Pathergy-like Reactions Following Laser Hair Removal.

Report Highlights Laser Hair Removal Procedures as a Trigger of “Pathergy” for Patients with Behcet’s Disease

Van der Ree-Pellikaan C et al, 2016

Authors from the Netherlands recently reported a very interesting case of 25-year-old man was admitted to his local medical center with fever, severe ulceration of the oral and pharyngeal mucosa, and pustules on his skin. These pathergy-like lesions developed after placement of orthodontic braces and laser hair removal therapy.

The patient was born in Iraq but moved to the Netherlands when he was 5 years old. For 4 weeks prior to the hospital admission, the patient experienced high fevers without any clear source of infection. His general practitioner prescribed empiric antibiotic treatment but these did not affect the fever. It was noted that during this period, he had received orthodontic braces for teeth straightening. Within days after placement, painful oral ulcerations occurred. One week prior to the hospital admission, the patient had also undergone laser hair removal on the arms and torso. Within days after the procedure, pustules occurred at the specific sites of laser treatment, but later also at distant sites such as the face.

The patient’s blood tests showed increased erythrocyte sedimentation rate (36 mm/h) and mildly elevated C reactive protein level (42 mg/L). A chest X-ray was normal. A PCR for herpetic viruses on an oral swab was negative. Bacterial culture of the content of a skin pustule was negative.

REFERENCE

Van der Ree-Pellikaan Cet al. Oral ulcerations after placement of orthodontic braces and skin pustules after laser hair removal: novel inducers of pathergy reactions in new-onset Behçet's disease. BMJ Case Rep. 2016 Mar 7;2016:bcr2014209208. doi: 10.1136/bcr-2014-209208.