John Hatzis

ORF. CLINICAL AND EPIDEMIOLOGICAL STUDY

Twenty eight human cases of orf were studied from clinical and epidemiological points of view. Most of the patients were shepherds who were inoculated from infected animals during all seasons of the year. Typical lesions of different stages of orf were located on the hands, and were accompanied by local symptoms such as pain, pruritus, lymphangitis and adenitis, or less frequently by systemic symptoms such as fever or malaise. Two cases developed erythema multiforme, one developed erysipelas and another a papulovesicular eruption. Tzanck test may contribute to the diagnosis. The course of the disease can not be influenced by antibiotics, and only measures of local hygiene are recommended, except in complicated cases.

CONGENITAL SENSORY NEUROPATHY WITH ANHIDROSIS (HEREDITARY SENSORY NEUROPATHY TYPE IV)

Hereditary sensory neuropathies comprise a group of rare childhood diseases which are classified into four types. We present a Greek boy 11 years old with hereditary sensory neuropathy type IV (congenital sensory neuropathy with anhidrosis) whom we have followed up and studied during the last seven years. Our patient presented for the first time with recurrent hyperthermic episodes without sweating, and lack of pain sensation from the first months of life. Insensitivity to pain and thermal stimuli had resulted in burns on the extremities and self‐mutilation of the tongue, lips and fingertips. When he was five and seven years old respectively he had two painless fractures of the ankles which led to insoluble orthopedic problems. He also suffered from mental retardation, which was obvious from his first years of life. Sweat gland investigations showed significant hypohidrosis or anhidrosis although the sweat glands were normal microscopically. Hereditary sensory neuropathy type IV, although rare, is important for dermatologists because it must be differentiated from other anhidrotic syndromes, and in view of the poor prognosis of the condition.

LINEAR SCLERODERMA WITH SEVERE LEG DEFORMITY

Linear scleroderma is an unusual form of localised scleroderma, mainly affecting the legs and occurring primarily in children. Sometimes the linear lesions may extend to involve the underlying muscles and bones, with severe disturbances in growth and possibly flexion deformities of the legs.1,2,3,4 In this study, two cases suffering from linear scleroderma of the legs are presented.

Patch test reactivity in young and aged patient groups

Discussion The present study showed differences in morphology between allergic, irritant and negative patch test reactions. Examination of the surface of the skin site of allergic reactions showed an increase in crista, deepening of sulci and papules on the gypsum cast. The use of replicas in the dermatology clinic has previously been studied (4-8). Their use has, however, been limited to observation of the reaction of the skin surface to irritants or other factors, not to evaluate patch test results; nor have gypsum casts been used. The present system can store morphological changes during skin reactions on a gypsum cast like a photograph, allowing comparison of patch test results and examination of features of the positive reaction. This could hold an advantage over conventional methods that rely solely on direct inspection and palpation, followed by description (3, 9, 10) on the patients chart. However, a gypsum cast does not record changes in skin color, which is valuable information about a reaction. Nor does this system perceive softness of the skin surface. Furthermore, fabrication of the gypsum cast could be tedious in a dermatology clinic without familiarity with the technique. Despite these shortcomings, this technique of evaluating patch test results appears to be useful in creating a permanent 3-dimensional record of skin reactions, as well as allowing their detailed examination. Conluc£ Dermulilis 1994: 31: 191

ANONYCHIA OF ALL TOES WITH ABSENCE OF PHALANGEAL BONES

A ten year old girl suffered from anonychia of all toes, present from birth. The absence of nails was accompanied by absence of one or two phalangeal bones in toes other than the big toes. Other abnormalities consisted of short toes, incomplete syndactyly of the 2nd and 3rd toes of each foot and transfer of the dermatoglyphics from the plantar to the dorsal surface of the digits. The combined defect of the nails and the phalangeal bones can be explained by the close relationship of the two structures during the morphogenesis of the digits.

Measurement of shrinkage ability of the stratum corneum under dehydration conditions

Background/aims: Pliability and elasticity of stratum corneum (SC) depends on hydration. The aim of the present study was to introduce a new method for the measurement of the ability of the stratum corneum to shrink following dehydration and rehydration.