Tungiasis.

A 24-year-old man developed slow-growing lesions on subungual and plantar areas that appeared a few weeks after returning from a trip to South America. The diagnosis of tungiasis was established by microscopic examination of a lesion. Tungiasis is rarely seen in non-endemic areas.

[Cutaneous leishmaniasis: incidental outbreak in a new endemic area?].

In the autumn of '94 we saw 32 patients with cutaneous leishmaniasis from a newly populated areas south of Yerucham. Yerucham had never previously been reported as a focus of leishmaniasis. Ongoing construction in the town and the health hazards that resulted may play a part in this new situation. There are a number of ways of controlling and preventing outbreaks leishmaniasis. They include elimination of the vector, Phlebotomus and its host, the gerbils as well as their food supply, "maloach" bushes, other health hazards and vaccination of the population. Patients were treated according to the severity of disease. It is still too early to determine whether our efforts to limit the spread of the outbreak have been successful.

[Vasculitis with cutaneous necrosis induced by oral contraceptive].

Multiple ulcerated and necrotic lesions developed in a 29-year-old woman. Response to treatment during the next few months was minimal. The most plausible explanation was drug-induced vasculitis caused by contraceptive pills (Microgynon: levonorgestrel 0.15 mg and ethinyl oestradiol 0.03 mg). The diagnosis of vasculitis was confirmed by histopathological and immunofluorescent studies. Urticarial manifestations had developed into necrotizing inflammation and the lesions only began to heal after discontinuation of the pills. Contraceptive pills are not included among the drugs causing necrotizing vasculitis, and to the best of our knowledge, this is the first report. Although contraceptive pills are commonly implicated in the induction of erythema nodusom or vasculitis, such a severe reaction with necrosis is rare.

PIP: Oral contraceptives (OCs) have been implicated as a major cause of mostly mild vascular diseases; cutaneous necroses are rare. A 29-year old married female developed vasculitis following administration of (OCs). The disease which developed her knees, progressed into cutaneous ulcerative necrosis that was impervious to therapy. She had stopped taking OCs a month before. The presence of staphylococci and streptococci were detected in the ulcer cultures. A slight improvement of the ulcers occurred following treatment with cephalosporins. 1 week after treatment ceased she returned with new ulcers. She had resumed taking OCs and had taken 5 pills at once to make up for 5 omitted days. 2 days later new ulcers appeared, and the existing ones became aggravated. Histology showed an inflammatory reaction rich in leukocytes, monocytes, and eosinophils, and endothelial edema of vessels with fibrin deposition. In some places, partial obstruction of the blood vessels was observed. Partial involvement of the subcutaneous fat was also observed. Improvement occurred 1 month later following discontinuation of OCs.

Widespread oral papillomatosis due to chronic buccal trauma.

We present a case of oral papillomatosis occurring in a 52-year-old woman. This condition is well known and is characterized by an exuberant proliferation of multiple, flat, verruca-like elevations on the oral and pharyngeal mucosa. This is apparently the first documented case of oral papillomatosis due to trauma to the oral tissue from a dental prosthesis, with subsequent inflammation. Correction of the prosthesis resulted in marked improvement. This presentation emphasizes the causes, diagnosis, pathologic basis, and treatment of this condition.