I Do Not Like Green Eggs.

Shells of pinworm ova contain chitin, which stains bright green when exposed to chlorazol black E. The objective was to determine whether chlorazol black E could assist in identification of pinworm ova from skin scrapings. Skin scrapings were stained using chlorazol black E and pinworm ova were more easily recognized, staining a blue-green color.

RARα/RXR synergism potentiates retinoid responsiveness in cutaneous T-cell lymphoma cell lines.

Retinoids, natural and synthetic derivatives of vitamin A, induce cellular changes by activating nuclear retinoic acid receptors (RAR) and retinoid X receptors (RXR). Although the ability of retinoids to govern gene expression is exploited clinically for cancer therapeutics, the full benefit of retinoid-based strategies is unrealized due to detrimental side effects. Delineating the receptors that prompt cellular outcomes is critical to advancing retinoid-based approaches. Here, we identify the receptors that evoke multiple responses in cutaneous T-cell lymphoma (CTCL). The data demonstrate that RARα drives integrin ß7-dependent adhesion and CCR9-mediated chemotaxis in CTCL cells. Of note, concomitant activation of RARα and RXR nuclear receptors yielded synergistic increases in adhesion and migration at concentrations where single agents were ineffective. As the established paradigm of retinoid action in CTCL is apoptosis and growth arrest, the role of RARα/RXR in these events was studied. As with adhesion and migration, RARα/RXR synergism prompted apoptosis and dampened CTCL cell proliferation. Strikingly, RARα/RXR synergism induced responses from CTCL cell lines previously reported to be unresponsive to retinoids. These data provide a novel framework that may further refine a proven CTCL therapy.

Parasitic Diseases With Cutaneous Manifestations.

Parasitic diseases result in a significant global health burden. While often thought to be isolated to returning travelers, parasitic diseases can also be acquired locally in the United States. Therefore, clinicians must be aware of the cutaneous manifestations of parasitic diseases to allow for prompt recognition, effective management, and subsequent mitigation of complications. This commentary also reviews pharmacologic treatment options for several common diseases.

Retinoids Bias Integrin Expression and Function in Cutaneous T-Cell Lymphoma.

Cutaneous T-cell lymphoma (CTCL) is a heterogeneous group of malignancies characterized by accumulation of malignant T-cells within the skin. Retinoids, metabolic derivatives, and synthetic analogs of vitamin A embody an effective CTCL therapy with over three decades of clinical use. The established mechanism of action is induction of growth arrest and apoptosis. However, the natural role of retinoids in T-cell biology is imprinting gut-homing properties by inducing integrin α4ß7 expression. How the natural role of retinoids relates to therapeutic effectiveness in CTCL has not been addressed and merits investigation. Here we provide evidence that retinoids, including Bexarotene, selectively induce CTCL lineages to increase integrin ß7 expression and function prior to growth arrest and apoptosis. Interestingly, augmented CTCL cell adhesion obtained with retinoid exposure was potently attenuated by 1,25-dihydroxyvitamin D3, a metabolic vitamin derivative involved in prompting immune cell skin homing. The integrin-dependent adhesion changes in CTCL cells occurred through synergistic activation of RAR and RXR nuclear receptors. These data explore the early cellular changes induced by retinoids that may be pivotal to sensitizing CTCL cells to growth arrest and apoptosis.

Herpes esophagitis in the setting of immunosuppression from pemphigus vulgaris therapy.

We report a case of herpes esophagitis in a 35-year-old man with pemphigus vulgaris (PV) who was undergoing treatment with corticosteroids and mycophenolate mofetil (MMF). Pemphigus vulgaris is an autoimmune intraepithelial bullous disease resulting from pathogenic IgG antibodies toward desmoglein antigens that often requires long-term immunosuppressive therapy for control of disease symptoms. Herpes esophagitis is an ulcerative eruption caused by viral reactivation in the setting of immunosuppression. Acute odynophagia in patients undergoing systemic treatment of active PV has a broad differential and warrants prompt endoscopic evaluation.

Cutaneous mastocytosis: a review focusing on the pediatric population.

Cutaneous mastocytosis can be divided into 4 different clinical variants--urticaria pigmentosa, solitary mastocytoma, diffuse cutaneous mastocytosis, and telangiectasia macularis eruptiva perstans. Skin findings are often accompanied by symptoms secondary to mast cell release of mediators. These symptoms can be both localized to the skin lesion and systemic because of the release of mediators into the bloodstream. The majority of pediatric cases of cutaneous mastocytosis show a good prognosis with gradual resolution of both symptoms and skin lesions. This article will review each of the 4 clinical presentations focusing on pediatric-onset of disease while reviewing the literature.

Cutaneous manifestations of Staphylococcus aureus disease.

Staphylococcus aureus is a common pathogen in clinical infectious disease. The cutaneous manifestations can vary dramatically from a simple infected hair follicle to a life-threatening illness such as toxic shock syndrome or staphylococcal scalded skin syndrome. The authors review the variety of manifestations of various S aureus infections on the skin.