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Measurement of the concentration of iron in the skin, if correlated with total body iron stores, may enable better informed decisions on when to initiate, change or stop therapy in hereditary heamochromatosis. Naive haemochromatosis patients with iron overload and with C282Y and/or H63D HFE mutations were evaluated at the following time-points: disease diagnosis, end of the therapy programme, and 6 months after the end of therapy. The distribution and concentration of iron in the skin were assessed by quantitative nuclear microscopy methods, in parallel with serum and plasma iron concentration. Iron content in the liver was determined by nuclear magnetic resonance. Iron accumulated in the epidermis; its concentration increased from outer to inner layers, being maximal in the basal layer (7.33±0.98 μmol/g). At all 3 time-points, most of the iron was associated with the extracellular space. During the phlebotomy programme the iron content of the skin and the liver decreased by a factor of 2. These data suggest that measurements of iron concentration in the epidermis, which is a readily accessible tissue, reflect iron overload in the liver. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to a case study of an immunocompetent female adolescent patient with extensive and destructive primary cutaneous nocardiosis over the thoracic wall and neck.

A letter to the editor is presented in response to the article on persistent herpes gestationis treated with high-dose intravenous immunoglobulin, published in the previous issue.

The article presents a case study of a 25 year old female patient who presented to physicians with a ten year history of bluish-red discoloration of his upper and lower limbs. A discussion of diagnostic testing which was conducted on the patient and resulted in him receiving a diagnosis of livedoid vasculopathy associated with plasminogen activator inhibitor-1 promoter homozygosity (4G/4G) and prothrombin G20210A heterozygosity, is presented.