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• BACKGROUND.— The association of anal carcinoma with human papillomavirus (HPV) type 16 infection is well documented. Anal carcinoma is also frequently associated with a history of anogenital condylomata. More than 90% of anogenital condylomata contain HPV type 6 or 11. It is rare for a condylomatous lesion to contain HPV 16. We report the unusual case of a homosexual man, testing positively for human immunodeficiency virus, with carcinoma in situ evolving within perianal condylomata infected with HPV 16. OBSERVATIONS.— Microscopic examination of tissue specimens from ulcerated verrucous lesions on the perianal mucosa revealed changes of classic condylomata acuminata with contiguous focal squamous cell carcinoma in situ. Testing for HPV DNA by in situ hybridization identified HPV 16 in both the condylomatous and carcinoma in situ areas. CONCLUSIONS.— The association of HPV 16—infected condylomata and adjacent carcinoma in situ implies that cutaneous genital condylomata may progress to high-grade lesions. Given that homosexual men are at high risk for perianal carcinomas, HPV typing of perianal condylomata specimens may help identify immunocompromised patients who are at risk for the development of carcinomas.(Arch Dermatol. 1992;128:949-952)

• Recently, the ingestion of tryptophan has been associated with eosinophilia-myalgia syndrome, which is characterized by eosinophilia, myalgias, and several less consistently reported findings. We treated 13 patients who exhibited clinical features of eosinophilic fasciitis who were taking high-dose tryptophan before the onset of clinical symptoms. Twelve patients exhibited eosinophilia, with eosinophil counts ranging from 0.13 to 0.88. The remaining patient was taking oral corticosteroids when her eosinophil count was determined. Eight patients complained of myalgias. Other symptoms included arthralgias, pruritus, cutaneous burning, weakness, fever, rashes, malaise, edema, muscle spasms, and alopecia. 5-Hydroxyindoleacetic acid levels were elevated in four of the eight urine specimens that were tested. Our findings suggest that previously diagnosed cases of eosinophilic fasciitis may represent variants of tryptophan-associated eosinophilia-myalgia syndrome. Derangements in the metabolism of tryptophan may play a role in sclerotic diseases.(Arch Dermatol. 1991;127:217-220)

• Workers engaged in a molded plastics operation were studied to determine the etiology of yellow staining reactions involving the skin, nails, and hair. A walk-through survey of the facility, medical interviews, physical examinations, and blood and urine tests were performed. 4,4'-Methylenedianiline (MDA), a component chemical of the manufacturing process, produced intense yellow discoloration of nitrocellulose paper in the laboratory and appeared to volatilize readily under ambient conditions. Thirty-five (65%) of 54 process workers showed varying degrees of staining while 11 workers employed in other parts of the factory showed no staining. Yellow staining was restricted to areas of the body where direct contact with MDA appeared likely. Laboratory studies did not provide evidence of systemic toxic effect. Because MDA is a known hepatotoxin for man, with carcinogenic properties in animal test systems, it is important to recognize yellow staining as a cutaneous marker of exposure to this chemical.(Arch Dermatol 1985;121:1022-1027)

• Vibration syndrome (VS), which typically presents as a variant of Raynaud's phenomenon, has been characterized recently as a multisystem disorder of the peripheral circulation, nerves, muscles, and joints. The sequelae of the disorder are irreversible, but most clinical evidence indicates that vibration injury is completely reversible by early intervention. Advanced VS occurred in a jackhammer operator; his condition went unrecognized for more than 11 years. The clinical findings illustrate the broad spectrum of pathologic abnormalities associated with VS and emphasize the need for increased physician awareness of this disabling condition.(Arch Dermatol 1985;121:1544-1547)

• Erythema dyschromicum perstans (EDP) is a cutaneous pigmentary disturbance originally considered to be a variant of erythema perstans. The nosologic identity of EDP has been challenged repeatedly as the number of patients with concurrent EDP-like eruptions and lichenoid disorders has increased. In this report, we describe a woman who had EDP for two years before the onset of classic lichen planus (LP). The active lesions of LP gradually evolved into typical ashy-gray macules of EDP. This case provides further support for the concept that EDP and EDP-like conditions should be classified, in certain instances, as erythema dyschromicum variants of LP.(Arch Dermatol 1982;118:683-685)

† Two patients with recurrent, intensely pruritic, grouped red papules on the chest, abdomen, and thighs were examined and found to have Cheyletiella der matitis. Cheyletiella, a nonburrowing cies of mite, was isolated from fur brushings of the household pets, including one dog and two cats. Treatment of the affected pets resulted in complete resolution of symptoms and signs in both animals and patients. This appears to be the third instance of human Cheyletiella dermatitis recorded in North America.(Arch Dermatol 116:435-437, 1980)