Hydroa vacciniforme: dietary fish oil (Maxepa (R)) as an effective treatment.

Background. Hydroa vaccinniforme is a highly uncommon photodermatosis acqui red in childhood. The clinical course is dominated by the risk of variolifo rm rears. Numerous treatments have been proposed with variable efficacy. On e recent open study suggested dietary fish oil could be useful. We report a case of hydroa vacciniforme treated successfully with dietary fish oil (Ma xepa (R)). Case report. A 15-year-old girl consulted in May 1988 for vesiculobullous l esions typical of hydroa vacciniforme in photo-exposed areas. Anti-malaria drugs and photoprotection had been used for several years without success. Maxepa (R) was introduced in June 1998 and was followed by regression of th e lesions within a few weeks despite the summer season. The treatment was i nterrupted at the patient's request due to fetid breath. Reintioduction of Maxepa (R) in April 1999 after an episode of recurrent lesions, again led t o total resolution of the lesions within three weeks. Discussion. Hydroa vacciniforme ir an exceptional photodermatosis of uncert ain etiology. It may possibly be related to an abnormal sensitivity to ultr aviolet A. Fish oil rich in 3-omega polyunsaturated fatty acids would reduc e the local inflammation triggered by sun exposure. Recent studies have dem onstrated that dietary fish oil can increase the level of 3-omega polyunsat urated fatty acids in the epidermis and reduce the level of prostaglandins in the skin. Our case would appear to confirm the contribution of dietary f ish oil to treatment despite the poor tolerance due to fetid breath.