Jordi Peyrí

Prevalence of dermatophyte onychomycosis in Spain : a cross-sectional study

To evaluate the prevalence of dermatophyte onychomycosis in Spain, a cross‐sectional study was conducted between 1992 and 1993. A total of 10,007 subjects over the age of 15 years were interviewed (using the computer‐assisted telephone interview system), completed a directed questionnaire, and reviewed a series of photographs of diverse nail disorders. The period prevalence of onychomycosis was 2.6% and the point prevalence 1.7%. The prevalence of onychomycosis was higher in women (1.8%) than in men (0.8%). Age group distribution showed a higher onychomycosis prevalence (1.2%) in the oldest age group (>55 years). With regard to localization, the prevalence of toenail onychomycosis was higher than that of fingernail onychomycosis and of concurrent infection in both sites. The results of this study suggest that 802,893 inhabitants of Spain have, or have previously suffered from dermatophyte onychomycosis. Only 38.6% have sought medical advice, and only 14% of those who did so consulted a dermatologist.

Primary cutaneous marginal zone B-cell lymphoma : a clinical, histopathological, immunophenotypic and molecular genetic study of 22 cases

Summary Background  Primary cutaneous marginal zone B‐cell lymphoma (MZCL) has recently been described. Differentiation from follicular centre cell lymphomas and lymphocytomas is often difficult due to insufficient experience and a lack of large series of patients.

Subcutaneous sarcoidosis--clinicopathological study of 10 cases.

Background  Subcutaneous sarcoidosis is a specific cutaneous lesion of sarcoidosis that is rarely reported.

Calciphylaxis associated with alcoholic cirrhosis

Calciphylaxis is an uncommon disease characterized by calcification of dermal vessels that determines skin necrosis. Calciphylaxis has been almost exclusively reported in association with renal failure and altered phosphor–calcium metabolism. Only a few cases have been described in hyperparathyroidism, malignancies, and, recently, cirrhosis. We report a patient that developed calciphylaxis related to end‐stage alcoholic cirrhosis, without any alteration in the phosphocalcic and parathyroid hormone metabolisms. Possible contributing factors were repeated albumin infusions and low levels of protein C and S.

Hundreds of basal cell carcinomas in a Gorlin-Goltz syndrome patient cured with imiquimod 5% cream.

JEADV 2006, 20, 868–902

Simultaneous occurrence of cutaneous T cell lymphoma and low-grade B cell lymphoproliferative diseases: A report of two cases

Two previously unreported patients with cutaneous T cell lymphoma associated with systemic low-grade B cell proliferations are presented. The first patient had Waldenströms macroglobulinemia and the second had simultaneous chronic lymphocytic leukemia. The use of immunosuppressive drugs or a genetic predisposition may have contributed to the second malignancy. However, the possibility that malignant helper/inducer T lymphocytes were a factor in the promotion of the proliferation of B cells cannot be excluded.

Calcinosis cutis following liver transplantation: a complication of intravenous calcium administration

Calcinosis cutis may be a complication of administration of intravenous calcium solutions. We report four patients who developed calcinosis cutis following orthotopic liver transplantation, all of whom had received calcium chloride solutions intravenously during surgery. There was no evidence of extravasation of the solutions. A gradual improvement of the lesions was seen in the subsequent months.

Kaposi‐like acroangiodermatitis induced by a suction‐socket prosthesis

concerning the incidence of skin cancer in the North Humberside area of England. The authors found that the age-standardized incidence of basal cell carcinoma per 100.000 population in 1978 was 38-8 among men and 37-1 among women. For 1991. the corresponding iigures were 115-6 and 103-7 for men and women, respectively. This corresponds to an increaseof 14% per year for males, and 12% per year for females. The authors also found an equal male/ female ratio (1:1). These findings correlate well with the results of our study** on the incidence of basal cell carcinoma in the Stockholm area. In 1971. the age-standardized incidence was 20-8 for men and 18-3 for women. In 1980 the corresponding figures were 48-8 and 44-4, respectively. The age-standardized incidence rate of basal cell carcinoma during the 10-year period between 1971 and 1980 increased 14% for men and 10% for women, annually. Overall, it increased 12% annually. We found no difference in the male/ female ratio, which was equal. The study was conducted in an area of Stockholm with a population of about 320,000. and a well-known migratory pattern. The steep Increase in the incidence of basal cell carcinoma in the years 1971-80 which we found in our study is in accordance with the findings of Ko ft ((/. concerning the change in the incidence of skin cancer between 1978 and 1991. Thus, it seems to be a true change in the incidence of basal cell carcinoma in Europe, and the reported iigures point to an alarming development in the near future. We can only agree with Ko et al. that skin cancer is a major health problem, and that the incidence of skin cancer is an important public health matter, which represents a challenge in preventive medicine.

