Scurvy in a 10-year-old boy.

Scurvy, or hypovitaminosis C, is an uncommon condition that exists today primarily within certain unique populations-particularly the elderly subjects, patients with neurodevelopmental disabilities or psychiatric illnesses, or others with unusual dietary habits. Vitamin C is an essential nutrient in the human body, and is important in synthesizing collagen factor whose faulty production is responsible for most of the clinical manifestations of scurvy. These clinical manifestations can include dystrophic or corkscrew hairs, gingival hyperplasia, and weakened blood vessel walls, causing bleeding in the skin, joints, and other organs. Although rare in the Unites States, the presence of scurvy should not be forgotten because of its presence among susceptible populations. Moreover, with its diagnosis, treatment and cure is one of the simplest in modern medicine. We report a case of scurvy in a 10-year-old autistic child.

Two reports of phacomatosis pigmentovascularis type IIb, one in association with Sturge-Weber syndrome and Klippel-Trenaunay syndrome.

We present two rare cases of phacomatosis pigmentovascularis type IIb, with one patient demonstrating concurrent Sturge-Weber syndrome and Klippel-Trenaunay syndrome. To the best of our knowledge, this is the second infantile case meeting diagnostic criteria for systemic phacomatosis pigmentovascularis type IIb, Sturge-Weber syndrome and Klippel-Trenaunay syndrome in the English language literature.

Acquired acrodermatitis enteropathica secondary to alcoholism.

Acrodermatitis enteropathica is a zinc deficiency disorder characterized by well-demarcated, erythematous, eczematous plaques in a periorificial and acral distribution. Hereditary and acquired forms have been described. We report a case of acquired acrodermatitis enteropathica secondary to alcoholism. Treatment of the underlying disorder and zinc replacement therapy resulted in rapid resolution of the condition.

Human dirofilariasis: raccoon heartworm causing a leg nodule.

Human dirofilariasis is a rare zoonotic infection caused by various filarial species of the genus Dirofilaria. Dirofilaria tenuis causes heartworm infection in raccoons and infrequently causes human disease. The Dirofilaria organism accidentally is transmitted to humans through the bite of a mosquito and subcutaneous nodules, coin lesions of the lungs, or ophthalmic lesions develop at the inoculation site. We report a rare case of D tenuis infection in a patient that manifested as a subcutaneous nodule.

UV light tanning as a type of substance-related disorder.

OBJECTIVE: To better understand the complex motivations involved with UV light (UVL) tanning behavior. DESIGN: Two written instruments, the CAGE (Cut down, Annoyed, Guilty, Eye-opener) Questionnaire, used to screen for alcohol abuse or dependence, and the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria for substance-related disorders, were modified to evaluate subjects for a substance-related disorder involving UVL tanning. SETTING: Galveston Island beach. Subjects A total of 145 beach-goers. MAIN OUTCOME MEASURES: Positive findings from the 2 evaluation instruments. RESULTS: Of the 145 subjects, 38 (26%) met the modified CAGE criteria, and 77 (53%) met the modified DSM-IV-TR diagnostic criteria for a substance-related disorder with regard to UVL and related sun tanning. The results from both instruments were significantly associated (P = .03). CONCLUSIONS: Individuals who chronically and repetitively expose themselves to UVL to tan may have a novel type of UVL substance-related disorder.

Acneiform eruption induced by Iressa (gefitinib) tablets used to treat non-small cell lung cancer.

Many medications have been reported to induce acneiform eruptions. A relatively new chemotherapy drug, gefitinib (Iressa), approved by the Food and Drug Administration in 2003 for the treatment of advanced-stage non-small cell lung cancer (NSCLC), has been reported to cause acne or an acne-like eruption. We report an Asian female who presented with hundreds of erythematous papules and pustules on her face, chest, and back, all of which appeared after starting gefitinib to treat non-small cell lung cancer.

The economic impact of acute sunburn.

OBJECTIVE: To estimate the economic impact of sunburn in a beachgoing population during the summer. DESIGN: Survey. SETTING: Galveston, Tex, beachfront. PARTICIPANTS: Convenience sample of 56 sunburned beachgoers. Intervention None. MAIN OUTCOME MEASURES: Days of work lost as a result of sunburn in the previous year. RESULTS: Thirty-eight respondents (68%) reported painful sunburn. Sunscreen use did not prevent painful sunburn (23/38 [60%]). Those consuming alcohol at the beach had more severe sunburns than nondrinkers and had a higher frequency of analgesic use after sunburn (69% vs 26%, P =.007). Five men (5/18 [28%]) and 4 women (4/38 [10%]) missed a total of 9 and 8 days of work, respectively, because of sunburn within the prior year. Based on these findings and attendant assumptions, it is estimated that sunburn may account for as many as 92 720 lost workdays by Galveston beachgoers each year. The annual economic impact for lost work and treatment may exceed $10 million. CONCLUSION: Sunburn is a costly and preventable skin injury.

Double exposure: natural and artificial ultraviolet radiation exposure in beachgoers.

BACKGROUND: Although the beach is a high-risk environment for ultraviolet light exposure and subsequent skin damage, little is known about beachgoer tanning habits outside the beach setting. Our purpose was to evaluate indoor tanning and additional, nonbeach sunlight exposure in a beachgoing population. METHODS: We conducted an epidemiologic survey. RESULTS: There was more use of indoor tanning salons among sunbathing beachgoers who applied little or no skin protection from the sun (50.8% [31 of 61 respondents]) compared with nonsunbathing beachgoers (22.7% [5 of 22 respondents]). In addition to increased use of tanning salons, we observed that poorly protected sunbathers tanned at locations other than the beach on a regular basis (50.8% [31 of 61 respondents]) more than nonsunbathers did (9.1% [2 of 22 respondents]). CONCLUSION: Beachgoing sunbathers often used both natural sunlight and tanning beds, subjecting themselves to two forms of ultraviolet radiation exposure.