Scalp skin lesion in Turner syndrome: more than lymphoedema?

We present a case of a newborn with Turner syndrome (TS) and a scalp skin lesion resembling cutis verticis gyrata (CVG). Several reports on CVG in TS describe the lesions and correlate it with lymphoedema frequently seen in foetuses and infants with Turner syndrome. Histological examination in this case, however, shows a congenital mucinous nevus. Possibly an abnormal amount of proteoglycans in the skin of patients with TS can clarify the occurrence of this type of skin lesion.

SDZ ASM 981: an emerging safe and effective treatment for atopic dermatitis

BACKGROUND

SDZ ASM 981 is a selective inhibitor of the production of pro-inflammatory cytokines from T cells and mast cells in vitro. It is the first ascomycin macrolactam derivative under development for the treatment of inflammatory skin diseases.

OBJECTIVES

This study was designed to determine the safety and efficacy of SDZ ASM 981 cream at concentrations of 0.05%, 0.2%, 0.6% and 1.0% in the treatment of patients with atopic dermatitis and to select the concentration to be used in phase III studies.

METHODS

This was a double-blind, randomized, parallel-group, multicentre dose-finding study. A total of 260 patients were randomly assigned to treatment with SDZ ASM 981 cream at concentrations of 0.05%, 0.2%, 0.6%, or 1.0%, matching vehicle cream, or the internal control 0.1% betamethasone-17-valerate cream (BMV). Treatment was given twice daily for up to 3 weeks.

RESULTS

A clear dose-response relationship for SDZ ASM 981 was evident, with 0.2%, 0.6% and 1.0% SDZ ASM 981 creams all being significantly more effective than vehicle (P = 0.041, 0.001 and 0.008, respectively) in terms of baseline to end-point changes in the Eczema Area Severity Index (EASI) and pruritus score. The 1.0% cream was the most effective SDZ ASM 981 concentration. BMV was more effective than the SDZ ASM 981 creams tested in this study. It appears that the efficacy plateau was not reached with the SDZ ASM 981 creams within 3 weeks treatment. SDZ ASM 981 was well tolerated. Burning or a feeling of warmth were the only adverse events reported more frequently in the 0.6% and 1.0% SDZ ASM 981 treatment groups than in the vehicle treatment group (42.9%, 48.9% and 34.9%, respectively). Few systemic adverse events were reported during the study (headache was the most frequent systemic event reported by 15 of 252 patients) and none was considered to be related to treatment. The local tolerability profile of the 1.0% cream was similar to that of the lower concentrations.

CONCLUSIONS

1.0% SDZ ASM 981 cream, which was shown to be safe, well tolerated and the most effective concentration in this study, was selected as the concentration to be further developed in phase III studies.

Protein contact dermatitis: myth or reality?

Protein contact dermatitis is a dermatosis which usually presents as a chronic eczema with episodic acute exacerbations a few minutes after contact with the offending allergen. Patch tests with the responsible allergen are usually negative, and the diagnosis can only be made by means of scratch or prick tests with the allergen. Sometimes, specific IgE antibodies can be detected in the blood. As there is considerable confusion about this entity, we have reviewed the cases reported in the literature.

Chronic renal failure and skin calcifications

Two patients with chronic renal failure who developed very painful ulcerations and histologically manifested skin calcifications are described. An overview of the skin calcifications with chronic renal failure is given, and the theory of Selye, which is often used to explain this calcification process, is briefly described.

Results of routine patch testing with corticosteroid series in 2073 patients

The patch test results of 61 patients allergic to at least 1 corticosteroid molecule are presented. These contact allergies were detected by testing with several corticosteroids included in our standard patch test series between February 1988 and December 1990. Whenever possible, further investigations were conducted by means of a more complete corticosteroid series. We found corticosteroids to be the 7th most frequent allergen, positive results being obtained in 2.9% of all patients referred to our contact dermatitis unit. In this series, budesonide was the most common allergen and often gave simultaneous reactions with other corticosteroids.

A case of Omenn-like immunodeficiency syndrome

We report the case of a child with a variant of the Omenn immunodeficiency syndrome. He presented with erythroderma, lymphadenopathy, hepatosplenomegaly, failure to thrive, and recurrent purulent infections. The immunological studies showed marked disturbances in the subpopulations and functions of T lymphocytes, which suggests a defect in T cell differentiation as the cause of the disease.

Transient acanthosis-nigricans-like dermatosis in re-epithelializing lesions of pemphigus foliaceus

A patient is described who developed hyperkeratotic, hyperpigmented plaques, similar to acanthosis nigricans in re-epithelializing erosions of pemphigus foliaceus. The lesions regressed completely after a few months. This phenomenon can be attributed to a Köbner phenomenon after epidermal damage or can be a result of systemic corticosteroid therapy.

Silver polish: another source of contact dermatitis reactions to thiourea

A cleaning woman in a restaurant became sensitized to thiourea in a silver polish. The dermatitis persisted for several months and occasionally flared up after exposure to sunlight, even after she no longer used the product. Patch testing and photopatch testing showed that she had both contact and photocontact allergy.