Demonstration of gastrointestinal venous malformations in blue rubber bleb naevus syndrome using capsule endoscopy

© 2008 The Authors JEADV 2009, 23 , 317–368 Journal compilation © 2008 European Academy of Dermatology and Venereology results in the rebalancing of bone turnover in favour of bone formation. 3 Although the original data sheet mentions local eczemas during the therapy in 1.5% of the patients, 1 generalized skin rash had not previously been referred. However, the EMEA has recently released a press note warning of 16 cases of DRESS syndrome in patients treated with strontium ranelate, two of which resulted in death. 2 In our case, both the lag time between the first administration of strontium ranelate and the occurrence of the eruption and the one between withdrawing the drug and improvement highly suggested a causal relation. The changes observed in the skin biopsy were also consistent with this diagnose. 4 Despite patch and prick tests with suspected drugs could not prove the involvement of strontium ranelate in the pathogenesis, it is well known that false negatives are common when performing cutaneous tests. 5 Colecalciferol was concluded to have no active role in the aethiology of the rash, after being safely reintroduced. In conclusion, despite our case did not show systemic symptoms as those seen in DRESS syndrome, we think it may support the existing evidence of severe cutaneous side effects related to strontium ranelate.