). Due to its psoralen containing furocoumarins, it has the potential to induce photosensitive reactions. We present the first reported case of Babchi-induced phytophotodermatitis in the UK, presenting as sunburn.

Haemolytic uraemic syndrome - a rare case report of bloody diarrhoea in adults.

BACKGROUND: Haemolytic uraemic syndrome is a rarely seen in adults often leading to critical illness. This case highlights how difficult it can be to establish a diagnosis and treat when a patient presents with bloody diarrhoea. CASE PRESENTATION: A 17-year-old Iraqi man presented to the emergency department with abdominal pain and bloody diarrhoea. He was initially treated as acute appendicitis, undergoing an appendectomy but following a recurrence in his symptoms a colonoscopy was performed. A diagnosis of shiga toxin-producing Escherichia coli leading to HUS was suspected following histology obtained at colonoscopy and this was confirmed on antibody testing. Despite intravenous fluids and supportive therapy the patient's symptoms and condition deteriorated. He developed seizures and acute renal failure requiring intubation and plasma exchange in the intensive care setting. He eventually required treatment with ecluzimab therapy; a monoclonal antibody and subsequently made a full recovery. CONCLUSIONS: Haemolytic uraemic syndrome is a triad of progressive renal failure, thrombocytopenia and haemolytic anaemia which is a condition rarely seen in adults. It is usually associated with an E. coli infection and supportive therapy remains the mainstay of treatment.