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"Goodbye Sunshine": effects of a television program about melanoma on beliefs, behavior, and melanoma thickness.

Of 333 persons interviewed after a television show about the effects of melanoma, 113 (34%) saw the show and 73% believed that the sun protection/skin examination message applied to them. Fifty-six percent of persons examined their own skin and 36% examined someone else's skin after seeing the program. Fifteen persons (4.5% of the total sample) planned to visit a doctor for an abnormal skin spot as a result of the program, of whom three actually did so within 4 weeks of the show. An increase of 167% was observed in the number of melanomas diagnosed in the 3 months after the show, compared with those diagnosed in the same period the year before. There was a significant shift in the proportion of tumors removed in the thin, easily cured stage. The high rate of diagnosis of new tumors and the high proportion of thin tumors was maintained a year after the program. By extrapolation from these figures, it is estimated that 208,000 Victorians out of a total population of 4.1 million intended to seek a consultation after a single television program. Of these, it is estimated that about 27,000 actually sought attention in the month after the viewing.

Adolescent↗

Targets of v-myc tumorigenesis in the avian embryo depend on time and not on site of retroviral infection.

The present study extends our previous data, showing that the v-myc oncogene induces heart tumors and skin anomalies in young avian embryos [Saule et al., Proc. Natl. Acad. Sci. USA 84, 7982-7986 (1987)]. We now report that the target cells which become transformed are the same, whether the MC29 retrovirus is injected at E3 in various sites of the embryo (coelom, heart, brain, lateral plate mesoderm) or deposited on the embryo. Furthermore we confirm, in the quail, the time-specific pattern previously observed in the chick. In the quail, the incidence of heart tumors falls from 100% to 28% when injection is delayed from E3 to E4. By contrast, the incidence of skin anomalies rises from 30% to 64% when injection is delayed from E3 to E4. The skin defect, which consists of the presence of bell-shaped cornified feathers, could be assigned to hyperkeratinization of the epidermis. Both the dermis and the epidermis displayed hyperproliferation, whereas skin muscle hypertrophy during the embryonic period could not be confirmed. The presence of myc gene products was investigated using an antibody that recognizes both the c- and v-myc proteins. In the skin of control embryos, nuclei were well stained at E12-E13. At E14 the signal had disappeared. In abnormal skin patches from infected embryos, the antibody still marked heavily epidermal and dermal nuclei at E18. Finally we injected MC29 through the chorioallantoic vein in E10 chickens. No tumors were found during embryonic life, but 81% of the chickens developed tumors of hemopoietic or endothelial origin from the 14th posthatching day onwards. Studies of MC29 integration sites demonstrated that these tumors were derived from only a few transformed cells. Thus, contrasting with in vitro experiments, in vivo this virus has a restricted number of targets varying with the time of injection.

Animals↗

[Congenital anomalies reflected in materials of obstetric ward of the Hospital of Internal Affairs in Warsaw during the period 1988-96].

A congenital anomaly consists of a departure from the normal anatomic architecture of an organ or system. Malformations can be considered as the result of a developmental arrest of the primordium (incomplete morphogenesis), redundant morphogenesis, or aberrant morphogenesis. Congenital malformations establish more and more percentage of reason of incidence and morbidity in newborn and young children. It is also great family and social problem. The subjects studied were all cases of abnormality identified pre- or postnatally. The commonest system malformations were urogenitally tract, central nervous system, skeleton, craniofacial, heart and skin abnormalities. The most frequent single anomalies were--hypospadias, cleft lip/cleft palate, anomalies of hands and feet, vertebral malformations, meningocele, heart abnormalities and Down syndrome.

Adult↗

Elastic fiber and microvascular abnormalities in aging skin.

In summary, the aging process in skin has at least two major manifestations: elastic fiber abnormalities involving degradation and assembly, and microvascular wall alterations of widening and atrophy depending on the functional state of the veil cell. The abnormalities of the elastic fiber network most likely correlate with the increasing cutaneous laxity associated with aging. The microvascular abnormalities are not easily related to any specific clinical feature of aging skin. The finding of identical abnormalities in the skin of juvenile diabetes strengthens this hypothesis, as well as suggesting that these alterations are accelerated in diabetic patients. Diabetic skin might be another model system for studying cutaneous aging.

