Ichthyosiform eruption caused by paradichlorobenzene toxicity from chronic mothball ingestion

Acquired ichthyosis, asteatotic dermatitis or xerosis? An update on pathoetiology and drug-induced associations

Acquired ichthyosis (AI) is a relatively rare cutaneous entity characterized by transient, generalized scaling and pruritus in the absence of family history of ichthyosis or atopic disease. The hyperkeratosis in AI can range from the mild, white-to-brown scaling resembling that in ichthyosis vulgaris (IV) to the more prominent dark brown scaling phenotype, similar to that found in lamellar ichthyosis. The disease can wax and wane in relation to endogenous and/or exogenous factors. Histopathology of AI is similar to that found in IV. AI is usually of cosmetic concern to patients but can, in some cases, reflect the presence of more serious conditions, including malignancies, autoimmune diseases or metabolic disorders. In some cases, AI can be an adverse effect of a medication or the cutaneous symptom of a toxic exposure. Other conditions, such as severe xerosis or eczema, can present with clinical findings similar to AI, making diagnosis a challenge. Furthermore, cases of AI are sporadic throughout the literature and have been documented across a wide variety of medical settings distinct from dermatology, which often contribute to misdiagnosis of this disease. Definitive management requires prompt identification and treatment of the inciting factors combined with conservative therapies, which can include topical emollients, keratolytics, retinoids or corticosteroids, and in rare cases, oral retinoids.

Development of an esophageal stricture following paradichlorobenzene mothball ingestion

A 2-year-old patient presented with a paradichlorobenzene mothball ingestion. The foreign body was removed with a straight Miller blade and a curved Allis clamp. Two weeks following the removal of the mothball, the patient developed solid food dysphagia due to an esophageal stricture. This complication after a short exposure to mothballs is unreported in the literature to date, making this a unique and interesting case. In addition, a comparison of the clinical presentation and treatment of naphthalene and paradichlorobenzene mothballs was reviewed in this article.