PERFORATION OF THE NASAL WALL AND HYPER-IGE SYNDROME

Hyper-IgE syndrome is basically characterized by recurrent infections, chronic eczematous lesions, specific IgE antibodies against Staphyloc occus aureus and markedly high serum IgE values. We present the case o f an 11-year-old boy with no relevant personal or family history, who came to our Department with highly pruriginous papulovesicular skin le sions of 3 years' duration. He presented marked obesity (+4 SD) and mi cropapulovesicular lesions in the trunk and extension areas of the lim bs. The rest of the physical exploration was normal. Complementary stu dies revealed peripheral eosinophilia, increase in globular sedimentat ion rate and IgE values of 20,000 IU/ml, a nonspecific reaction to ski n tests, and a skin biopsy compatible with atopic dermatitis. Three mo nths later, he presented eczematous lesions in the trunk and limbs, pe rforation of the nasal wall due to staphylococcal abscess (diagnosed b y biopsy), bilateral maxillary sinusitis and IgE values of 59,238 IU/m l. The differential diagnoses are discussed, as well as new diagnostic -therapeutic possibilities.