Efficacy and safety of diphenylcyclopropenone among Chinese patients with steroid resistant and extensive alopecia areata.

BACKGROUND: Topical immunotherapy has recently been found useful in the treatment of chronic and extensive Alopecia Areata (AA). OBJECTIVE: To evaluate the efficacy and safety of diphenylcyclopropenone (DPCP) use among Chinese patients with steroid resistant and extensive AA in our institute. METHODS: The medical records of 31 Chinese patients treated with DPCP were analysed retrospectively. The efficacy, adverse effects, and relapse rate of DPCP treatment were reviewed. RESULTS: Thirty-one (16 male, 15 female) Chinese patients with extensive, steroid resistant Alopecia Areata and a mean age of 28.9 years (SE 10.4) were treated. The mean age of onset was 17.8 years (SE 8.8) with an average disease duration of 11.2 years (SE 7.7). Ten patients had a history of atopy and 4 had a history of thyroid disease. Nail changes were found in 14 patients and a family history of AA was found in 2 patients. Thirteen patients (41.9%) had experienced total hair loss. Two patients abandoned the treatment due to severe side effects. Of the remaining 29 patients, 4 (13.8%), 7 (24.1%), 5 (17.2%), and 13 (44.8%) achieved >90% complete response, >50-90% partial response, >10-50% minimal response, and <10% no response hair regrowth, respectively. Adverse effects included pruritus, erythema, vesiculation, scaling, cervical lymphadenopathy, dyspigmentation and urticarial reactions. Relapse occurred (>25% hair loss) in 69.23% of patients after 18 months of follow up. CONCLUSIONS: DPCP is an effective and tolerable treatment for Chinese patients with extensive, steroid resistant AA.

Spontaneous regression of primary cutaneous Epstein-Barr virus-positive, CD30-positive anaplastic large T-cell lymphoma in a heart-transplant recipient.

We presented a rare case of primary cutaneous Epstein-Barr virus-positive, CD30-positive anasplastic large cell lymphoma in a 64-year-old man who had received a heart transplant 11 years previously. The first presenting symptom was the appearance of erythematous skin nodules on the right leg. The lesions subsided with dose reduction of immunosuppressant alone. There was no recurrence 9 months after the first diagnosis. We propose that dose reduction of immunosuppressant alone may be an effective treatment for localized, indolent, post-transplant-related primary cutaneous lymphoma. Our case shows the importance of regular surveillance of skin cancer in patients who have received organ transplant.

Prevalence and molecular characteristics of Staphylococcus aureus isolates colonizing patients with atopic dermatitis and their close contacts in Singapore.

BACKGROUND: Staphylococcus aureus colonization is an established pathogenic factor for disease flare in atopic dermatitis (AD). OBJECTIVES: We conducted a study to investigate the colonization of S. aureus in patients with AD and their close contacts in order to evaluate the possibility of intrafamilial transmission. We sought to determine the distribution of the bacterial virulence factors and their correlation with disease severity. METHODS: Nasal swabs and skin swabs (patients with AD only) were taken from patients with AD aged 2-21 years and their close contacts, seen at the National Skin Centre from January to March 2007. All S. aureus isolates were typed using multilocus variable-number tandem-repeat fingerprinting (MLVF) and screened for virulence factors via polymerase chain reaction (PCR) analysis. AD severity was determined by the SCORAD index. RESULTS: A total of 34 patients with AD and 55 close contacts were recruited. Thirty-one (91%) patients were colonized with S. aureus. Twenty-five (45%) of their close contacts were also colonized, and MLVF showed a high concordance of S. aureus isolates in index patients and their close contacts. On multivariate analysis, patients with a moderate SCORAD were more likely to be colonized by enterotoxin B-positive S. aureus (P = 0.027). No virulence factor was significantly associated with a severe SCORAD. CONCLUSIONS: The prevalence of S. aureus colonization was high among patients with AD and their close contacts. However, no predominant isolate of S. aureus was found to be associated with AD. The presence of superantigen B is possibly associated with moderate rather than severe disease in our population.

Direct delivery of cardioplegia to the coronary arteries during arterial switch operation.

A DLP pediatric cardioplegia cannula was used to deliver cardioplegic solution to the coronary arteries: it seals on the artery button. The technique has been used in consecutive 37 patients during arterial switch operation without complication. This way of delivering cardioplegia solution is simple and effective.

On the lognormality of rain rate.

A stochastic regression model is used in modeling rain rate. Under some conditions on the model parameters, it is shown that rain rate is asymptotically lognormal. An application of the model to the GATE (global atmospheric research program, Atlantic tropical experiment) data shows a remarkable agreement between the assumed and estimated model parameters for rain rate averaged over sufficiently large area and a sampling interval of 15 min.