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Background. Seborrheic dermatitis (SD) is a frequent complication of infection with the human immunodeficiency virus (HIV). Most studies examining the cause of SD have concentrated on the roles of Pityrosporum ovale and sebaceous lipids. Previous studies of skin surface lipid from patients with so have produced conflicting results, with some authors reporting an abnormal lipid composition and others finding little or no abnormality. Methods. The composition of skin surface lipid was studied in 15 HIV-positive and 10 HIV-negative men with SD, in 14 HIV-positive men without SD, and in 16 unaffected controls. Total lipids were extracted from unaffected forehead skin into petroleum ether and separated into lipid classes by thin layer chromatography. The lipid classes were quantitated by densitometry after charring with sulfuric acid. Results. Patients, HIV-positive with SD, had significantly lower proportions of free fatty acid (FFA) and higher levels of triglyceride than normal controls. Patients, HIV-positive without SD, had a significantly increased proportion of FFA compared to HIV-positive patients with SD. Patients with so, both HIV-positive and HIV-negative, had a similar pattern of skin surface lipid. Levels of FFA were lower and those of triglyceride higher than in the patients unaffected by SD, whether Hay-positive or not. There was no significant difference found between groups in free cholesterol, wax esters, and squalene. Conclusions. Abnormalities of skin surface lipid Composition may play a part in the development of SD in both HIV-positive and HIV-negative men. [ABSTRACT FROM AUTHOR]

OBJECTIVE Previous endocrine studies of women with acne have produced diverse results. This study was designed to seek evidence, from endocrine and genetic studies, for impaired steroid biosynthesis in patients with acne. DESIGN Adrenal stimulation tests with synthetic adrenocorticotrophic hormone (ACTH) were performed. MEASUREMENTS Steroid hormones were measured basally and 30 minutes after ACTH. The results were correlated with analysis of the steroid 21-hydroxylase gene (CYP21 ). PATIENTS Fifty-one consecutive female patients (mean age 27.1 years) referred with acne. RESULTS The median plasma 17-hydroxyprogesterone (17-OHP) before and 30 minutes after ACTH were 2.5 nmol/l (range 1.1–8.2) and 7.3 (2.1–17.8) nmol/l which were significantly above normal female controls (n = 11, mean age 25.6 years) at 1.5 (0.9–4.2) and 4.6 (2.6–8.4) nmol/l. Eighteen of 51 acne patients showed an abnormal 17-OHP response. The 21-hydroxylase gene (CYP21 ) was examined for major deletions and for three common point mutations in 31 of the patients (14 with exaggerated 17-OHP response). One patient had a deletion of CYP21 on one allele consistent with carrier status for the classical congenital adrenal hyperplasia (CAH). Five patients, one of whom had a normal 17-OHP response to Synacthen, were heterozygous for the val 281 leu mutation in exon 7 of the CYP21 and were therefore carriers for a mutation associated with late-onset CAH. One patient with a raised 17-OHP response was homozygous for the splice site mutation in intron 2 and one patient with a normal 17-OHP response was heterozygous for the mutation. None of the patients had the ile 172 asn mutation. Eight of the 31 acne patients who had CYP21 gene analysis were carriers for mutations in the 21-hydroxylase gene but only six would have been detected by an abnormal response of 17-OHP on stimulation. CONCLUSION Although alterations of the CYP21 gene were more common in acne than in controls there is a... [ABSTRACT FROM AUTHOR]

The integrated behaviour of multiple senescent cell types within a single human tissue leading to the development of malignancy is unclear. Patients with Familial Melanoma Syndrome (FMS) have heterozygous germline defects in the CDKN2A gene coding for the cyclin inhibitor p16INK4a. Melanocytes within skin biopsies from FMS patients express significantly less p16INK4a but express higher levels of the DNA‐damage protein 훾H2AX a than fibroblastic cells. However, patient fibroblasts also exhibit defects since senescent cells do not increase in the skin during ageing and fibroblasts isolated from the skin of patients have increased replicative capacity compared to control fibroblasts in vitro, culminating in abnormal nuclear morphology. Patient derived fibroblasts also secreted less SASP than control cells. Predisposition of FMS patients to melanoma may therefore result from integrated dysregulation of senescence in multiple cell types in vivo. The inherently greater levels of DNA damage and the overdependence of melanocytes on p16 for cell cycle inhibition after DNA damage makes them exquisitely susceptible to malignant transformation. This may be accentuated by senescence‐related defects in fibroblasts, in particular reduced SASP secretion that hinders recruitment of T cells in the steady state and thus reduces cutaneous immunosurveillance in vivo. [ABSTRACT FROM AUTHOR]

Background. Cutaneous malignant melanoma (CMM) is a recognized feature of the Lynch type II cancer-family syndrome and the Li-Fraumeni's syndrome. A significant contribution of these syndromes to the total burden of CMM would be reflected in an increased risk of nonmelanoma cancers in first degree relatives. Methods. Pedigrees were taken from 85 patients with CMM using a family history questionnaire. The relative risk of death from all cancers and individual cancers in first degree relatives was calculated. Results. Of the 85 questionnaires, those of 79 patients were completed and of adequate quality for analysis. The first degree relatives of CMM patients showed no increased risk of cancer death, the relative risk of cancer death being 1.0. Six patients (7.6%) had first degree relatives with CMM. One patient had a family history compatible with the dominant transmission of a predisposition to cancer. Conclusions. It is important to establish whether an increased cancer risk is present in relatives of patients with malignancies so that screening programs may be offered. This study provides little evidence to support seeing relatives for noncutaneous malignancies in the absence of a dominant family history of predisposition to cancers. The Increased frequency of CMM in relatives suggests that relatives of CMM patients should be counseled on protection from the sun and examination of the skin for melanoma. [ABSTRACT FROM AUTHOR]

The article presents information on treatment of atopic eczema with traditional Chinese medicinal plants. The author states that although atopic eczema is often a mild disease that may respond satisfactorily to simple treatments, in an important minority of children and adults it is severe and disabling. In such patients, the disease may be unresponsive to treatment unless therapy with substantial associated toxicity is used, such as oral psoralen-photochemotherapy or oral cyclosporine. Clinical observations have made it clear that decoctions of traditional Chinese medicinal plants might be generally more effective than the conventional treatments used for atopic eczema in Europe and North America. The aim of traditional Chinese treatment for any disease is to restore harmony to functions of the body, which generally requires the simultaneous use of several plant materials.

This article presents a medical case related to kaposi's sarcoma following renal transplantation. A 55-year-old man originally from Sierra Leone had a cadaveric renal transplant in February 1990 for hypertension induced chrohic renal failure. He was maintained on cyclosporine 600 mg/day, azathioprine 75 mg/day, and prednisolone 15 mg/days. Cyclosporine A therapy was rapidly tailed off and then stopped. Azathioprine and prednisolone were reduced to 50 mg and 10 mg respectively. He had radiotherapy to his soles in one fraction, and this improved the pain in his feet.