Scleredema of Buschke: a report of seven cases.

Scleredema of Buschke is an uncommon dermatosis characterized by thickened, indurated skin, sometimes with erythema. Histopathology shows thickened dermal collagen with a mild infiltrate of mucin in the deeper dermis. Seven adults with scleredema are presented, four females and three males, and their mean age at diagnosis was 54 years. All had diabetes mellitus for an average of 13 years prior to the onset of scleredema. Complications of diabetes, especially retinopathy (n = 5), neuropathy (n = 4) and peripheral vascular disease (n = 3), were present in five patients. One patient died (cause not established), and another has life-threatening cardiomyopathy. We have no evidence that the scleredema was a significant aetiologic factor in either case, despite published reports of fatalities related to scleredema. Three patients were followed up for more than 1 year and, irrespective of therapy, the scleredema did not resolve in any patient.

The eastern Australian childhood nevus study: prevalence of atypical nevi, congenital nevus-like nevi, and other pigmented lesions.

BACKGROUND: Various melanocytic lesions are frequently observed. An understanding of phenotypic factors and environmental stimuli that are associated with these lesions may help explain their pathogenesis. OBJECTIVE: This study was undertaken to determine the prevalence of atypical nevi, blue nevi, cafe-au-lait macules, congenital nevus-like nevi, halo nevi, nevi spili, nevi 5 mm or more in diameter, and skin-colored melanocytic nevi in a population of schoolchildren and to explore risk factors including solar radiation in the development of these melanocytic lesions. METHODS: A cross-sectional study was performed by the same medical investigators to examine schoolchildren in three Australian cities that span a wide range of latitudes. RESULTS: Data from 1123 white Australian schoolchildren, 6 to 15 years of age, were analyzed. Acquired melanocytic nevi (atypical nevi, nevi > or = 5 mm in diameter, and skin-colored nevi) were more likely to develop in older fair-skinned subjects who had freckles and lived closest to the equator. Café-au-lait macules and congenital nevus-like nevi were observed in 36.3% and 4.4% of the total population, respectively. Prevalence for both these types of melanocytic lesions increased significantly with decreasing latitude. Halo nevi were present in 5.3% of the subjects and were usually solitary. These lesions were related to the presence of atypical nevi primarily by virtue of their size rather than of other features of clinical atypia. CONCLUSION: Like melanocytic nevi in general, large and atypical nevi are strongly influenced by geographic location and, by implication, degree of solar radiation. The same can be said for congenital nevus-like nevi, which suggests that many so-called congenital nevi are in fact acquired early in life.

Sunlight: a major factor associated with the development of melanocytic nevi in Australian schoolchildren.

BACKGROUND: Case-control studies have identified melanocytic nevi (MN) as the most important phenotypic risk factor for melanoma. A knowledge of any environmental factors that cause MN may facilitate prevention of melanoma. OBJECTIVE: This study was undertaken to explore the possible role of ambient solar irradiation in the development of MN in children. METHODS: With a standard protocol developed after international consultation, the same medical observers examined children in three Australian cities (Melbourne, Sydney, and Townsville) that span a wide range of latitude. RESULTS: A total of 1123 Australian schoolchildren 6, 9, 12, and 15 years of age were surveyed. Larger numbers of MN were found (mean 65.4 MN, standard deviation 52.9) than in previous studies of children. Prevalence increased with diminishing latitude (51.1 in Melbourne, 66.5 in Sydney and 77.2 in Townsville), particularly in children 6 and 9 years of age. Although nevus numbers were higher in children with light skin and hair, blue eyes, and freckling, the latitude gradient remained after adjustment for these and other factors in multivariate analysis. CONCLUSION: Latitude of residence, and by implication ambient UV radiation, is strongly related to nevus prevalence in young Australian children. However, these differences diminish with age and may disappear by 15 years of age.

Expression of the high responder/non-responder human Fc gamma RII. Analysis by PCR and transfection into FcR-COS cells.

Distinct differences in the capacity of monocyte Fc gamma RII of different individuals to bind or not bind mouse IgG1 defines a polymorphism of Fc gamma RIIa and has previously been defined as the high responder (HR) or low responder (LR) polymorphism of Fc gamma RII. The precise definition of the molecular basis of the human HR/LR polymorphism of Fc gamma RIIa from the peripheral blood mononuclear cells of normal individuals has been determined by anti-CD3 induction of T cell proliferation, the polymerase chain reaction (PCR), nucleotide sequencing, transfection and IgG binding. Amplification of first strand cDNA from mRNA isolated from mononuclear cells was performed by PCR using primers specific for the sequences encoding the leader and cytoplasmic sequences of PCR using primers specific for the sequences encoding the leader and cytoplasmic sequences of Fc gamma RIIa, which is normally expressed in monocytes. Sequencing of the PCR products and transfection of these to Fc gamma R- cells indicated that in Fc gamma RIIa of HR or LR individuals: (i) three nucleotide substitutions (CA to TG and G to A) resulted in the change of glutamine to tryptophan at position 27 (first extracellular domain) and arginine to histidine at position 131 (second extracellular domain); (ii) expression of cDNA encoding the various combinations of these indicated that arginine at position 131 was essential for IgG1 binding whereas the amino acid changes at position 27 had no effect; and (iii) IgG1 at high concentration bound to all allomorphic forms of Fc gamma RIIa.(ABSTRACT TRUNCATED AT 250 WORDS)