[Congenital pachyonychia type II (Jackson-Lawler syndrome)]. / Pachyonychia congenita Typ II (Jackson-Lawler-Syndrom).

Pachyonychia congenita (PC) is a rare ectodermal dysplasia with variable expression. The condition is usually inherited as an autosomal dominant trait. Several classifications of PC have been proposed. Feinstein and colleagues suggested four clinical types of PC. Type II, the Jackson-Lawler-Syndrome, is characterized by multiple epidermal cysts, palmoplantar bullae and hyperhidrosis as well as natal teeth in addition to the main findings of pachyonychia, palmoplantar hyperkeratosis and follicular keratosis. We report two patients (father and son) with Jackson-Lawler-Syndrome and describe in detail pathogenesis, diagnostic criteria and treatment approaches as well as the different classifications of pachyonychia congenita.

[UV-therapy in HIV-infected patients]. / UV-Therapie bei HIV-Patienten.

We examined the prevalence of HIV-associated cutaneous disorders as well as the frequency and efficiency of UV-radiation in HIV-infected patients by evaluating the clinical records of 1310 patients seen between and 1994 and 1996. 41 patients were treated with UVB-radiation and 4 patients with UVA1-radiation, while three patients received PUVA-therapy. UV-radiation proved to be efficient and safe in the treatment of pruritic papular eruption, atopic dermatitis and psoriasis. Although some in vitro studies and studies with transgenic mice have suggested a negative impact of UV radiation on the immunosystem of HIV-positive patients, no progression of the HIV infection due to phototherapy has been proven.

[Acral papular lichen myxedematosus]. / Akraler papulöser Lichen myxoedematosus.

In 1986 Rongioletti introduced the term acral persistent papular mucinosis for persistent papules on the dorsum of the hands and distal forearms. Skin specimens reveal mucin deposits which resemble those in lichen myxedematosus (LM). Laboratory results are usually unremarkable. Our 54-year-old female patient showed a 2 1/2 year history of skin lesions in the typical acral distribution pattern. This entity appears to be an acral papular subtype of LM. In the classification of LM, acral papular lichen myxedematosus should replace the discrete papular form. This latter form has been well known for many years, but is not sufficiently definable and is of secondary clinical importance.

Allergic contact dermatitis from pyoctanin.

Although pyoctanin is widely used in medicine, there are hardly any reports of contact allergy to it. Most reports of side-effects refer to irritant reactions after topical application. We describe 2 patients who developed pyoctanin contact dermatitis after long-term application on damaged skin. Positive patch test results down to concentrations of 0.0025% and 0.05% aqueous pyoctanin solution, respectively, were found.

[Erysipelas after leg vein harvesting for aortocoronary bypass operation]. / Erysipele nach Entnahme von Beinvenen für eine aortokoronare Bypassoperation.

We have seen 4 patients in 1995 who showed erysipelas in the leg used for vein graft harvesting for coronary bypass surgery. None of the patients had experienced erysipelas prior to surgery. One patient had his first attack erysipelas while the others experienced recurrent disease. Venectomy puts these patients at risk for later erysipelas. Therefore careful foot hygiene, eradication for mycotic infections and adequate therapy for initial erysipelas are mandatory in cardiac high risk patients after coronary bypass surgery.