Edith Orion

Pemphigus vulgaris induced by radiotherapy

Pemphigus can be triggered or induced by many insults, such as drugs, infections, viruses and neoplasms. X‐ray‐induced pemphigus has been recorded only rarely in the literature. We describe the case of a woman with pemphigus vulgaris in remission, who relapsed 1 week after completion of an irradiation course for breast cancer, in the exact location of the radiation. We review the previous 15 cases from the literature and outline the common features of those cases.

Pemphigus vulgaris possibly triggered by cilazapril

Sir, Cilazapril is a new angiotensin converting enzyme inhibitor (ACEI) which, like other ACEIs, is a non-thiol molecule, containing an active amide group. Since the early 1990s an increasing number of case reports have been published pointing to the role of this family of drugs in inducing or triggering pemphigus (1). In 1992, the ACEI Enalapril was found to be the most powerful acantholytic drug in vitro (2). Buzon et al. (3) reported the ®rst case of pemphigus foliaceous associated with Cilazapril. We describe here the possible association of the drug with pemphigus vulgaris.

Stress-induced SAPHO syndrome

We describe the case of a woman with the classic combination of features of synovitis‐acne‐pustulosis‐hyperostosis‐osteitis (SAPHO) syndrome, including pustulosis palmo‐plantaris and anterior chest wall involvement. The varying symptomology, etiology and pathogenesis of this syndrome and the contribution of stress are discussed. The authors ascribe the dearth of reported cases to lack of awareness and recognition of SAPHO, and not to the real incidence of the syndrome.

“More is missed by not looking than by not knowing”[Thomas McCrae, 1870–1935]

Case 1u2002 A 19‐year‐old woman presented with a black crust on one part of the tattoo on her right leg ( Fig. 1 ) which appeared after laser‐assisted hair removal by an alexandrite laser (755 nm).

Tumbu larvae do not have abdominal hooklets and can be easily extracted

A 31-year-old male presented with five inflamed, painful, erythematous nodules on his left chest (two lesions) (Fig. 1), the left belt area, left forearm, and right leg. The patient is an Israeli, who has been residing and working for the past year in Angola. He reported feeling something stirring under the site of the lesions. The diagnosis was clearcut as the patient brought with him the corpus delicti (two larvae that had spontaneously emerged alive and wriggling from the lesions of his leg and arm) with him. He reported that he usually hangs his washed clothes on a line outdoors and does not iron them routinely before he puts them on, so the source of infection was obvious as well. We extracted three additional larvae by simply squeezing the skin surrounding them out after applying a local anesthesia, in a similar way one would treat a giant comedo (Fig. 2). The extracted larvae (Fig. 3) were identified as Cordylobia anthropophaga.