MEP1A allele for meprin A metalloprotease is a susceptibility gene for inflammatory bowel disease.

The MEP1A gene, located on human chromosome 6p (mouse chromosome 17) in a susceptibility region for inflammatory bowel disease (IBD), encodes the alpha-subunit of metalloproteinase meprin A, which is expressed in the intestinal epithelium. This study shows a genetic association of MEP1A with IBD in a cohort of ulcerative colitis (UC) patients. There were four single-nucleotide polymorphisms in the coding region (P=0.0012-0.04), and one in the 3'-untranslated region (P=2 x 10(-7)) that displayed associations with UC. Moreover, meprin-alpha mRNA was decreased in inflamed mucosa of IBD patients. Meprin-alpha knockout mice exhibited a more severe intestinal injury and inflammation than their wild-type counterparts following oral administration of dextran sulfate sodium. Collectively, the data implicate MEP1A as a UC susceptibility gene and indicate that decreased meprin-alpha expression is associated with intestinal inflammation in IBD patients and in a mouse experimental model of IBD.

Fungiform papillary glossitis: atopic disease in the mouth?

BACKGROUND: Asthma, eczema and hay fever are the classical manifestations of atopic disease. Geographic tongue (benign migratory glossitis) has also been reported to be a manifestation. Anecdotally, atopic people frequently report irritation of the tongue by heat and certain foods, which may be more common than realized. OBJECTIVES: To determine whether atopic people have an increased likelihood of a sensitive tongue manifest as inflamed fungiform papillae and a history of irritation by certain foods. PATIENTS/METHODS: A descriptive classification of inflammation of the fungiform papillae on the tongue was developed using a 9-point analogue scale where 1 was considered normal and 9 was considered to be severely inflamed. An opportunistic sample of participants were classified as atopic or not on the basis of a personal history of asthma, eczema or hay fever. An examination of the tongue was performed using the classification and then a questionnaire was administered on whether they burnt their tongue easily with hot food and whether they were irritated by certain foods. RESULTS: There were 200 participants aged 20 years and over of whom 104 (52%) were classified as atopic on the basis of the personal history. There was a significant positive association between increasingly inflamed fungiform papillae and the likelihood of being atopic. There was also a positive association between increasing inflammation of the fungiform papillae and a history of both burning the tongue easily and irritation of the tongue by food. There was an increased likelihood of a history of irritation of the tongue with certain foods amongst atopic participants and they were also more likely to burn their tongue with hot food than those who were nonatopic. CONCLUSION: Atopic people are more likely than the normal community to have inflammation of the fungiform papillae of their tongue which correlates with a history of a sensitive tongue manifest as irritation by heat and certain foods. These data suggest that atopic disease may occur in the mouth as a common inflammatory change on the tongue-fungiform papillary glossitis.

Drug-induced solar urticaria due to tetracycline.

Solar urticaria is an uncommon disorder characterized by pruritus, erythema and whealing commencing within minutes of exposure to ultraviolet (UV) and visible light, and generally resolves in a few hours. We describe a 28-year-old woman who developed pruritus and erythema 5 min after sun exposure while on tetracycline for treatment of perioral dermatitis. Phototesting elicited urticarial reactions in the UVA, UVB and visible spectra. Repeat phototesting after cessation of tetracycline was negative. This report documents the first case of solar urticaria induced by tetracycline.

Primary cutaneous B-cell lymphomas.

B-cell lymphomas comprise up to 25% of primary cutaneous non-Hodgkin lymphoma (NHL). Two main classification systems are used, namely the European Organization for Research and Treatment of Cancer (EORTC) and the World Health Organization (WHO) classification of tumours. Indeed, there is much controversy surrounding which classification system to use, which in turn influences the interpretation of existing data and subsequently how we manage patients with these conditions.