Turner's syndrome associated with psoriasis and alopecia areata

Turner's syndrome is a sex chromosomal abnormality characterized by gonadal failure, short stature, skeletal and medical anomalies due to structural defects or monosomy of the X chromosome. The association between this syndrome and autoimmune diseases has been reported in the literature. This case report highlights the finding of two immunological skin diseases, alopecia areata and psoriasis, in an 18-year-old girl with Turner's syndrome. By the time of her referral to the Department of Dermatology, Verona University (Italy) the girl had suffered from psoriasis on the scalp for 5 years and alopecia for 6 months; the diagnoses were confirmed by histological evaluation. Topical therapy was useful for the treatment of the psoriatic lesions but not for the alopecia areata. Alopecia areata and psoriasis occurring together in Turner's syndrome may indicate some genetic relationship and could support the concept that these patients have the tendency to develop autoimmune or immunological diseases. Anxiety, depression and unsatisfactory relationships could have been important trigger factors in our patient. Multidisciplinary management, including psychological, educational and behavioural techniques, in addition to other therapies, could be useful in treating these conditions.

Granulomatous folliculitis as a manifestation of post-herpetic isotopic response

We report a case of postherpetic granulomatous folliculitis in a 52-year-old female. The several cutaneous granulomatous eruptions following herpes zoster reported in the literature include annular, sarcoid and tuberculoid granuloma, granulomatous vasculitis and granulomatous folliculitis. The mechanism of granuloma formation is probably triggered by a delayed hypersensitivity response to the virus.

Is there a relationship between influenza vaccinations and risk of melanoma? A population-based case-control study

The aim of the present case-control study was to ascertain whether, in adults, yearly repeated anti-influenza vaccinations (AIV) enhance protection against cutaneous melanoma (CM), as do repeated febrile infections. Ninety-nine new cases of histologically confirmed CM and 104 healthy controls (matched to cases for sex, age, and skin colour) selected from the general population were examined in order to ascertain their skin type, the number of nevi on both arms, and the intensity of freckles on the face and the arms; in these subjects, a structured questionnaire was used to obtain information on age, sex, education, social class, exposure and susceptibility to sunlight, history of febrile infectious diseases, and vaccinations. The odds ratio (OR) and the 95% confidence interval (CI) were estimated by commonly used methods and by fitting models of logistic regression. The risk of CM was reduced in subjects with a history of febrile (temperature above 38.5 degrees C) infections in the 5 years prior to CM surgery (cases) or interview (controls), but was increased in those with voluntary exposure to sunlight in tropical countries. By holding the above factors constant at logistic regression analysis, it was found that a history of repeated AIV (3-5 times in the last 5 years) halved the risk (OR: 0.43; CI: 0.19-1.00; p < 0.05). With the variable 'nevi on arms' included, the protective influence of repeated AIVs was observed in a similar magnitude. The inverse relationship found between melanoma and influenza vaccinations is unlikely to have depended on a bias, even if based on replies in a questionnaire, because neither the interviewers nor the interviewers were informed in advance of the working hypothesis.

Risk of nonmelanoma skin cancer in Italian organ transplant recipients. A registry-based study

BACKGROUND

Organ transplant recipients are at an increased risk of nonmelanoma skin cancer. Few data concern heart transplantation and populations from southern Europe.

METHODS

A total of 1,329 patients who received their first kidney (1,062 subjects) or heart allograft (267 subjects) were included in a partly retrospective cohort study to evaluate the risk of skin cancer. The incidence rate per 1,000 person-years and the cumulative incidence were computed. Standardized morbidity ratio was estimated by comparison with Italian cancer registry data. To analyze the role of potential prognostic factors, Cox's regression method was used.

RESULTS

The overall incidence rate of nonmelanoma skin cancer was 10.0 cases per 1,000 posttransplant person-years (95% confidence interval 8.2-11.7). This estimate was far higher than expected in the general population. The overall risk of developing skin cancer increased from a cumulative incidence of 5.8% after 5 posttransplant years to an incidence of 10.8% after 10 years of graft survival. In a Cox proportional hazard risk model, the most important factors that appeared to favor the development of skin cancer were age at transplantation and sex. After adjustment for age at transplantation and sex, no definite increased risk was documented among heart as compared with kindney transplant recipients.

CONCLUSIONS

Our study confirms the increased risk of nonmelanoma skin cancer among organ transplant recipients in a southern European population.

