bluuebunny/crossref_metadata_2025 huggingface dataset:
Lateral displacement of the nipples and unilateral renal hypoplasia: another mammo‐renal syndrome?⋆
Authors: Urbani Carlo Enrico
Published: August 2010

Background of study Polythelia is a cutaneous marker of congenital diseases of the kidneys. Lateral displacement of the nipples (e.g. laterally located to their respective midclavicular lines) is considered a further sign of renal disorders, particularly of bilateral renal hypoplasia, as reported by Fleisher in a detailed study on seven infants.

Subject We observed a 45‐year‐old white man with his morphologically normal nipples displaced on the lateral aspects of the trunk without any other consistent clinical features such as accessory nipples or areolae, gonadal dysgenesis, face or car anomalies.

Aims and methods In order to reveal congenital abnormalities of the kidneys and the urinary collecting systems the following investigations were undertaken: renal ultrasound, intravenous pyelography. abdomen CT and NMR scans, urethrocystography, transurethral cystoscopy, urinalysis, laboratory tests including karyotype, ECG and cardiovascular evaluation.

Results Instrumental findings disclosed a hypoplastic left kidney in an ectopic site, located below the right kidney (cross type of renal ectopy) without any connection between their urinary‐ collecting systems. Complex malformations of the urinary tract such as an orthotopic narrow right ureteral orifice and ridge, a large‐sized diverticulum on the left wall of the bladder were also present. Moreover, a tumour on the upper pole of the right kidney, 20 mm in diameter, with a histological picture of renal‐cell carcinoma was detected.

Conclusions A lateral displacement of the nipples is a clue for the presence of renal hypoplasia both bilateral and unilateral. The significance of this association is unclear and its occurrence is probably underestimated.
Amyopathic dermatomyositis (dermatomyositis sine myositis) and cutaneous dermatomyositis with mild muscle disease
Authors: Haustein U.‐F.
Published: August 2010

We report on one patient suffering from amyopathic dermatomyositis, and two patients with transient or mild muscle involvement, respectively. The rare subset of amyopathic dermatomyositis is characterized by benign clinical course and prognosis. Leading cutaneous symptoms are heliotropic rash, periorbital violaceous‐red erythema and edema, erythematous lichenoid plaques at the dorsum of the hands and fingers, hyperkeratotic, hyperesthetic eponychium, nailfold capillary abnormalities and the skin histology, while itching and photosensitivity are optional features. On the other hand, clinical or laboratory evidence of muscle involvement is absent for at least 2 years. The two patients with transient or mild muscle involvement point to transitional forms between amyopathic and classical dermatomyositis. As differential diagnosis lupus erythematosus, (photo)contact eczema, lichen planus, psoriasis, seborrhoic dermatitis and atopic dermatitis, as well as polymorphic light eruption and erythroderma, should be considered. Association with internal malignancy is rare, but is to be excluded. Waiting, hydroxychlorochine and systemic glucocorticoids are the steps of treatment, depending on the clinical course.
Skin diseases in children with type 1 diabetes mellitus
Authors: Verrotti A. , Chiarelli F. , Amerio P.L. , Morgese G.
Published: August 2010

Aim To evaluate the presence of skin diseases in diabetic children and adolescents and analyse the risk factors involved.

Background There are few studies in pediatric population with type 1 diabetes mellitus and these present conflicting results

Setting and Patients The Department of Pediatrics and Dermatology, University of Chieti, Italy. A group of 146 (86 female, 60 male) children. Their mean age ± SD was 13.9 ± 7.8 (range: 2.1‐18.0) years; their duration of disease was 10.7 ± 8.8 (range: 1.5‐17.3) years.

Results Thirty‐six patients showed skin problems: the most frequent disease was skin infection, followed by necrobiosis lipoidica; this last disorder is linked to the presence of microvascular complications.

Conclusions The skin problems were more frequent in children with long duration of disease than in patients with a duration less than 7 years. All the patients who had limited joint mobility showed sclerodema, Dermatological evaluation is strongly reccomended in children with type 1 diabetes mellitus.
Melasma and acquired immunodeficiency syndrome (AIDS)
Authors: Gaddoni Giuseppe , Baldassari Laura , Albertini Francesco , Misciali Cosimo
Published: August 2010

Background Hyperpigmentation of skin, mucous membranes and nails has been described in patients with acquired immune deficiency syndrome (AIDS).

Patients and methods 7 AIDS patients affected with melasma‐like facial hyperpigmentation were studied. The patients had human immunodeficiency virus infection associated with recurrent mucocutaneous and systemic opportunistic infections. All had a low T4‐CD4 helper cell count and four of them died of severe infections, caused by cytomegalovirus (CMV), mycobacteria (Mycobacterium tuberculosis or Avium) and Pneumocystis carinii pneumonia. In these patients the autopsy showed intense infiltration of the adrenal glands. One of them died of Waterhouse‐Friderichsen syndrome; her autopsy showed a massive presence of cytomegalovirus in the adrenal glands.