Keratoacanthoma arising in hypertrophic lichen planus

Sir, We read with interest the recent report by Cox et al. on the association of atopic dermatitis with the beta subunit of the high-affinity IgE receptor (Fc1RI-b). The gene was originally identified as a candidate for atopy on human chromosome 11q. Fc1RI-b has been shown to be involved in the amplification of Fc1RI-mediated signalling that might be related to the pathogenesis of atopic disease. Because of the predominantly maternal transmission of atopy, it has been strongly suggested that the gene for Fc1RI-b may show a parent-of-origin effect such as genomic imprinting. One previous report consistent with this notion showed maternal transmission of the I181L allele in a British population, while another showed no parent-of-origin effect of the transmission of the E237G allele in an Australian population. The report by Cox et al. again raises this issue by demonstrating exclusive maternal transmission of Fc1RI-b alleles to offspring with atopic dermatitis. None the less, as far as we know, there has been no direct test of possible allele-specific expression of this gene. To study the possible involvement of a genomic imprinting mechanism, we have used the widely applicable mouse model system. We find, as detailed below, that the Fc1RI-b gene shows no parent-of-origin-specific expression, using F1 hybrids between a laboratory mouse strain (C57BL/6J) and wild mouse strains [either Mus musculus molossinus (MOLF/Ei) or M. spretus (SPRET/Ei)]. The parental mouse strains (C57BL/6J, MOLF/Ei, SPRET/ Ei) were purchased from Jackson Laboratory (Bar Harbor, ME, U.S.A.). Cloning, sequencing, total RNA extraction and reverse transcription±polymerase chain reaction (PCR) analysis of Fc1RI-b were done as described previously. Based on a human genomic DNA sequence (GenBank M89796) and a mouse cDNA sequence (GenBank J05019), we designed a PCR primer pair spanning exon 6, intron 6 and exon 7 of the Fc1RI-b gene, so that an intron could be included in the PCR target. This allowed us to measure the gene expression directly, without interference by possible contamination of genomic DNAs in RNA samples. Sequence polymorphisms among C57BL/6J, MOLF/Ei and SPRET/Ei were identified by sequencing PCR products from each strain (deposited in GenBank; accession numbers U90217±U90219). A 395-base pair (bp) fragment of the gene for Fc1RI-b was amplified from cDNAs with primers up6: 5 0-ATCCTGGCCTTTTGCAGTGC-3 0 and dn10: 5 0-TGTATGTGAAATTGTGACAC-3 0. To obtain enough DNA for analyses, a shorter fragment (361 bp) was reamplified from the PCR products with primers up6 and dn4: 5 0-GGAGTGAATGATATCCGCAA-3 0. Allele-specific expression in reciprocal crosses between C57BL/6J and MOLF/Ei was examined by using a Sau3AI restriction fragment length polymorphism (RFLP) in a 361-bp PCR product (Fig. 1A). For RFLP analysis, 3 mL of unpurified PCR products were digested with 5 U of Sau3AI in a 15-mL reaction mixture at 37 8C for 3 h, then electrophoresed in a 12% polyacrylamide gel. The gel was stained by ethidium bromide and photographed under ultraviolet radiation. Both paternally and maternally derived alleles were expressed in all examined tissues, i.e. embryo, placenta and yolk sac at 14 ́5 days postconception, whole body and skin at the newborn stage (Fig. 1B), and spleen, lung and colon in adults (not shown). The data clearly demonstrate the biallelic expression of the gene for Fc1RI-b. To confirm these data, interspecific hybrids between a laboratory mouse strain and M. spretus were used. In these crosses, the C57BL/6J-specific allele (296 bp) can be distinguished from the SPRET/Ei-specific allele (279 bp) by length

Multiple familial pilomatricomas associated with myotonic dystrophy

9. Maghnie M, Villa A, Arico M, et al. Correlation between magnetic resonance imaging of posterior pituitary and neurohypophyseal function in children with diabetes insipidus. J Clin Endocrinol Metab 1992; 74:795-800. 10. Tien R, Newton TH, McDermott MW, et al. Thickened pituitary stalk on magnetic resonance images in patients with diabetes insipidus and Langerhans cell histiocytosis. Am J Neuroradiol 1990; 11:703-708. 11. Rosenfield NS, Abrahams J, Komp D. Brain magnetic resonance in patients with Langerhans cell histiocytosis: findings and enhancement with Gd-DTPA. Pediatr Radiol 1990; 20:433-436. 12. Tien R, Kucharczyk J, Kucharczyk W. Magnetic resonance imaging of the brain in patients with diabetes insipidus. Am J Neuroradiol 1991; 12:533-542.