Penicillamine induced pseudoxanthoma elasticum with elastosis perforans serpiginosa.

Long term D-penicillamine therapy, especially when used to treat Wilson's disease has been shown to cause elastosis perforans serpiginosa, pseudoxanthoma elasticum perforans and other degenerative dermatoses. We report a 23-year-old male patient who presented with multiple firm papules, nodules over the neck, axillae, front of elbows for five years. He was a known case of Wilson's disease on long-term treatment with penicillamine for the past 12 years. The papulonodular lesions were non-tender and some were discrete while others were arranged in a circinate pattern. There was central scarring of the skin within the circinate lesions. In addition, there were several small yellowish papules on both sides of the neck which eventually became confluent to form plaques. Histopathology confirmed the diagnosis of elastosis perforans serpiginosa and pseudoxanthoma elasticum. He was treated with cryotherapy (using liquid nitrogen through cryojet) for former lesions. The lesions showed remarkable improvement after five sittings. Now the patient is under trientine hydrochloride (750 mg twice daily) for Wilson's disease.

Connective tissue lipoatrophic panniculitis.

A 23 years old girl with a past history of sero-positive oligoarticular juvenile idiopathic arthritis developed nodules and depressed scars over face and limbs. Biopsy from the lesion revealed mixed panniculitis. She responded to steroids and hydroxychloroquine but has residual lipoatrophic scars needing reconstructive surgery.

Sweet's syndrome.

A series of 10 cases of Sweet's syndrome observed during a period of 3 years in Eastern parts of Libya is reported. All the patients were females. Fever and peripheral neutrophilia were not found in all these cases. Dapsone was found to be very effective in the cases in which it was tried.

Fixed drug eruption due to cotrimoxazole.

Drug eruptions are among the most common cutaneous disorders encountered by dermatologists. They occur in many forms and mimic many dermatoses. Fixed Drug Eruption (FDE) has its own characteristics and may be associated with ingestion of a number of agents. The incidence of FDE induced by a specific drug depends on the frequency with which the agent is used in a given part of the world. Recently we have encountered many cases of FDE due to Cotrimoxazole.

Pediculosis capitis in Benghazi, Libya. A school survey.

A school survey of pediculosis capitis in Benghazi, Libya, revealed an alarmingly high prevalence of 78.6%. The percentage of infestation was 67.2% for boys and 88.1% for girls. It was more frequent in schools located in rural areas (85.55%) as compared with those in urban areas (44.28%). There was no significant difference in infestation in younger and older children of either sex. Besides other factors for such a high prevalence, the lack of health education of family members may play a crucial role in transference and louse infestation.

Ninety-eight fixed drug eruptions with provocation tests.

Ninety-eight patients having fixed drug eruptions were subjected to provocation tests. Cutaneous involvement was seen in 43, mucous membrane in 33 patients, while cutaneous and mucous membrane involvement was seen in 22 patients. The causative drugs were found to be trimethoprim-sulphamethoxazole (45), acetylsalicylic acid (24), hyoscine butylbromide (Buscopan) (8), ibuprofen (Brufen) (6), oxyphenbutazone (6), tetracycline hydrochloride (2), phenolphthalein (1) and phenobarbitone (1). There was evidence of cross-sensitivity between oxyphenbutazone and phenylbutazone.

Herpetiform Pemphigus.

In a case of pemphigus foliaceus, the initial clinical presentation was like dermatitis herpetiformis. The patient responded to low doses of corticosteroids.

Clinical Pattern of Bullous Disorders in Eastern Libya.

A retrospective clinical analysis of 66 patients with various bullous disorders seen over a period of 5 years in Benghazi, Libya showed that pemphigus vulgaris was the commonest disorder followed by buuous' petaphigoid. Other bullous dermatoses were rare. The clinical picture and treatment schedule with follow up of some patient is presented.

Acrokerato - Elastoidosis Lineaius Manus.

A Variant of acrokerato elastoidosis characterized by linear, scaly, hyperkeratotic, fissured and transluscent papules on sides of thumbs and index fingers, was seen in 55 male patients, above the age, of fifty years. Actinic damage and repeated trauma were not evident. The term acrokerato - elastodosis linearis manus is suggested for this variant.

Ichtryosis Linearis Circumflexa.

A case of inchthosis linearis circumflexa occurring in the same family having classical migratory polycyclic skin lesion and flexural hyperkeratosis since infancy of ichthyosis linearis circumflexa multiple serpiginous polycyclic acteristic double edged scales. The patient had unusual features like pruritus and thickening of the plams and soles. One younger sib of the patient appeared to have lamellar ichtyosis. The response to therapy was not satisfactory.

Lipoid Proteinosis.

A case of lipoid proteinosis presented with multiple papular lesions on the face and hoarseness of voice from early infancy. Five sibs of the patient were affected and one had died early in infancy, probably because of laryngeal obstruction.