Immunoglobulins
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Immunoglobulins Pompholyx: case report A 40-year-old woman developed pompholyx while receiving IV immunoglobulins for autoimmune cerebellar disease. The woman had a history of an eczematous reaction on her hands after using perfumed soap several years previously. She received a 5-day course of IV immunoglobulins [Flebogamma 5%] at a dose of 0.4 g/kg/day. On the last day, she developed an acute reaction with pruritic erythematous papules and vesicles on her palms. The lesions persisted for longer than 2 weeks. Six months later, before the woman’s next cycle of immunoglobulins [dosage not stated], a course of dexchlorpheniramine was added to the treatment for prevention of the lesions. However, a similar reaction occurred [duration of therapy to reaction onset not stated]. On this occasion, the right side of her face was also affected, and she had mild general symptoms of malaise and a febrile sensation. She received topical corticosteroids and, after 2 weeks, her lesions subsided again. She was referred for further evaluation. Patch tests were performed with standard allergens, Flebogamma 5% and artificial leather. Prick and intradermal tests were performed with immunoglobulin. Artificial leather was tested because of a topographical correlation between the location of the lesions on her palms and the right side of her face, and the areas of skin that were in contact with the artificial leather of the armchair during the infusion. All tests were negative except for the fragrance mix. A third cycle of IV immunoglobulins [dosage not stated], avoiding contact with artificial leather, led to a similar skin reaction [duration of therapy to reaction onset not stated]. The reaction was clearly identified as dyshidrotic eczema of the palms. Avoiding prolonged direct contact with synthetic surfaces and concomitant treatment with topical corticosteroids was suggested for her next cycle [patient outcome not stated]. Llombart M, et al. Pompholyx induced by intravenous immunoglobulin therapy. Journal of Investigational Allergology and Clinical Immunology 17: 277-278, No. 801091423 4, 2007 - Spain
0114-9954/10/1170-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 22 Sep 2007 No. 1170
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