Sudden onset anhidrosis in an otherwise healthy male.

Acquired idiopathic generalised anhidrosis (AIGA) is a rare disorder that is characterised by sudden onset generalised absence of sweating without any dermatological, neurological or sweat gland abnormalities. AIGA predominately affects young males, mostly involving patients of Asian descent. There have been approximately 100 reported cases worldwide, most of which were reported in Japan. In Singapore, it is rarely seen with one case series on 15 cases of AIGA reported in a 2014 study. Here, we present a case of AIGA who responded well to conservative management with sweating activity.

Eccrine nevus affecting the forearm of an 11-year-old girl successfully controlled with topical glycopyrrolate.

Eccrine nevi are rare lesions characterized by a sharply demarcated area of localized hyperhidrosis. We present an 11-year-old girl with an eccrine nevus on her right lower forearm. To the best of our knowledge, this is the first case successfully controlled with topical glycopyrrolate wipes.

First case report of Nocardia veterana causing nodular lymphangitis in an immunocompromised host.

We report a unique case of ascending cutaneous lymphangitis in a 72-year-old immunocompromised man from which a newly described Nocardia species was isolated by 16S ribosomal gene sequencing. Treatment with trimethoprim-sulfamethoxazole resulted in successful resolution of symptoms. To the best of our knowledge, this is the first case report of N. veterana implicated in causing ascending cutaneous lymphangitis.

Mycoplasma pneumoniae infection associated with urticarial vasculitis mimicking adult-onset Still's disease.

Mycoplasma pneumoniae is well known to be a frequent cause of atypical pneumonia worldwide. However, it may also present with a wide variety of clinical features, including cutaneous symptoms, which are not widely recognised. Urticarial vasculitis occurring with M. pneumoniae has been described to occur in only one other case report. This amalgamation of non-specific clinical symptoms and signs can lead to a diagnostic dilemma. We describe a case of M. pneumoniae infection presenting with extrapulmonary manifestations and urticarial vasculitis, which was misdiagnosed as adult-onset Still's disease (AOSD). Had immunosuppressive therapy been commenced for AOSD in the presence of undiagnosed infection, this may have resulted in potentially serious consequences. This case highlights the need to remain vigilant about diagnosing M. pneumoniae as its serological diagnosis may take weeks and it has many extrapulmonary manifestations, which can masquerade as other conditions.