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We report unusual congenital ichthyosiform dermatosis in 5 of 12 children in two related families of unaffected, consanguineous Bedouin parents. It appeared shortly after birth as a fine peeling of nonerythematous skin on palms and soles. Gradually it evolved into prominent, well-demarcated areas of peeling skin in moist and traumatized regions. The cutaneous manifestations share features of ichthyosis bullosa of Siemens (IBS) and peeling skin syndrome (PSS). Histologic examination revealed orthokeratosis, a thickened granular cell layer, and spongiosis without epidermolytic hyperkeratosis. On electron microscopy there was prominent intercellular edema and numerous aggregates of keratin filaments in basal keratinocytes. This combination of clinical, histologic, and ultrastructural features has not been previously reported in the heterogeneous group of congenital ichthyoses. We suggest that it represents a new variant of exfoliative ichthyosis. [ABSTRACT FROM AUTHOR]

A 91-year-old patient presented with a nonfebrile, pruritic, widespread eruption that appeared 10 days after starting therapy with cefuroxime tablets, 1000 mg/day, due to stasis dermatitis with secondary infection. The patient was also treated with paracetamol tablets, 500–1000 mg/day, 10 days before the onset of the eruption. Previous diseases included congestive heart disease, hyperglycemia, and ectropion. There was no personal or family history of psoriasis. Additional medications, taken for more than 2 years at the time of the eruption, included indomethacin, captopril, hydrochlorothiazide, isosorbide-5-mononitrate tablets, and a combination drug Laxative®. Examination revealed widespread erythema involving 95% of the total body surface area, with numerous 1–2 mm nonfollicular pustules (Fig. 1). There was no predilection to the body folds. Within 24 h of hospitalization, during intravenous therapy with cefuroxime, the patient's condition worsened and bullae containing clear fluid appeared. Nikolsky's sign was positive on erythematous skin, and eventually skin detachment involved 41% of the total body surface area (Fig. 2). There were no target or target-like lesions and there was no involvement of the mucous membranes. An early biopsy from a pustule revealed subcorneal and intraepidermal spongiform pustules, papillary edema, perivascular mononuclear infiltrate with a few eosinophils in the dermis, and leukocytoclastic vasculitis. A later biopsy showed similar findings with no evidence of full-thickness epidermal necrosis or necrotic keratinocytes. Direct immune fluorescence (DIF) taken from erythematous skin was negative. Laboratory studies showed the following results: sedimentation rate, 80 mm/h; white blood cell count, 26,200/mm3 with 87% polymorphonuclears and 1.8% eosinophils; hemoglobin, 13.0 g/dL; albumin, 2.8 g/dL (normal, 3.5–5.5 g/dL); other blood chemistry tests were normal. Immunologic studies for... [ABSTRACT FROM AUTHOR]

A 44-year-old woman presented with a 6-month history of subcutaneous nodules involving her face and shins. Her past history revealed myomatous uterus with menometrorrhagia, resulting in an iron deficiency anemia, treated by ferrum sulfate tablets. She also had diabetes mellitus type II treated by glibenclamide and metformin tablets. There was no evidence of bromide or iodide ingestion. On initial examination, several firm, tender, erythematous subcutaneous nodules, 2–4 cm in diameter, were present on the face (Fig. 1) and shins (Fig. 2), two with normal overlying skin. Within a few weeks, the nodule on the left shin enlarged and several superficial ulcers appeared, surrounded by purplish borders, secreting sinuses, and a vegetative exophytic surface (Fig. 3). Physical examination was normal. Incisional biopsies from the ulcer margins showed pseudoepitheliomatous hyperplasia, diffuse neutrophilic infiltration with microabscess formation (Fig. .4), and the presence of a dense infiltrate composed of epithelioid cells, giant cells, and a few lymphocytes forming non-necrotizing granulomas within the dermis and subcutaneous lobules (Fig. 5). Leukocytoclastic vasculitis was also present in the lower dermis. Routine blood tests and urine analysis were normal, except for a high erythrocyte sedimentation rate (120/h) and anemia with a hemoglobin level of 10 g%. The results of the following laboratory tests were found to be within normal limits: rheumatoid factor; antinuclear antibody; C3; C4; serum immunoglobulins; serum protein electrophoresis; stool for parasites and occult blood; X-ray of the chest, left shin, hands, and facial bones; isotopic bone scanning; abdominal ultrasonography; chest and abdominal computerized tomography. Repeated smears and tissue cultures for bacteria, nmycobacteria, and fungi obtained from several ulcer sites were negative. Smears and cultures for Leishmania and polymerase chain reaction (PCR) for Leishmania were negative. Based on the clinical and histologic picture, our case was diagnosed as vegetative pyoderma gangrenosum. The lesions did not respond to systemic antibacterial agents including minocycline and cotrimoxazole. A marked improvement was observed following treatment with prednisone at an initial dose of 40 mg/day. Relapse of the lesions was observed after several attempts to reduce the steroid dose. Using dapsone as an adjuvant therapy in increasing dose up to 250 mg/day induced significant improvement, which allowed us to reduce the dose of prednisone to 10 mg/day. Dapsone was discontinued after 3 weeks of treatment due to acute hepatitis induced by the drug. A few days after cessation of dapsone, the cutaneous lesions recurred, and were only partially controlled by a prednisone regimen of 10/20 mg on alternate days. Complete remission was achieved after 6 months of therapy, leaving a small cribriform scar on the leg. [ABSTRACT FROM AUTHOR]

