J. Handley

Common association of HPV 2 with anogenital warts in prepubertal children

Abstract: Anogenital (AG) warts in 31 prepubertal children were HPV typed by nonisotopic in situ hybridization (NISH) using digoxigenin labeled probes for human papilloma virus (HPV) types 1–5, 6,11,16,18, 31, and 33. Mode of transmission was determined from historical, clinical, and laboratory data independent of HPV typing. HPV 2 was detected most commonly (13/31 warts) followed by HPV 6 (7/31), HPV 11 (5/31), and HPV 16 (1/31). Although not reaching statistical significance, our results suggested that a mucosal HPV type (6,11,16) in a childs AG warts implied transmission from mucosal warts and conversely cutaneous HPV 2 transmission from warts at a cutaneous site. HPV typing provided no helpful information regarding actual mode of transmission of AG warts In these children. The high prevalence of HPV 2 in childrens AG warts and the low prevalence of sexual abuse (2 of 31 children) found in this study suggest innocent auto‐ or heteroinoculation from cutaneous warts may be a common means by which children acquire AG warts.

Multiple lentigines, myxoid tumours and endocrine overactivity; four cases of Carney's complex

Four patients with Carneys complex, one sporadic and three familial, are described. The sporadic case was a young male with centrofacial lentigines, who developed cyclical Cushings syndrome secondary to bilateral pigmented nodular adrenocortical disease, two separate left atrial myxomas, and buccal mucosal myxomas. The three familial cases, who all had varying degrees of centrofacial/mucosal lentigines and cutaneous myxoid tumours, were a woman with myxoid mammary fibroadenomatosis and a left atrial myxoma, her daughter who developed a prolactin‐secreting pituitary adenoma, and her son who had bilateral large‐cell calcified Sertoli cell testicular tumours, and an axillary psammomatous melanotic schwannoma.

Chronic bullous disease of childhood and ulcerative colitis

Abstract: A 12‐year‐old girl with ulcerative colitis (UC) treated by colectomy with rectal stump preservation, salazopyrin, and systemic steroids developed persistent mouth ulcers, cutaneous target like lesions, papulopustules, and builae. The clinical, histologic, and immunopatriologic features were typical of chronic bullous disease of childhood (CBDC). Although resistant to combined Immunosuppressive therapy with low‐dose prednisolone, cyclosporin, and thalldomide, striking remission of the mucocutaneous symptoms resulted with surgital resection of the diseased rectal stump. An etiologic association between CBDC and UC Is postulated.

Dermatological presentation of disease associated with antineutrophil cytoplasmic antibodies: a report of two contrasting cases and a review of the literature

Summary Antineutrophil cytoplasmic antibody (ANCA)‐associated disease (AAD) constitutes a pathological disease spectrum of a necrotizing vasculitis of small‐ and medium‐sized vessels, extravascular granuloma formation. and necrotizing and crescentic glomerulonephritis. and also a clinical disease continuum which ranges from renal‐limited disease to a widespread systemic vasculitis. including Wegeners granulomatosis and microscopic polyangiitis. In the latter, circulating ANCA are an aid to diagnosis and also may play a pathogenic part. Two contrasting patients with AAD are described. both of whom presented primary with dermatological features. These included a cutaneous purpuric vasculitis. orogenital ulceration. infarction of the fingertip, and pyoderma gangrenosum‐like ulceration. These cases will familiarize dermatologists with both the concept and dermatological features of AAD.

Carney complex: report of a kindred with predominantly cutaneous manifestations.

We report a four‐generation kindred with the complex of myxomas, spotty pigmentation and endocrine overactivity. This kindred demonstrates a relatively limited phenotypic expression with predominance of cutaneous features. Male‐to‐male transmission confirms the autosomal dominant nature of the condition. We propose that pilonidal sinus may be an associated manifestation in this kindred.

Laryngo-onycho-cutaneous syndrome associated with familial benign hypercalcemia

A Pakistani boy had chronic ulceration of the cheeks, generalized nail dystrophy, ulceration and hypergranulation of the nail beds, conjunctiva, and vocal cords, and dental enamel hypoplasia. These features are consistent with laryngo-onycho-cutaneous (LOCS) syndrome or Laryngeal and Ocular Granulation tissue in children from the Indian subContinent (LOGIC) syndrome. Both he and his elder brother had elevated levels of serum calcium consistent with familial benign hypercalcemia. Laryngo-onycho-cutaneous syndrome is a newly recognized condition and its association with familial benign hypercalcemia has not been previously reported.

(9) Carney's complex

History. This woman presented in October 1989 complaining ol painful hlistering on the hacks of her hands. This started for the first time in April of that year and persisted throughout the summer. She noted that the blisters faded leaving some small depressed marks. She had been on oral iron for 6 years as well as several courses of intramuscular iron for what she described as an iron deficiency anaemia.