Joseph Alcalay

Bullous pemphigoid mimicking bullous erythema multiforme: An untoward side effect of penicillins

Three young and middle-aged patients developed severe bullous eruption after receiving various penicillins. The clinical findings included high fever, prostration, widespread bullous eruption mainly on the head, face, and extremities, targetlike lesions on the palms and soles, and severe erosions in almost all the mucous membranes. Direct and indirect immunofluorescence studies were those of bullous pemphigoid. Complete clearing of the eruption occurred with prednisone therapy. We conclude that drug-induced bullous pemphigoid is a different entity from the classic bullous pemphigoid.

Linear IgM dermatosis of pregnancy

An intensely pruritic dermatosis that occurred in a woman during the third trimester of pregnancy is described. The clinical manifestations included red follicular papules symmetrically distributed on the skin of the forearms, abdomen, thighs, and legs. The histopathologic findings were not specific. However, immunopathologic examination revealed dense linear deposition of IgM in the dermoepidermal junction. The eruption and the immunopathologic findings disappeared at the end of the puerperium. This dermatosis differs from previously described specific dermatoses of pregnancy because of the clinical appearance and the immunopathologic findings. Thus we propose the term linear IgM dermatosis of pregnancy.

Cutaneous Reactions to Nifedipine

Nifedipine, a calcium-channel-blocking agent, is widely used as an antianginal and antihypertensive drug. Cutaneous reactions to nifedipine are extremely rare. A review of the literature revealed only three additional cutaneous eruptions which include vasculitis, erythematous edema of the legs and erythromelalgia. We present the first case of fixed drug eruption due to nifedipine.

Generalized vitiligo following Sezary syndrome

A patient with Sézary syndrome is reported in whom generalized vitiligo occurred. This is, to our knowledge, the first patient reported with vitiligo following T cell cutaneous lymphoma.

Sweet’s Syndrome and Subacute Thyroiditis

A 63-year-old woman developed simultaneous occurrence of acute febrile neutrophilic dermatosis and subacute thyroiditis, thus suggesting that both diseases had a possible identical viral etiology. As far as we are aware, this is the first report of the association of Sweets syndrome and subacute thyroiditis.

Multiple dermal fibroblasts in patients with pruritic urticarial papules and plaques of pregnancy. A clue to the etiology

We have recently demonstrated that in pruritic urticarial papules and plaques of pregnancy (PUPPP) there are multiple dermal fibroblasts with no deposition of mucin. We suggest that in the dermis of patients with PUPPP there is a deposition of a substance that induces fibroblasts proliferation. We assume that this substance (marked as F-substance) is a product of the placenta, which is released to the maternal circulation during pregnancy.

Interferon and T-Cell Lymphoma

Excerpt To the editor: In 1984, Bunn and associates (1) reported that high-dose recombinant leukocyte A interferon was highly effective in the treatment of advanced refractory cutaneous T-cell lymp...

Asymptomatic liver injury due to erythromycin stearate.

A 73-year-old woman with rosacea, who had started treatment with erythromycin stearate 2 g/d, developed asymptomatic liver injury. The drug was discontinued and the laboratory findings of liver damage disappeared within 11 days. This is the first report of erythromycin stearate-induced asymptomatic hepatotoxicity.

Horizontal gaze palsy as presenting symptom of brainstem encephalitis

A 48-year-old female presented with bilateral paralysis of supranuclear hori zontal conjugated gaze and impairment of various pontine, cerebellar and cervical spinal cord functions.The clinical signs and laboratory work-up indicated myeloencephalitis, probably of viral etiology. Paralysis of supranuclear horizontal conjugated gaze was produced experimentally by damaging the paramedial pontine reticularformation(PPRF). In the human, this a bnor-mality is extremely rare and, to the best of our knowledge, has not been reported previously in reversible encephalitis.