Melanonychia striata in Chinese children and adults.

BACKGROUND: There is considerable racial variation in the occurrence of melanonychia striata. The prevalence of melanonychia striata in the Chinese population is not known. The purpose of this study was to investigate the prevalence and characteristics of melanonychia striata in a Chinese population of patients. METHODS: Two thousand, four hundred and fifty-seven Chinese patients attending an Asian medical clinic were examined for the presence of melanonychia striata in a cross-sectional prevalence survey. The examinations were carried out as part of the routine medical care provided to these patients. Patients of mixed racial background were excluded. The fingernails and toenails of each patient were examined, and the presence or absence of melanonychia striata, the anatomic distribution of the lesion, and the age and sex of the patient were recorded. RESULTS: Melanonychia striata was not detected in patients aged less than 20 years. The condition was present in 0.6% of patients aged between 20 and 29 years. Thereafter, the prevalence increased gradually to 1.7% in patients aged 50 years and over. There was a significant relationship between age and the presence of melanonychia striata (chi(2) = 141, P < 0.01). There was no significant sex-related difference in the age-specific prevalence (P > 0.05). The thumbs were most frequently affected, followed by the index fingers (P < 0.001). The condition was bilateral in 40% of cases. None of the patients had involvement of more than two digits. CONCLUSION: Melanonychia striata is uncommon in Chinese individuals, especially in those aged under 20 years. The male to female ratio is approximately equal. The thumbs are most frequently affected and the condition is often bilateral.

A giant congenital nevus spilus in an 8-year-old girl.

Congenital nevus spilus is rare, and the lesion is usually small. This report describes an 8-year-old girl with a giant congenital nevus spilus that involved the left side of her abdomen, perineal area, and left upper thigh. The patient also had a Mongolian spot in the lumbosacral area.

Treatment of labial fusion with topical estrogen therapy.

Twenty girls with labial fusion that covered at least 50% of the vaginal opening were treated with a topical estrogen cream. The cream was precisely applied to the fused area twice a day until the adhesions were totally lysed. After separation of the adhesions, a petroleum ointment (Vaseline) was applied twice a day to the labia minora for at least 1 month. The introital area was carefully rinsed twice each day before application of either the estrogen cream or the petroleum ointment. The mean age of the studied population was 13.2 months (range, 2 to 38 months). The mean duration of estrogen treatment was 2.4 months (range, 1 to 3.5 months). All patients were successfully treated. Five patients developed vulval pigmentation, which lasted for a mean of 1.5 months. One patient developed breast enlargement, which lasted for 1 month. The mean duration of follow-up was 3.1 months, and there was no recurrence of labial fusion during the period of follow-up. We conclude that treatment of labial fusion with topical estrogen therapy is safe and effective.

Urinary tract infection due to Salmonella stanleyville in an otherwise healthy child.

A healthy four-year-old boy developed a febrile urinary tract infection (UTI) due to Salmonella stanleyville. The UTI developed following an episode of enteritis due to the same organism. Salmonella UTI is uncommon and is reported more often in patients with a predisposing factor, such as immune deficiency or a structural abnormality, in the urinary tract. Salmonella stanleyville has not been previously reported as a cause of UTI.

Persistent Mongolian spots in Chinese adults.

Four Chinese females aged 21-35 years with Mongolian spots are reported. Two patients had the spots on their arms while the other two had the spots on their shoulders. The persistence of Mongolian spots in Chinese adults has not been previously reported.

Internipple distance and internipple index.

OBJECTIVE: To determine the internipple distance and internipple index in Chinese children. METHODS: The internipple distance and chest circumference were measured in 3,290 healthy Chinese children (1,715 males and 1,575 females) aged birth to 18 years seen at the Asian Medical Centre. The internipple distance and chest circumference were obtained at the end of expiration whenever possible, with a standard nonstretch tape measure graduated in millimeters with the arms hanging relaxed alongside the body. Patients under two years of age were measured supine and those over two years of age standing. The internipple distance was measured between the centers of both nipples, and the chest circumference was measured across the internipple line. The internipple index was calculated according to the formula: internipple distance (cm) multiplied by 100 and divided by chest circumference (cm). RESULTS: The internipple distance and chest circumference increased with age. The internipple index was highest in the neonatal period (26.4 +/- 1.6 for males and 26.3 +/- 2 for females), and decreased steadily until the age of four years (23.8 +/- 1.2 for males and 23.8 +/- 1.4 for females), and thereafter was relatively constant through the age of 18 years in males and the age of 11 years in females. In females, the internipple index decreased gradually from the age of 11 years to 18 years. CONCLUSIONS: While internipple index is a more practical way to assess nipple placement, there are ethnic differences in the internipple index. Proper reference standards should be used in the assessment whether the nipples are closely or widely spaced.

Mammary duct ectasia: a cause of bloody nipple discharge.

We report a 13-year-old girl with bloody nipple discharge as a result of mammary duct ectasia. Our patient is the second reported case of mammary duct ectasia in a pubertal girl.

Duplication of the testis with contralateral anorchism.

We describe the case of a newborn infant with duplication of the testis and absence of the contralateral testis. The patient also had bilateral indirect inguinal hernias and an ipsilateral undescended testicle.

Familial clinodactyly of the fifth finger.

We describe a caucasian family of which whom five members in three generations had clinodactyly of the fifth fingers. This report confirms that clinodactyly of the fifth finger can be transmitted as an autosomal dominant trait.

Cholelithiasis in an infant with Klinefelter's syndrome.

Cholelithiasis has been reported only rarely in infants. We describe a case of cholelithiasis in a 1-month-old infant with Klinefelter's syndrome. This association has not been previously reported.