Subacute cutaneous lupus erythematosus leukoderma treated with melanocyte‐keratinocyte transplantation procedure

Depigmented lesions may occur as postinflammatory sequelae of subacute cutaneous lupus erythematosus (SCLE), leading to great psychosocial impact. A 53‐year‐old male patient presented with post‐SCLE depigmented facial lesions after five years of disease stability. We proposed surgical treatment with melanocyte‐keratinocyte transplantation procedure (MKTP), and after five months the patient achieved 90% repigmentation, without Koebner phenomenon (KP). In theory, KP is a possible complication of MKTP procedure since the preparation of the receptor area involves the use of dermabrasion. In an attempt to avoid it, we suggest to maintain the treatment of the underlying disease and wait for a minimum period of disease stability before the procedure.     

Successful treatment of hemorrhagic bullous Henoch‐Schonlein purpura with intravenous immunoglobulins

Henoch‐Schonlein purpura (HSP) is the most common systemic vasculitis in childhood. There is no consensus about the management for isolated cutaneous manifestations in HSP. We describe a case of HSP presenting with severe skin lesions that did not respond to standard therapy with corticosteroids. The 11‐year‐old child was treated with intravenous immunoglobulins, which induced rapid and persistent resolution of symptomatology.     

The clinical efficiency of the Portex in-line blood warmer

The Portex blood warming coil (200/700/000) and water bath (500/111/010) were tested by comparing the body temperatures of two groups of patients undergoing similar operations, but having transfusions of different rate and quantity. The skin and oesophageal temperatures in the massively transfused patients (5-31 units) did not differ significantly from those having minor transfusions (1-5 units). The temperatures were well maintained in both groups. The lowest mean oesophageal temperatures, during the transfusions, were 35.2 +/- 0.2 in the massively transfused patients and 35.4 +/- 0.1 (SEM) in the control group. The warming capacity of the Portex blood warmer was therefore sufficient for our patients. If, however, transfusion rates, higher than those in this study (maximum 96 ml min-1 during the rapid transfusion phase) are needed, a more effective blood warmer may be beneficial.