[SMS reminders can reduce non-attendance at consultations].

Each year, thousands of patients fail to attend their consulta-tions. In January 2014, 89/955 (9.3%) planned consultations were misheld at the Dermatology Department of Bispebjerg Hospital, Denmark. A total of 209 patients were interviewed about SMS (short message service) reminders. 82% of re-spondents had a positive opinion of SMS reminders, however, reminders were only enrolled in 17.7% and awareness unknown in 33%. Reminders guaranteed attendance in 6.2%, otherwise forgotten, but the system has a significant untapped potential. It can be improved through automatic enrolment already when referring the patient.

Pregnancy loss ascribable to parvovirus B19/erythrovirus is associated with a high prevalence of trisomy.

INTRODUCTION: In most cases of stillbirth, the cause is still unknown. AIM: The impact of parvovirus B19/erythrovirus infection and chromosomal abnormalities in stillborns and neonatal deaths. MATERIAL AND METHODS: 57 consecutive cases, 23 second-trimester abortions (from gestational weeks 16 to 22), 27 intrauterine fetal deaths (from gestational week 22 onwards) and 7 early neonatal deaths were examined for intrauterine parvovirus B19 infection with PCR, dot blot, Southern blot, in situ hybridization, specific IgM and IgG antibodies in maternal serum, fetal serum, placenta and fetal liver tissue. Chromosomal analysis and extensive histopathology were performed on all fetuses. RESULTS: A sensitive PCR was developed and enabled detection of 9 (15.8%) parvovirus B19-infected fetuses. Parvovirus B19 IgM and IgG antibody tests were in good concordance with PCR findings. 5 of 9 infected fetuses had a concurrent abnormality that could have contributed to fetal death, 4 of which (44%) were trisomy karyotypes, compared to 0/48 in the non-B19-infected group (p = 0.0004). CONCLUSION: Combination of PCR and specific parvovirus B19 IgG/IgM tests enabled high detection rates of parvovirus B19 infection in this series of 57 consecutive pregnancies with adverse outcomes. The high mortality rate in the B19-infected fetuses was partly explained by a high occurrence of fetal trisomy, compared to non-B19-infected fetuses, suggesting a higher vulnerability of the former. After correction for this concomitant karyotype abnormality, the percentage of presumably lethal infection due to parvovirus B19 was 8.8%.

A subcutaneous tumour in a patient with rheumatoid arthritis.

A 79-year-old Caucasian woman with rheumatoid arthritis (RA) for 27 years presented with a swelling on her left wrist. Both pain and a tingling sensation in the radial four fingers could be elicited by applying light pressure on the swelling. The patient was uncertain as to the actual onset of this swelling and had not complained, as it resembled many of the swellings of the hand region she had previously experienced. Primarily, an organised tenosynovitis was suspected with a presumed pressure on the median nerve, and a puncture was considered. Ultrasonography diagnosed a large hypoechoic mass. This is not unusual with longstanding inflammatory changes, which may contain elements of connective tissue. Using the Doppler function it turned out to be highly vascularised. The tumour could not be removed, but histology revealed a diagnosis of schwannoma.

Human parvovirus B19 (B19V) infection in systemic sclerosis patients.

BACKGROUND: Our previous reports suggested a possible association between parvovirus B19 (B19V) infection and systemic sclerosis (SSc), based on higher prevalence of B19V DNA in SSc patients in respect to controls. METHODS: In the present study, to further evaluate the differences in the pattern of B19 infection in SSc, skin biopsies and bone marrow samples from patients and controls were analysed for B19V DNA detection, genotyping and viral expression. RESULTS: B19V DNA was detected in skin biopsies from 39/49 SSc patients and from 20/28 controls. Bone marrow showed positive in 17/29 SSc patients, 5/21 haematological patients and 0/10 healthy controls. Genotype 1 was more frequent in skin and bone marrow from patients than from controls. Simultaneous persistence of 2 genotypes was detected in SSc skin and bone marrow samples, never in controls. Viral mRNA for capsid protein was detected in the skin of genotype 1-positive patients and not in control skins. CONCLUSION: The results outline some differences in the rate of persistence of B19V DNA, in the simultaneous persistence of 2 genotypes and in the pattern of viral expression among SSc patients and controls.

Phytophotodermatitis in 19 children admitted to hospital and their differential diagnoses: Child abuse and herpes simplex virus infection.

BACKGROUND: Phytophotodermatitis is a non-immunologic cutaneous reaction that can be provoked after contact with plants containing psoralens followed by sun exposure. OBJECTIVES: The purpose of this study is to describe the clinical features of phytophotodermatitis and its differential diagnoses, especially child abuse and herpes virus infection. METHODS: Nineteen children seen in two county hospitals are described. RESULTS: The 19 children had various cutaneous manifestations, which were mistaken in one patient for child abuse and in one child for herpes simplex virus infection. LIMITATIONS: The doctors' perception is based on the doctors' education. CONCLUSION: Children are susceptible to contact with psoralen-containing plants followed by sun exposure. Phytophotodermatitis is a difficult diagnosis, which can sometimes lead to the inappropriate investigation of child abuse or herpes simplex virus infection.