BackgroundSolar urticaria is a chronic inducible urticaria also classified as an idiopathic dermatosis. The objective of this paper is to define the phenotypic characteristics of solar urticaria and to evaluate its incidence.Material and methodThis was a retrospective multicenter study in which data were gathered on the epidemiology and clinical, photobiologic, laboratory, and therapeutic characteristics of solar urticaria.ResultsA total of 224 patients (141 women and 83 men) were included from 9 photobiology units. The mean age of the patients was 37.9 years (range, 3-73 years). A history of atopy was detected in 26.7%, and the most common presentation was allergic rhinitis (16.5%). Clinical signs were limited to sun-exposed areas in 75.9% of patients. The light spectrum most commonly implicated was visible light only (31.7%), and in 21% of cases it was only possible to trigger solar urticaria with natural light. The treatments most widely used by photobiology experts were oral antihistamines (65.46%), followed by different forms of phototherapy (34%). Complete resolution was observed most often in patients with solar urticaria triggered exclusively by visible or natural light, with statistically significant differences with respect to other wavelengths (P<.05). No increase in the annual incidence of solar urticaria was observed.ConclusionsWe have presented the largest series of solar urticaria published to date. The epidemiological, clinical, and photobiologic findings confirm previously reported data, although there was a particularly high rate of negative phototests in our series. Reactivity exclusively to visible or natural light was associated with a higher probability of resolution. No increasing trend was observed in the annual incidence.

Cowden syndrome is an autosomal dominant genodermatosis, characterized by the presence of multiple hamartomas in the skin, breast, thyroid, gastrointestinal tract, central nervous system, and an increased risk in developing breast and thyroid carcinomas. Over 80 germline mutations of the tumor suppressor gene PTEN, on chromosome 10q23, have been reported in more than 100 unrelated patients and families; however, questions regarding distribution of the mutations in populations from different geographic areas, and phenotypic expression are still unclear. In this study the results are reported of mutation analysis of PTEN in 13 families from Spain and one family of Brazilian origin with Cowden syndrome. PTEN germline mutations were detected in nine of them (64%). Five mutations were located in exon 5, one in exon 6, two in exon 7, and one in exon 8. Four of the mutations were novel. In another case, an identical change had been previously reported as a somatic mutation in an endometrial carcinoma. In one family, the patient presented a de novo mutation, which was not detected in his parents. In five patients, the detection of the PTEN germline mutation confirmed their condition, even in the absence of sufficient criteria to make the clinical diagnosis of Cowden syndrome.

Background: Muir-Torre syndrome (MTS) is characterized by the co-existence of sebaceous gland tumors of the skin and internal malignancies. Currently, MTS is regarded as a variant of the hereditary non-polyposis colon cancer syndrome (HNPCC). Both MTS and HNPCC are secondary to germline mutations in DNA mismatch repair genes (mainly MSH-2 and MLH-1).Methods: Cutaneous (eight sebaceous adenomas, one sebaceous carcinoma and one keratoacanthoma) and internal tumors (four colonic adenocarcinomas, two endometrial carcinomas, two transitional cell carcinomas of renal pelvis and ureter, one adenocarcinoma of the small bowel, one ovarian carcinoma and one colonic tubular adenoma) were obtained from six patients with MTS and were subjected to microsatellite instability (MI) analysis, and to immunostaining for MLH-1 and MSH-2. MI was assessed by evaluating three (CA)n dinucleotide repeats (D2S123, D5S346, D17S250) and the mononucleotide tracts BAT 26 and BAT 25.Results: All cutaneous and internal tumors exhibited MI. An immunohistochemical concordance between all tumors within each single patient was obtained in five cases. In these five patients all tumors exhibited a lack of MSH-2 staining, consistent with a germline abnormality in this gene. In the one remaining case, the immunohistochemical staining in the sebaceous adenoma was negative for MLH-1 and positive for MSH-2, consistent with a germline alteration in MLH-1. However, the colonic adenocarcinoma in that patient showed positivity for MSH-2 and an equivocal positivity for MLH-1.Conclusions: The results confirm that tumors from patients with MTS exhibit MI. Moreover, immunostaining for MLH-1 and MSH-2 may be useful to identify the most probable gene responsible for the disease in each family.

