ABSTRACT
The prevalence of dermatophyte infection was assessed in 100 patients with well-controlled insulin-dependent diabetes, and in a control group of 100 non-diabetics matched for age, sex, occupation and sporting activity. Immediate and delayed responses to intradermal testing with Trichophyton antigen were recorded in both groups. The overall infection rate (skin and nails) was 19% in diabetics and 17% in controls. There was a higher infection rate in the skin of diabetics (17%) than in controls (8%), but this was not significant. Nail infection was seen in 12% of diabetics and in 11% of controls. Intradermal testing with Trichophyton antigen gave a higher proportion of both immediate and delayed positive results in diabetics. However, more control patients showed only an immediate positive response or only a delayed one. There was no evidence of an increased infection rate in those with immediate positive responses or of diminished infection rates in those with delayed positive responses, and no correlation with oral Candida infection. These findings applied equally to diabetics and controls.
Subject(s)
Antigens, Fungal/immunology , Dermatomycoses/complications , Diabetes Mellitus, Type 1/complications , Opportunistic Infections/complications , Trichophyton/immunology , Adult , Aged , Case-Control Studies , Dermatomycoses/immunology , Diabetes Mellitus, Type 1/immunology , Female , Humans , Hypersensitivity, Delayed/complications , Hypersensitivity, Immediate/complications , Intradermal Tests , Male , Middle Aged , Nail Diseases/complications , Nail Diseases/immunology , Opportunistic Infections/immunologyABSTRACT
An eczematous eruption developed on the anterior chest of a 58-year-old woman with known nickel sensitivity after the insertion of nickel-containing sternotomy wires. Her wound was revised with removal of the wires to give immediate and sustained relief from the itch. The electron microscopy and parasternal biopsy histology demonstrating a sarcoidal reaction are discussed.
Subject(s)
Dermatitis, Allergic Contact/etiology , Nickel , Pruritus/etiology , Sutures/adverse effects , Female , Granuloma/etiology , Granuloma/pathology , Humans , Middle Aged , Sternum/surgery , Wolff-Parkinson-White Syndrome/surgeryABSTRACT
Topical 0.05% isotretinoin (Isotrex gel) was used to treat a test patch of skin in 11 patients with Darier's disease. Hyperkeratosis and papules improved in six patients after treatment for 3 months. Erythema, burning and irritation were common adverse effects, and these were severe in three patients, one of whom stopped treatment. Patients with mild Darier's disease may find topical isotretinoin helpful, but it is likely that most patients with widespread disease will require treatment with systemic retinoids.
Subject(s)
Darier Disease/drug therapy , Isotretinoin/administration & dosage , Keratolytic Agents/administration & dosage , Administration, Cutaneous , Adolescent , Adult , Drug Administration Schedule , Female , Humans , Male , Middle AgedABSTRACT
In 1948 Dr Sophie Spitz described criteria that distinguished juvenile melanoma from malignant melanoma. Since then the cases of eruptive Spitz naevi have been reported arising on normal skin, on lightly pigmented patches and on hypopigmented patches. There are only 12 reports of Spitz naevi arising on hyperpigmented patches: we describe here three further cases, all on the arms of children, seen in our department in a single year.
Subject(s)
Hyperpigmentation/complications , Nevus, Epithelioid and Spindle Cell/pathology , Skin Neoplasms/pathology , Child , Child, Preschool , Female , Humans , Male , Nevus, Epithelioid and Spindle Cell/etiology , Skin Neoplasms/etiologyABSTRACT
Step aerobic classes are at present one of the most popular forms of exercise undertaken by young adults. To date no dermatological abnormalities have been described in people regularly performing step aerobics. We describe a case in which a healthy young woman developed an extensive pigmented purpuric eruption 4 weeks after commencing regular step aerobic classes. The eruption resolved completely 8 weeks after regular exercise was ceased.
Subject(s)
Exercise , Pigmentation Disorders/etiology , Purpura/etiology , Adult , Female , HumansABSTRACT
Thirty-seven patients with chronic otitis externa were investigated for contact hypersensitivity to 49 agents using standardized patch testing. Positive reactions were found in 22 (58%) patients. This incidence is higher than the 40% found in the only previous similar study and is within the range of 32-72% found in patients with contact dermatitis. The average age of subjects showing sensitivity was 56.7 years compared with 34.9 years for those with negative tests. This significant age difference suggests that contact hypersensitivity is not an aetiological factor in the younger patient. There was no significant difference in the duration of otitis externa between those with positive and negative tests. This feature has not been previously examined or reported. Neomycin was the commonest sensitizing agent, sensitization occurring in 12 (32%) patients.
Subject(s)
Dermatitis, Contact/immunology , Otitis Externa/immunology , Adolescent , Adult , Aged , Dermatitis, Contact/epidemiology , Female , Framycetin/adverse effects , Humans , Incidence , Male , Middle Aged , Neomycin/adverse effects , Skin TestsSubject(s)
Cicatrix/complications , Foot Diseases/diagnosis , Myxedema/diagnosis , Tibia , Adult , Diagnosis, Differential , Female , Foot Diseases/etiology , Humans , Middle Aged , Myxedema/etiologySubject(s)
Granuloma , Skin Diseases , Diabetes Mellitus, Type 1/complications , Female , Forearm , Hand Dermatoses , Humans , Middle AgedABSTRACT
Two patients with lichen planus pemphigoides and two with bullous lichen planus were compared. Lichen planus pemphigoides was clinically distinguished by a more generalized lichen planus, more extensive blistering, the need for systemic corticosteroids and by a longer course. The blister of bullous lichen planus was a subepidermal bulla showing degeneration of the epidermal basal layer and other features of lichen planus, whereas in lichen planus pemphigoides the bulla was similar to that of bullous pemphigoid albeit with rather more neutrophils than are usually seen. Direct immunofluorescence was positive in lichen planus pemphigoides and negative in bullous lichen planus. Lichen planus pemphigoides and bullous lichen planus are separate entities: the former is an auto-immune disease precipitated by lichen planus and not related to bullous pemphigoid, the latter is probably not auto-immune but represents the extreme consequence of the lymphoid infiltrate at the dermo-epidermal junction.