Aged↗

Elastic fiber and microvascular abnormalities in aging skin.

In summary, the aging process in skin has at least two major manifestations: elastic fiber abnormalities involving degradation and assembly, and microvascular wall alterations of widening and atrophy depending upon the functional state of the veil cell. The abnormalities of the elastic fiber network most likely correlate with the increasing cutaneous laxity associated with aging. The microvascular abnormalities are not easily related to any specific clinical feature of aging skin. The finding of identical abnormalities in the skin of juvenile diabetics strengthens this hypothesis, as well as suggesting that these alterations are accelerated in diabetic patients. Diabetic skin might be another model system for studying cutaneous aging.

Adolescent↗

Neurocutaneous syndromes with pigmentary abnormalities and central nervous system involvement. II. Two cases with atypical incontinentia pigmenti.

Two cases are reported of a boy and a girl with similar neurocutaneous syndromes clinically characterized by hyperpigmented skin patches and severe CNS involvement. The diagnosis of atypical cases of Incontinentia Pigmenti is suggested. The different syndromes with mental and motor retardation associated with skin abnormalities (Incontinentia Pigmenti, Ito's hypomelanosis, phakomatoses, etc.) are reviewed.

Child, Preschool↗

Complicated infections of skin and skin structures: when the infection is more than skin deep.

Skin and skin-structure infections are common, and range from minor pyodermas to severe necrotizing infections. Complicated infections are defined as involving abnormal skin or wounds, occurring in compromised hosts, or requiring surgical intervention. Classification schemes for these infections are varied and confusing. Distinguishing characteristics include the aetiological agent(s), clinical context and findings, depth of tissue involvement and rate of progression. The most common pathogens are aerobic Gram-positive cocci, but complicated infections frequently involve Gram-negative bacilli and anaerobic bacteria. Initial antibiotic therapy is usually empirical, and later modified by the results of stains and cultures of wound specimens. Broad-spectrum coverage is frequently needed for complicated infections. Ertapenem is a once-a-day parenteral Group 1 carbapenem antibiotic, recently licensed in the USA and Europe, which may assume an important role in treating some complicated skin and skin-structure infections. Surgical debridement is important for many complicated infections, and is the critical element in managing necrotizing fasciitis and myonecrosis.

Adult↗

Skin-testing with neurotransmitters in schizophrenic patients.

Pilot data are presented on a methodology to study a profile of simultaneous reactivity to intradermally injected norepinephrine, dopamine, serotonin, and histamine. The subject groups were young and old schizophrenics on medication and young control volunteers. Skin reactivity in terms of vasoconstriction, vasodilation, and whealing was measured over the course of 3 hours after the injections. Although interpretation of the results is limited by several sources of confounding error and the small number of subjects, the data suggest that skin-test profiles are sensitive enough to yield significant differences between the groups, particularly in the area of vasoconstriction. Further, abnormal skin reactivity may mirror the hypothesized alterations in CNS neurotransmitter physiology in schizophrenic patients.

Adult↗

Epidermal abnormalities may distinguish type 2 from type 1 and type 3 of Gaucher disease.

A major clinical challenge in Gaucher disease is the early and presymptomatic discrimination of type 2 (acute neuronopathic) from milder type 1 and type 3 Gaucher patients to enable appropriate management and counseling. Although most patients with Gaucher disease do not have skin abnormalities, a subset of patients with severe type 2 Gaucher disease display ichthyosiform skin. Analogous findings occur in the skin of type 2 (null allele) Gaucher mice. Ultrastructural and functional studies of epidermis from these mice reveal that glucocerebrosidase is required to generate functionally competent membranes for normal epidermal barrier function. We have extended our studies by examining the epidermal lipid content and ultrastructure in all three types of Gaucher patients. Only the type 2 Gaucher patients, some of whom had clinical ichthyosis, demonstrated an increased ratio of epidermal glucosylceramide to ceramide as well as extensive ultrastructural abnormalities, including the persistence of incompletely processed lamellar body-derived contents throughout the stratum corneum interstices. These epidermal alterations may provide a means for early differentiation of type 2 Gaucher disease.

Animals↗

Lichen planus and discoid lupud erythematosus. Overlap syndrome associated with cryoglobulinemia and hypocomplementemia.

A patient with the discoid lupus erythematosus and lichen planus overlap syndrome has profound depression of serum C4 concentration associated with substantial mixed cryoblobulinemia. A family study failed to disclose evidence of a familial hypocomplementemia, cryoglobulinemia, or a dermatologic condition. Immunologlobulin, but no complement, was detected at the site of the skin abnormality. This case illustrates an immune-complex disorder with a mixed cryoglobulinemia that is related to immunoglobulin deposition in the skin.

Complement C4↗

Prevalence of atopy in a population of hairdressing students and practising hairdressers in Melbourne, Australia.

Hairdressers are one of the largest groups affected by occupational contact dermatitis. In this population-based study, 193 trainee hairdressers and 184 practising hairdressers each completed a questionnaire and had their hands examined. Participants were asked about past or present atopy including eczema, asthma or hayfever, which occurred in 59.2%, and were individually correlated with a history of occupational skin problems. Almost 60% of hairdressers and trainees had experienced changes on their hands since commencing hairdressing, while 29% had evidence of abnormal skin on examination on the day of participation. Atopic individuals, who plan to work in a career such as hairdressing with known high rates of occupational contact dermatitis, should be advised to care for and protect their skin from the outset to prevent the development of this condition. There has been little awareness of this issue in Australia, despite longstanding knowledge of the association of hairdressing and contact dermatitis.

Adult↗

Multicentric reticulohistiocytosis: a rare cause of erosive arthropathy of the distal interphalangeal finger joints.

BACKGROUND: Multicentric reticulohistiocytosis (MRH) is a rare systemic disease, presenting with typical skin abnormalities and erosive polyarthritis, which is often associated with malignancy. CASE REPORT: A case of MRH arthropathy, in which the typical nodular skin manifestation of the disease was absent, is described in a patient with a past history of breast cancer and no evidence of recurrent or new malignancy. RESULTS: Careful clinical and roentgenological evaluation disclosed important clues to differentiate this condition from other more common distal interphalangeal arthritides--namely, osteoarthritis and its "erosive" variant, rheumatoid arthritis, psoriatic arthritis, tophaceous gout, dialysis related hand arthropathy, and from the rarer fibroblastic rheumatism, all of which can be mimicked by MRH. Histopathology showed the characteristic histiocytic and multinucleated giant cell infiltrate with ground glass cytoplasm, and immunohistochemical analysis showed markers evocative of a monocyte/macrophage origin of MRH.

Aged↗

Nasal septum lesions caused by chromium exposure among chromium electroplating workers.

A chromium electroplating worker, suffering from epistaxis during work, was found to have nasal septum perforation. To determine the etiology and prevalence of nasal septum lesions, we conducted a survey of seven chromium electroplating factories and examined 79 workers. Forty workers from three aluminum electroplating factories were also enrolled as the reference group. Subjects were thoroughly examined by an otolaryngologist and each of them provided a blood and urine sample. A questionnaire interview regarding symptoms of the upper respiratory tract, past medical history, life style, and work history was also conducted. Air chromium concentrations were measured by taking area samples for 4-6 hours. Based on field observation and chromium measurements, we divided chromium electroplating into three different exposure zones: workers directly dealing with electroplating tanks (n = 31), other process workers (n = 29), and office workers and drivers (n = 19). Among the 79 chromium electroplating workers, there were 16 cases of nasal septum perforation, and 42 with either scar formation or ulceration; 10 chromium electroplating workers developed skin ulcers after performing chrome plating. No workers from aluminum electroplating factories had any nasal septum or skin abnormalities. There was a consistent trend between the degree of chromium exposure and the signs and symptoms related to the nose, throat, and skin. Immediate improvement of occupational hygiene is warranted.

Adult↗

Synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome in childhood: a report of ten cases and review of the literature.

