Successful Treatment of Severe Pityriasis Rubra Pilaris with Cyclosporine A in An Infant

Introduction:Pityriasis rubra pilaris(PRP)is a rare chronic papulosquamous disease and is often difficult to treat,especially in children.Here we reported a PRP infant successfully treated by cyclosporine A.Case presentation:An 18-month-old infant with severe PRP presented with reddish follicular papules and inflammatory,infiltrated erythema over the whole body.The condition rapidly and completely responded to oral cyclosporine A.Complete clearance of the lesions was achieved within 16 weeks,and no recurrence developed during 6 months of follow-up.During both treatment and follow-up,routine blood parameters,serum creatinine,serum urea nitrogen,liver function,and blood pressure were regularly monitored once a month and remained within the reference ranges.Moreover,the child grew and developed normally and the body weight increased by 3 kg.Discussion:To date,there are not well established protocols for treatment of PRP in children.Cyclosporine A has been demonstrated to be effective treatment in psoriasis in adults and children which do not respond to some other treatments.The rapid onset of action and good efficacy of cyclosporine A were observed in our case,who achieved complete response after 16 weeks of treatment without any side effects.Conclusion:Cyclosporine A might be a safe and effective option for treating severe PRP in children.

Efficacy of Acitretin Monotherapy on Basal Cell Carcinoma:A Case Report

Introduction:Basal cell carcinoma(BCC)is the most common skin cancer which mainly affects the population over 50 years of age.In addition to surgical treatment,nonsurgical treatment is also an attractive option for some patients.We herein report a case of an 82-year-old man with BCC successfully treated with acitretin.Case presentation:An 82-year-old man presented with BCC on his left nose wing more than 2 years ago.Due to his unwillingness to accept treatment that may lead to pain,discomfort,or trauma,the patient was prescribed oral acitretin 25 mg twice daily[0.8 mg/(kg·d)]and was instructed to apply 2%fusidic acid cream topically once daily for trauma protection.The lesion progressively shrank in size after 4 weeks of treatment,and was almost completely resolved after 28 weeks of follow-up.The patient reported mild adverse effects,such as mild skin fragility and cheilitis,and apparent scaling skin,which caused minor discomfort but did not affect the continuation of treatment.Discussion:The pathogenesis of BCC is still unclear,but it has been demonstrated to be linked to overactive hedgehog signaling and its crosstalk with other pathways such as phosphoinositide 3-kinase and mammalian target of rapamycin.Acitretin could obviously inhibit cell growth and proliferation and down-regulate AMP-dependent protein kinases that plays critical role in the blocking of malignant progression of several tumors including BCC.Conclusion:We provide an effective alternative for the patients with BCC who are unwilling to receive surgical therapy.