Adult onset still's disease and prurigo pigmentosa: an unusual association and review of literature

This study was conducted in the Department of Medicine, Department of Dermatology, Al-Adan Hospital, Ministry of Health-Kuwait. This patient was hospitalized as a case of pyrexia of unknown origin. We report atypical skin eruption in this patient who fulfilled the criteria for Adult Onset Still's Disease [AOSD] despite the absence of the typical still's rash. Skin biopsy revealed prurigo pigmentosa [PP]. To elucidate this unusual association, we searched the literature for the cutaneous manifestations of AOSD. Kahori T, et al had described PP like lesions in a patient with AOSD in addition to the typical still's rash and it is the only case report that exists in English literature. In our case, except for still's rash, all the criteria of AOSD were present, the diagnosis was made after excluding all other possible causes i.e. infectious diseases, other rheumatic diseases, vasculitis and malignant disease. The objective for reporting this case and review of literature is to shed more light on the rare dermatological disorder Prurigo Pigmentosa [PP] and its unusual association with Adult Onset Still's Disease [AOSD]. Clinicians and dermatologist must be aware of this unusual association of PP and AOSD as the diagnosis of AOSD can be made in the absence of the typical still's rash but in the presence of other atypical cutaneous manifestations including PP

Predictors for early diagnosis of CNS infiltration in acute lymphoblastic leukemia

The study was held to define the factors helping in prediction of CNS infiltration by leukemia [ALL], type and rate of relapse. Also studing clinical and laboratory diagnosis especially CSF analysis at the primary diagnosis. The study was done in pediatric oncology unit of Zagazig University Hospital on 24 cases of newly diagnosed ALL ranging from 1-14 years. Males were 16 cases and females were 8 cases with male to female ratio of 2: 1. L[1] represented 75% of cases, Patients were subjected to different tests e.g CBC with differential count, hemoglobin level and B[2] microglobulin, bone marrow aspiration, morphological and chemical tests. CNS relapses were 20.9% of cases, hematological relapses were 12.9% and testicular relapses were 4.2%. Serum B[2] microgIobulin, CSF B[2] microglobulin and CSF LDH are useful indicators for cytological diagnosis of CNS infiltration at time of presentation. Cases with elevated B[2] M and/or LDH levels at presentation should be subjected to intensive CNS prophylaxis and CSF monitoring and follow up for better diagnosis and prognosis

Histopathological changes in vocal folds of female rabbits after injection of anabolic steroids

In this experimental research, a study group of ten unmarried female rabbits was injected with anabolic steroids and their vocal folds were examined histopathologically and compared with those of a control group of five rabbits. There were no differences in the epithelial, elastic or muscular tissues between both groups. However, there was some increase in the density of subepithelial collagen fibers of the vocal fold ligament in three rabbits of the study group, which may be attributed to the individual sensitivity of the rabbits. This increase may explain the irreversible virilization of voice in human females