Aquagenic wrinkling of the palms in a cystic fibrosis carrier.

A 16-year-old girl presented with a 3-year history of painful swelling and wrinkling of her palms on exposure to water. Physical examination, after less than 2 min of immersion, showed thickening and exaggerated wrinkling of the palms giving a whitish pebbly appearance. Aquagenic wrinkling of the palms was diagnosed. The patient was tested for the common cystic fibrosis mutations, and was found to be heterozygous for the arg117His cystic fibrosis mutation. Her sweat test was normal.

Unusual case of lymphoedema in a morbidly obese patient.

A morbidly obese 57-year-old woman presented with dermatological complications of obesity including cellulitis and severe localized lymphoedema of the right leg. There were two large pedunculated masses on the right lateral thigh with early involvement of the left and overlying skin changes of chronic lymphoedema. Our patient's condition is clinically consistent with a new entity recently described in the surgical pathology literature as massive localized lymphoedema.

Toward the discrimination of early melanoma from common and dysplastic nevus using fiber optic diffuse reflectance spectroscopy.

We describe a study of the discrimination of early melanoma from common and dysplastic nevus using fiber optic diffuse reflectance spectroscopy. Diffuse reflectance spectra in the wavelength range 550 to 1000 nm are obtained using 400-microm core multimode fibers arranged in a six-illumination-around-one-collection geometry with a single fiber-fiber spacing of 470 microm. Spectra are collected at specific locations on 120 pigmented lesions selected by clinicians as possible melanoma, including 64 histopathologically diagnosed as melanoma. These locations are carried through to the histopathological diagnosis, permitting a spatially localized comparison with the corresponding spectrum. The variations in spectra between groups of lesions with different diagnoses are examined and reduced to features suitable for discriminant analysis. A classifier distinguishing between benign and malignant lesions performs with sensitivity/specificity of between 6469% and 7278%. Classifiers between pairs of the group common nevus, dysplastic nevus, in situ melanoma, and invasive melanoma show better or similar performance than the benign/malignant classifier, and analysis provides evidence that different spectral features are needed for each pair of groups. This indicates that multiple discriminant systems are likely to be required to distinguish between melanoma and similar lesions.