High-dose dexamethasone therapy for a 14-month-old boy with refractory idiopathic thrombocytopenic purpura

A 14-month-old boy with refractory idiopathic thrombocytopenic purpura (ITP), who was successfully treated with pulsed high-dose oral dexamethasone therapy is reported. The platelet count increased after six scheduled courses of treatment (10 mg/day × 4 days, six courses). Twenty-four months later, the platelet count remained over 10.0 × 10⁴/μL. No obvious side effects were observed during or after the therapy. This treatment could be taken into consideration not only for adults but also for young children with refractory ITP. It is effective, safe, easy to administer, patient comfort is taken into consideration, and hospitalization duration and costs are minimized.     

MALIGNANT ATROPHIC PAPULOSIS (DEGOS'' SYNDROME)

A 29-year-old Japanese man with malignant atrophic papulosis had a 1-year history of scattered, asymptomatic, whitish or skin-colored papules, as well as erythematous papules with central atrophy showing a porcelain-like appearance on the trunk and extremities. Histologic examination revealed lymphocyte-mediated necrotizing vasculitis with considerable deposition of mucin in the dermis. The wedge-shaped necrosis of the dermis was not detected. Based on a review of the literature we think that this case represents the histologic features of the early skin lesions of malignant atrophic papulosis.