Cutaneous periarteritis nodosa: a clinicopathological study of 79 cases.

Cutaneous periarteritis nodosa (PAN) is a well-recognized entity characterized by tender subcutaneous nodules and livedo that may ulcerate. The pathogenesis of cutaneous PAN is not known. The objective of the study was to evaluate the clinical and histological features of 79 cases of cutaneous PAN and to investigate any clinical, pathological and immunological differences that may distinguish those cases likely to have a prolonged course. A retrospective analysis of 79 cases was conducted. Thirty-nine patients had ulcers during the course of their illness. Women were affected more than men. Painful nodules on the lower extremities, with oedema and swelling, were the most common clinical finding; 22% of patients had some evidence of neuropathy. Most of the laboratory findings were non-specific. There was no evidence for hepatitis B infection and hepatitis C infection was present in only one patient. Most patients (60%) had no associated medical condition. The disease course was prolonged but benign, and systemic PAN did not develop in any patient. Corticosteroids given systemically induced remission in most acute cases. The ulcerative form of disease was more prolonged and frequently associated with neuropathy.

Angiotensin-converting enzyme inhibitor-induced pemphigus: three case reports and literature review.

OBJECTIVE: To identify patients examined in the Mayo Clinic Department of Dermatology whose pemphigus was attributable to an angiotensin-converting enzyme inhibitor and to compare these cases with previously reported cases of drug-induced pemphigus. RESULTS: A retrospective review of medical records revealed two cases of captopril-induced pemphigus and one of enalapril-induced pemphigus. Our patients had substantially increased circulating IgG autoantibodies to intercellular substance, as detected on monkey esophagus substrate. CONCLUSION: Our findings contrast those of other reports of drug-induced pemphigus in which circulating autoantibodies are implied to be low or absent.

Regional anesthesia of the hand for dermatologic surgery.

The basic principles of regional and local anesthesia of the hand are reviewed, and safe and effective methods for outpatient dermatologic procedures and three representative cases are discussed with respect to anatomy, local anesthetic agents, and techniques. Block techniques are preferred to local infiltration because they provide complete and long-lasting anesthesia more comfortably.

Recurrent aphthous stomatitis.

Recurrent aphthous stomatitis is the most common ulcerative disease of the oral mucosa. The lesions of aphthous stomatitis are mucosal manifestations of a variety of conditions, 30 per cent of which may be discerned by history, physical examination, and appropriate laboratory testing. Correction of underlying conditions or deficiencies results in improvement or remission in aphthous disease activity. Treatment of lesions for which an underlying cause cannot be discerned is discussed.