White superficial onychomycosis caused by Trichophyton rubrum.

A patient with T. rubrum WSO is reported. The presence of this pathogen, a rare cause of this condition, can be confirmed by examination of smears and cultures taken from scrapings of the white spots on the nail plate.

Benign chronic bullous dermatosis of childhood: a review.

Chronic bullous dermatosis of childhood is one of the nonhereditary blistering diseases of children. Clinically, it is characterized by predominantly monomorphous, large tense bullae, which often form a "rosette pattern" or "jewel-like" clustering and have a predilection for the lower trunk, pelvic region, and lower extremities. Histologically, a subepidermal blister is seen, which is indistinguishable from either bullous pemphigoid or dermatitis herpetiformis. Although usually responsive to sulfone therapy, some cases require the combination of sulfones and systemic corticosteroids or corticosteroids alone to control the disease. Recent advances in immunologic techniques reveal: 1. a linear band of IgA at the dermal-epidermal junction on direct immunofluorescence that has been reported both in the lamina lucida and below the basal lamina on immunoelectron microscopy; 2. IgA antibasement membrane antibodies on indirect immunofluorescence; 3. normal jejunal biopsies; and 4. a high association with HLA-B8. It remains unclear whether chronic bullous dermatosis of childhood represents a separate disease entity or is merely a variant of dermatitis herpetiformis. Chronic bullous dermatosis of childhood also differs from linear IgA dermatosis of the adult in that the latter is not associated with HLA-B8, and thus should not be confused with this disease by similar nomenclature.

Management of congenital nevocytic nevi: a survey of current practices.

Questionnaires were sent to the chairmen of 105 dermatology training programs and to sixty practicing dermatologists (randomly chosen from the American Academy of Dermatology directory) in order to identify current practices regarding the management of congenital nevocytic nevi. The return rate was 45.7% and 43.3%, respectively. A clear majority of dermatologists both in private practice and in academia recommend the removal of giant- and medium-sized congenital nevocytic nevi. There is less agreement among dermatologists with regard to the treatment of smaller lesions.

Frigipoint: a new cryosurgical instrument.

Frigipoint, a new handheld dipstick cryoprobe, will be introduced. This apparatus has three components: (1) a thermal conductive housing chamber (reservoir) tapered to tips with diameters of 2-10 mm (applicator); (2) a cryogen absorbent member within the housing chamber; and (3) a low-thermal conductivity handle, which is threaded onto the housing chamber. Laboratory experiments employing a gelatin medium showed that the delivery of the cryogen is uniform over the area of application, producing a flat-bottom ice ball. In animal studies, liquid nitrogen spray produced greater depth of destruction and inflammation than Frigipoint. In preliminary clinical studies, 68 lesions, including actinic keratosis, molluscum contagiosum, verruca plana, solar lentigo, seborrheic keratosis, and verruca vulgaris, were treated in 16 patients. All but one resolved after cryosurgery with Frigipoint. Frigipoint is an effective, safe, and easily portable cryosurgical instrument that has a wide spectrum of dermatologic applications. It provides efficient, well-controlled focal cryosurgical treatment of multiple lesions with one immersion of the probe in liquid nitrogen. In addition, its simple operation is met with high patient and physician acceptance.

Urinary tract infection in infants with unexplained fever: a collaborative study.

Nine centers collaborated to determine the rate of urinary tract infection in infants with unexplained fever, to determine whether the rate is higher in febrile infants than in asymptomatic infants, and whether the yield justifies urine cultures in febrile infants. Urine cultures were done in 501 infants 0 to 2 years of age. The rate of confirmed urinary tract infections in the 193 febrile infants was 4.1%. All infections were in girls, with a rate of 7.4%. The rate of confirmed urinary tract infections in the 312 asymptomatic infants was 0.3%; again, all infections were in girls, with a rate of 0.7%. The rate in febrile girls was significantly higher than the rate in asymptomatic girls (P less than 0.01). The data support the advisability of culturing the urine of infant girls with unexplained fever.