RESUMEN
Bullous pemphigoid (BP) is an acquired immunobullous disorder rarely seen in childhood. We report the case of an infant with BP successfully treated with oral corticosteroids. The onset of BP was associated with use of complementary medications and we speculate that these may have been triggering factors.
Asunto(s)
Corticoesteroides/uso terapéutico , Terapias Complementarias/efectos adversos , Penfigoide Ampolloso/inducido químicamente , Compuestos de Plata/efectos adversos , Interacciones Farmacológicas/inmunología , Humanos , Lactante , Masculino , Penfigoide Ampolloso/tratamiento farmacológico , Penfigoide Ampolloso/inmunología , Penfigoide Ampolloso/patología , Piel/inmunología , Piel/patología , Resultado del TratamientoRESUMEN
BACKGROUND: Eczematous skin changes overlying port-wine stains have been reported to improve with pulsed-dye laser (PDL) treatment. However, PDL has not as yet been evaluated for the treatment of atopic dermatitis (AD; eczema). AIM: To evaluate in a controlled trial the effects and safety of PDL treatment in children with AD who had chronic localized lesions. METHODS: Twelve children with localized, chronic eczema were treated with PDL (595 nm), with untreated areas used as an intrapatient control. Treatment was given at baseline and patients were followed up at 2 and 6 weeks. Clinical outcome measures were localized Eczema Severity Score (ESS), a visual analogue scale (VAS) indicating eczema severity assessed by photographs, and adverse events. RESULTS: After 2 and 6 weeks, a significant decrease in ESS was seen for the PDL-treated areas compared with the control areas (mean +/- SEM reduction in ESS 7.0 +/- 1.0 vs. 3.3 +/- 0.8 at 2 weeks, P = 0.003, and 7.8 +/- 1.4 vs. 4.9 +/- 1.3 at 6 weeks, P = 0.002). A significant difference in eczema severity assessed by VAS at 6 weeks was seen in favour of PDL (mean +/- SEM improvement 78% +/- 20% vs. 52% +/- 10%, P = 0.003). Treatment was well-tolerated. CONCLUSIONS: In this pilot study, PDL treatment was effective in treating small areas of chronic localized eczema. This may suggest that in AD dermal vasculature plays an important role or that PDL may have an effect on cutaneous immunological activation.
Asunto(s)
Dermatitis Atópica/radioterapia , Láseres de Colorantes/uso terapéutico , Terapia por Luz de Baja Intensidad , Mancha Vino de Oporto/radioterapia , Adolescente , Niño , Preescolar , Relación Dosis-Respuesta en la Radiación , Emolientes/uso terapéutico , Femenino , Humanos , Masculino , Proyectos Piloto , Índice de Severidad de la Enfermedad , Resultado del TratamientoRESUMEN
We describe an infant with atopic eczema, treated with homoeopathic medicines, who presented with erythema and limb oedema. Concentrations of urinary and plasma sodium and plasma albumin were low. On conventional treatment he made a satisfactory recovery.