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Thirteen cases of pustulotic arthro-osteitis are reported: 3 children and 10 adults. The clinical and radiological aspects of this rare entity are discussed as well as the classification of this disease in the context of seronegative spondyloarthropathies.
Highly potent drugs should be studied by means of double placebo experiments rather than by semi-blind trials. In semi-blind trials, possible side effects induced by the placebo might not be sufficiently registered, and those induced by the verum cannot be adequately evaluated.
A 46-years-old man with non familial acrokeratosis verruciformis of Hopf is described. We comment on the clinical and histopathological features of this rare dermatosis and the unsuccessful therapy with etretinate.
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There are many possible causes of yellow-orange discoloration of the skin. It is important to ascertain the presence or absence of scleral icterus in determining the diagnosis. Yellow sclerae are found in patients with all causes of hyperbilirubinemia due to the predilection of bilirubin for elastic tissue. The sclerae are also involved in the staining due to some drugs such as quinacrine. Hypercarotenemia, lycopenemia, and riboflavinemia do not involve the sclerae. In our case there are several possible causes for yellow-orange pigmentation of the skin. The patient had malaria, as well as a history of hepatitis, both of which could have resulted in hyperbilirubinemia. However, a bilirubin level of 1.2 mg/100 ml was not sufficient to result in jaundice. The most important finding was that his sclerae were uninvolved, leading us to consider other causes of yellow-orange coloration. The localization of the pigment to the palms and soles is consistent clinically with the diagnosis of hypercarotenemia. This was verified by a serum beta-carotene level slightly above normal. In this case, the carotenemia was due to the ingestion of red palm oil, which the patient had consumed in great quantities while living in Liberia. The surprisingly low level of serum beta-carotene is explained by the fact that he had not consumed red palm oil or another concentrated source of carotene for about three months since living in the United States. Due to the lipophilic nature of the carotenoids, sufficient amounts remained in the tissue to produce discoloration for up to five months, regardless of serum levels.(ABSTRACT TRUNCATED AT 250 WORDS)
Thirteen cases of eczema that followed acute cutaneous trauma were observed. On the basis of the present case series, the following conclusions may be drawn: 1. Cutaneous trauma may precipitate eczema. 2. The trauma is sufficient to cause obvious tissue damage accompanied by an inflammatory or regenerative response. 3. Eczema usually begins within a few weeks of acute injury at the site of the cutaneous trauma. 4. Eczema may occur as an isolated idiopathic reaction or as an isomorphic reaction either preceding or following the appearance of an endogenous eczematous condition in nontraumatized skin. 5. Individual lesions of post-traumatic eczema may persist or recur for long periods of time. 6. The occurrence of post-traumatic eczema following occupational injury has important medicolegal implications.
Based on an analysis of his experience with the treatment of different kinds of acute suppurative diseases of hands and fingers the author gives reliable recommendations for prevention of the pathology in countrymen, complex treatment of the diseases with the application of present-day antiseptics.
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Ten cases of infantile acropustulosis were studied clinically, in laboratory and histopathologically. There was no racial predominance. In most of the cases the lesions started in the first 6 months of life and were located mainly on the feet severe itching. Was a constant symptom. Laboratory studies were negative for fungus, bacteria and acarus. Atopy was found in 20% of the cases and 30% of the families. Blood eosinophiles was found in 70% of the lesions.
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In a survey of 399 patients with superficial fungal lesions who had been born outside Western Europe, 32 cases of Hendersonula toruloidea infection and 11 cases of Scytalidium hyalinum infection were diagnosed. The hyphae of these two non-dermatophytes in skin were indistinguishable from each other but could be distinguished from those of dermatophytes. Both the non-dermatophyte infections were limited to the palms, soles, two webs and nails. The geographical origins of the infected patients were analysed and it appeared that S. hyalinum infection was geographically more limited than H. toruloidea infection.
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Dysfunction of sweat glands and acrosyringia are not involved in the pathogenesis of dyshidrosis. Clinically, dyshidrotic dermatitis (atopic, toxic, contact allergic, hematogen-allergic) and dyshidrotic tinea should be differentiated. Therapeutic possibilities comprise symptomatic topical and systemic treatment, whereas causal treatment is only possible in cases of tinea.
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