Eruptive cherry angiomas-a novel cutaneous manifestation of immunoglobulin type gamma 4-related disease.

Immunoglobulin type gamma 4-related disease (IgG4-RD) is a fibroinflammatory condition that can have systemic and/or cutaneous manifestations. The most common cutaneous features are erythematous papules, nodules and/or plaques, typically involving the head and neck (J Am Acad Dermatol. 2016;75:197). We report a case of IgG4-RD presenting with eruptive cherry angiomas, a novel cutaneous presentation.

Halo naevi and café au lait macule regression in a renal transplant patient on immunosuppression.

A case of halo naevi and café au lait macule regression in a renal transplant patient receiving long-term immunosuppressive therapy is described. We propose the direct transfer of an auto-reactive antibody, CD8 T-cells or tumour necrosis factor α from the transplant donor to the recipient as a possible cause. We have also considered insufficient immunosuppressive therapy as a possible mechanism.

Reactive angioendotheliomatosis associated with cyroglobulinemia in a marathon runner.

We report a case of a 65-year-old marathon runner who presented with painful plaques, which were worse in cold weather and progressed to ulceration. A punch biopsy revealed vascular endothelial hyperplasia and an appearance consistent with reactive angioendotheliomatosis (RAE), a rare, but benign disorder of the skin. Subsequent investigations resulted in the diagnosis of type I cryoglobulinemia; the lesions resolved completely following treatment of the underlying disorder with lenalidomide.

Allergic contact dermatitis to methylisothiazolinone: exposure from baby wipes causing hand dermatitis.

BACKGROUND/OBJECTIVES: Methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) is a preservative used in both cosmetic and industrial settings. In Europe it is allowed to be used in rinse-off cosmetics only because of its propensity to cause allergic contact dermatitis (ACD). No such legislation exists in Australia. In recent years MI without MCI has been used. In August 2010 the first cases of MI causing non-occupational ACD were reported in Europe. The objective here was to present a case series of ACD to MI occurring in the Australian setting. METHODS: : We retrospectively reviewed positive reactions to MI and MCI/MI from the Skin and Cancer Foundation patch test clinical database. MI was added to our baseline test series in January 2011. RESULTS: : In total 653 patients were tested for MI and there were 43 reactions, of which 23 were relevant, based on a history of exposure to MI. Seven were parents of young children with hand dermatitis caused by ACD to MI contained in baby wipes. The remaining patients reacted to MI in shampoos, conditioners, deodorants, moisturisers, a skin cleanser and a facial wipe. Three patients had ACD to MI associated with occupational exposure to hand cleansers. CONCLUSIONS: These data demonstrate for the first time that MI is an emerging, important allergen in both cosmetic and occupational settings in Australia. An important source of exposure was baby wipes, which was predominantly associated with hand dermatitis in parents. We believe that it is important to test for MI, not just MCI/MI, in the baseline series.

Combination therapy with finasteride and low-dose dutasteride in the treatment of androgenetic alopecia.

We report on a 47-year-old man who was initially treated with finasteride for androgenetic alopecia. Despite continuous treatment, after year 4 his hair density was not as good as at year 2, and low-dose dutasteride at 0.5 mg/week was added to the finasteride therapy. This resulted in a dramatic increase in his hair density, demonstrating that combined therapy with finasteride and dutasteride can improve hair density in patients already taking finasteride.