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Furuncular myiasis from Dermatobia hominis infestation. Diagnosis by light microscopy.

Myiasis, the infestation of humans or other vertebrates with fly larvae, may appear as furuncular nodules. Furuncular myiasis occurring in the Western hemisphere, especially in Central and South America, is usually caused by Dermatobia hominis infestation. Travel history, gross examination, and histologic evaluation of the submitted fly larvae will allow the clinician and dermatopathologist to identify the causative organism. We report two cases of furuncular myiasis due to Dermatobia hominis and review the clinical and histopathologic findings pertinent to its diagnosis. In addition, we attempted to identify some of the cardinal internal structures of this organism by extrapolating known information about insect internal anatomy and physiology to the structures visualized during serial transverse sectioning of the larvae.

Adult↗

Infantile acropustulosis.

A case of infantile acropustulosis is described. The condition responded to sulfones while it was not affected by any other therapy. Histologically, subcorneal pustules were found; persistent modest eosinophilia and eosinophils were present in the vesicular content, a feature never observed before. The significance of this finding is discussed.

Dapsone↗

Localized scleroderma with cutaneous calcinosis. A distinctive variant.

Two patients had a distinctive variant of localized scleroderma. Both have a history of sclerodermatous changes of the skin over the face developing relatively late in life and accompanied by hair loss, cutaneous calcification, and prominent beaking of the nose. A striking lack of systemic involvement also was noted.

Aged↗

Permanent wave contact dermatitis: contact allergy to glyceryl monothioglycolate.

Eight hairdressers and four clients were found to be allergic to glyceryl monothioglycolate (GMTG) contained in "acid" permanent waves used in American beauty salons only since 1973. Previous studies in Germany showed that compounds closely related to GMTG were strong sensitizers. In contrast, ammonium thioglycolate (ATG) has been used since 1943 in cold "alkaline" permanent waves both in homes and in salons with no clearly documented cases of contact allergy. Our allergic patients reacted to GMTG in concentrations as low as 0.25%, although their exposure in practice could reach concentrations of 20% to 80%. GMTG-allergic patients reacted to GMTG when it was tested through a variety of glove fabrics. Household-weight neoprene gloves were protective.

Adult↗

Frontoparietal scleroderma (en coup de sabre) following Blaschko's lines.

We describe three patients with frontoparietal scleroderma showing multiple lesions. The lesions were in two different lines that seemed to belong to Blaschko's lines. It remains controversial whether linear scleroderma follows Blaschko's lines, but our observations presented here suggest that frontoparietal scleroderma occurs along the lines of Blaschko.

Adult↗

Granuloma annulare, nodular type--a subcutaneous pseudorheumatoid lesion in children.

Five cases of patients aged between 2 years 8 months and 5 years 6 months with subcutaneous nodular granuloma annulare are reported. Histologically the lesions resembled rheumatoid nodules, consisting of acellular central areas surrounded by palisading histiocytes. Complete or partial excisions were done for diagnosis. Initially the granulomata were not associated with any symptoms of systemic illness, but one patient with IgG deficiency developed subsequent polyarthritis. Antistreptolysin O, antinuclear antibodies and latex fixation test for rheumatoid arthritis were negative except for one patient with additional erythema nodosum and elevated antistreptolysin level. In the other patients the laboratory data were uncharacteristic. The clinical course may be characterized by spontaneous regression and frequent recurrence. In asymptomatic patients further treatment is not necessary. Patients with progressive disease or elevated inflammatory activity were treated with nonsteroidal antirheumatics. The development of subsequent rheumatoid disease in primarily asymptomatic patients is unlikely, but we recommend further observation by an experienced pediatrician.

Child, Preschool↗