Squamous cell carcinoma developing in two Chinese patients with chronic discoid lupus erythematosus: the need for continued surveillance.

Squamous cell carcinoma (SCC) is a rare late sequel of chronic discoid lupus erythematosus (CDLE). We report two cases of SCC developing in Chinese patients with CDLE. The first patient had prior biopsies from the same site that showed viral warts and the second patient had multiple histologically confirmed viral warts around the vicinity of the previously excised SCC. In this paper, we emphasize the need to be suspicious of warty lesions on skin afflicted by CDLE, and repeat biopsies should be performed if there is failure to respond to conventional therapy.

Characteristics of Hori naevus: a prospective analysis.

BACKGROUND: Acquired, bilateral naevus of Ota-like macules or Hori naevus (HN) is a common dyschromia seen in Orientals. Other than the original report which documented the clinical spectrum in a group of 22 patients, there have not been many epidemiological reports of this condition. OBJECTIVES: To evaluate the epidemiology and clinical characteristics of HN in Asian patients. METHODS: A prospective analysis of 161 patients with HN seen from June 2003 to June 2004 was performed. RESULTS: All 161 patients in the study were women. Patients were Chinese (n = 155), Eurasian (n = 4), Malay (n = 1) and Indian (n = 1). The median age at onset was 30 years. The malar region was the most frequently affected area. Discrete brown macules were the most common early presentation. Confluent slate-grey macules occurred later. Aggravating factors included sun exposure and pregnancy. Sixty-seven patients reported a positive family history. CONCLUSIONS: We report our data on the largest series of HN in the literature so far. Predisposing factors in our study are Chinese race, female sex and positive family history. HN became progressively more confluent and grey over time, suggesting migration from the epidermis to the deeper dermis. More studies are needed to confirm the pathogenesis.

Autosomal dominant familial chronic mucocutaneous candidiasis associated with acne rosacea.

INTRODUCTION: Autosomal dominant chronic mucocutaneous candidiasis (CMC) without endocrinopathy (OMIM 114580) is a well-described entity. The associations recorded with this disorder to date are intercellular adhesion molecule-1 (ICAM-1) deficiency and hyper-immunoglobulin E syndrome. CLINICAL PICTURE: We report a new association in a family (mother and nonidentical twin sons) where acne rosacea is a prominent feature together with CMC. In addition, antibodies to thyroid microsomal and antiparietal cell were also isolated. The autoantibodies might be associated with a current "latent" endocrinopathy in particular autoimmune thyroiditis. TREATMENT: The patient was treated with intermittent pulses of itraconazole for the candidiasis and doxycycline initially before being substituted with isotretinoin 6 months later for the rosacea. OUTCOME: The patient's candidiasis responded well and has been in remission for 3 months while his rosacea continues to improve.

Reticulate hyperpigmented scleroderma: a new pigmentary manifestation.

Scleroderma is a systemic disease with a myriad of cutaneous manifestations. Pigmentary disturbances have been described in scleroderma. While diffuse generalized hyperpigmentation and localized hypopigmentation with perifollicular hyper-pigmentation are well recognized, a vascular induced hyperpigmentation has only been recently described. In this paper, we report another unrecognized pigmentary abnormality in a 48-year-old patient who presented with a reticulate hyper-pigmentation affecting the trunk, upper and lower limbs. To our knowledge, cutaneous hyperpigmented reticulate scleroderma has not been reported previously.

Resolution of vulvitis circumscripta plasmacellularis with topical imiquimod: two case reports.

Vulvitis circumscripta plasmacellularis (VCP) is a rare but well-described entity. It is notorious for its recalcitrant nature to various modalities of treatment. Intralesional interferon-alpha showed some promise, with complete resolution, but is coupled with the side-effect of myelosuppression. Topical imiquimod is a novel immune response modifier with the ability to induce the production of interferon-alpha. In this paper, we report two cases of VCP whose lesions were resistant to antibiotics, topical and oral corticosteroids, but resolved after a treatment trial with imiquimod.