We report a case of a 45-year-old woman who presented a simultaneous foreign-body granuloma reaction to silicone in her face and to silica in the elbow and knee. The patient had received silicone injections in her face 7 years earlier and had suffered a motorcycle accident when she was young. Changes suggestive of silicone were observed in the biopsy obtained from the face, and silica was detected in the biopsy taken from the elbow, confirmed by polarized light and X-ray microanalysis. The presence of polarizable foreign matter in cutaneous epithelioid granulomas should alert to the diagnosis of sarcoidosis.

An 88‐year‐old man with a past medical history of pulmonary tuberculosis presented with a 2‐year history of an indolent enlarging ulcerated nodule on his left wrist following a venous blood test. Skin biopsy of the ulcer showed granulomas, Ziehl–Neelsen stain was negative, and cultures grew Mycobacterium tuberculosis. Underlying bone and joint disease was excluded, and the lesion healed completely with 6 months of standard antituberculous treatment. We review the literature on tuberculous gumma following an injury.

BACKGROUND:It has been suggested that the use of sunscreens to prevent skin cancer may put the population at risk of vitamin D deficiency, which in turn may lead to secondary hyperparathyroidism, loss of cortical bone and, ultimately, osteoporotic fractures.OBJECTIVE:To investigate whether sunscreen SPF15 may lead to loss of bone mass.METHODS:We followed 10 sunscreen users and 18 controls over 2 years, including two summers, two winters and a basal period (winter). Bone mass was evaluated each season with dual x-ray absorptiometry.RESULTS:During follow-up, mild fluctuations in bone mass could be seen at Ward's site in both groups, without a definitive pattern. At the final visit, no significant loss of bone mass was observed in sunscreen users or in the control group. We did not observe any significant differences between groups throughout the study.CONCLUSION:Although the study samples in this work are small, and a slight variation in bone mass may not be detected, in a clinical setting, sunscreen SPF15 protection does not seem to increase the risk of osteoporosis.

Some studies have suggested that the use of sunscreens to prevent skin cancer may put the population at risk of vitamin D deficiency. We followed 24 sunscreen users and 19 controls over 2 years, including two summers, two winters and a basal period (winter). Vitamin D, parathormone and bone biological markers were evaluated each season. Mean levels of 25-hydroxyvitamin D rose in summer, with the increments being significantly higher for the second year in the control group. Levels decreased in winter in both groups, and were significantly lower in sunscreen users. We did not observe any significant change in parathormone, tartrate resistant phosphatase, total alkaline phosphatase, osteocalcin, urine hydroxyproline or urine calcium. Clinically prescribed sunscreen creams (sun protection factor 15) caused a minor decrease in 25-hydroxyvitamin D levels, which did not induce secondary hyperparathyroidism or an increment in bone biological markers.

BACKGROUND: Erythema induratum of Bazin (BEI), is included in the group of cutaneous granulomatous lobulillar panniculitis. The aethiopathogenic association between EI and tuberculosis can not rely on the clinicohistological features of these panniculitis and M. tuberculosis has never been isolated from BEI lesions. Detection of the mycobacterial DNA by PCR on cutaneous biopsy samples would allow to confirm this association.PATIENTS AND METHODS: Fourteen patients with clinical BEI were chosen retrospectively. Seventeen lesional biopsy samples were obtained, stained with the Kinyoun carbolfuchsin acid-fast technique and haematoxylin and eosin and tested by PCR, A fragment of the IS6110 insertion sequence specific of M. tuberculosis was amplified and confirmed by digestion with Sal I restriction endonuclease. The efficiency of the procedure, the presence of inhibitory substances and the preservation of DNA were checked by PCR of the beta-actin gene.RESULTS: M. tuberculosis DNA was detected in 12 of the 17 samples tested (70.5%) which corresponded to 10 of the 14 patients (71.4%). According to beta-actin PCR results, the rate of extracted DNA was inadequate on four of the five negative biopsies.CONCLUSIONS: The results of these series suggest the probable involvement of M. tuberbulosis on the BEI pathogenesis and give support to the usefulness of the PCR in the diagnosis of this pathology concerning the need of specific treatment.

