platelet activation and improves skin vascularization. Moreover, iloprost was efficacious in a case of calciphylaxis. 9 HLU and calciphylaxis share a common increase in local vascular resistance and clinical aspect. 10 In our series, five patients received concomitant skin grafting. Considering that skin grafts were previously unsuccessful in all patients of our series, iloprost may enhance the efficacy of the graft. Our case series suggests that iloprost, alone or as adjuvant treatment to skin grafting, may be a potential and safe therapeutic option in patients with severe HLU with failure of previous skin grafts. Larger series are warranted to confirm our results. Acknowledgement The patients in this manuscript have given written informed consent to the publication of their case details.

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Fusarium species are a known cause of ocular infection that can produce local and/or systemic invasive fusariosis. Fusarium ocular infection can evolve to keratitis, endophthalmitis and, in extreme cases, ocular perforation. We report, for the first time in children, the case of a 5 year old girl diagnosed with toxic epidermal necrolysis who developed Fusarium ocular infection requiring ocular enucleation.

LEOPARD syndrome is an autosomal dominant disease caused by germline mutations in the RAS-MAPK (mitogen-activated protein kinase) pathway. LEOPARD is an acronym for the main manifestations of the syndrome, namely, multiple Lentigines, Electrocardiographic conduction abnormalities, Ocular hypertelorism, Pulmonary stenosis, Abnormalities of genitalia, Retardation of growth, and sensorineural Deafness. None of these characteristic features, however, are pathognomonic of LEOPARD syndrome, and since they are highly variable, they are often not present at the time of diagnosis. We describe 2 cases of LEOPARD syndrome without hearing loss or pulmonary stenosis in which diagnosis was confirmed by identification of a mutation in the PTPN11 gene. Regular monitoring is important for the early detection of complications, as these can occur at any time during the course of disease.