Use of commercial somatic cell counters to quantify somatic cells in non-lactating bovine mammary gland secretions.

Measurement of the somatic cell count (SCC) in milk is commonly used to detect mastitis in lactating dairy cows. Many techniques and tools have been developed and adapted to quantify milk SCC, but few tools have been evaluated in their ability to enumerate somatic cells in non-lactating bovine mammary secretions. This limits the tools available for detecting mastitis in non-lactating animals. The objective of these studies was to evaluate methods of somatic cell quantification, originally developed for milk, in their ability to quantify the SCC in non-lactating bovine mammary secretions when compared to the gold standard microscopic quantification method. Two experiments were conducted. In a first experiment, 222 mammary secretions were collected and diluted 1:10 with PBS. Cells in these suspensions were quantified microscopically and with a DeLaval Cell Counter. Microscopic SCC (MSCC) ranged from 1.9 × 106 to 259.5 × 106 cells/mL while DeLaval Cell Counter SCC (DSCC) ranged from 1.8 × 106 to 27.0 × 106 cells/mL; a measurement of agreement between the 2 measures, based on the Lin's Concordance Correlation Coefficient (CCC) suggested moderate agreement between measures (CCC = 0.60). In a second experiment 72 mammary secretions were collected and diluted 1:50 in PBS. Somatic cells in these suspensions were quantified microscopically, with a DeLaval Cell Counter, and by a DHIA laboratory using a Fossomatic™ FC. MSCC ranged from 1.6 to 47.5 × 106 cells/mL, DSCC ranged from 1.0 to 35.7 × 106 cells/mL, and Fossomatic SCC (FMSCC) ranged from 1.6 to 46.7 × 106 cells/mL. CCCs of 0.81 and 0.88 resulted when DSCC and FMSCC were paired with the MSCC, respectively. The results of this work indicate that a significantly greater concentration of somatic cells exist in non-lactating mammary secretions and dilution of these mammary secretions influences accuracy of SCC estimates. Future studies seeking to quantify somatic cells in mammary secretions from non-lactating cows should identify the most appropriate dilution factors specific to each method of measure, given that these two factors will influence the accuracy of SCC estimates. Development of a standardized approach for quantifying somatic cells in non-lactating dairy animals such as heifers and cows, via a rapid automated counter, can allow for the detection of mastitis in non-lactating dairy animals.

Myeloma-associated systemic amyloidosis presenting as chronic paronychia and palmodigital erythematous swelling and induration of the hands.

Mucocutaneous involvement occurs predominantly in primary systemic amyloidosis as well as in myeloma-associated systemic amyloidosis. It is rarely observed in other types of amyloidoses. Signs of such involvement may aid in the early diagnosis of the disease process. Herein, we describe a 64-year-old white male patient with myeloma-associated systemic amyloidosis in whom the disease presented with unique cutaneous lesions consisting of chronic paronychia and palmodigital erythematous swelling and induration of the hands. Following weekly regimens with prednisone (20 mg/day) and melphalan (2 mg/day) administered every 16 weeks, almost complete resolution of the cutaneous lesions was observed after 1 year of therapy. Also, in response to chemotherapy, modest regression of the myelomatous bone lesions and complete resolution of the underlying gammopathy occurred.

Crystal deodorant dermatitis: irritant dermatitis to alum-containing deodorant.

Two patients developed an irritant dermatitis of the axillae shortly after using an over-the-counter "natural deodorant crystal" product containing alum. We discuss this previously unreported, untoward reaction to alum, an ancient agent with newfound popularity as an alternative health product.

Report of an association between discoid lupus erythematosus and smoking.

Smoking has been shown to be associated with many medical disorders, including many involving the skin. While preliminary studies suggest a modest association between smoking and systemic lupus erythematosus, epidemiologic data on discoid lupus erythematosus (DLE) and smoking are lacking. To study this relationship, we examined current smoking habits in two unique patient populations with DLE. One group was compared with matched dermatology patients while the second group was compared with the corresponding statewide population. For both groups, the current smoking prevalence was much higher than that of the comparison population. For the control-matched group of DLE patients, smoking prevalence was found to be significantly greater than that of controls (odds ratio 12.2; p = 0.001). We therefore propose that smoking is a risk factor for development of DLE.

