Objective assessment of meconium content of amniotic fluid.

The amount of meconium in amniotic fluid is subjectively estimated by visual inspection and classified as thin (light), moderate, or thick (heavy). This estimate may be important for assessing the neonatal risk of perinatal asphyxia and meconium aspiration syndrome. This study reports on the "meconium-crit," a simple, rapid, inexpensive, and reproducible method of quantifying meconium concentration in amniotic fluid. The purpose of the study was to determine the relationship between the meconium-crit and meconium concentration. Specimens were prepared by placing 3.0 g of fresh neonatal meconium into clear amniotic fluid and vortexing for 15 minutes to obtain a stock solution of 15.0 g meconium/100 mL amniotic fluid. Stock solutions were then diluted with clear amniotic fluid to obtain concentrations of 10.0, 7.5, 5.0, 3.0, and 1.5 g/100 mL. One-tenth milliliter of the amniotic fluid/meconium mixture was drawn into a standard hematocrit tube and centrifuged. The meconium-crit was then measured directly as with a hematocrit. Regression analysis indicated that meconium-crit values were linearly related to meconium concentration (r = 0.901-0.995). This method provides a reproducible means of quantifying meconium in amniotic fluid.

Ichthyosis follicularis in two girls: an autosomal dominant disorder.

Ichthyosis follicularis (IF) is a rare disorder of keratinization that has been described primarily in males and proposed as a possible X-linked disorder. We report two black girls with nonscarring alopecia; photophobia; follicular hyperkeratoses; hyperkeratosis of the extensor aspects of the hands, knees, and elbows; fixed, erythematous, perineal plaques; and angular cheilitis who seem to fit the clinical criteria for IF. One girl also had gingival hypertrophy and a hearing deficit. One child's father had identical symptoms. We propose that these girls may have a variant of IF that is inherited as an autosomal dominant trait.

Alopecia areata.

Alopecia areata is an asymptomatic, nonscarring hair loss with spontaneous remissions and exacerbations. Although the etiology is unknown, the disorder is associated with vitiligo, atopy, pernicious anemia, Down syndrome and thyroiditis. The area of hair loss may remain localized or may involve the entire scalp or all body hair. Treatment is difficult to assess because of individual response and spontaneous remissions, as well as a high rate of relapse. Intralesional injection of corticosteroids is the most common mode of treatment, although systemic steroid therapy, contact allergens, minoxidil, psoralens plus ultraviolet light, and other agents have been tried.

Pediatric bowenoid papulosis: risks and management.

A 34-month-old Haitian girl had a six-month history of asymptomatic vulvar papules. Histologic features and DNA probe studies were diagnostic of bowenoid papulosis. Resolution of the lesions was enhanced by cryotherapy. This is the third reported patient with prepubertal bowenoid papulosis. Sexual abuse should be suspected, but not assumed, in pediatric patients with this condition. Our patient had no evidence of sexual abuse. Bowenoid papulosis has been associated with cervical intraepithelial neoplasia and rarely with squamous cell carcinoma. Close gynecologic follow-up is recommended.

Giant cell fibroblastoma. A report of a case and review of the literature.

A 15-year-old white boy with a giant cell fibroblastoma of the skin of the abdomen is described. Giant cell fibroblastoma is a rare soft tissue neoplasm that most commonly occurs in children as a small, painless mass in the dermis and subcutaneous tissue. Although local recurrences have been reported, no metastases have occurred. Giant cell fibroblastoma must be differentiated from other spindle cell neoplasms.

Vesicular scabies in an adult.

We describe an unusual vesicular eruption occurring secondary to scabies in an elderly patient receiving high-dose prednisone therapy.