Eruptive generalized clear cell syringomas.

Syringomas occur quite commonly, but the occurrence of widespread lesions is rare. A patient is described with the unique coincident findings of eruptive generalized syringomas associated with an unusual microscopic preponderance of clear cells.

Erythema elevatum diutinum. Response to dapsone.

A patient with a 20-year history is presented as a classic example of erythema elevatum diutinum, with a dramatic response to dapsone therapy, and with interesting features of improvement during pregnancies and occurrence of giant cell tumors of soft tissue, neither of these latter features having been previously reported.

Pseudofolliculitis vibrissa.

Pseudofolliculitis can occur wherever hair is cut. A perforating, ingrowing vibrissa developed in our patient, who admitted to cutting his nasal hair. We call this condition, "pseudofolliculitis vibrissa."

Emotional eccrine sweating. A heritable disorder.

A family with hereditary emotional hyperhidrosis is described. The inheritance pattern is autosomal dominant. A simple quantitative palmar sweat test was used to objectively confirm historical data. Of two family members tested, both had a marked decrease in palmar sweat secretion during administration of diltiazem, a calcium-channel blocker. Additional studies in a large group of patients are needed to extend this observation.

Thiotepa-induced leukoderma.

Periorbital depigmentation developed in a black man approximately six months after the application of an ophthalmic solution containing thiotepa. The drug was used postoperatively to prevent revascularization after removal of a pterygium. By light and electron microscopy, melanocytes were apparently absent in the depigmented area. The list of medications and chemicals that can cause cutaneous depigmentation is growing. An appropriate history may be of considerable value in the evaluation of vitiligo-like conditions.

Hidrotic ectodermal dysplasia in a black mother and daughter.

Hidrotic ectodermal dysplasia is a rare genodermatosis with clinical hallmarks of alopecia, nail dystrophy, and palmoplantar hyperkeratosis. This report calls attention to the first reported cases, to our knowledge, of hidrotic ectodermal dysplasia in a black mother and daughter.

Multiple hamartoma syndrome (Cowden's disease) associated with non-Hodgkin's lymphoma.

A 70-year-old woman with the multiple hamartoma syndrome is described. Diagnosis was based on the clinical presentation and histopathologic examination of cutaneous trichilemmomas. The case is reported to document the association of Cowden's disease with non-Hodgkin's lymphoma. This is the first known report of the occurrence of trichilemmomas in the sacral area. The literature concerning the association of the multiple hamartoma syndrome with malignancy is reviewed.

Oral hairy leukoplakia. A distinctive marker of human T-cell lymphotropic virus type III (HTLV-III) infection.

Oral hairy leukoplakia (HL) is a newly described lesion occurring principally on the lateral borders of the tongue in immunosuppressed homosexual men infected with human T-cell lymphotropic virus type III (HTLV-III). Clinically, HL appears as a slightly raised, poorly demarcated lesion with a corrugated or "hairy" surface. Histologically, the lesion is characterized by keratin projections on the surface (which often resemble hairs), parakeratosis, and acanthosis. In addition, large pale-staining cells with pyknotic nuclei are seen in the upper stratum malpighii, which appear similar to the koilocytes described in uterine condylomata. Candida organisms are frequently observed on the lesion surface. Little, if any, subepithelial inflammation is present. Human papillomavirus and Epstein-Barr virus have been identified in biopsy specimens from lesions of oral HL. The association of this lesion in patients with HTLV-III infection has been established. We saw a patient with HTLV-III infection and HL, in whom the immunochemical and ultrastructural findings revealed the presence of a mixed viral infection. Because oral HL may be of diagnostic value as an early indicator of HTLV-III infection, awareness of its characteristic clinical, histologic, immunochemical, and ultrastructural features is important.

Mandibulofacial dysostosis (Treacher Collins syndrome): a case report.

Mandibulofacial dysostosis, also known as Treacher Collins syndrome, is a rare congenital anomaly that must be identified in infancy to prevent irrevocable developmental impairment. Information is sparse in the current medical literature concerning this rare syndrome. This article reports a case of Treacher Collins syndrome with the presence of a scarring alopecia and acne keloidalis nuchae, which are possibly coincidental symptoms, but have not been previously described clinically in this malady.

