Human herpes virus type 6 can cause skin lesions at the BCG inoculation site similar to Kawasaki Disease.

Kawasaki Disease (KD) is acute, febrile, multisystem vasculitis of early childhood, the detailed mechanism of which is still unclear. Skin symptoms occur in KD, such as edema of the hands and feet with subsequent desquamation and redness at the inoculation site of bacillus Calmette-Guerin (BCG). The change at the BCG inoculation site has been considered as a specific feature of KD, although its mechanism is not fully understood. We present an 11-month-old boy who developed fever with redness of the BCG site due to infection with human herpes virus type 6 (HHV6). At the age of 3 months, the patient received BCG. His fever remitted 7 days after the onset of skin redness, with sequential desquamation at the BCG site and extremities, which is not a common feature of HHV6 infection that typically lasts for 3 days. The final diagnosis was exanthema subitum. Characteristically, the HHV6 infection in our patient appeared to be associated with the invigoration of the T cell system, as represented by the elevated serum levels of soluble interleukin-2 receptor (3,490 U/ml vs. normal range 145-519 U/ml). This patient clearly showed redness and crusting at the BCG inoculation site, suggesting that HHV6 infection might cause skin changes similar to those of KD via an unknown mechanism. In addition, we suggest that the activation of the T cell system may account for the skin lesions in KD, characterized by redness and subsequent crusting of the BCG inoculation site and desquamation of the extremities.

Phaeohyphomycosis Caused by Phaeoacremonium rubrigenum in an Immunosuppressive Patient: A Case Report and Review of the Literature.

Phaeohyphomycosis (PHM) is a rare, deep fungal infection of the skin and subcutaneous tissues caused by dematiaceous fungi. In this report, we describe a case of PHM caused by Phaeoacremonium rubrigenum, which is generally known to infect woody plants. We detected the gray-blackish villi by biopsy culture material, and slide culture revealed the conidia arising from slightly tapering phialides. Furthermore, we differentiated these fungi as P. rubrigenum by Basic Local Alignment Search Tool (BLAST) algorithm. We performed surgical debridement of disseminated nodules and administered oral itraconazole for a duration of 4 weeks. One year after stopping itraconazole, there was no sign of relapsing subcutaneous nodules. To our knowledge, this is the third case report of PHM developing from skin infection by P. rubrigenum in human.

Non-pigmenting fixed drug eruption caused by allylisopropylacetylurea.

An unusual case of a non-pigmenting fixed drug eruption caused by allylisopropylacetylurea is reported. Several hours after taking an analgesic (New Kaiteki A), a 30-year-old Japanese woman, who had experienced similar eruptions several times after taking other analgesics, developed numerous variously sized, itchy, round-to-oval erythematous eruptions on the trunk and extremities. After she discontinued taking this drug, all such eruptions resolved within 2 weeks, without leaving postinflammatory pigmentation. Patch testing with New Kaiteki A itself and one of its active ingredients, allylisopropylacetylurea, on lesional skin, but not on uninvolved skin, showed positive erythematous reactions after 2 days.

Characterization of the physical properties of the stratum corneum by a new tactile sensor.

BACKGROUND/AIMS: The physical properties of the stratum corneum (SC) change with its water content, which is regulated by the presence of water solutes (natural moisturizing factors) and lipids in the SC, and are considered to be responsible for the induction of desquamation, skin surface roughness, and fine wrinkles. Recently a new type of tactile sensor developed for evaluating the physical properties of objects has been introduced as a simple, non-invasive method to evaluate them; because the data obtained with this sensor have not yet been characterized in detail, we compared them with other physical parameters of the skin. METHODS: A change in resonant frequency (Deltaf ) was measured under various levels of pressure applied by a tactile sensor placed on the cheeks of 29 women. We also measured high-frequency conductance that reflects the hydration state of the skin surface, water holding capacity of the SC, transepidermal water loss (TEWL), skin flexibility, skin elasticity, amino acid composition of the SC, and desquamation index of the SC at the same time, and evaluated the correlation between Deltaf and other physical parameters. RESULTS: The correlation between Deltaf and high-frequency conductance of the SC, and that between Deltaf and the water holding capacity of the SC were substantially high. Deltaf under high pressure was more closely correlated with the acidic amino acid ratio of the SC. Deltaf also showed a correlation with desquamation index for thickness of the SC as well as with skin elasticity, independent of the applied pressure. CONCLUSIONS: Because Deltaf determined with the tactile sensor correlated with other physical parameters specific to the properties of the SC, such as high frequency conductance of the SC, its water holding capacity, ratio of acidic amino acids, and the desquamation index for thickness, the physical properties of the SC may be adequately evaluated with the measurements of Deltaf.