Juxta-clavicular beaded lines: a subepidermal proliferation of sebaceous gland elements.

Juxta-clavicular beaded lines typical arise at puberty as an asymptomatic, linear papular eruption involving the neck and supraclavicular areas. This entity appears to be more common in blacks than caucasians, and a female predominance has been noted. Microscopically, the papules noted clinically appear secondary to sebaceous gland hyperplasia, which is particularly prominent in the immediate subepidermal zone. Mild papillated epidermal hyperplasia may be observed. Whereas many regard this entity as an anatomic variant of normal, it may be confused clinically and histologically with a number of pathologic processes. A case of juxtaclavicular beaded lines in a 14-year-old caucasian girl is presented.

Newer aspects of inflammatory bowel disease and its cutaneous manifestations: a selective review.

Idiopathic inflammatory bowel disease (IBD) denotes several types of gastrointestinal disorders characterized by protracted inflammation of the large or small bowel, and a tendency toward relapse or recurrence. The two major groups of IBD are identified as chronic nonspecific ulcerative colitis (UC) and Crohn's disease (CD). Extraintestinal manifestations of IBD are diverse and may antedate, occur with, or postdate the onset of the disease process itself. Cutaneous diseases such as erythema nodosum or pyoderma gangrenosum are not infrequent, and test the clinician's ability to recognize the underlying bowel pathology and institute appropriate treatment. This selective review will address the immunological pathogenesis of IBD, new or rarely reported skin markers in IBD, drug therapy and side effects, zinc deficiency, management of osteotomy patients, and cutaneous cancer complicating IBD. Although the prognosis of IBD has improved, the role of the dermatologist as a consultant remains invaluable in reducing the attendant cutaneous morbidity.

Cutaneous leukocytoclastic vasculitis complicating hairy cell leukemia (leukemic reticuloendotheliosis).

A patient with hairy cell leukemia (HCL) receiving fluoxymesterone developed cutaneous leukocytoclastic vasculitis. His clinical picture was of purpuric papules and pustules on his chest and limbs. Oral corticosteroid therapy and colchicine therapy were tried, with only minimal improvement. Chemotherapy with pentostatin (2'-deoxycoformycin) resolved the vasculitis and placed the HCL in remission. Fifteen cases of HCL associated with vasculitis have been reported previously. Hairy cell leukemia and vasculitis appear to have more than a coincidental relationship.