Abraham Feinstein

TREATMENT OF PYODERMA GANGRENOSUM WITH CLOFAZIMINE

We report a case of pyoderma gangrenosum in a 80‐year‐old woman suffering from ulcerative colitis and treated with clofazimine. Significant improvement was evident within 5 days following commencement of therapy, complete healing occurred after only 4 weeks of treatment.

Painful piezogenic pedal papules in patients with Ehlers-Danlos syndrome

Painful piezogenic pedal papules were observed in 10 of 29 patients with Ehlers-Danlos syndrome. The diagnosis was made by examining each patient while he or she stood with full body weight on the heels and by observing the appearance of the painful papules on the medial, posterior, and lateral aspects of both heels. Biopsy specimens of papules demonstrated a thickened and dense dermis. The subcutaneous fibrous trabeculae were thin, with resultant poor compartmentalization of the fat. Painful piezogenic pedal papules are due to herniation of subcutaneous fat into the dermis, which is possibly due to structural defects of the connective tissue. The high prevalence of painful piezogenic pedal papules in our group of patients (34.5%) makes its direct association with the Ehlers-Danlos syndrome highly feasible, most probably because of the connective tissue defect that occurs in patients with Ehlers-Danlos syndrome.

Pemphigus in Families

Abstract: A family in which two sisters are affected by pemphigus is described. Literature research has revealed the presence of 25 families, comprising 53 patients, in which pemphigus existed in more than one member. The relationships between those affected were mainly parent‐child or sibling‐sibling. Pemphigus was found to be associated with specific HLA antigens: A26, Bw38, DRw4. and additionally occurred with a higher frequency in certain ethnic groups. The variety of etiologic factors in the pathogenesis of pemphigus is discussed and the significance of a genetic role elucidated. Pemphigus is a chronic bullous disease with an autoimmune etiology. The typical histologic characteristic is acantholysis with intraepidermal cleavage, and immunofluorescent studies show antibodies in the epidermal intercellular substance.

Urticaria and fixed drug eruption in a patient treated with griseofulvin

We report a case of urticaria and fixed drug eruption ( FDE ) caused by griseofulvin. Although griseofulvin-induced urticaria is well documented, FDE secondary to griseofulvin is distinctly uncommon. Moreover, the appearance of urticaria and FDE in the same patient following treatment with griseofulvin is, we believe, the first to be described in the literature. The concept of FDE is briefly reviewed.

Lichen Aureus Occurring in Childhood

A 8-year-old girl presented with a 3-month history of scattered, bruise-like, pigmented patches on the posterior aspect of the left thigh, without previous trauma or previous drug intake. P.ist meciical history and family history were noncontributory. The lesions were usually asymptomatic, but slight pruritus was noted occasionally. Examination indicated golden-hueci patches varying in size from 0.8-1.5 cm in diameter (Figs. 1, 2). A skin biopsy specimen showed a normal epidermis and a band-like lymphohistiocytic infiltrate in the upper dermis with many extravasated erythrocytes (Fig. 3). Staining with potassium ferrocyanide demonstrated dense deposits of hemosiderin in the area of the infiltrate.

LYMPHOCUTANEOUS NOCARDIOSIS DUE TO NOCARDIA ASTEROIDES IN A PATIENT WITH INTESTINAL LYMPHOMA

A 49-year-old farmer, with a 3-month history of periungual inflammation of the right thumb and a series of lesions along the right upper limb, was seen at the Department of Dermatology at the Chaim Sheba Medical Center, TelHashomer, Israel. He had intestinal lymphoma over the preceding 2 years and was being treated with 10 mg prednisone every other day and 36 mg chlorambucil every 3 weeks. On admission, the patients lymphoma was in remission. There was no history of trauma to the arm. Cutaneous examination revealed multiple reddish-purple, elevated, ulcerating plaques distributed in a linear arrangement on the flexor aspect of the right upper limb (Fig. 1). A rough cord connecting these plaques from the palm to the axilla was palpable. Paronychia of the nail of the right thumb also was observed (Fig. 2). Apart from hepatosplenomegaly (secondary to the intestinal lymphoma), the findings of the physical examination were unremarkable. Laboratory studies revealed a mild normocytic, normochromic anemia (hemoglobin, 12.9 g/dL; hematocrit, 38.5%; leukocyte count, 4900); an erythrocyte sedimentation rate of 30/50 (after 1 and 2 hours, respectively); and a normal biochemical profile. Results of urinalysis were within normal limits. On the chest roentgenogram, cardiomegaly was observed, with an enlarged left ventricle. The electrocardiogram was normal. A biopsy specimen from one of the nodules on the right forearm showed a nor-

Herpes Zoster in a Husband and Wife

ABSTRACT: The wife of a 75‐year‐old man with zoster began to suffer from this disease some 24 days after it appeared in her husband. Although zoster is generally regarded to be an endogenously noncommunicable disease, the case reported herein suggests that the infection was exogenously communicated. The literature pointing up that zoster may possibly be acquired exogenously, particularly in immunosuppressed patients, is extensively reviewed.

Traumatic Plantar Plaques of Childhood

visiting professorship program in which the surgeon would participate. An international panel of dermatologic surgeons of varying subdisciplines is being recruited to participate in these exchanges. Thus, dermatoiogic plastic and reconstructive surgeons, aesthetic surgeons, cryosurgeons, chemosurgeons, laser surgeons, micrographic surgeons, liposuction surgeons, etc., are all invited to serve on the faculty. Different sponsors will make their requests for particular types of teachers to grace their portals, and every effort will be made to facilitate those requests. Teaching will consist of both lectures and performing the various types of surgery with the inviting doctors. These teaching interchanges might continue 1 to 4 weeks, the time to be mutually agreed between the sponsor and surgeon. Sponsors must additionally guarantee proper legal licensure as issued by the host country, provide appropriate insurance coverage, pick up and drop off the surgeon at the nearest major airport, provide adequate housing facilities, provide meals, local transportation and, critically, promote the integration of the Chair into the cultural and social milieu of the sponsors. Although the transportation costs of the surgeon are paid by the endowment, the travel costs of a surgeons assistant must be incurred by the surgeon. However, should a surgical assistant travel with the Chair, appropriate accommodations, board, and local support would also be provided to that assistant. After the interchange is completed, both surgeon and sponsor would provide a timely written critique of the program such that future visits could be improved. Should it become infeasible or inappropriate for the ISDS to continue to administer the Chair, the Chairs endowment would pass to the ASDS for similar usage. As the Traveling Chair is a tax-deductible charitable endowment, others who believe in such interchanges are invited to contribute to: