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A case of generalized idiopathic pigmented purpuric eruption with distinctive and rare palmar-plantar involvement is presented. The clinical and histopathologic features, differential diagnosis, and nosology of the idiopathic pigmented purpuric eruptions are presented.
In 6 patients with clinically and histologically proven pustulosis palmaris et plantaris the disease was complicated by osteo-articular manifestations. Five patients presented with articular symptoms and one with aseptic subacute osteomyelitis. The distribution of these bone and joint disorders was different from that of Sonozaki's "pustulotic arthro-osteitis": in contrast with the latter, the anterior chest was inconstantly involved whereas the spine, sacro-iliac joints and peripheral articulations were more frequently affected. Although the B27 antigen is usually absent, it seems possible to classify the rheumatic disorders of pustulosis palmaris et plantaris among seronegative spondylo-arthropathies.
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Hand protection entails many problems. There is a wide variety of individual differences in the types of skin among human beings, and an even wider variety of chemicals to be handled and working methods to be learned in various workplaces. There are great differences in the degree of experience and education among job applicants and thus in their ability to understand the importance of instructions on safe working methods and the use of personal protective equipment. Therefore, proper employee selection is an important and demanding task for occupational health care personnel and dermatologists. Despite these complexities, an appropriate means of hand protection is essential in the prevention of many skin disorders and injuries.
The hospital records of 105 subjects with professional dermatitis, admitted at the Institute of Occupational Health of Verona between 1972 and 1985, were reviewed. Work sectors, chemicals, sites of dermatitis, latency and age of onset were evaluated. Contact allergic dermatitis were 80% while irritative ones were 10%. Metal-, construction- and tannery workers were more frequently involved. The most common causes were salts of heavy metals. The authors discuss results and remark the need of standardization in diagnostic procedures.
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Three cases of skin infections are reported. The biological examination revealed the presence of gram-negative bacillus Serratus marcescens whose chemical characteristics enabled its identification. Treatment was based on the respective antibiograms, cure being obtained in two patients. The third patient was treated with an antibiotic to which he was not sensible, with the consequent failure. Perusal of the literature at our disposal failed to reveal skin infections due to Serratus marcescens. Thus, in such patients who do not respond to the usual therapy, it is suggested that the Serratus marcescens bacillus be systematically looked for an reported in order to confirm this preliminary publication.
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We report on an 8-year-old female patient showing the typical lesions of acropustulosis of infancy. Our case is unusual because infantile acropustulosis mostly affects male patients and occurs during the first year of life, persisting for a period of approximately 2 years.
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