Following the second series of intravenous human
immunoglobulins (
IVIg; 0.4 g/kg) prescribed to treat a sensorimotor
polyneuritis, a 28-year-old woman developed
pompholyx that recurred after each of the following monthly treatments with
IVIg. During the administration of the 10th series, the patient developed a typical baboon syndrome. Immunohistochemical studies of a skin biopsy revealed an unexpected epidermal expression of
P-selectin, usually expressed by endothelial cells. Patch, prick and intradermal tests performed with
IVIg on the back, arms and buttocks gave negative results on immediate and delayed readings.
IVIg were re-administered, with the informed consent of the patient, and induced a generalized maculopapular
rash. This is the first reported case of baboon syndrome induced by
IVIg. Although extensive skin testing was performed, all test sites remained negative. We wonder whether
IVIg could reproduce immunological mechanisms involved in the 3 types of systemic
contact dermatitis (
pompholyx, baboon syndrome and maculopapular
rash), including the epidermal expression of
P-selectin.