Report of a nipple nevus and an overview of accessory mammary tissue.

Supernumerary nipples, also known as accessory nipples, are the most frequently encountered congenital anomaly of the breast. Once associated with fertility or divine powers, they are now widely held to be of cosmetic significance only. During the past 20 years, however, there has been a steady number of articles reporting the suspected association of supernumerary nipples with numerous benign and malignant medical conditions. We describe a previously unreported accessory nipple variant occurring as a nevoid nodule surmounting an otherwise normal primary nipple. The patient was otherwise healthy. The embryogenesis of this anomaly is hypothesized to result from in utero nipple dichotomy, rather than a failure of regression along the embryonic milk line.

The causes and treatment of pseudofolliculitis barbae.

Pseudofolliculitis barbae, commonly referred to as "razor bumps" or "ingrown hairs," is a papular and pustular, foreign body inflammatory reaction that can affect any individual who has curly hair and who shaves. This condition is a particular nuisance to African-Americans. This report will discuss the causes of pseudofolliculitis barbae and present a systematic approach to treatment.

Localized crusted scabies of the scalp and feet.

An atypical case of crusted scabies in a patient with acquired immunodeficiency syndrome is presented in which lesions at the time of evaluation were confined to the scalp and feet. Because of the unusual presentation, the scalp involvement (which clinically mimicked seborrheic dermatitis) was initially missed. Although both the crusted variant of scabies and scabietic involvement of the scalp are well documented to occur in immunocompromised patients, to our knowledge scabies confined to the scalp and feet has not been previously reported.

Practical method for collecting nail plate specimens.

The use of a biopsy bag allows for the efficient collection of nail plate specimens. The bag functions as both a shield and net for the control and capture of nail clipping projectiles.

Hair casts: a case of pseudonits.

Hair casts are often misdiagnosed because of their close resemblance to nits from an infestation with pediculosis capitis. In their clinical presentation both of these disorders may appear to have white keratinous material adherent to hair shafts and can look very similar. Microscopic examination provides the definitive and correct diagnosis. We report a case of hair casts, also referred to as pseudonits.

An update on molluscum contagiosum.

Molluscum contagiosum is a common viral infection of the skin, and occasionally the mucous membranes, manifesting as benign tumors. The characteristic appearance is of pearly, umbilicated papules. The disease is self-limited in immunocompetent hosts, but may be protracted in those who are immunocompromised. Multiple local therapeutic options are available; the use of systemic agents has been reported in recalcitrant cases or in patients in whom topical therapy is difficult to apply.

The highly effective use of topical zinc pyrithione in the treatment of psoriasis: a case report.

Psoriasis is a common condition which, at times, can be difficult to treat. Patients with psoriasis face many social challenges and can suffer a great deal with their disease. As a result, any new topical agent is a welcomed addition to our therapeutic armamentarium. We present here a report of a case using a novel topical preparation of zinc pyrithione for the treatment of psoriasis. Topical zinc pyrithione appears to be a safe and effective treatment for psoriasis.

Drywall stilt dermatosis.

We describe a previously unreported occupational dermatosis occurring in a worker employed in drywall installation and finishing. This 50-year-old man presented with bilaterally symmetrical, parallel, linear crusted erosions on his anteromedial legs after wearing drywall stilts. The pathophysiology of this condition is considered.

Negative regulation of serum-responsive enhancer elements.

Transcription of the c-fos proto-oncogene and the cytoskeletal actin genes is induced within minutes of the addition of serum growth factors in a variety of cell types. Inhibitors of protein synthesis such as cycloheximide have been shown to dramatically potentiate the transcriptional response, an effect termed 'superinduction'. Although the stimulatory effect of serum has been shown to be transmitted through a cis-acting enhancer sequence termed a serum response element (SRE), the sequence element(s) responsible for mediating the effect of cycloheximide has not been identified. We now report that a synthetic copy of the c-fos SRE is sufficient to confer cycloheximide-dependent inducibility upon a heterologous promoter. This does not require the presence of serum, but several mutations in the SRE that impair serum-inducibility also impair cycloheximide-inducubility. These results imply that serum-responsive enhancer elements are negatively regulated by one or more labile proteins and that both positive and negative regulators of enhancer activity require a functional 'CArG box', a sequence domain previously implicated in muscle-specific transcription.