Determination of simazine, terbuthylazine, and their dealkylated chlorotriazine metabolites in soil using sonication microextraction and gas chromatography

A rapid analytical method is proposed for the determination of simazine, terbuthylazine, and their chloro dealkylated metabolites (simazine-desethyl, simazine-bisdesethyl, and terbuthylazine-desethyl) in soil. A sonication micromethod is presented for the extraction of -triazine herbicides and their metabolites. Final determination is by gas chromatography (GC) with nitrogen-phosphorus detection. The identity of all compounds was confirmed by GC with mass selective detection in the selected-ion monitoring mode. All chromatograms were very clean, without interfering peaks, and no cleanup was needed. The limits of detection were 1 pg for simazine-bisdesethyl; 5 pg for simazine, terbuthylazine, and terbuthylazine-desethyl; and 10 pg for simazine-desethyl. The limits of quantitation were 1, 5, and 10 ppb, respectively. Mean recoveries from fortified soils ranged from 76% for simazine-bisdesethyl to 102% for simazine-desethyl, with relative standard deviations of 3-6%.

Evolution of chlorpyrifos, fenarimol, metalaxyl, penconazole, and vinclozolin in red wines elaborated by carbonic maceration of Monastrell grapes

The influence of the different steps involved in the wine-making process on the disappearance of chlorpyrifos, fenarimol, metalaxyl, penconazole, and vinclozolin in red wines elaborated by carbonic maceration of Monastrell grapes was studied. The initial levels of the residues in grapes ranged from 0.28 mg/kg (penconazole) to 1 mg/kg (chlorpyrifos). Ten days after the beginning of maceration, the compound that had decreased least was chlorpyrifos (83% of initial value remaining), whereas metalaxyl, the least persistent of the residues, had decreased to 49% of its initial value. In the free-run juice, on the other hand, the highest percentage remaining corresponded to metalaxyl (10%) and the lowest to chlorpyrifos (0. 1%). After pressing, the percentages of initial values eliminated in pomace varied from 82.7% for chlorpyrifos to 17.7% for metalaxyl, whereas in the press juice the opposite was the case (37% metalaxyl and 2% chlorpyrifos remaining). In finished wine, there were residues of all the pesticides, with the exception of chlorpyrifos, metalaxyl (21%) being the most persistent. The percentages eliminated in the lees varied from 1.5 to 2.5% of the initial value.

Multiresidue method for the rapid determination of organophosphorus insecticides in grapes, must and wine

A rapid multiresidue gas chromatographic method for determining 12 insecticides in grapes, must and wine is described. A simple on-line microextraction method for isolating frequently applied insecticides on vineyard is used. The matrix, once extracted with an acetone-dichloromethane (1:1, v/v) mixture, was filtered and concentrated. Nitrogen-phosphorus detection (NPD) and electron-capture detection (ECD) were used to identify and quantify the insecticides, the findings being confirmed using mass spectrometric detection (MSD). No clean-up was necessary for either NPD or ECD. The regression coefficients relating to linearity were at least 0.99. Recoveries from spiked grape, must and wine samples ranged from 80 to 108% and relative standard deviations were no higher than 16% in the most unfavourable case. Individual detection limits were in the range 0.02-0.1 ng. Limits of quantification varied from 0.01 to 0.05 mg kg(-1), which are below the maximum residue limits set by the legislation of the main wine-producing countries of the European Union. Only in the case of methidathion and quinalphos were the limits of quantification equivalent to the maximum residue limits (0.05 mg kg(-1)) established by Spanish and French legislation, respectively.

Multiresidue method for the rapid determination--in grape, must and wine--of fungicides frequently used on vineyards

A rapid multiresidue gas chromatographic method for determining 17 fungicides in grapes, must and wine, widely used on vineyards, is described. A simple on-line microextraction method for isolation of fungicides was used. Nitrogen-phosphorus and electron-capture detection were used for the identification and quantitation of pesticides. For confirmation, mass spectrometic detection was used. Because of the high selectivity of both detection methods, no clean-up was necessary. The regression coefficients relating to linearity were at least 0.994. Recoveries from spiked grapes, must and wine samples ranged from 78 to 107% and relative standard deviations were not higher than 14%. Individual detection limits were in the range 0.02-0.1 ng. Limits of quantification varied from 0.01 to 0.05 mg/kg, smaller in all cases than the maximum residue limits set down by the legislations of Spain, France and Italy, the main wine-producing countries of the European Union. Only for fludioxonil and hexaconazole do the limits of quantification coincide with the maximum residue limits (0.05 mg/kg) established by the Spanish legislation.

Effect of pesticide residues on the aromatic composition of red wines

The influence of pesticide residues on the aromatic composition (major and minor volatiles) of red wines made from Vitis vinifera (Monastrell var.) was studied by comparing the concentration of aromas in wines made from grapes subjected (or not) to phytosanitary treatment with chlorpyrifos, fenarimol, mancozeb, metalaxyl, penconazole, and vinclozolin, according to the agricultural practice of the area. The analytical determination of the major volatiles was made by gas chromatography using a flame ionization detector, while the minor volatiles were determined by adsorption-thermal desorption gas chromatography using a mass selective detector. There were significant differences between the ethyl acetate, methanol, isobutanol, and diethylacetal levels of the control wine and that containing chlorpyrifos residues, although only the ethyl acetate exceeded the olfactory threshold. With regard to the minor volatiles, significant differences were detected in the concentrations of some esters, aldehydes, and acids. However, only isoamyl acetate exceeded the olfactory threshold in wines containing residues of chlorpyrifos, fenarimol, and vinclozolin.

