ABSTRACT
We studied the clinical and histopathologic characteristics of melanotic macules of the penis and vulva. The 10 lesions studied were relatively large (up to 2 cm), multifocal, irregular in outline, and had variegated pigmentation. Most were regarded as clinically atypical in appearance. Histologic examination of the lesions showed basal layer hyperpigmentation, slight melanocytic hyperplasia, epithelial hyperplasia, and stromal melanophages. No cytologic atypia of melanocytes was detectable. Information is insufficient at present to predict the natural history of genital lentiginosis or its relation to mucocutaneous melanoma.
Subject(s)
Lentigo/pathology , Penile Diseases/pathology , Vulvar Diseases/pathology , Adult , Aged , Biopsy , Female , Humans , Hyperplasia , Lentigo/epidemiology , Lentigo/etiology , Male , Middle Aged , Penile Diseases/epidemiology , Penile Diseases/etiology , Vulvar Diseases/epidemiology , Vulvar Diseases/etiologyABSTRACT
Erythema annulare centrifugum (EAC), a chronic figurate eruption, occurred in a 28-year-old male physician several months following the onset of recurrent abdominal pain. Two months after the manifestation of EAC, another episode of abdominal pain culminated in appendectomy for perforated appendicitis. During his convalescence, the skin lesions faded and did not reappear. We propose that recurrent appendiceal inflammation caused both the episodic pain and the skin eruptions. Additionally EAC may be a sign of chronic infection, internal malignancy, or food allergy. Although truly chronic appendicitis is a disputed entity, recurrent, spontaneously resolving episodes of appendicitis occasionally do precede surgical appendicitis. The presence of EAC in a patient having recurrent abdominal pain should discourage a precipitant diagnosis of functional illness and prompt further investigation.
Subject(s)
Appendicitis/complications , Erythema Multiforme/complications , Leg Dermatoses/complications , Acute Disease , Adult , Humans , Male , RecurrenceABSTRACT
In 1981, outbreaks of itchy skin rashes were reported accompanying the heavy infestation of gypsy moths (GM) in the Northeastern United States. The rash problem was widespread and a considerable public annoyance. In the spring of 1982, during the period of greatest contact with the caterpillars, a telephone survey was carried out in a highly infested community (HI) and a minimally infested community (LO). Information was collected from 1,000 persons, representing more than 90 per cent of those selected for study. The one-week risk of rash was 10.4 per cent in the HI area and 1.6 per cent in the LO area, for a risk ratio (RR) of 6.5. The occurrence of rash was strongly related to a history of having had a rash in the previous year or having had a caterpillar crawl on the affected area. The combination of both factors additively increased the risk of rash. Hay fever and hanging the wash outside were other related variables. History of allergies other than hay fever since childhood and the use of insecticides were unrelated to rash occurrence.
Subject(s)
Dermatitis/epidemiology , Disease Outbreaks/epidemiology , Lepidoptera , Moths , Adolescent , Adult , Age Factors , Animals , Child , Child, Preschool , Dermatitis/etiology , Epidemiologic Methods , Female , Humans , Infant , Infant, Newborn , Male , Massachusetts , Middle Aged , Socioeconomic FactorsABSTRACT
Seventeen workers in a laboratory where research with the gypsy moth was being performed were subjected to a questionnaire and to skin tests in an attempt to clarify the extent of allergy-like reactions in these workers. Ten of 17 reported dermatologic and/or pulmonary reactions associated with exposure to the caterpillar. Of the subjects with reactions, seven (70%) had reactions to allergens in the past. When all the workers were skin tested with various extracts, there was a strong relationship between reactions to the skin tests and clinical symptoms. The documentation of this problem helps to explain the outbreak of cutaneous reactions seen in the general population during the massive gypsy moth outbreak in spring 1981 in the Northeast.
Subject(s)
Dermatitis, Contact/etiology , Dermatitis, Occupational/etiology , Lepidoptera/immunology , Moths/immunology , Adult , Female , Humans , Laboratories , Larva , Male , Middle Aged , Pest Control , Skin TestsABSTRACT
We review the association of concurrent dermatophytic infections in patients with chronic mucocutaneous candidiasis and add twelve new patients to the seventeen previously reported ones. In sixty patients with chronic mucocutaneous candidiasis studied at the National Institutes of Health (NIH), twelve (20%) also had significant local or diffuse dermatophytosis. A comparison between candidiasis patients with and without dermatophytosis revealed no significant differences in their distribution within the various clinical syndromes of chronic mucocutaneous candidiasis nor in the immunologic responses that were tested. Failure to recognize coexistent dermatophytosis in candidiasis patients may lead to unsatisfactory responses to treatment.
