Cutaneous leishmaniasis in Cuban immigrants to Texas who traveled through the Darién Jungle, Panama.

Cutaneous leishmaniasis is rarely seen in the United States. Four Cuban immigrants traveled along the same route at different times from Cuba to Ecuador, then northward, including through the Darién Jungle in Panama. These patients had chronic ulcerative non-healing skin lesions and were given a diagnosis of leishmaniasis.

Fixed drug eruption related to ibuprofen presenting as giant bullae on the posterior thigh.

Fixed drug eruptions (FDEs), first described by Bourns in 1889, are solitary or multiple, sharply demarcated, round to oval, edematous and erythematous patches that arise after exposure to a specific medication. They can be pink to dark red to brown and can be larger than 10 cm in size. In almost a third of patients in some case series, these lesions have been reported to progress to vesicles or bullae. Fixed drug eruptions have been associated in up to 40 percent of cases with non-steroidal inflammatory drugs, including ibuprofen. We describe an interesting case of a biopsy-confirmed FDE that presented as large bullae on the posterior thigh after ibuprofen use.

Symmetrical bilateral Becker melanosis: A rare presentation.

Becker melanosis, also known as Becker nevus, is a relatively common cutaneous hamartoma. The condition is classically characterized by a unilateral, hyperpigmented patch with varying degrees of hypertrichosis on a peripubertal individual. As Becker nevi are generally singular in a given individual, there are very few reported cases of multiple or bilateral lesions. We herein report a rare case of bilateral, symmetrical, non-syndromic Becker melanosis and we discuss possible pathogenesis and current treatment options.

Standardizing the 60-second hair count.

OBJECTIVE: To define the range of normal for a standardized 60-second hair count in men without alopecia. DESIGN: Convenience sample. SETTING: Hospital-based practice. PARTICIPANTS: The study included 60 healthy men (age range, 20-60 years) without evidence of alopecia. MAIN OUTCOME MEASURE: Range of normal for a standardized 60-second hair count. RESULTS: Among the 20- through 40-year-old men, the shedding range was 0 to 78 hairs, with a mean of 10.2 hairs. Among the 41- through 60-year-old men, the range was 0-43 hairs, with a mean of 10.3 hairs. Low intrapatient variability for hair counts was found in both age groups, indicating consistent results on consecutive days for all participants. When repeated 6 months later in both age groups, the hair counts did not change much. The hair counts were repeated and verified by a trained investigator, with results similar to those of subject hair counts. CONCLUSION: A properly performed 60-second hair count is a simple, practical, and reliable tool for the assessment of hair shedding.

Acneiform eruption following anti-TNF-alpha treatment: a report of three cases.

Tumor necrosis factor-alpha (TNF-alpha) antagonists are used to treat many autoimmune disorders including Crohn's disease, ulcerative colitis, rheumatoid arthritis, and more recently, psoriasis. The adverse effects of the treatment regimen for psoriasis are not as well documented as those for Crohn's disease and rheumatoid arthritis. We report the development of acne vulgaris in 3 patients with psoriasis after initiating anti-TNF-alpha therapy.