A randomized, double-blinded, placebo-controlled trial of pseudocatalase cream and narrowband ultraviolet B in the treatment of vitiligo.

BACKGROUND: Pseudocatalase cream in conjunction with narrowband ultraviolet B (NB-UVB) has previously been reported to result in repigmentation of vitiliginous skin. OBJECTIVES: The purpose of this 24-week, double-blind, placebo-controlled, randomized, single-centre trial was to assess the efficacy of pseudocatalase cream and NB-UVB vs. placebo and NB-UVB for the treatment of vitiligo. METHODS: Patients with active vitiligo on their face and/or hands applied either pseudocatalase cream or placebo to their whole body, twice daily for 24 weeks. NB-UVB therapy was administered three times a week for the duration of the trial. Efficacy was assessed primarily by digital image analysis of photographs. RESULTS: Thirty-two patients were randomized to either the pseudocatalase arm (n = 14) or placebo (n = 18). Between-group analysis did not show a statistically significant improvement in percentage area affected in the pseudocatalase cream group when compared with placebo. However, a statistically significant improvement was found within each group by week 12, which was maintained throughout the study. CONCLUSIONS: NB-UVB treatment is a moderately effective treatment for vitiligo. Pseudocatalase cream does not appear to add any incremental benefit to NB-UVB alone.

Childhood pemphigus initially seen as eosinophilic spongiosis.

The condition of a 3-year-old boy with an intermittent, generalized, bullous eruption was initially diagnosed as (and treated as) bullous impetigo. After a relapse, two skin biopsies were performed. Each biopsy specimen showed the changes of eosinophilic spongiosis. A third biopsy specimen was also examined by direct immunofluorescence microscopy. The specimen showed deposition of IgG in the intercellular region of the epidermis. The patient's serum contained intercellular antibodies in a dilution of 1:160, confirming the diagnosis of pemphigus. A biopsy should be performed in the case of a child with a persistent or recurring bullous eruption; immunofluorescence microscopy of the biopsy is essential.

Subcutaneous fat necrosis following traumatic pancreatitis.

A 25 year old female who developed subcutaneous fat necrosis and polyarthritis secondary to post-traumatic pancreatitis is reported. This is a well documented but uncommon phenomenom, affecting less than 1% of patients with pancreatic disease.