The challenge of diagnosing atypical exanthems: a clinico-laboratory study.

BACKGROUND: Although atypical exanthems pose a severe diagnostic challenge, they have not been studied widely. OBJECTIVE: To identify the clinical features, laboratory parameters and other characteristics that help establish the etiology of atypical exanthems. METHODS: We collected the following information from 260 consecutive patients with atypical exanthems, including 108 children and 152 adults: demographic data, exanthem and enanthem morphology, clinical symptoms, month of outbreak and total duration. Throat, rectal, and vesicle swabs as well as urine and skin samples were examined for bacterial and viral signs. Serologic studies were performed for the most common infectious agents. RESULTS: Seven morphological patterns were identified: macular erythema, papular erythema, macular-papular erythema, erythematovesicular, macular-papular erythema with petechiae, erythema with pustules, and urticarial. Ninety-four cases were due to viruses, 38 to bacteria, 65 to drugs, 3 to parasites, and one to viruses-plus-drugs. Nineteen of the 25 cases with a petechial pattern had an infectious etiology (12 viral and 7 bacterial) and only 4 were iatrogenic. Sixty-one of 69 patients with enanthems were infectious (57 viral and 4 bacterial), 6 were iatrogenic, and 2 remained undiagnosed. The petechial pattern was infectious in 80% of cases (14 viral and 2 bacterial). Four cases were iatrogenic. During the spring and summer, 60% of exanthems were infectious and 21% were iatrogenic. Picornavirus infections exhibited summer prevalence (57%), peaking in July. LIMITATIONS: There were a variable number of patients with each of the morphological patterns. CONCLUSIONS: Morphological patterns, seasonal occurrence, and enanthem are key for etiological diagnosis of atypical exanthems.

Polymorphous light eruption and benign summer light eruption in Italy.

BACKGROUND/PURPOSE: Polymorphous light eruption (PLE) heterogeneity has been postulated, but the existence of benign summer light eruption (BSLE) is controversial. We studied the prevalence of the clinical patterns, criteria distinguishing BSLE from PLE, and diagnostic usefulness of phototest. METHODS: Five Italian Photodermatology Centres recruited retrospectively 346 patients with typical clinical history and/or presentation of PLE. Age, gender, skin type, family history and presence of atopy were considered. UVA and UVB MEDs and provocative phototests with UVA and UVB were obtained with a standardized procedure. Photopatch tests were applied according to the IRCDG rules. ANA were assessed by indirect immunofluorescence. RESULTS: Four criteria (predominance of women, shorter latency, uninvolvement of the face and absence of relapse during summer) identified BSLE in only 6.1% of cases. All had positive phototests, mostly with UVA. Uninvolvement of face, short latency and no seasonal relapses identified 11.7% patients, mostly with positive phototests to UVA. Short latency and no seasonal relapses in women identified 11.2% patients. Uninvolvement of face and no seasonal relapses in women identified 8.1% of patients. Uninvolvement of face and short latency in women identified 17.6% of patients. CONCLUSION: Criteria diagnosed BSLE in only a minority of patients, who were positive at phototesting, mostly with UVA.

Proteomic-based screening of miRNAs metabolic pathway targeting.

The analysis of miRNA expression profile is powerful support to screen new disease biomarkers. One miRNA can control the expression of several different protein mRNAs. Lack of knowledge about the process of target recognition is a weak point in the development of reliable computational tools for miRNA target selection. Here we present a novel integrative approach for to predict potential miRNA target. It is a workflow founded on integration proteomic and miRNA information. The software has been tested on a sample of proteomic data obtained from samples of mouse subjected to the effect of Environmental Cigarette Smoke (ECS).

In silico determination of potential antisense targets for human beta-globin variants.

The functional characterization of available genomic sequences is the major task of the research in the post-genome era. This complex task requires an integrative approach of high-throughput systems with in vitro and in vivo models in order to have a reliable evaluation of the biological function. The oligonucleotide antisense technology is one of the most promising approaches for the investigation of gene function; the crucial point of antisense experiments is the identification of optimal target sites for hybridisation. In this paper we have applied a bioinformatic tool for the recognition of optimal antisense targets. In order to evaluate the effect of mutational events on target selection we have tested the program on a sample of human beta-hemoglobin variants. The proposed algorithm software will be integrated in a web based tool at the site: http://www.nettab.org/agewa.