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Terbinafine at 500 mg/day doses represents one of the best treatments for chromoblastomycosis due to its efficacy and excellent tolerability.

Mycetomas are exceptional in children; in our setting, actinomycetomas are more frequent than eumycetomas. The clinical and microbiologic diagnosis is simple. Overall, treatment response is better for actinomycetomas than for eumycetomas.

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Here, we report a patient with serum factor positive UVA-induced solar urticaria unresponsive to omalizumab. A 64-year-old Caucasian woman presented with a 28-year history of severe solar urticaria. Wheals developed within 3 min of exposure to sunlight, including through window glass. Sunlight exposure repeatedly provoked systemic symptoms with nausea and cardiovascular reactions. The relevant induction spectrum was found to lie between 340 and 400 nm (UVA1). The minimal dose was positive at 10 J/cm 2 and a profound urticarial response was elicited in all test fields. Intradermal skin test with UVAirradiated autologous serum was positive implicating the presence of a serum factor. FBC, ANA, liver and renal profiles were normal. Serum IgE was 12,6 kU/L. Treatment with sunscreens, antihistamines, including high-dose desloratadine 20 mg/die in combination with ranitidine 300 mg/die was ineffective. Light hardening with narrow band UVB over 6 months resulted in marginal, short-lived reduction in symptoms. Two grams of Mycophenolate mofetil daily showed no effect and nine cycles of plasmapheresis resulted in only very transient improvement in the severity of symptoms.Omalizumab was commenced at a dose of 150 mg every 4 weeks. Following three treatment cycles, she reported no improvement, in contrast she felt symptoms had worsened. On