Clinical features of patients with blepharospasm: a report of 240 patients.

BACKGROUND AND PURPOSE: To characterize patients with benign essential blepharospasm (BEB) by diagnosis, environmental risk factors, and family history. METHODS: Two hundred and forty patients with BEB were evaluated through a clinical examination and questionnaire. The questionnaire reviewed personal medical history, demographic factors, risk factors for the development of blepharospasm and family history of dystonia and other neurological conditions. RESULTS: Benign essential blepharospasm was more commonly found in women (2.8:1) and 93% of the patients were Caucasian. Fifty percent had pure BEB, 31% had BEB/Meige's syndrome, and 4% had BEB and eyelid opening apraxia (+/- Meige's syndrome). A minority of patients reported preceding photophobia (25%) or other eye conditions (22%). The majority were non-smokers, had no exposure to anti-emetic or antipsychotic agents, had a normal birth history, and had no history of head trauma. Seventy-two percent did report a stressful event immediately prior to the development of symptoms. Treatments reported included botulinum toxin (BoNT), oral medications, surgical procedures, and acupuncture. Thirty-two percent of patients reported a family history of focal dystonia, and BEB was the most commonly reported. CONCLUSION: This study confirms previous reports of usual age, sex, caffeine and tobacco use, and family history in patients with blepharospasm. New findings include a report on occupation, lower reports of preceding eye conditions and photophobia, and higher reported stressful events. Further, this study shows a change in treatment with an increase in BoNT use and decrease in surgical procedures.

Dapsone syndrome: A case study.

A 47-year-old woman developed fever, dermatitis, lymphadenopathy and hepatitis a few days after taking dapsone. She was investigated and diagnosed as'dapsone syndrome'

The hypereosinophilic syndrome.

A 64-year old woman patient with dry pruritic rash, oral ulcers, persistent cough and significant weight loss was investigated and proved to be a case of hypereosinophilic syndrome.

Generalized umbilicated granuloma annulare.

Generalised umbilicated granuloma annulare is reported in an elderly man. There was no association of diabetes or other systemic disease.

Wells' syndrome.

Eosinophilic cellulitis/Wells' syndrome is a rare dermatosis with erythematous, urticarial plaques that become more indurated and eventually have grey blue discoloration. The histopathology is distinctive, with a diffuse infiltrate composed predominantly of eosinophils but admixed with lymphocytes, histicytes and occasionally multinucleated histiocytes. There is dermal edema with so called "flame figures" that is composed of collagen focally enveloped with aggregates of eosinophilic granules. These collagen fibres may be surrounded by palisading histiocyes. The course is variable with waxing and waning and eventual spontaneous resolution.

Glucagonoma syndrome.

A case of glucagonoma is being presented. The patient presented with erosions, crusts, bullous dermatitis, glucose intolerance and weight loss.

Follicular mucinosis.

A case of follicular mucinosis is being reported. Clinically, the patient had discrete follicular and non-follicular papules on the face, neck and arms. Light microscopy confirmed the follicular outer root sheath, and sebaceous gland epithelial degenerative changes. The infiltrating inflammatory cells were morphologically benign. The response to oral dapsone therapy is highlighted.