A Case of Red Lunulae After Hematopoietic Stem Cell Transplantation

    Yosuke Mai, Hideyuki Ujiie, Akihiro Iguchi, Hiroshi Shimizu
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    TLDR Adjusting the medication tacrolimus resolved a boy's red nail beds after a stem cell transplant.
    The document describes a case where a one-year-old boy developed red lunulae and diffuse alopecia after a hematopoietic stem cell transplantation for Wiskott-Aldrich syndrome. The symptoms appeared during the tapering of oral tacrolimus, which was used to prevent graft-versus-host disease. When the tacrolimus dose was adjusted, the red lunulae resolved, and hair regrowth occurred, suggesting that red lunulae may be a symptom of chronic GVHD. The document also reports a separate study comparing the effects of levobupivacaine and ropivacaine on human skin cells. Levobupivacaine was found to be less inhibitory to cell colony formation and more apoptotic at a lower concentration than ropivacaine, but at higher concentrations, the difference in apoptosis was not significant. This supports the use of diluted local anesthetics in skin surgery. No conflicts of interest were disclosed in the document.
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