Facial basal cell carcinomas recurring after photodynamic therapy: a retrospective analysis of histological subtypes.

BACKGROUND: Photodynamic therapy (PDT) is an established treatment for basal cell carcinomas (BCCs). Although recurrences are sometime observed, their histological patterns have never been specifically studied or compared with the one of the initial tumor. OBJECTIVE: To compare the histopathological aggressiveness of BCCs recurring after PDT with that of the primary tumors. METHODS: The study population included 12 patients with 16 post PDT recurrent BCCs. Outcome measures were proportion of histologically aggressive subtypes in BCC recurrences vs. primary tumor. RESULTS: 62.5% of recurrent BCCs displayed a transition from a non-aggressive to an aggressive subtype. CONCLUSIONS: Post PDT recurrences appear to display an increased histological aggressiveness, although the latter may reflect the natural course of tumor progression. Despite the presence of potential biases, our study raises the possibility that PDT favors the selection of more aggressive tumor cells. Better systematic large-scale follow-up studies are required to assess the exact frequency and histological types of BCC recurrences after PDT.

Acute generalized exanthematous pustulosis induced by olanzapine.

The case of a 56 years old man is presented, who developed acute generalized exanthematous pustulosis 5 days after the introduction of olanzapine 10 mg. Multiple 1-mm pustules appeared on the whole body, concentrated especially on her neck and face. Within 2 days, the eruption was increasingly accompanied by erythema and pruritus. No fever, chills, nausea, vomiting, arthralgias or myalgias were recorded. The diagnosis was corroborated by hystopathology. After 7 days of treatment, olanzapine and valproate were stopped. Concomitantly, cetirizine 20 mg p.o. and methylprednisolone 500 mg i.v. were given once. During the following week betamethasone cream was applied, and the pustular eruption resolved completely.