Netherton syndrome (NS) is an orphan disease characterized by congenital ichthyosis, hair abnormalities, and atopy, with limited treatment options. We achieved temporary improvement only during the initial 6 weeks of treatment with dupilumab, which differs from the sustained improvement observed in 2 other recently published cases. Although the clinical presentation of atopy and increased pre-allergic cytokines in NS patients suggest that dupilumab may be beneficial, larger studies are required.

Background Omalizumab is a third‐line treatment for chronic spontaneous urticaria (CSU). However, the real‐life data on the impact of omalizumab on CSU‐related quality of life (QoL) remain scarce. Objectives To investigate the impact of omalizumab on QoL and its predictors in CSU. A retrospective cohort study was done. The response to therapy was evaluated using urticaria activity score over 7 days (UAS7) and urticaria control test (UCT); the impairment in QoL was assessed using dermatology life quality index (DLQI) and chronic urticaria quality of life questionnaire (CU‐Q2oL). Results Forty‐two patients were included. All scores improved from baseline to first month and remained stable at the third month of treatment (p < .001). The gender, age, and angioedema had no significant effect on QoL, but the complete responders (UAS7:0–1) had better improvement rates in all scores compared to others. The baseline UAS7, DLQI, and CU‐Q2oL scores were lower at the baseline in complete responders (p = .0001). Conclusions A rapid and continual improvement in QoL was obtained with omalizumab treatment. A better UAS7, UCT, DLQI, and CU‐Q2oL score at the baseline might be a predictor of a better response to omalizumab and more improvement in QoL.

K E Y W O R D S : case report, contact allergy, methylchloroisothiazolinone/methylisothiazolinone, methylisothiazolinone, paediatric, slime dermatitis Methylchloroisothiazolinone (MCI)/methylisothiazolinone (MI) (eg, Kathon CG), and MI are widely available preservatives that are mainly used in cosmetic and household products. Following a worldwide increase in contact allergy to MCI/MI and MI, 1 regulatory measures have been implemented. Although a decrease in contact sensitization has been reported, MCI/MI and MI are still frequent causes of contact dermatitis, and unexpected sources of exposure may be encountered in clinical practice. 2 Herein, we report three children with allergic contact dermatitis caused by MCI/MI and/or MI following exposure to a homemade play material called "slime." CASE REPORTSA 9-year-old girl presented with hand dermatitis of 3 months' duration. Dermatological examination showed papules and vesicles involving the lateral aspects of the fingers and periunguium ( Figure 1A). She had no personal or family history of atopy. Previous treatment attempts with topical corticosteroids led to temporary improvement, but the lesions had recurred. A 12-year-old girl was referred to our clinic with hand dermatitis of 5 months' duration. Physical examination showed erythematous, scaly plaques on both palms ( Figure 2A).The patient's medical history was insignificant. Treatment with topical corticosteroids was of no benefit. A 10-year-old, otherwise healthy girl presented with hand eczema that had developed after contact with homemade slime. Physical examination showed mild erythema with desquamation on the sides of the fingers ( Figure 3A). The patient claimed that the initial vesicular eruption has resolved shortly after she had stopped coming into contact with slime.The patients were patch tested with the European baseline series by the use of IQ Ultra Chambers obtained from Chemotechnique Diagnostics (Vellinge, Sweden). Reading of test results was performed on day (D) 2 and D3, according to ESCD guidelines. 3 The patch test results were as follows: In case 1, there was a + reaction to MCI/MI 0.02% aq. on D2, and there was a ++ reaction to MCI/MI 0.02% aq. on D3 ( Figure 1B). In case 2, there were + reactions to MCI/MI 0.02% aq. and to MI 0.2% aq. on D2, and ++ reactions to MCI/MI 0.02% aq. and to MI 0.2% aq. on D3 ( Figure 2B). In case 3, there was a ?+ reaction to MCI/MI 0.02% aq. on D2, and there was a + reaction to MCI/MI 0.02% aq. on D3 ( Figure 3B).A detailed repeat history showed contact with a homemade play material called "slime" in all three patients before the onset of symptoms.The cosmetic and household products added to the slime mixture were brought in by each patient, and detailed inspection of the labels and material safety data sheets confirmed the presence of MCI and MI in the following products: case 1-dishwashing liquid ( Figure S1A); case 2-Polyvinyl acetate glue (Figure S1B); and case 3-liquid soap ( Figure S1C). DISCUSSIONAlthough MCI/MI contact sensitization and MI contact s...

No abstract

shorter turnaround time. Hence, skin biopsies for NTM PCRs should be performed early if Mycobacterium abscessus is a possibility or if there is failure of response to oral antibiotics.In conclusion, we highlight that 28% of cutaneous NTM infection occurs at the cubital forearm. The involvement of the cubital forearm should be recognised and raise the index of suspicion for NTM infections. We emphasise the emergence and importance of Mycobacterium abscessus as a pathogen and recommend aids to its early identification via NTM PCRs.