Jacob W.E. Dijkstra

Eosinophilic cellulitis associated with urticaria: A report of two cases

Two patients with the clinical and histopathologic findings of eosinophilic cellulitis are presented. In one patient there was a definite relationship between upper respiratory tract infection and flare-ups of eosinophilic cellulitis. This patients condition was superimposed on a long history of chronic urticaria. In the other patient a relationship to recurrent sinusitis was possible but not definite. There were no other contributory underlying skin diseases in either patient. Eosinophilic cellulitis is not likely a disease entity as such but, instead, represents a severe urticarial hypersensitivity reaction to various stimuli. Collagen alteration by eosinophil granules results in flame figure formation and a granulomatous response, which may explain the prolonged persistence of the lesions.

Purpuric pityriasis rosea

An ll-year-old girl noticed several asymptomatic spots on her abdomen. The eruption spread to the remainder of her trunk and proximal extremities during the next 3 weeks. Physical examination revealed multiple, nonscaling petechiae and ecchymoses oriented along Langers lines on the neck, trunk, and proximal extremities. Complete blood cell count, prothrombin time, partial thromboplastin! time, 16-variable automated chemistry panel and urinalysis were all normal. Antinuclear antibody, rapid plasma reagin, rickettsial profile, and streptococcal antibody titers were unremarkable. A skin biopsy specimen demonstrated a superficial and mid-dermal perivascular mononuclear cell infiltrate with erythrocyte extravasation, No foci of parakeratosis or spongiosis were seen, and there was no evidence ofvascu-

Relapsing polychondritis: A case diagnosed by direct immunofluorescence and coexisting with pseudocyst of the auricle

A case of relapsing polychondritis with perichondrial IgG and C3, dermoepidermal IgG, and a coexisting pseudocyst of the auricle is reported. The use of direct immunofluorescence testing in establishing a diagnosis of relapsing polychondritis and the expected findings are reviewed. In some cases direct immunofluorescence may allow a diagnosis of relapsing polychondritis before clinical criteria or a routine histologic evaluation suggests a definite diagnosis.

Childhood vitiligo successfully treated with bath PUVA.

Abstract: A significant proportion of vitiligo patients are children. Systemic PUVA therapy, the most consistently effective and practical therapy for this disease, has not been recommended in pediatric patients because of concerns regarding potential long‐term side effects. We report a 9‐year‐old Caucasian girl with progressive vitiligo who was successfully treated with bath PUVA. This form of PUVA therapy may provide a wider margin of safety, in that less exposure to ultraviolet A (UVA) radiation is required and systemic absorption of psoralen is minimal.

RETICULATE NONMELANOCYTIC HYPERPIGMENTATION ANOMALY : A PROBABLE VARIANT OF DOWLING-DEGOS DISEASE

ABSTRACT: A 26‐year‐old white woman had reticulate nonmelanocytic hyperpigmentation anomaly characterized by partially blanching red‐brown papules and macules and a histologic picture of digitate epithelial budding proliferation with lightly pigmented rete ridges. Except for the classically described hyperpigmentation at the rete ridge tips, the patient has Dowling‐Degos disease. This case of a reticulate nonmelanocytic hyperpigmentation anomaly is probably a variant of Dowling‐Degos disease.

Interleukin-3—induced urticaria-like eruption

We describe an interleukin-3 (IL-3)-induced urticaria-like reaction in a patient with mesothelioma. IL-3 or multi-colony-stimulating factor (CSF) is a hematopoietic growth factor derived from T lymphocytes. 1 It is a member of the broad class of non-immunoglobulin polypeptide cytokines that includes hematopoietic growth factors, interferons, tumor necrosis factor, and interleukins. 1,2 IL-3 promotes the survival, proliferation, and differentiation of multipotential hematopoietic stem cells and committed progenitor cells of megakaryocyte, granulocyte-macrophage, erythroid, eosinophil, basophil, and mast cell lineages. 1-4 A cytokine with IL-3-like activity has been isolated from human keratinocytes 5 and recombinant human IL-3 (rhIL-3) is currently undergoing clinical trials in patients with advanced malignancies, myelodysplastic syndromes, aplastic anemia, and bone marrow failure. 3,4,6-8 Treatment with rhIL-3 may reduce the complications of chemotherapy, radiation therapy, and diseases associated with pancytopenia by stimulation of leukopoiesis, erythropoiesis, and thrombopoiesis. 1-4,6-8