Professional dermatology societies in the USA: an overview.

This is a concise overview in a table format for the current membership-based dermatology societies in the USA. The primary objective of these societies is to provide continuous medical education. These societies serve all health care providers in dermatology care, including physician assistants and nurses. There is a clear need for establishing more societies which focus on different aspect of dermatology. There is always a potential for improving the educational activities of these societies.

Claude Huriez and his syndrome.

Claude Huriez (1907-1984) was a well-known French dermatologist. In the 1960s, Huriez and colleagues reported two families from northern France with a rare congenital genodermatosis-later known as Huriez syndrome. This syndrome is characterized by scleroatrophy of the hands and feet, nail hypoplasia, mild palmoplantar keratoderma, and hypohidrosis and is a cancer-prone genodermatosis. This report sheds light on Huriez and the syndrome that bears his name.

Salim Haim and the syndrome that bears his name.

Professor Salim Haim (1919-1983) was a well-known dermatologist. In 1965, Dr. Haim and Dr. Munk, a radiologist, reported a rare congenital type of genodermatosis, later known as Haim-Munk syndrome. This syndrome is characterized by palmoplantar keratosis, pes planus, onychogryphosis, periodontitis, arachnodactyly, and acroosteolysis. This report discusses Haim and Haim-Munk syndrome.

Eponyms in leprology.

Leprology is the medical science that focuses on the study of leprosy. There are several eponymic terms that are in common use in leprology, and this paper sheds some light on these eponyms.

The founder of Vicks: Lunsford Richardson (1854-1919).

Vicks VapoRub (Procter & Gamble, Cincinnati, OH) is one of the most popular over-the-counter therapies in the world, used to provide relief from the symptoms of the common cold and non-life-threatening respiratory infections. Even as more advanced products have come and gone, VapoRub continues to dominate the market almost 9 decades after the death of its formulator, Lunsford Richardson (Figure).

Midfacial leprosy.

Leprosy is a chronic bacterial disease that has many clinical presentations. We are reporting a patient who presented with an erythematous plaque over the nose, which was proved to be due to leprosy. We think that this type of clinical feature is not a common presentation for leprosy.

Lamellar ichthyosis in a Saudi kindred.

A series of 20 patients aged 4-16 years presented with lamellar ichthyosis at the dermatology unit of King Faisal Hospital at Taif in western Saudi Arabia. Though they had come from different families, they all belonged to the same tribe that was confined to a rural area in the precincts of Taif. The tribe is known for consanguineous marriages. The affected children are from 5 sibships. All the children presented with generalized thick dark scales. The history revealed that they all were born with a thick membrane around them, which was shed soon after. Gradually over months and years there was development of generalized scaling. A prototype is shown in the Figure. The scales had become darker and thicker with the passage of time. There was no pruritus. Teeth and mucous membranes were normal. None of the patients had erythroderma. The associated findings in some of the children were ectropion and alopecia. Contractures including pseudoainhum were also observed in some children. None of the patients' parents was found to be affected with a similar condition. There was no improvement with age. Skin biopsies from several of the patients revealed only hyperkeratosis. All had to be managed with topical emollients since they could not afford oral retinoids.

Blood transfusion and dermatology.

Blood transfusion is an accepted therapeutic procedure in all specialties of medicine. In dermatology, specialized techniques like plasmapheresis and extracorporeal photochemotherapy have provided a good treatment option in immune-mediated disorders like bullous dermatoses, collagen vascular diseases and cutaneous lymphomas. Other anecdotal and less substantiated reports point to its use in chronic disorders like atopic dermatitis and psoriasis. Untoward dermatological manifestations include mainly purpuric rash and GVHD. Since planned studies may not be possible, pertinent observations from chance situations on the effect of blood transfusion in dermatoses would add valuable information.

Dermatological aspects of cerebrovascular diseases.

Neurological symptoms are sometimes triggered by the same mechanisms as are skin manifestations. They include genetic conditions like the epidermal nevus syndrome, the Sneddon syndrome, Fabry disease and others, as well as certain inflammatory disorders like erythematous lupus, Bechet disease. Basically all conditions giving rise to anticoagulation processes may cause simultaneously neurological and cutaneous manifestations. Cerebrovascular stroke is the third most common condition of death in the developed world after cancer and ischemic heart disease. The mechanisms responsible for development of skin manifestations in patients afflicted by stroke are shortly reviewed. Stroke may also influence the already existent skin diseases.

Pigmentary mosaicism of hyperpigmented type in two sisters.

A 17-year-old girl and her 15-year-old sister presented with progressively increasing streaks of reticulate hyperpigmented macules arranged in a whorled pattern over the trunk and extremities (Figure), which appeared soon after birth. The face, palms, soles, eyes, and mucous membranes were spared. Both parents were unrelated Saudis. There was no history of any preceding eruption or any associated systemic abnormality, except for recurrent oral ulcers in both patients for several years. The younger one also had one episode of genital ulcers. Dermatological examination of both parents and the patients' three brothers and one sister were normal with no history of oral ulceration. Examination revealed few aphthous ulcers in either cases, but no joint or eye symptoms. Pathergy testing in both cases was negative. Ophthalmological examination and consultation revealed no signs of Behcet's disease. Routine blood tests did not show any abnormalities. Skin biopsies were taken from pigmented and normal skin in both patients. Histopathological examination of pigmented skin in both cases revealed basal cell hyperpigmentation with pigmentary incontinence. Similar features but in milder form were seen in the biopsies of normal skin in both cases.

King Faisal International Prize for Medicine.

This is a brief commentary about the King Faisal International Prize for Medicine and its previous winners.

Fixed drug eruption to ibuprofen in daughter and father.

Fixed drug eruption (FDE) is a common cutaneous reaction which may be seen in reaction to several medications. The usual etiologic agents associated with FDE are phenazones, sulfonamides, and tetracyclines. Often the causative agent is made out from the patients history; in some cases, oral challenge or topical testing may be required. The pathophysiology of FDE is unclear. Cell-mediated, rather than humoral immunity is thought to be involved. Herein we report a case of FDE in a daughter and father.

Dermatological publications in the Gulf Cooperation Council countries. An analysis of 1966-2004 Medline papers.

OBJECTIVE: To investigate the publications in dermatology cited in the Medline from 6 countries of the Gulf Cooperation Council (GCC) from 1966 to 2004. METHODS: Medline was searched with the aid of Internet provider Pubmed using the same strategy at a given time for all countries. RESULTS: At the time of search, the Medline listed biomedical research papers from the GCC countries totaled 12837. Of these, 140 were in Dermatology. The Kingdom of Saudi Arabia followed by Kuwait was by far the most prolific contributor, whereas almost none were noted from Bahrain. The publications were highest during the year 2002 (19) followed by 2003 (13), most of them being in the English language in the International Journal of Dermatology (60 citations) and Pediatric Dermatology (13 citations). CONCLUSION: Though the GCC countries have seen a relatively small period in the history of development of medical research, data show that they are trying to keep pace with the rest of the developed world. What remains to be exploited is their good economy that should be directed to provide better infrastructure and improve the quality of training programs. Professional societies within the region must play an active role in ensuring optimum and judicious use of funds.

Skin cancers in Western Saudi Arabia.

OBJECTIVE: A retrospective analysis of skin cancers in a major referral centre in Taif region, Kingdom of Saudi Arabia, (KSA). METHODS: The case records of all malignant skin cancers diagnosed during a 10 year period, from 1992 through to 2001 were taken for the study. The clinical and histopathological details were noted. These were compared to reports from the rest of KSA and other countries. RESULTS: One hundred and four cases of malignant skin lesions including primary and metastatic tumors were seen. The majority were Saudis. The male to female ratio was 2.25:1. Most of the patients were over the age of 60 years. Basal cell carcinoma was the most frequent (51%) followed by squamous cell carcinoma (26%) and malignant melanoma (12.5%). Other rare primary tumors were those arising from the skin appendages, dermatofibrosarcoma protuberans and Kaposi's sarcoma. Metastatic skin lesions were seen in 5; in one it resulted from a surgical procedure and in the others the primary site could not be determined. CONCLUSION: The number of patients seen in this report is not high indicating that protective factors like clothing and skin type of the individual played a protective role. However, we feel that more studies should be encouraged in other regions along with the creation of a registry within each area to monitor the information regarding skin cancers. This could then be incorporated in health education programmes to be imparted to the public.

Cutaneous signs.

Cutaneous signs play a significant role in clinical medicine. Signs have often been named after the initial observer. They may indicate either dermatologic or systemic illness and aid the examiner in diagnosis and relevant investigations. Some are specific, some have been described in other conditions, and few have lost their relevance. Most of the signs are related to the pathogenesis of the disease but the cause of some is not clear.

Kindler syndrome: two additional features.

Kindler syndrome is a hereditary condition that combines the features of blistering and photosensitivity in infancy and early childhood with progressive poikiloderma. We report additional features observed in one affected individual.