title: Pompholyx of the hands after intravenous immunoglobulin therapy for clinically isolated syndrome: a paediatric case.
abstract: Pompholyx is a common eruption of small vesicles on the palms, soles, and/or lateral aspects of the fingers. It has a multifactorial etiology, including genetic determinants, allergy to metals, and id reaction; rarely it is a drug-related side effect. We report a paediatric case of pompholyx of the hands related to the intravenous immunoglobulin (IVIG) therapy for Clinically Isolated Syndrome (CIS). A 10-year-old boy, received an IVIG therapy (Venital, Kedrion Spa, Italy) at a dose of 400 mg/kg daily for five days. The fifth day of IVIG infusion, a symmetrical vesicular eruption appeared on the palms of the hands and on lateral aspects of the fingers. The lesions improved with application of topical steroids in few days. The mechanism of induction of pompholyx by IVIG therapy is unknown. A review of the Literature suggests the hypothesis that dyshidrotic eczematous reactions may be related not only to the type of IVIG, to the dose and the rates of infusion, but also to an allergic response to excipients and preservatives contained in the drug, probably elicited by an underlying neurological disease in some cases.
authors.affiliation: Institute of Dermatology, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Brazzelli
authors.affiliation: Institute of Dermatology, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Grassi
authors.affiliation: Department of Paediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Savasta
authors.affiliation: Department of Paediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Ruffinazzi
authors.affiliation: Institute of Dermatology, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Carugno
authors.affiliation: Institute of Dermatology, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Barbaccia
authors.affiliation: Department of Paediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
authors.forename: G L
authors.initials: GL
authors.lastname: Marseglia
authors.affiliation: Institute of Dermatology, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Borroni
mesh_terms: D000279:Administration, Cutaneous; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D003711:Demyelinating Diseases / Q000188:drug therapy*; D011146:Eczema, Dyshidrotic / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D016756:Immunoglobulins, Intravenous