ABSTRACT
Human papillomavirus (HPV) infection is associated with genital malignancy and specific cutaneous malignancies. We report a case of an HPV-associated concurrent vulval intraepithelial neoplasia and periungual Bowen's disease in a young immunocompetent Afro-Caribbean woman with no known risk factors for either disease. HPV genotyping studies detected multiple alpha and beta papillomaviruses with concordance for HPV-34 [a high-risk (HR) mucosal type], and HPV-21 [an epidermodyslasia verruciformis (EV) type] in both vulval and finger tissue. Although the HR-mucosal viruses detected are likely to have a pathogenic role in vulval intraepithelial neoplasia, this is the first report of concordance for EV HPV types in both genital and nongenital skin premalignancies. This case, in the context of accumulating epidemiological and experimental data in cutaneous SCC, raises the question of whether EV HPV may contribute to vulval malignancy, and further study is merited.
Subject(s)
Bowen's Disease/virology , Fingers/virology , Papillomaviridae/isolation & purification , Papillomavirus Infections/virology , Skin Neoplasms/virology , Vulvar Neoplasms/virology , Adult , Female , HumansABSTRACT
We describe a patient with acute generalized eosinophilic pustuloderma induced by mesalazine therapy. The patient responded to cessation of mesalazine and treatment with systemic corticosteroids. This type of unusual pustuloderma to mesalazine has not to our knowledge been described before.
Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Colitis, Ulcerative/drug therapy , Drug Eruptions/diagnosis , Mesalamine/adverse effects , Adult , Diagnosis, Differential , Drug Eruptions/etiology , Drug Eruptions/pathology , Face , Female , Forearm , HumansABSTRACT
BACKGROUND: Healthcare workers (clinical, allied/paramedical professions and ancillary workers) may have prolonged contact with natural rubber latex devices, particularly in the form of natural rubber latex gloves. OBJECTIVES: To examine the changing frequency of type IV thiuram allergy in healthcare workers with hand dermatitis over a 16-year period. METHODS: During the study period, 450 healthcare workers (352 women and 98 men) with hand dermatitis were investigated, and their patch test results were analysed retrospectively. RESULTS: On average, a thiuram-positive patch test was noted in 12% of individuals, with a peak incidence of 27% of the patients patch tested in 1994. Comparison of results between 1983--88 and 1989--93 showed a statistically significant increase in the incidence of thiuram-positive patch tests (odds ratio 2.55, 95% confidence interval 1.25--5.20, P = 0.01). CONCLUSIONS: We have documented a changing frequency of thiuram-positive patch tests in healthcare workers with hand dermatitis since 1983. This may reflect changes in degree of exposure to thiurams in medical gloves during this period.
Subject(s)
Dermatitis, Allergic Contact/epidemiology , Dermatitis, Occupational/epidemiology , Hand Dermatoses/epidemiology , Health Personnel , Latex Hypersensitivity/epidemiology , Thiram/adverse effects , Adolescent , Adult , Aged , Dermatitis, Allergic Contact/etiology , Dermatitis, Occupational/etiology , Female , Gloves, Protective/adverse effects , Hand Dermatoses/chemically induced , Humans , Incidence , Latex Hypersensitivity/etiology , London/epidemiology , Male , Middle Aged , Patch Tests , Retrospective StudiesABSTRACT
Necrotizing fasciitis is an uncommon condition which may complicate any surgical procedure, including 'minor' dermatological procedures. However, it may arise de novo in the absence of any discernible trauma. We report a patient who acquired a fulminant form of this condition following excision of a malignant melanoma. The development of necrotizing fasciitis in association with melanoma has not previously been reported.
Subject(s)
Fasciitis, Necrotizing/microbiology , Melanoma/surgery , Postoperative Complications/microbiology , Skin Neoplasms/surgery , Streptococcal Infections/etiology , Adult , Ambulatory Surgical Procedures , Fatal Outcome , Humans , MaleABSTRACT
Labial fusion is a common condition seen most frequently in infants and young children. While most cases are "physiological," we believe it can occasionally be the presenting feature of genital lichen sclerosus.
Subject(s)
Lichen Sclerosus et Atrophicus/diagnosis , Vulva/abnormalities , Vulvar Diseases/etiology , Administration, Topical , Anti-Inflammatory Agents/administration & dosage , Biopsy, Needle , Child, Preschool , Clobetasol/administration & dosage , Diagnosis, Differential , Female , Follow-Up Studies , Glucocorticoids , Humans , Lichen Sclerosus et Atrophicus/complications , Lichen Sclerosus et Atrophicus/drug therapy , Lichen Sclerosus et Atrophicus/pathology , Treatment Outcome , Vulvar Diseases/drug therapyABSTRACT
This aim of this study was to undertake a retrospective analysis of the notes of all new patients who attended the joint vulval clinic between 1994 and 1997. One hundred and forty-five patients were seen, and data analysed for 133 (92%). The study identified the range of diagnoses seen; treatment modalities undertaken; and enabled comparisons to be made between our findings and those of other workers.
ABSTRACT
This report describes a female patient with Munchausen's syndrome who made a false allegation of rape, buggery and indecent assault to the Metropolitan Police. The indecent assault took the form of inserting numerous wax crayons into the vagina, necessitating her admission to hospital for their removal under a general anaesthetic. Whilst in hospital she developed a status epilepticus-like condition, requiring admission to the Intensive Therapy Unit. As a specific method of self-harm in Munchausen's syndrome, this case appears to be unique. It has not previously been reported in the literature.
Subject(s)
Child Abuse, Sexual/diagnosis , Forensic Psychiatry , Munchausen Syndrome/diagnosis , Adolescent , Diagnosis, Differential , England , Female , Humans , Munchausen Syndrome/psychologyABSTRACT
The term 'false allegation', when applied to rape and assault, is a difficult concept for forensic medical examiners and the police to comprehend. Reliable evidence about how prevalent these allegations are is hard to obtain. This paper is a transcript of the oral presentation given at the 6th Cross-Channel Conference in Clinical Forensic Medicine held in Southampton, May 14-16th, 1998.