UNLABELLED: Chronic recurrent multifocal osteomyelitis is a rare chronic inflammatory musculoskeletal process observed in children and young adults. Recently, the acronym SAPHO syndrome (for synovitis, acne, pustulosis, hyperostosis, osteitis) was coined to emphasise the association between osteo-articular inflammations and different skin abnormalities which are aseptic and filled with neutrophils. In adults, chronic recurrent multifocal osteomyelitis is now a classical manifestation of SAPHO syndrome. Chronic skin disorders were seen in eight of ten children on follow-up at the University Children's Hospitals in Bern and Zurich and in 61 of 260 paediatric cases reported in the literature. The different skin lesions were palmoplantar pustulosis (n = 40), non-palmoplantar pustulosis (n = 6), psoriasis vulgaris (n = 16) or severe acne (n = 4). More rarely Sweet syndrome (n = 2) or pyoderma gangrenosum (n = 1) were reported. CONCLUSION: The synovitis, acne, pustulosis, hyperostosis, osteitis syndrome is pertinent even in paediatrics since skin involvement is frequent.

Acquired Hyperostosis Syndrome↗

Primary anetoderma: phagocytosis of elastic fibres by macrophages.

We report a 22-year-old female with a 2-year history of increasingly numerous well-circumscribed, asymptomatic skin lesions. The clinical and histological features were consistent with anetoderma and investigations failed to reveal any associated underlying disorders. Electron microscopy of abnormal skin showed phagocytosis of elastic fibres by macrophages. Although the aetiology of primary anetoderma remains unknown, this finding suggests that phagocytic destruction of elastic fibres plays a major role in its pathogenesis.

Adult↗

Gene for arrhythmogenic right ventricular cardiomyopathy with diffuse nonepidermolytic palmoplantar keratoderma and woolly hair (Naxos disease) maps to 17q21.

BACKGROUND: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a heart muscle disease of unknown etiology that causes arrhythmias, heart failure, and sudden death. Diagnosis can be difficult, and this hampers investigation of its molecular basis. Forms of ARVC in which gene penetrance and disease expression are greater should facilitate genetic study. We undertook a clinical and genetic investigation of Naxos disease, originally described by Protonotarios in 1986. This disease constitutes the triad of ARVC, diffuse nonepidermolytic palmoplantar keratoderma, and woolly hair. METHODS AND RESULTS: We evaluated the population of Naxos, Greece, to identify probands, which was followed by family screening. Twenty-one affected persons from 9 families of 150 persons were identified. Linkage analysis was performed with microsatellite markers. The disease locus mapped to 17q21. A peak 2-point LOD score of 3.62 at theta=0.0 was found with a marker within intron 4 of the keratin 9 gene, a member of the type I (acidic) keratin family. A preserved homozygous disease haplotype was identified. Haplotype analysis delimited the disease interval. CONCLUSIONS: Hair and skin abnormalities were found to be reliable markers of subsequent heart disease. This suggests the presence of a single mutant gene with novel cardiac, skin, and hair function or two or more tightly linked disease genes. Recessive inheritance of Naxos disease and a founder effect were demonstrated. Identification of a fully informative genetic marker linked to the disease and uncommon in the background population may be of use as a test to identify disease gene carriers.

Arrhythmogenic Right Ventricular Dysplasia↗

Activating Smoothened mutations in sporadic basal-cell carcinoma.

Basal-cell carcinomas (BCCs) are the commonest human cancer. Insight into their genesis came from identification of mutations in the PATCHED gene (PTCH) in patients with the basal-cell nevus syndrome, a hereditary disease characterized by multiple BCCs and by developmental abnormalities. The binding of Sonic hedgehog (SHH) to its receptor, PTCH, is thought to prevent normal inhibition by PTCH of Smoothened (SMO), a seven-span transmembrane protein. According to this model, the inhibition of SMO signalling is relieved following mutational inactivation of PTCH in basal-cell nevus syndrome. We report here the identification of activating somatic missense mutations in the SMO gene itself in sporadic BCCs from three patients. Mutant SMO, unlike wild type, can cooperate with adenovirus E1A to transform rat embryonic fibroblast cells in culture. Furthermore, skin abnormalities similar to BCCs developed in transgenic murine skin overexpressing mutant SMO. These findings support the role of SMO as a signalling component of the SHH-receptor complex and provide direct evidence that mutated SMO can function as an oncogene in BCCs.

Adenovirus E1A Proteins↗