Pityriasis lichenoides chronica in black patients.

Pityriasis lichenoides chronica (PLC) is a cutaneous disease of unknown etiology that most commonly affects children and young adults. The highly variable presentation of this condition often poses a diagnostic challenge. The clinical presentation of PLC in black patients is not well described. We report a series of 5 black patients (4 children and 1 young adult) with PLC who presented with extensive hypopigmentation and prominent facial involvement. One patient had concomitant mycosis fungoides (MF). The diagnosis of PLC should be included in the differential diagnosis in dark-skinned patients who present with widespread hypopigmented macules and patches. The presence of MF in one of our patients underscores the potential relationship between MF and PLC.

Propionic acidemia manifesting with low isoleucine generalized exfoliative dermatosis.

We describe an infant with propionic acidemia who developed a generalized exfoliative eruption. Preceding the eruption, he was on an amino acid restricted formula. Within days of liberalizing his restricted diet, the eruption resolved completely. A similar dermatitis has been reported in infants with inborn errors of metabolism who were on amino acid modified formulas. However, in most instances, the eruption was predominantly limited to the periorificial regions. Most critical in the etiology of cutaneous eruptions in these patients is low serum isoleucine. Amino acid malnutrition should be considered in the differential diagnosis of generalized exfoliative dermatosis in an infant. Supplementation with isoleucine-containing dietary proteins results in rapid clinical resolution.

Treatment of recalcitrant atopic dermatitis with omalizumab.

Atopic dermatitis is a common diagnosis that presents a therapeutic challenge. Although multiple therapeutic modalities exist, there is no single monotherapy that has proven exceptional in ameliorating the symptoms of this disease. Current topical and systemic therapeutic options offer benefit but carry varying degrees of adverse effects that often limit their application. We present 3 patients with severe, recalcitrant atopic dermatitis successfully treated with omalizumab.

Unilateral Basal cell carcinomas: an unusual entity treated with photodynamic therapy.

BACKGROUND: Unilateral localized basal cell carcinomas are an uncommon finding that presents both a diagnostic and therapeutic challenge. Exclusion of unilateral nevoid basal cell carcinoma syndrome is indicated. There are few reports in the literature regarding this entity and even less regarding therapeutic strategies. OBJECTIVE: We present a patient with unilateral localized basal cell carcinomas who was successfully treated with photodynamic therapy. METHODS: Photodynamic therapy was started using Levulan) Kerastick) as previously described. The topical solution was applied to the patient's back and illuminated the following day via the BLU-U Blue Light Illuminator. RESULTS: The patient tolerated the procedure well and without complications. The patient had an excellent therapeutic response with no clinically apparent basal cell carcinomas for 18 months. CONCLUSIONS: We report a patient with unilateral basal cell carcinomas successfully treated with photodynamic therapy. This uncommon entity represents a diagnostic challenge in its inherent absence of the classic clinical and radiographic findings of nevoid basal cell carcinoma syndrome. Like nevoid basal cell carcinoma syndrome, unilateral basal cell carcinomas poses a therapeutic challenge with the sheer number of cutaneous tumors. The use of photodynamic therapy carries a proven therapeutic efficacy, a low rate of adverse events and excellent cosmesis.