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Oral propranolol (OP) has been shown to be effective in the treatment of complicated infantile hemangiomas (IHs), but optimal treatment duration to avoid relapses after stopping OP treatment has not been established. The objective of this study was to compare the frequency of relapses in long-term OP treatment with that of short-term OP treatment. This was a retrospective cohort study of 30 patients with complicated IHs who received treatment with OP. Patients were divided into two groups: OP treatment of 8 months or less and OP treatment of longer than 8 months. OP was started at 1 mg/kg/day in three doses every 8 hours for 1 week and increased to 1.5 to 4 mg/kg/day afterward. Ultrasound was used to objectively measure the response to treatment. Clinical and ultrasound assessment showed a decrease in IH size and resolution of complications in all patients (n = 30). In the short-term group (n = 10), nine patients (90%) relapsed after stopping treatment. In the long-term group (n = 20), the duration of treatment was 12 months in all patients, and only 1 patient out of the 20 treated (5%) showed relapse 2 months after finishing the full treatment (odds ratio = 18, 95% confidence interval 2.6, 123, p < 0.001. Twelve months of treatment of IH with OP is associated with a significantly lower rate of relapse than with shorter treatment.

We report an 8-year-old boy who developed dystrophic calcinosis cutis that occurred following trauma. Multiple abrasions were observed in the inguinal folds after a soccer game. Subsequently, multiple papules with soft centers and white particles appeared in the same area. A biopsy specimen showed calcinosis cutis with transepidermal elimination of calcium. The causes of the underlying tissue damage associated with dystrophic calcinosis are discussed.

We report the occurrence of calcinosis cutis in a 3-year-old girl after liver transplantation. The cutaneous lesions consisted of 5 mm white papules on an erythematous base in linear and rosette configurations that developed in the abdominal and lumbar areas 10 days after transplantation. The patient had received calcium chloride solution intravenously during surgery. We excluded other causes of ectopic calcification such as hyperparathyroidism, renal failure, and extravasation of calcium solution. We discuss the etiology of calcinosis cutis after liver transplantation. This sequence of events has not been previously described in pediatric patients.

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Presentación de casos clínicos RESUMENEl eritema multiforme, el síndrome de Stevens-Johnson y la necrólisis epidérmica tóxica representan diferentes manifestaciones de un mismo espectro de graves reacciones cutáneas idiosincrásicas a fármacos y, en menor medida, están asociados a agentes infecciosos. De estos últimos, Mycoplasma pneumoniae es uno de los más frecuentes. Se presenta el caso de una niña de 5 años, con una necrólisis epidérmica tóxica asociada a infección aguda por Mycoplasma pneumoniae, que comenzó con un cuadro febril acompaña-do de un exantema generalizado y compromiso de todas las mucosas. Se obtuvo serología IgM positiva para Mycoplasma pneumoniae y una biopsia inicial compatible con eritema multiforme mayor. La paciente fue tratada con corticosteroides, gammaglobulina intravenosa, plasmaféresis y estrictos cuidados para la prevención de sobreinfección y posibles secuelas. Después de 31 días de internación fue dada de alta hospitalaria. Palabras clave: necrólisis epidérmica tóxica, síndrome de StevensJohnson, Mycoplasma pneumoniae. SUMMaRyErythema multiforme, Stevens-Johnson syndrome and toxic epidermal necrolysis represent different manifestations of the same spectrum of severe idiosyncratic cutaneous reactions to drugs and to a lesser extent are associated with infectous agents. Among these, Mycoplasma pneumoniae is one of the most frequent. We report the case of a female patient aged 5 years, with a toxic epidermal necrolysis associated with Mycoplasma pneumoniae infection, which begins with a fever accompanied by a generalized rash with involvement of the mucous membranes. IgM serology for Mycoplasma pneumoniae was positive and initial biopsy was compatible with erythema multiforme major. The patient was treated with corticosteroids, intravenous Necrólisis epidérmica tóxica asociada a infección aguda por Mycoplasma pneumoniae INTRODUCCIÓNEl síndrome de Stevens-Johnson y la necrólisis epidérmica tóxica representan las variedades más graves de un grupo heterogéneo de enfermedades inflamatorias agudas de la piel y las mucosas, con afectación sistémica.Pueden ser desencadenados por múltiples causas, principalmente farmacológicas e infecciosas, y obedecen a mecanismos inmunitarios. Mycoplasma pneumoniae y el virus del herpes simple son los agentes infecciosos más frecuentes.Se caracterizan por una apoptosis masiva de queratinocitos epidérmicos. El compromiso mucoso grave y generalizado es la norma.Es importante el diagnóstico y tratamiento intensivo precoz, dada la alta morbimortalidad asociada.El objetivo de esta publicación es presentar un caso de necrólisis epidérmica tóxica asociada a infección aguda por M. pneumoniae, en el cual el diagnóstico temprano y el abordaje multidisciplinario instituyendo el tratamiento adecuado lograron resolver correctamente todas las complicaciones asociadas a la evolución de esta entidad, con una restitución ad integrum de las lesiones cutáneas. CaSO CLÍNICOUna paciente de 5 años fue llevada a la consulta por presentar un cuadro febril de 72 horas de evolución...

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