We report an immunocompromised patient who developed a cutaneous infection caused by acremonium which is a rare opportunistic fungi. With the increasing number of immunocompromised patients opportunistic fungal infection can cause serious diseases and early recognition is mandatory. [ABSTRACT FROM AUTHOR]

In most plant species, a rapid increase in free proline content occurs following exposure to hyperosmotic stress conditions. However, inconsistent results were reported concerning the role of such an increase on the plant response to water shortage or excess salt. Therefore, the possibility that proline accumulation may help the cell to withstand stress conditions, or that it simply represents a stress marker, is still a matter of debate. A possible relationship between proline accumulation and salt tolerance was investigated in a set of 17 Italian rice varieties.Rice seedlings were exposed to increasing salt concentrations during germination and early growth. The resulting levels of free proline were measured separately in shoots and roots and compared to those in untreated controls. Results were related to the corresponding ability of a given genotype to tolerate stress conditions.Neither absolute proline levels in untreated or in salt‐stressed seedlings showed a straightforward relationship to the relative tolerance to salt, estimated as conductivity values able to reduce growth by 10 or 50%. Conversely, a highly significant correlation was found between the increase in proline levels in shoots and the ability to withstand stress.The results strengthen a recent hypothesis suggesting than an increase in proline metabolic rates, more than the resulting proline content, may help the cell to counteract the effects of abiotic stress conditions. [ABSTRACT FROM AUTHOR]

ABSTRACT We describe a patient with an unusual presentation of multiple arteriovenous haemangioma (AVH) grouped in one area of the scalp. The diagnosis was confirmed by histological, X-ray and ultrasound studies. These lesion represent a rare, benign, acquired vascular hamartomatous formation that arises from the suprapapillary vascular plexus. [ABSTRACT FROM AUTHOR]

A 7-month-old infant developed a discrete pustular rash confined to both soles during the acute phase of Kawasaki disease. Histological examination of a pustular lesion from the sole of a foot showed subcorneal neutrophilic microabscesses, psoriasiform acanthosis with a thin granular layer and mononuclear perivascular infiltrates in the upper dermis, consistent with psoriasis. Following the standard treatment with intravenous gamma globulin, the initial symptoms and signs of Kawasaki disease resolved completely. Eight weeks later, psoriasiform plaques appeared on both cheeks and on the extensor surfaces of the forearms and legs. Skin biopsy from one of these lesions revealed psoriasiform epidermal hyperplasia, focal parakeratosis and dilated papillary capillaries. The patient was treated with mild-potency topical steroids that resulted in rapid and complete resolution of the skin lesions. Concurrent association of psoriatic skin lesions and Kawasaki disease might not be incidental and could stem from a common pathogenetic mechanism induced by superantigens. [ABSTRACT FROM AUTHOR]

SUMMARY: A 60-year-old woman presented with a 3-week history of a pruritic papulo-nodular eruption on the face and trunk after a bee sting. Histological examination showed a predominantly lymphocytic infiltrate with follicular centres and tingible body macrophages. Immunohistochemically, positive staining for both kappa and lambda light chains was noted. The eruption settled with oral antihistamine and topical corticosteroid. These findings support the diagnosis of follicular B-cell pseudolymphoma. [ABSTRACT FROM AUTHOR]

Aims: To find a possible correlation of Ki67 antigen and proliferating cell nuclear antigen (PCNA) with prognosis in anorectal malignant melanoma. Methods and results: Thirty patients with anorectal malignant melanoma were studied. The percentage of tumour cells stained for Ki67 and PCNA in paraffin sections was assessed. Mode of treatment (local excision or abdominoperineal resection), depth of tumour invasion, attempt at cure as defined by complete tumour excision and absence of distant metastases at presentation, tumour blood vessel invasion, and tumour necrosis, as well as Ki67 and PCNA, were all correlated with survival. By univariate analysis, PCNA, Ki67, attempt at cure, local excision (and not abdominoperineal resection), and depth of invasion were all significantly associated with longer survival. By multivariate analysis, only PCNA was significantly associated with survival, while Ki67 showed a significant positive correlation with PCNA. With a cut-off point of 40%, patients with lower Ki67 scores showed survival advantage over those with higher Ki67 scores (P =0.0004). With a cut-off point of 80%, patients with lower PCNA scores showed survival advantage over those with higher PCNA scores (P =0.0001). The staining for proliferation markers was also associated with depth of tumour invasion. Conclusions: Ki67 and PCNA immunostaining in paraffin sections may be useful for the prediction of survival in patients with anorectal malignant melanoma. Larger studies are needed to confirm our results. [ABSTRACT FROM AUTHOR]

A case study of a 25-year-old man was referred for dermatological consultation with an asymptomatic swelling of the penis and scrotum present for 9 months is presented. The patient has no history of surgery, trauma or venereal disease, and no other symptoms. Chronic scrotal or penoscrotal oedema can be a result of venous or lymphatic obstruction that may be caused by malignancy, venereal disease, trauma and peritoneal dialysis.