Skin manifestations caused by pigeon ticks (Argas reflexus).

Three adult patients (one woman and two men) presented with polymorphous skin manifestations caused by pigeon ticks (Argas reflexus). These manifestations were characterized by wheals with a central hemorrhagic point in the first patient, crusted-ulcerative lesions in the second, and pustular lesions in the third patient. We observed specific IgE against a somatic extract (antigen A) and the saliva (antigen B) of A. reflexus in two patients.

Albendazole: a new therapeutic regimen in cutaneous larva migrans.

BACKGROUND: Various therapeutic modalities have been used to treat cutaneous larva migrans, including physical treatments (cryotherapy), topical drugs (tiabendazole), and systemic drugs (tiabendazole, albendazole, and ivermectin). Physical treatments are often ineffective and not devoid of side-effects. Topical tiabendazole is difficult to find in many countries; it is effective orally but frequently causes side-effects. Ivermectin has been used in a small number of patients. METHODS: Eleven (six men and five women) adult patients with cutaneous larva migrans characterized by multiple and/or diffuse lesions were treated with oral albendazole (400 mg daily for 7 days). No other topical or systemic drugs were used and no physical treatment was given. RESULTS: All patients were cured at the end of treatment. No side-effects were complained of or observed, and no laboratory abnormalities were recorded. No recurrences were observed. CONCLUSIONS: Albendazole is effective in the treatment of cutaneous larva migrans characterized by multiple and/or diffuse lesions. This new therapeutic regimen can reduce the number of no responses and recurrences, sometimes observed following shorter (e.g. 3-5 days) treatments with albendazole. The longer duration of treatment is not accompanied by the appearance of new and/or more severe side-effects.

Acute urticaria caused by pigeon ticks (Argas reflexus).

A 28-year-old man was admitted to our institute because of acute urticaria appearing a few hours earlier. The patient stated that during sleep he had been bitten by a large number of "insects," which had dropped from wooden ceiling beams under the roof of his room. The patient was living in the center of Milan in a very old house, where numerous pigeons had built their nests under the rooftop. The patient brought along with him some examples of these "insects," which were later classified as pigeon ticks (Argas reflexus) (Figs. 1,2). Dermatologic examination revealed the presence of numerous wheals and erythemato-papular lesions on the neck and trunk. These lesions were of different shapes and sizes, bright red in color, and with a small central ulceration corresponding to the tick bite. In addition, there were numerous excoriated lesions due to scratching; the patient in fact complained of very intense pruritus. The general physical examination was within normal limits. Laboratory examinations revealed only slight leukocytosis (9300 WBC/mm3). All other laboratory tests were negative; in particular, the assay for anti-Borrelia burgdorferi IgG and IgM was within normal ranges (< 1:256 and < 1:64, respectively). These results were confirmed on subsequent blood samples. Positive radioallergosorbent tests (RAST) to a somatic extract and to the saliva of the tick were observed. A diagnosis of acute urticaria caused by A. reflexus was made. The patient was treated with betamethasone (4 mg intravenously) and chlorpheniramine (10 mg intramuscularly), with resolution of the clinical picture within 3 days.

Tinea corporis bullosa anularis.

A case of annular bullous tinea corporis (tinea corporis bullosa anularis) in a 27-year-old woman is reported. The infection was characterized by numerous lesions localized exclusively to the forearms and the legs. These lesions were erythematous and scaling with bullous and annular borders. Mycological culture yielded Microsporum canis.

Pterygium inversum unguis. Report of 19 cases and review of the literature.

BACKGROUND: Pterygium inversum unguis is a rare abnormality of the nail bed that remains adherent to the ventral surface of the nail plate, resulting in a subungual extension of the hyponychium and obliteration of the distal groove. OBJECTIVE: The aim of our article is to illustrate the cases of pterygium inversum unguis that we observed in the last 20 years and to discuss them according to a broad review of the literature. RESULTS: Nineteen new cases of pterygium inversum unguis have been observed: one congenital idiopathic form, five acquired idiopathic forms, and 13 secondary forms. CONCLUSION: Our study and the review of the literature demonstrate that the most common forms of pterygium inversum unguis are the acquired secondary ones. They are generally related to systemic connective tissue diseases and, in particular, to progressive systemic sclerosis and systemic lupus erythematosus.

Familial occurrence of isolated accessory tragi.

Three sibs were affected by numerous accessory tragi. On clinical examination, no other associated developmental defects, such as the Goldenhar syndrome, were detected.

Pigmentation of the gums following hydroxychloroquine therapy.

The authors describe a case of pigmentation of the gums occurring after therapy with hydroxychloroquine. A twenty-eight-year-old woman with discoid lupus erythematosus was treated only with hydroxychloroquine. After seven months of this therapy, a diffuse bluish-gray pigmentation was apparent on the vestibular surface of the gums of both dental arches. No pigmented lesions were noticed on either the skin or the nails.

[Efficacy and cardiovascular tolerability of minotricon in the treatment of seborrheic alopecia]. / Studio di efficacia e tollerabilità cardiovascolare di "Minotricon" nel trattamento dell'alopecia seborroica.

The paper reports the results of local treatment using minoxidil 2% in a watery solution at a dose of 2 ml/day in 50 patients affected by androgenetic alopecia. The results were analysed statistically using Wilcoxon's non-parametric test and Mac Nemar's test.