Condyloma acuminata and mollusca contagiosa: a giant manifestation in a patient with lupus.

A 27-year-old woman with systemic lupus erythematosus since childhood and treated with immunosuppressive therapy for many years was referred to our clinic for the presence of widespread condylomatosis and mollusca contagiosum localized in the genital area. These lesions appeared 4 years before and had been treated with both surgery and topical immunomodulation therapy without resolution. The patient stated that she had two sexual partners in that period, who showed no skin lesions. Cutaneous examination showed about 30 to 40 molluscoid lesions of 0.5 cm to 2 cm in diameter and widespread cauliflower-like condyloma acuminata (Figure) spread on the vulvovaginal and perianal region without any symptoms. At the time of observation, she was under treatment with corticosteroids and mycophenolate mofetil.

Role of radiation therapy in mycosis fungoides refractory to systemic therapy.

The long natural history of early stage mycosis fungoides (MF) makes its management a difficult problem. Skin lesions are sensitive to different therapies and a variety of treatment modalities have been used, such as topical nitrogen mustard, puvatherapy, UV-B, retinoids, radiation therapy, extracorporal photopheresis and systemic chemotherapy. For patients with refractory early stage MF, treatment selection is made by clinical parameters such as the age, sex and performance status of the patients, as well as the institutional expertise and the toxicity profiles of the different therapeutic approaches. We report radiation therapy in a relapsed/resistant stage IB patient with mycosis fungoides treated with local radiation therapy for symptomatic progression unresponsive to bexarotene therapy. Total skin electron beam therapy has been employed in early stage and for limited skin failure MF, while the role of local radiation therapy in MF is less defined. In our experience local radiotherapy has proved to be a very efficient, tolerable and cost effective approach in patients with MF unresponsive to systemic approaches.

Topical and systemic therapies for nickel allergy.

Nickel allergy can result in both cutaneous and systemic manifestations, and can range from mild to severe symptoms. A severe form of this allergy is the Systemic nickel allergy syndrome, clinically characterized by cutaneous manifestions (contact dermatitis, pompholyx, hand dermatitis dyshydrosis, urticaria) with chronic course and systemic symptoms (headache, asthenia, itching, and gastrointestinal disorders related to histopathological alterations of gastrointestinal mucosa, borderline with celiac disease). This review aims to briefly update the reader on past and current therapies for nickel contact allergy.