Staphylococcus aureus carriage in patients with psoriasis

The aggravating role of Staphylococcus aureus is well known in atopic dermatitis but has not yet been proven in psoriasis. The role of Staphylococcus aureus superantigens is emphasized in the initiation, maintenance and complications of psoriasis. We investigated the frequency of nasal, axillary, and perineal carriage of Staphylococcus aureus [SA] in patients with psoriasis and its possible influence on the severity of the disease. One hundred patients with the clinical diagnosis of psoriasis participated in the study. Cultures of the bacterial flora were obtained from the right and left axilla and nasal nares and perineum, inoculated on standard bacterial medium [blood agar], and incubated at 37°C degrees for 48 h. One hundred patients with the clinical diagnosis of psoriasis [42% female and 58% male] comprised the study group. Mean age of the patients was 41.1 +/- 17.1 years. About 42% of the patients carried S. aureus; of these, 32% were from the nose, 13% from axilla, and 11% from the perineum. Three patients were carriers in all 3 sites. There was no significant difference in the severity of the disease between the carriers and non-carriers measured by the psoriasis area and severity index [PASI] score. According to our findings, S.aureus carriage in psoriasis had no significant influence on disease severity. It might be relevant for a subgroup of patients only when superantigen productions are found

case of lipomembranous panniculitis associated with rheumatoid arthritis

Lipomembranous panniculitis is a special type of fat necrosis which has been associated with several clinical conditions, mainly chronic venous insufficiency and connective tissue disorders such as lupus profundus, morphea, systemic sclerosis, and dermatomyositis .We report a 50 year old woman with known rheumatoid arthritis who presented with a painful indurated erythematous plaque on her right leg. Histologic examination demonstrated cystic areas of fat necrosis lined by wavy eosinophilic hyaline membrane with convoluted projections of the membrane into the cysts. This finding is diagnostic of lipomembranous panniculitis. To our knowledge, this is the first report on lipomembranous panniculitis associated with rheumatoid arthritis

Case: erosive nodule on the vulval skin

A 64-year-old Iranian woman presented with a genital erosive skin lesion that she had noticed from two years ago. On physical examination, a 20 to 25 millimeter purplish lesion was observed on the vulval skin [Figure 1]. The indurated lesion showed a small central erosion measuring 3 to 5 mm. Inguinal lymph nodules were not palpable. A skin biopsy specimen was obtained from the eroded lesion [Figure 2]