BACKGROUND:To know the incidence, clinical presentation, differential diagnosis and resistance level to antibiotics in pediatric meningitis.METHODS:173 cases of meningitis (bacterial: 69, viral: 104) have been prospectively followed during 1988 according to a previously established clinical and laboratory protocol.RESULTS:Meningitis attack rate was 60 cases/100,000 children younger than 15 years per year (meningococcal: 25/100,000, Haemophilus: 2/100,000). Mortality was 1.4%. 40% of bacterial meningitis received previous antibiotic treatment. Sensitivity of culture, Gram stain, and direct antigen detection by latex and EIA was 79%, 61.7%, 20.5% and 34%, respectively. Bacterial and viral differential diagnosis, by the application of Boyer's score was 95% sensitive and 98% specific. Four out of six cases of Haemophilus meningitis were ampicillin and chloramphenicol resistant; 39% of meningococcus had their penicillin susceptibility decreased between 2 and 8 times, although no therapeutic failures were seen.CONCLUSIONS:Laboratory parameters might not separate bacterial and viral meningitis at early stages of illness. Gram stain is an excellent and sensitive method of bacterial detection in CSF. Moderate resistance to penicillin in meningococcus is very frequent but clinical failures are not yet present.

The clinical, electron microscopic, and freeze-fracture features of the skin of a harlequin fetus are described. Ultrastructural findings included large, concentric lamellar bodies, focal absence of intercellular stratum corneum lipid, and an increase in the size of desmosomes and the number of tight junctions. Although the cause of this genodermatosis is unknown, these features may partially explain the marked thickening of stratum corneum that characterizes this disorder.

Three additional cases of hypomelanosis of Ito (HI) are reported. HI is a syndrome manifested by irregular macular hypopigmented lesions, resembling the negative image of incontinentia pigmenti. Their cutaneous manifestations, associated abnormalities and the peculiar characteristics of the reported cases are discussed.

We report our results on 110 patients that attended our Hospital during a four years period(1981-84). The range age was between three months to 16 years.Short treatment with INH+RMP during nine months, and also ETB or SM during the first three months, it was given to the first group of 61 patients. The same treatment during 12 to 18 months was done to a second group of 49 children.After treatment suppression, both groups have been controlled at least during one year. At 9 months treatment normal clinical examination was found on all patients (110/110), and none showed relapse. Normal chest X-Ray examination was obtained on 48 over 61 patients of first group. On 12/61 patients it became normal between 10 and 16 months. On account of bronchiectasis abnormal images persisted in one case (1/61).In the second group normal radiological exam was seen on 17/49 patients, when they finished 9 months treatment. And 26/49 patients obtained it, between 10 and 25 months. Remaining pathological images was due to bronchiectasis(3/49), pulmonary sequester(1/49), fibrocaseous tuberculosis(1/49) and tuberculous granuloma(1/49).CONCLUSION: The above mentioned 9 months treatment is able to heal the disease on almost all cases. Though afterwards we recomend a follow-up during one year.

The presence of IgG, IgA, IgM, C1q, C3c, fibrinogen and properdin has been studied using direct immunofluorescence technique. The same study has been performed in clinically normal mucosa of patients with aphthous ulcers, normal mucosa of healthy volunteers and traumatically induced ulcers. We have also studied the possible presence of reactive serous immunoglobulins with normal mucosa by indirect immunofluorescence. Our findings do not support previous studies which claimed the presence of vasculitis induced by the presence of immunoreactants in the vessel walls.

Contact DermatitisVolume 9, Issue 1 p. 76-76 Addison's disease and contact dermatitis from mercury in a soap A. Alomar, A. Alomar Dermatology Department, Hospital de las Santa Cruz y San Pablo, Autonomous University, Barcelona, SpainSearch for more papers by this authorJ. G. Camarasa, J. G. Camarasa Dermatology Department, Hospital de las Santa Cruz y San Pablo, Autonomous University, Barcelona, SpainSearch for more papers by this authorM. Barnadas, M. Barnadas Dermatology Department, Hospital de las Santa Cruz y San Pablo, Autonomous University, Barcelona, SpainSearch for more papers by this author A. Alomar, A. Alomar Dermatology Department, Hospital de las Santa Cruz y San Pablo, Autonomous University, Barcelona, SpainSearch for more papers by this authorJ. G. Camarasa, J. G. Camarasa Dermatology Department, Hospital de las Santa Cruz y San Pablo, Autonomous University, Barcelona, SpainSearch for more papers by this authorM. Barnadas, M. Barnadas Dermatology Department, Hospital de las Santa Cruz y San Pablo, Autonomous University, Barcelona, SpainSearch for more papers by this author First published: February 1983 https://doi.org/10.1111/j.1600-0536.1983.tb04633.xCitations: 7AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume9, Issue1February 1983Pages 76-76 RelatedInformation