Determination of chlorpyrifos, penconazole, fenarimol, vinclozolin and metalaxyl in grapes, must and wine by on-line microextraction and gas chromatography

A rapid gas chromatographic method for determination of residue levels of one insecticide (chlorpyrifos) and four fungicides (penconazole, fenarimol, vinclozolin and metalaxyl) in grapes, must and wine is described. An on-line microextraction method was used. The matrix, once extracted with a mixture of acetone-dichloromethane (1:1, v/v) was filtered and concentrated. Electron-capture detection for chlorpyrifos, penconazole, fenarimol and vinclozolin and mass-selective detection in the selected-ion monitoring mode for metalaxyl were utilised. No clean-up was necessary because there were no interferences in the area of interest of the chromatogram. Linearity of both detectors, in the range 0.02-2 ng/microliter, was checked. In all cases, the correlation coefficient was the same or superior to 0.997. Recoveries from spiked grapes, must and wine ranged from 78% to 101% (fortification level, 0.1-1 mg/kg). Limits of determination were between 0.01 mg/kg for metalaxyl and 0.001 mg/kg for vinclozolin.

Evolution of residual levels of six pesticides during elaboration of red wines. Effect of wine-making procedures in their dissappearance

The effect of wine-making procedures on the concentrations of six pesticides (chlorpyrifos, penconazole, fenarimol, vinclozolin, metalaxyl, and mancozeb) in red wines has been studied. During maceration stage (4 days), the percentage remaining of chlorpyrifos, penconazole, and metalaxyl was approximately 90%, whereas that of fenarimol, vinclozolin, and mancozeb is somewhat smaller (74-67%). The residual levels found in pressed must were </=20%, except for metalaxyl (69%). From the whole concentration of chlorpyrifos in must, 85% is eliminated from the racking step; clarification (bentonite plus gelatin) eliminates 43% of the product found in the decanted wine, and with filtration, all of the residue is eliminated. Penconazole and mancozeb are retained on the lees in proportions of 43 and 31%, respectively. The eliminated percentage of vinclozolin after racking is 29%, whereas clarification and filtration reduce its proportion in the wine to 33 and 28%, respectively. Finally, fenarimol and metalaxyl are eliminated in smaller proportion with the realization of these processes.

Analysis of risk factors for cutaneous warts in renal transplant recipients

We have investigated some possible risk factors for cutaneous warts in a consecutive group of renal transplant recipients treated with three different immunosuppressive regimens: prednisolone + azathioprine (PA), prednisolone + azathioprine + cyclosporin (PAC), prednisolone + cyclosporin (PC). Kaplan and Meier analysis showed an earlier onset of warts in the PAC and PC groups than in the PA group (p < 0.0001), which might be related to the different immunosuppressive action of the pharmacological treatments including cyclosporin. Seven patients had skin cancer: 4 of them also had multiple warts on the cancer site. In 2 patients, histological examination demonstrated the neoplastic transformation of a wart. Maintenance posology of azathioprine, cyclosporin and prednisolone may be an important risk factor for cutaneous warts; on the other hand HLA-B mismatch and HLA-A11 seem to have no effect.

Effect of Wine-Making Practices on the Concentrations of Fenarimol and Penconazole in Rosé Wines

The changes in and influence of the anti-powdery-mildew fungicides fenarimol and penconazole were studied in the production and quality of rosé wines made with Monastrell grapes grown in the Jumilla wine-producing region in SE Spain. Fungicide concentrations were estimated by gas-liquid chromatography with electron-capture detection. Fermentation was retarded more by penconazole than by fenarimol; in both cases, the slowdown was directly proportional to fungicide concentration. However, the mature wine contained normal concentrations of residual sugars; other enological parameters (pH, volatile acidity, intensity of color and hue) were not significantly affected. Thirty-four days after the start of the experiment, 67% of fenarimol and 52% of penconazole, with respect to the smaller amount initially added (1 mg/liter), were found in the finished wine. The calculated half-life times were 45 and 59 days for penconazole and fenarimol respectively. Different wine-making techniques (racking, clarification, and filtration) had no decisive influence on the removal of fungicide residues from the must, although they eliminated slightly more penconazole than fenarimol.

Renal transplantation and skin diseases: review of the literature and results of a 5-year follow-up of 285 patients

We present a review of the current literature on skin diseases in renal transplant recipients (RTR) and the results of a 5-year follow-up of 285 patients. Many skin diseases are only an aesthetic and functional cause for interest, but HPV infections and skin cancers are significantly more frequent in RTR than in immunocompetent subjects and can affect a patient's prognosis. For this reason, we feel dermatological surveillance of RTR is necessary for early diagnosis and treatment of all high-risk lesions.