Hypoacusia in a patient treated by isotretinoin.

Isotretinoin is the most effective treatment for severe acne, but there are several adverse effects associated with its use, some of them very exceptional (<1/10000). We report one case of hypoacusia and tinnitus in a 15-year-old boy treated with isotretinoin during 6 weeks, who quickly improved after isotretinoin withdrawal. Also, we comment other publications about hearing alterations in patients treated with isotretinoin and other retinoids.

Imiquimod in mycosis fungoides.

Imiquimod is a topically active imidazoquinoline immunomodulator agent. It works as an indirect antiviral and antitumoral and stimulates the production of INF-alpha and various other cytokines. We assayed topical imiquimod in treating early stages of mycosis fungoides. We applied imiquimod 5% cream in four patients with multi-treatment resistant plaques of MF (stages IA and IIB). We applied it on one patient in association with systemic INFalpha-2a. We observed a complete clinical clearance of the lesions in all four patients. In three cases we achieved a complete histopathological clearance and in one case a partial histopathological clearance. The patient treated with imiquimod and systemic INFalpha-2a showed the most spectacular improvement with a rapid total response. We ascribe this improvement to a synergic effect of imiquimod and systemic INFalpha-2a treatment. Before the introduction of imiquimod, this patient had been treated for 2 years with systemic INFalpha-2a alone, without any evidence of clinical response. Imiquimod could be an effective therapy for early-stage disease of CTCL, used alone or in combination with systemic immunomodulatory therapy.

[Pancreatic panniculitis. Report of a case and review of literature]. / Presentación de un caso de paniculitis pancreática y revisión de la bibliografía.

Pancreatic panniculitis is an uncommon complication of pancreatic disease, which is characterized by liquefactive necrosis of the subcutaneous fat and may constitute the first evidence of a pancreatic illness. Herein, we report a case where cutaneous lesions of pancreatic disease were recognized prior to detection of an acute episode of a known chronic pancreatitis.

Fixed drug eruption from piroxicam.

The pathogenetic mechanism of fixed drug eruption (FDE) is still unknown. One of the most common causes of FDE is the use of nonsteroidal antiinflammatory drugs (NSAIDs). Oxicams are in the NSAID group and piroxicam is one of the most used of these drugs. FDE caused by piroxicam is rare but a few cases have been reported. Patch tests are useful for diagnosing some cases of FDE; they give variable results on previously affected skin while no reaction appears on unaffected skin. Some cases of cross-sensitivity among piroxicam and other substances have been reported. We report two new cases of FDE due to piroxicam with negative patch test on normal skin and positive results on affected skin.

Two cases in infantile and familial porphyria cutanea tarda.

In 2 children, both 7 years old, and with an obvious presence of clinical symptoms, the diagnosis of porphyria cutanea tarda was corroborated by the characteristic patterns of urinary and fecal prophyrin excretion. Familial studies allowed us to consider both cases as hereditary.