[Chronic laryngitis in children: the role of gastroesophageal reflux]. / Laryngite chronique chez l'enfant: place du reflux gastro-oesophagien.

UNLABELLED: Gastro-oesophageal reflux (GOR) is associated with a number of inflammatory ENT disorders in the adult and is correlated with recurrent croup in the child. AIM: To estimate the frequency of GOR in a population of children consulting for chronic laryngotracheal symptoms. METHOD: The study included 17 children, aged between 2 and 14 years (mean: 7 years) all of whom suffered from dysphonia or a chronic cough. After a clinical ENT examination, each child had a fibreoptic laryngoscopy and a long duration pH-study lasting between 18 and 24 hours. RESULTS: Pathological GOR was discovered in 10 children, i.e. 59%. Overall the number of refluxes per study varied from 6 to 816 (mean 156). The vast majority of these refluxes occurred when the child was awake. CONCLUSION: In our series of children with chronic laryngotracheal disorders, at least 59% were shown to suffer from pathological GOR.

[Gastroesophageal reflux and dysphonia in children]. / Reflux gastro-oesophagien et dysphonie chez l'enfant.

UNLABELLED: With the exception of congenital anomalies, the aetiology of dysphonia in children is often unknown. Yet, in adults, GOR has been shown to play an important role. 22 children (aged between 2 and 14 years, 14 boys and 8 girls), who had been suffering from a chronic dysphonia for more than six months were seen at consultation. After a clinical ENT examination including a fibreoptic laryngoscopy, each child had a long duration pH-study that lasted approximately 24 hours. Using the classical criteria for GOR, a pathological GOR was discovered in 14 children, ie 64%. Analysis of the pH traces revealed that the vast majority of refluxes occurred when the child was awake. CONCLUSION: more than 64% of children suffering from chronic dysphonia had pathological GOR. The pH traces highlighted that the majority of these refluxes occurred when the child was awake.

Keratotic scabies (Norwegian scabies): case reports and literature review.

Keratotic scabies (KS) (Norwegian scabies) is a rare variant of Sarcoptes scabeii infestation and is characterized by hyperkeratosis and crusting and by the presence of millions of mites in the horny layer of the skin. KS may be associated with underlying diseases, e.g. immune deficiency states and lymphoreticular disorders, or may occur in neglected or normal patients. We review the literature and present reports on 2 Black South African patients affected by KS. One was mentally defective; the other, submitted to extensive investigations, showed no abnormalities. This is, to the best of our knowledge, the first report of KS in South African Blacks.

Erythema multiforme -- an unusual reaction to BCG vaccination.

An eruptive form of erythema multiforme subsequent to BCG vaccination seen in a young Black nurse is reported. In a short review of the literature the author emphasizes that specific and nonspecific complications may occur after inoculation, but that the rare occurrence of these cutaneous manifestations cannot undermine the value of this preventive measure.

Granulomatous ochronosis -- a cosmetic-induced skin disorder in Blacks.

More skin eruptions than previously are appearing in Blacks after the application of a variety of topical cosmetics. Clinical and histological descriptions of these conditions are reviewed and classified. Four cases of sarcoid-like foreign-body granulomas are reported. The stricter control of cosmetics is recommended.

Leprostigma in hanseniasis.

Ignorance, fear and superstition surround the problems of hanseniasis. In almost all cultures the predominant attitude is emotion, disgust and rejection towards persons suffering from this disease. All efforts aimed at the control of hanseniasis are doomed to failure unless the significance of stigma and associated social and economic factors are given adequate consideration. A programme of destigmatization is outlined.

Leprostigma in hanseniasis

Ignorance, fear and supersition surrond the problems of hanseniasis. In almost all cultures the predominant attitude is emotion, disgust and rejection towards persons suffering from this disease. All efforts aimed at the control of hanseniasis are doomed to failure unless the significance of stigma and associated social and economic factors are given adequate consideration. A programme of destigmatization is outlined

Leprostigma in hanseniasis.

Ignorance, fear and superstition surround the problems of hanseniasis. In almost all cultures the predominant attitude is marked by emotion, disgust and rejection towards persons suffering from this disease. All efforts aimed at the control of hanseniasis are doomed to failure unless the significance of stigma and associated social and economic factors are given adequate consideration. A programme of destigmatization is outlined.

Actinic elastosis in black skin. A light- and electronmicroscopic study.

In 9 otherwise dermatologically normal South African Balck volunteers (1--72 years old), sunlight-exposed and non-exposed skin has been examined by light- and electronmicroscopy with special references to age-dependent and actinic alteration of dermal structures. Two 72 year old Blacks exhibited typical dermal elastosis: in 1 case to a marked extent and already detectable by lightmicroscopy, in the other case only to a mild degree. In contrast, only age-related elastic fibers were revealed in the lower dermis of sunlight-exposed skin and in all dermal layers of unexposed skin. These observations are contradictory to the general view that actinic elastosis does not occur in Blacks. The elastotic material is obviously a de-novo synthesized and secreted pathological product of chronically UV-altered fibroblasts.

Malignant change in a verrucous nevus.

A 41-year-old man developed squamous-cell carcinoma within a verrucous nevus of linear distribution of a long duration. Controversial cases have been reported in the literature. Such malignant change in verrucous nevus is extremely rare.

Schizophrenia and albinism.

A female albino with squamous cell carcinoma and schizophrenia is reported. The association of schizophrenia and albinism is exceptionally rare; the observation that schizophrenia is characterised by hypermelanosis is questioned.

Nutritional influences of pellagra on sebum composition.

Sebum composition has been measured in 51 patients with varying degrees of pellagra and compared with a control group of subjects in the same geographic area. In the pellagra group the wax ester percentage was 14-9 versus the normal of 21-9%. The squalene percentage was increased in the pellagra group (11-6%) versus a control value of 8-4%. A small increase in the percentage of cholesterol was also noted. These changes, which previously have been observed in starved but otherwise normal subjects, were reversible with adequate refeeding.

Acne infantum in an Indian child: Case report and review of the literature.

Acne infantum, a variety of acne affecting the newborn and children, appears to be very rare in dark-skinned populations and has not been described in this population group in South Africa. A case of acne infantum in a dark-skinned Indian child is reported. The recent literature is reviewed and comment is made on the classification and pathogenesis of the disorder.

Leprechaunism. Case report in a black African child.

A case of leprechaunism is described. This is thought to be the first reported in a black child.

Survey of skin disorders in the urban black population of South Africa.

Numerous and different methods of survey have been suggested and developed in recent years, but none of them appears to be entirely satisfactory. Insufficient classification, inadequate follow-up, incongruous rotation of investigators, notable variations in attendance, racial differences of the population submitted to statistical study, and other minor factors may account for possible errors and differences in evaluating the findings. We have conducted a survey, over a 3-year period, of the incidence of skin diseases affecting our urban black population, living in the township of Soweto (800,000 inhabitants) and attending our dermatological service at Baragwanath Hospital. Although this population is made up of a dozen different ethnic groups, they are fully urbanized and live under similar conditions and according to similar customs. We believe that the statistical data derived from these patients represent a significant expression of a uniform community.