Waldenström macroglobulinemia-induced bullous dermatosis.

BACKGROUND: Waldenström macroglobulinemia is a plasma cell dyscrasia of undetermined cause characterized by the monoclonal proliferation of lymphoplasmacytes in the bone marrow, lymph nodes, and spleen and elevated circulating levels and tissue deposition of monoclonal IgM produced by these aberrant cells. Rarely, cutaneous manifestations of this disease have been reported. OBSERVATIONS: We report the case of a patient with bullous dermatosis induced by Waldenström macroglobulinemia and demonstrate the subepidermal location of the separation and the presence of IgM and kappa light chains by immunoperoxidase, immunofluorescent techniques, and electron microscopy with immunogold staining. Immunoblotting revealed a strong band at the 290-kd area. CONCLUSIONS: The demonstration of the separation in the upper dermis at the site of IgM deposits suggests that these deposits may be an etiologic factor in this rare manifestation.

Comparison testing of the irritancy of children's liquid bubble bath using a modified human repeat insult patch test.

BACKGROUND: Bubble baths are common products used by parents with young children. Some dermatologists and pediatricians do not recommend the use of these products. OBJECTIVE: The purpose of this study was to compare the irritancy of nine children's liquid bubble bath solutions. METHODS: A modified human repeat insult patch test (HRIPT) was used to rank order the irritancy of nine bubble bath preparations. Erythema, scaling, and fissuring were evaluated at the patch test sites. RESULTS: The nine products tested varied in their ability to cause irritation. Based on the degree of erythema, the least irritation was produced with Sesame Street Fresh Apple Splash bubble bath. CONCLUSION: This study suggests that there are differences in the irritancy of brands of children's liquid bubble bath and that recommendations can be made by both dermatologists and pediatricians when parents choose to use these products on their children.