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[Ulcers of the tongue, pityriasis lichenoides and primary parvovirus B19 infection].

INTRODUCTION: We report a case of parapsoriasis en gouttes (or pityriasis lichenoides) which presents two peculiarities. First, the patient had lingual ulcerations and second, the eruption appeared during a seroconversion for Parvovirus B19. OBSERVATION: A 25 old woman presented a first episode of characteristic parapsoriasis en gouttes associated with purpuric palmoplantar lesions and lingual ulcerations, reaching deep muscular in histology. DISCUSSION: This observation of parapsoriasis en gouttes, peculiar because of lingual ulcerations, is mostly interesting because of its association with a primo-infection to Parvovirus B19. The receptor of the virus is localised on endothelial cells and that could explain purpuric lesions and ulcerations observed.

Adult↗

Generalized cutaneous leishmaniasis in acquired immunodeficiency syndrome.

BACKGROUND: Leishmaniasis associated with HIV/AIDS has been reported in the last decade. CASE REPORT: A case of generalized cutaneous leishmaniasis in a patient with AIDS is described. The case is paradoxical in that the cutaneous lesions resemble anergic leishmaniasis caused by Leishmania (L.) amazonensis and Jorge Lobo's disease, but the positive Montenegro test and the clinical improvement with antimonial are more commonly observed in leishmaniasis caused by L.(V.) braziliensis. COMMENT: The immunosuppression due to HIV/AIDS seen in this patient may explain the dissemination of the lesions, but the positive specific response to leishmanial antigen may explain the good response to the antimonial treatment.

AIDS-Related Opportunistic Infections↗

Hand dermatitis and symptoms from the fingers among Swedish dental personnel.

Hand dermatitis among dental personnel has been an issue in recent years. Dental personnel manually handle polymer materials which are known to irritate skin, and also cause allergy. In addition, dental personnel wash their hands frequently, and use latex gloves, and are therefore at risk to develop hand dermatitis. To survey the occurrence of hand dermatitis among dental personnel, questionnaires were sent to all dental teams (dentist + chair assistant) working in the two northern Swedish counties. Referents were; researchers, teachers, and secretaries from a university and high schools, from the same geographical area. The response rate was 76% for dental teams, and 66% for referents. The results show that male dentists reported a significantly higher prevalence of hand dermatitis than male reference. In contrast to chair assistants and referents, dentists (both male and female) reported a higher extent of hand dermatitis on the left than on the right hand. There was an association between hand dermatitis among dental personnel and; age, eczema in childhood, and hay fever but, not with; sex, asthma, frequent washing of the hands, and glove use. Whitening of the fingers increased with increasing age among dental personnel. Pricking was also associated with frequent glove use. Pricking of the fingers was associated with sex, and 3.5 times more common among female dental personnel than male dentists. Numbness of the fingers, and finger pain was reported by more dentists than chair assistants and referents.

Adult↗

Are local and systemic conditions important for the development of onychomycosis?

Available epidemiological data indicate that the prevalence of onychomycosis due to dermatophytes increases with ageing. The aim of this study was to investigate the epidemiology of dermatophyte nail infections in 2 populations selected only on an age basis and to verify whether the presence of onychomycosis was associated with increased exposure to possible predisposing factors. From January to June 1995, the nails of 1,800 military recruits and 253 elderly individuals living in a nursing home were examined. Mycological studies were performed in all cases of suspected onychomycosis. The presence of systemic or local diseases that may favor fungal nail infection as well as exposure to environmental factors were assessed in the 2 populations. Onychomycosis was diagnosed in 8 recruits (0. 44%) and 38 of the elderly people (15%). The presence of onychomycosis was not related to the degree of exposure to environmental factors or to systemic or local diseases.

Adolescent↗

Onychomycosis: diagnosis and systemic treatment.

Onychomycosis, a persistent fungal infection affecting the toenails and fingernails, can interfere with standing, walking, and exercising. Associated physical impairments can result in paresthesia, pain, discomfort, and loss of manual dexterity. Patients may also suffer from loss of self-esteem and social interaction. A definitive diagnosis is crucial for effective treatment, because many other skin and nail disorders mimic onychomycosis. Diagnosis involves microscopic potassium hydroxide preparation, cultures, nail biopsy, and histologic analysis. Treatment can include topical and systemic antifungal therapies as well as nonpharmaceutical methods. This paper discusses pathophysiology, diagnosis, and treatment options for this common nail dystrophy, including the newer antifungal medications now available.

Antifungal Agents↗

[Vitiligo in an pair of enzygotic twins].

Investigations of twins can contribute in the investigation of hereditary factors participating in the etiopathogenesis of vitiligo. A 28-year-old pair of male twins are presented, whose monovularity was conclusively proved by a comparison of morphological and serological features. Vitiligo developed as a concordant feature at the age of 13 and 22 years respectively. It is noticeable that there was a good concordance of the localisation of the vitiligo in both brothers. This concordance is most probably explained by genetic fixation of the disease, leading to the manifestation of vitiligo. Multifactoral heredity with threshold is discussed.

Adolescent↗

Occupational health complaints and adverse patient reactions as perceived by personnel in public dentistry.

A questionnaire survey on health complaints experienced by personnel in public dentistry was undertaken in 1979 and repeated in 1988/89. The reply rates were about 80% and 83%. In both surveys, about one half of the personnel reported occupation-related health complaints, a majority of which were dermatoses of hands and fingers. The dermatoses were attributed to seasonal air quality problems, or to contact with chemically active substances relevant to hygienic measures, treatment patterns, or other activities connected with the running of a dental clinic. The majority of the dermatoses were probably irritative. Some presumably hypersensitivity reactions occurred after handling of dental materials. Latex gloves, which were in general use only at the time of the last survey, seemed to have prevented some dermatoses formerly attributed to handwashing procedures. However, latex gloves per se had also induced dermatoses. Non-dermatological ailments of a transient nature comprised eye, respiratory, or systemic reactions and were connected with volatiles from X-ray liquids, methylmethacrylate monomer, and disinfectants. Adverse patient reactions occurred at a frequency of about one per 2600 treated patients. The observations comprised skin reactions (head/face), gingival/mucosal ulcerations, and sometimes systemic/urticarial reactions. The reactions were associated with the use of local anesthetics, orthodontic appliances, and other biomaterials. Two reactions were related to contact with the dentists' latex gloves.

Adult↗