Diffuse cutaneous mastocytosis mimicking staphylococcal scalded-skin syndrome: report of three cases.

Three cases of diffuse cutaneous mastocytosis (DCM) were at first incorrectly diagnosed as staphylococcal scalded-skin syndrome. In the first patient, at age 1 day the disease was recognized promptly by simple techniques such as Darier's sign and Tzanck smear. Much delay in making the diagnosis occurred in the other two patients, however: almost 1 year and 15 years, respectively. Bullous manifestations in mastocytosis occur only in the first two or three years. In the first months the disease can be dangerous and life threatening. To distinguish mastocytosis from vesicular and bullous neonatal disorders, one should perform Darier's sign and a Tzanck smear. The diagnosis is confirmed by histopathologic studies. Treatment of the bullous manifestations is symptomatic, with zinc oxide paste and oral antihistamines, which may provide some relief. In addition, cimetidine and sodium cromoglycate may be beneficial. At a later age psoralen plus ultraviolet A therapy may also relieve the symptoms. Particular foods and medicines can liberate histamine and should be restricted as much as possible in extremely affected patients. Special care should be taken when these patients are to undergo anesthesia. The risk of complications during and after anesthesia is also present in other forms of mastocytosis.

Susceptibility of Neisseria gonorrhoeae isolates from Jakarta, Indonesia, to antibiotics.

The minimum inhibitory concentration (MIC) of penicillin, tetracycline and spectinomycin was determined for 6 beta-lactamase (PPNG) and 73 non beta-lactamase producing Neisseria gonorrhoeae isolates from Jakarta, Indonesia. All PPNG were resistant to greater than or equal to 128 micrograms/ml penicillin. Forty-six percent of the non-PPNG strains were inhibited by less than or equal to 1.0 microgram/ml of penicillin and 97% by less than or equal to 4 micrograms/ml. Most of the PPNG and non-PPNG isolates (90%) were inhibited by less than or equal to 4 micrograms/ml tetracycline and less than or equal to 16 micrograms/ml spectinomycin. Two non-PPNG strains were resistant to 64 micrograms/ml of tetracycline, 8 micrograms/ml penicillin and 32 micrograms/ml spectinomycin. The non-PPNG strains generally were more resistant to penicillin and tetracycline compared to strains tested from other parts of the world in previously reported studies.

Neisseria gonorrhoeae and penicillinase producing N. gonorrhoeae among some patients in Jakarta Indonesia.

Neisseria gonorrhoeae was isolated from 14 out of 50 (28%) of one group and 35 out of 60 (58%) of a second group of females in different areas of Jakarta, Indonesia. four (7%) of the patients in the second group were infected with penicillinase producing Neisseria gonorrhoeae (PPNG). This may be the first reported isolation of PPNG in Indonesia.