A 33-day-old female with an ulcerated infantile hemangioma (IH) undergoing oral therapy with propranolol 2 mg/kg per day developed hyperkalemia and hyperphosphatemia 24 h after starting medication. No electrocardiographic or clinical abnormalities secondary to the electrolyte changes were noticed. A laboratory tumor lysis syndrome (TLS) was diagnosed after excluding other causes of electrolyte imbalance in the diagnostic workup. No treatment was required to reverse the TLS condition, and the propranolol therapy was continued as the electrolyte alterations were only mild. One month later, the IH was remarkably reduced in size and no longer ulcerated. Maintenance of propranolol was extended for a total of 6 months. Parallel to the gradual involution of the IH, serum potassium and phosphorus levels returned within normal levels. We suggest that TLS may be a rare complication of ulcerated IH treated with propranolol. Clinicians must be aware and order appropriate screening tests for TLS in patients at risk.

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In this small study, RCM was able to identify most of the established diagnostic histological features of CCA. RCM appears to be a useful tool for in vivo diagnosis of CCA and may help avoid unnecessary biopsies.

Background: Kaposi’s sarcoma (KS) is an unusual, clinically polymorphic, vascular neoplasm with genetic, infectious, environmental and immunological pathogenesis. Reflectance confocal microscopy (RCM) made in vivo noninvasive imaging of the skin possible and has been used for the evaluation of several skin diseases offering important microscopic information. Objective: The purpose of our study is to describe the RCM features of KS and correlate them with histopathology evaluating the effective prediction attitude and repeatability of RCM. Methods: Twelve KS lesions underwent RCM followed by histological examination. Data obtained were statistically correlated. Results: Analysis of the incidence of 11 selected microscopic criteria (by RCM and optical histology: inflammatory cells in the epidermis and in the dermis, single or in aggregates; spindle cells; stroma; anastomosing, newborn, increased number and dilated vessels; extravasated erythrocytes; deposits of hemosiderin) was performed disclosing a good correlation and high sensitivity of RCM. Conclusion: In our study RCM seems to provide high accuracy to predict histological findings, demonstrating its possible role in the management of patients affected by KS.