Malignant melanoma of the foot in black patients: a case report and literature survey.

Malignant melanoma in black patients is not the rare entity previously supposed if the numerous reported accounts are considered. In black patients, the tumor appears most commonly in the pedal region. The plantar surface appears to be most frequently involved. The literature on melanoma in blacks provides confusing statistics. Malignant melanoma in blacks represents a small, well-delineated subset of melanomas possibly with its own incidence and prognosis. A case report is presented, with a search of the Walter Reed Army Medical Center Tumor Registry and a review of pertinent current dermatological literature.

Trichostasis spinulosa.

Usually occurring on the mid-face, especially on the nose, trichostasis spinulosa occurs more commonly in young, adult black women. The lesions of trichostasis spinulosa resemble open comedones (blackheads). It may be treated with tweezing, dipilatory wax, and topical retinoic acid.

Papillary eccrine adenoma.

This benign tumor derived from eccrine sweat glands is usually found on the distal extremities. It is related to a syringoma and must be distinguished from a sweat gland carcinoma. It occurs most often in black patients. Complete surgical excision is the treatment.

Histopathologic changes in condylomata acuminata after application of podophyllum.

The histologic changes of podophyllin-treated condylomata acuminata were studied at 24-hour, 48-hour, and 7-day intervals. The 24-hour specimens had scattered individual atypical cells, whereas 48-hour specimens demonstrated small focal areas of atypia. Seven-day specimens exhibited very mild atypia of cells. All treated specimens had inflammation-necrosis ranging from scattered inflammatory cells to degeneration of the squamous epithelium.

Apert's syndrome.

We report herein a case of Apert's syndrome, which is characterized clinically by cranial, facial, and limb malformations. Acne vulgaris of the upper extremities constitutes the dermatologic hallmark of this rarely reported disorder.

Multifocal eosinophilic granuloma of skin and bone. Thirteen year surveillance of a patient.

A sixty-four-year-old man is presented herein with a documented history of eosinophilic granuloma of both mastoids associated with cutaneous involvement. The thirteen year course of his condition is described and histologic correlation, including electron microscopic studies, is presented. The presence of Langerhans' cell granules in the histiocytes corroborated the diagnosis. The clinical lesson gleaned here is that otitis media in a middle-aged or older adult may be the initial clue to a diagnosis of eosinophilic granuloma.

Pseudoainhum associated with plica neuropathica.

Pseudoainhum due to mechanical factors is an uncommon occurrence in adults. A patient is described in whom continuous manipulation of the hair resulted in both a constricting band of hair around one finger and the unusual hair formation known as plica neuropathica. The result was near amputation of the finger.

Cutaneous inoculation tuberculosis: prosector's wart occurring in a physician.

Cutaneous inoculation tuberculosis may occur either a primary or secondary infection. When the condition occurs in medical or laboratory personnel after contact with tuberculous material the term "prosector's wart" is often used. A case is reported in a physician following trauma during an autopsy on a tuberculous patient.

A new device in the treatment of hyperhidrosis by iontophoresis.

All participants with a baseline print score of greater than 1 demonstrated reduced sweating for up to six weeks following treatment with the Drionic device. Because of experimental design flaw, similar results were not obtained from those participants producing a baseline sweat print of 1. Therefore, the impression from these results is that, while not completely supported by objective data, it is possible to substantiate the subjective information related by patients in the control of hyperhidrosis.

Leukemia cutis mimicking stasis dermatitis.

A patient with chronic myelogenous leukemia (CML) in blast crisis experienced a peculiar painful eruption on his left lower extremity during the preterminal phase of his disease. The lesion was characterized by tender, edematous, purpuric infiltration which resembled stasis dermatitis clinically. Dermatopathologic examination demonstrated leukemia cutis.

Metastatic umbilical carcinoma: the Sister Joseph's nodule.

Metastatic umbilical carcinoma has been referred to by generations of physicians as Sister Joseph's nodule. Though not common, this characteristic lesion is important to recognize and properly evaluate. We present a case of an eighty-two-year-old woman with a Sister Joseph's nodule due to an unknown primary carcinoma, and we review the diagnostic and prognostic features of umbilical metastases.