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INTRODUCTION: IgG subclass deficiency was described by William Terry in a patient with recurrent infections. Selective IgG subclass is defined as a significant decrease in serum concentration of 1 or more IgG subclasses with normal total IgG, IgA and IgM levels. Persistent low serum levels of one or more immunoglobulin G (IgG) subclasses may be found in a high proportion of adult patients with increased susceptibility to infections (17). This deficiency has been described in association with other primary immunodeficiencies, including: selective IgA deficiency, selective IgM deficiency and Ataxia-Telangiectasia, growth hormone deficiency, Down syndrome, cystic fibrosis, among others (1). CLINICAL CASE:We present the clinical case of a 28-year-old female patient with a history of selective immunodeficiency to IgG immunoglobulin, repeated urinary tract infections, repeated vaginal infections and herpes simplex II infection, all of which have been treated, She went to a hospital in Morona Santiago three days ago for presenting, as the apparent cause, administration of immunoglobulin for a basic illness, a mild holocranial headache that evolved into a severe headache, accompanied by nausea that led to vomiting on one occasion, for which she was admitted to the hospital for pain management. Complementary examinations showed that there was no metabolic alteration or neurological deterioration, which is why she was classified as an adverse effect of the administration of immunoglobulin 3 days earlier. EVOLUTION:The patient was admitted for pain management due to severe headaches, multiple analgesics were administered without adequate response, so it was decided to start a tramadol infusion pump. During the following hours of hospitalization she remained with a feeling of nausea and weakness, however, the headache gradually subsided and it was decided to discontinue analgesic medication to assess the response of the clinical picture, and she was discharged 24 hours after admission with a favorable evolution. CONCLUSIONS: IgG subclass deficiency is a pathology characterized by the fact that it occurs in women over 16 years of age, with a very low prevalence; the presence of respiratory pathologies gives rise to the suspicion of this disease. The treatment of this pathology is based solely on the intravenous or subcutaneous administration of Immunoglobulin G, together with the concomitant treatment of the infections that the patient presents. Adverse effects should always be taken into account, as they are temporary, but quite disabling. KEYWORDS: Headache, Immunoglobulin G, Urinary Tract Infections, Herpes Simplex

Acne is the most traumatic and globally annoying chronic inflammatory skin disease. Its prevalence is highest among patients aged 12-24 years, at a frequency of 85%, although it can persist into adulthood, despite treatment. Its effect involves emotional and physical aspects (presence of marks), in addition to its effect on quality of life. Its clinical presentation ranges from the presence of comedones to mixed comedogenic acne with inflammation (1)(2). The face is the most affected area in most cases, and the trunk is affected in 61% of patients. The lesions caused by this can range from scarring to the presence of post-inflammatory hyperpigmentation. Stimulation of the immune system by hypercolonisation of Propionibacterium acnes is thought to be the possible cause (3). The aim of this literature review is to communicate to the scientific community the different measures and treatments for this disease, which, as will be analysed, has not only personal impacts, but also psychological and social implications. In fact, this work is based on a dissemination of studies and reviews from 5 years ago, which means that we have all the most up-to-date information possible on this subject. KEYWORDS: Acne, scars, benzoyl peroxide, comedones, sebaceous glands.