Scleromyxedema: therapeutic response to isotretinoin in three patients.

Scleromyxedema is a rare type of papular mucinosis that exhibits a generalized lichenoid pattern. A wide variety of clinical manifestations can occur in patients with this disease. Cutaneous involvement is characteristic, but neurologic, cardiovascular, renal, neoplastic, and other systemic manifestations have been described. A monoclonal gammopathy may be present. Many treatment modalities have been used in the past for scleromyxedema. None, however, have shown consistently favorable results. This report concerns the cases of three patients with scleromyxedema who were treated with isotretinoin.

Dyskeratosis congenita in a girl simulating chronic graft-vs-host disease.

Dyskeratosis congenita (DCG) is a rare genodermatosis characterized primarily by reticular hyperpigmentation of the skin, dystrophy of the nails, and leukoplakia. It is frequently associated with Fanconi-type pancytopenia. Although DCG has a male predisposition, it has been reported in several female patients. We encountered a case of DCG occurring in a girl whose clinical features simulated chronic graft-vs-host disease (GVHD). Because DCG and chronic GVHD share several clinical and histologic features, physicians should always examine a patient for possible DCG whenever a diagnosis of chronic GVHD is considered. In addition, the similar manifestations of the two disorders suggest a similar pathogenesis on a cellular level in the immunologic system.

A statistical analysis of a pediatric dermatology clinic.

Statistical analysis was performed of the diseases seen and therapies utilized during the first two years of the Pediatric Dermatology Clinic at the University of Miami School of Medicine, Miami, Florida. This survey includes 2,821 patient visits made by 1,578 patients. This analysis classifies patients by diagnosis, sex, age, race, and treatment. Diagnostic and treatment frequencies, sex and race ratios, and trends in the patient's age at presentation are also noted. This survey reveals a wide spectrum of pediatric dermatologic disease with 154 different diagnoses made. A review of the 86 different therapeutic modalities utilized is also presented.

Separation of platelet-rich plasma by modified centrifugal elutriation.

The Beckman centrifugal elutriation (CE) system is modified for the separation of platelet-rich plasma (PRP) from human and rabbit blood. The Beckman separation chamber is found inadequate for this purpose, and a new chamber of conical shape has been developed. Optimal flow rate for separating PRP from whole blood with the new chamber of 11.3 ml capacity is 3.5 ml/min while centrifuging at 2500 rpm or 700 g. Collection process takes about 4 minutes. This new process is based on the principle of centrifugal counterflow displacement and filtration, and is different from the CE process which is based on counterflow centrifugation and differential elution. About 90% of total platelets are recovered with this new process. The collected samples are free of leucocytes and contained only a few erythrocytes. Platelets collected by either differential centrifugation (DC) or new procedures are found to be similar in morphological characteristics, both being discoidal. Other characteristics such as aggregation response induced by ADP or epinephrine, serotonin-14C secretion, and survival of autologous platelets in rabbits are also found to be similar. However, ATP release induced by ADP is consistently higher from platelets prepared by our procedure than from those prepared by the DC procedure.