Arthropathy associated with cystic acne, hidradenitis suppurativa, and perifolliculitis capitis abscedens et suffodiens: treatment with isotretinoin.

A patient with arthropathy associated with cystic acne, hidradenitis suppurativa, and perifolliculitis capitis abscedens et suffodiens who showed a dramatic response to isotretinoin is described. This, to our knowledge, is the first report documenting effective treatment of this condition, whose nosologic position with respect to other spondyloarthropathies associated with cutaneous disease is considered.

Treatment of lichen planus and lichen nitidus with itraconazole: reports of six cases.

Six patients with either lichen planus or lichen nitidus were treated with itraconazole. Two of four patients with lichen planus experienced complete clearing, and the remainder showed a partial response. Itraconazole, like griseofulvin, may prove to be an alternative treatment worth considering in patients with lichen planus or lichen nitidus who have failed other therapies.

Symmetrical erosions in a neonate: a case of neonatal sucking blisters.

Neonatal sucking blisters appears as unilateral or bilaterally symmetrical bullae or erosions involving the distal upper extremities at birth. They represent minor self-inflicted trauma, presumably the result of a vigorous intrauterine sucking reflex. Recognizing this benign self-limited condition avoids unnecessary tests and alleviates anxiety on the part of the infant's family and physicians.

Dermatofibrosarcoma protuberans in an infant with a history of choroid plexus papilloma.

We describe an infant with a dermatofibrosarcoma protuberans (DFSP) who also had a choroid plexus papilloma. This report underscores the occurrence of DFSP in this age group and may support a neural pathogenesis of this tumor.

Congenital subungual nevus in a black infant.

A 6-month-old black infant is described with a congenital black subungual and periungual lesion of the right second toe. Histopathologic examination revealed a junctional nevus. Congenital subungual nevi are rare. To the best of our knowledge, this represents the first report in a black infant.

Cutaneous heparin necrosis in a patient with heterozygous protein S deficiency.

A patient with heterozygous protein S deficiency experienced cutaneous necrosis following subcutaneous heparin administration. Deficiencies of both protein C and protein S, known risk factors for the more frequently encountered coumarin necrosis, may predispose patients to this complication of heparin therapy as well. The putative association of protein S deficiency with cutaneous heparin necrosis could not be proven, however, since attempts to reproduce the heparin necrosis were unsuccessful.

Pigmented nail streaks may indicate Laugier-Hunziker syndrome.

Laugier-Hunziker syndrome is a rare, benign pigmentation disorder previously described only once in the United States. The syndrome is acquired in early or mid-adult life and is characterized by multiple longitudinal hyperpigmented bands on the nails and pigmented macules of the lips and buccal mucosa. Peutz-Jeghers syndrome and Addison's disease can present with pigment abnormalities similar to those characteristic of Laugier-Hunziker syndrome.

Post-cardiac transplant reactivation of Chagas' disease diagnosed by skin biopsy.

Reactivation of Chagas' disease in immuno-compromised hosts may represent a recognizable clinical syndrome that can be diagnosed by examination of skin biopsy specimens of characteristic lesions resembling ordinary bacterial cellulitis. This syndrome appears to result in significant morbidity, which can be avoided with the institution of prophylactic therapy for Chagas' disease. An awareness of this complication of immunosuppression is of paramount importance for the thousands of asymptomatic persons infected with Chagas' disease currently living in the United States and abroad.

Phakomatosis pigmentovascularis type IIIb.

A patient with a giant nevus flammeus, giant nevus spilus, and Klippel-Trenaunay-Weber syndrome is described. This case can be designated phakomatosis pigmentovascularis type IIIb and may represent the second case thus far reported.

Lichen sclerosus following the lines of Blaschko.

A case of lichen sclerosus that developed in a pattern corresponding to the lines of Blaschko is described. This pattern of extragenital lichen sclerosus has not, to our knowledge, previously been reported and could result from an epidermal clone with altered androgen sensitivity supporting a hormonal pathogenesis for this disease.

Ultraviolet radiation acts as an independent mitogen for normal human melanocytes in culture.

Identification of growth factors for normal human melanocytes has been significantly aided by the recent development of in vitro culture systems for this cell. Utilizing such a system, we studied the effect of ultraviolet radiation (UVR) on both melanocyte growth and melanization by incorporation of 3H-thymidine and 3H-L-dihydroxyphenylalanine (3H-DOPA), respectively. 3H-thymidine incorporation was found to be significantly stimulated during the first 24 h following a single irradiation. 3H-DOPA incorporation was stimulated after a delay of 2 days postirradiation. Whereas UVR has long been known to induce melanocyte proliferation in vivo, these studies show that UVR can act as a mitogenic stimulus for this cell independent of the cutaneous environment. UVR can thus be added to a growing list of growth factors for epidermal pigment cells and is the only physical agent conclusively shown to act as a mitogen. Included in this list are substances that act via stimulation of the CAMP-kinase or protein kinase systems such as cholera toxin and phorbol esters. UVR is postulated to induce melanocyte proliferation by modulation of these second messenger pathways. With recent evidence linking growth factors, oncogenes and malignant transformation, this study supports the association between UVR exposure and the development of malignant melanoma, and suggests mechanisms whereby UVR may contribute to malignant transformation of this cell.

Cutaneous Waldenström's macroglobulinemia: report of a case and overview of the spectrum of cutaneous disease.

Specific infiltration of the skin is a rare complication of Waldenström's macroglobulinemia. Cutaneous disease may also develop as a direct result of paraproteinemia and paraprotein specific antiepidermal autoimmune disease. We report a patient with Waldenström's macroglobulinemia in whom cutaneous infiltration developed with a clonal population of lymphoplasmacytoid B cells, summarize previously reported cases, and review the spectrum of cutaneous disease associated with this hematologic malignancy.