Results In 4 patients dosages of testosterone, cortisol, T3, T4, TSH gave normal results. The level of DHEA‐S was below normal revealing an adrenal insufficiency. The α‐MSH test in 12 patients (4 patients with AIDS and facial hyperpigmentation and 8 volunteers with AIDS, but without pigmented facial lesions) revealed blood levels of α‐MSH above the norm (60.33 pg/ml standard deviation 13.21). The α‐MSH test in 20 healthy subjects revealed a mean value of 44.40 pg/ml (standard deviation 10.47). The biopsy of melasma revealed that melanocytes were present in normal numbers and size with a localized increase of melanin pigment in the basal cell layer.

Conclusion An increased production of ACTH and its derivatives such as α‐MSH pituitary may be the cause of hyperpigmentation in AIDS patients.
p53 mutation in metastatic melanomas and primary melanomas from sun‐exposed and sun‐protected sites
Authors: Li G. , Ho V.C , Trotter M.J. , Horsman D.E. , Tron V.A.
Published: August 2010

Background p53 mutation has been observed in many human malignancies, including skin cancers. However, the data in melanoma has been conflicting.

Material and methods We have examined, by immunohistochemistry, using the DO7 and CM1 antibodies, the frequency of p53 overexpression in 14 metastatic melanomas and 61 primary melanomas, of which 30 were from sun‐protected sites and 31 from sun‐exposed sites.

Results Ten of 14 metastatic melanomas showed p53 overexpression compared to only eight of 61 primary melanomas (P < 0.004). No significant difference in p53 expression was found between primary melanomas from sun‐protected (2/30) and sun‐exposed sites (6/31). We have also examined p53 mutation by single‐strand conformation polymorphism (SSCP) analysis of four melanoma cell lines. One cell line established from a primary melanoma from a sun‐protected site showed evidence of an altered migration pattern in exon 7. Sequencing analysis of this region confirmed a point mutation in codon 244, showing a G to C transversion. This mutation is unlikely to be due to ultraviolet (UV) radiation since mutations caused by UV radiation are predominantly CC → TT or C → T transitions.

Conclusions In summary, p53 mutation in primary melanoma is uncommon and does not appear to be related to UV radiation. p53 mutation is more common in metastatic melanomas suggesting that it may be involved as a late event in melanoma progression.
Cowden's disease (multiple hamartoma syndrome) An underdiagnosed syndrome with increased risk of malignant development
Authors: Asklöf G. , Johansson J. , Svensson A.
Published: August 2010

Cowden's disease is so often followed by malignant diseases, such as cancer of the breast and thyroid, and different forms of gynaecological cancer, that surgeons should be made especially aware of those changes in skin and mucous membranes which, if multiple are pathognomic. It remains, however, an underdiagnosed syndrome. We believe a number of other conditions are also associated with Cowden's disease.
Kaposi's varicelliform eruption in a patient with pemphigus foliaceus under steroid therapy
Authors: Mastrolonardo M. , Arpaia N. , Rantuccio F.
Published: August 2010

The association between pemphigus and herpesvirus infection is only rarely observed. We report a Kaposi's varicelliform eruption developed in a woman with pemphigus foliaceus under steroid therapy.
Mycobacterial infections in AIDS patients; Lorraine, France⋆
Authors: May Th. , Dailloux M. , Amiel C. , Laurain C. , Canton Ph. , Le Faou A.
Published: August 2010

Objectives Description of the epidemiology of mycobacterial infections in HIV/AIDS patients in Nancy. Comparison of the main features of tuberculous and non‐tuberculous mycobacterial infections.

Patients 58 HIV‐positive patients with mycobacterial infections attended the Department of Infectious Diseases, University Hospital of Nancy from January 1985 to December 1992.

Results Tuberculosis identified in 17 patients who were only moderately immunosuppressed, and had a high fatality rate (65%): no resistant strains isolated. Non‐tuberculous mycobacteria infections occurred in 41 patients who were deeply immunosuppressed and had a poor prognosis. Mycobacterium avium‐intracellulare complex was the most frequently isolated species (31 cases) and showed a high level of antibiotic resistance.

Conclusions NTM infections are life‐threatening diseases in AIDS patients and should be systematically sought in HIV‐positive patients with low CD4 + lymphocyte count.
Early treatment of pemphigus does not improve the prognosis A review of 53 patients
Authors: Wolf Ronni , Landau Marina , Tur Ethel , Brenner Sarah
Published: August 2010

Background With the introduction of systemic steroids to control pemphigus vulgaris the prognosis and survival of these patients has changed dramatically. However, in contrast to their beneficial effects, in a once almost inevitably fatal disease, the steroid therapy has created other problems, including cases of mortality.

Objective To analyze the possible factors influencing the course and prognosis of the disease and to review the steroid complications in our patients.

Methods 53 patients with pemphigus, admitted to the Department of Dermatology of Ichilov Hospital between 1965 and 1989, were studied.

Results The total mortality rate of 26.4% (14 patients of 53) in the present study is within the range found by others. A long pretreatment period did not lead to a worse prognosis. Patients with a pretreatment period longer than 6 months had a lower mortality rate than patients with a pretreatment period shorter than 6 months. The age of the patient played a role in determining the outcome of the disease as patients older than 60 years had a worse prognosis compared with patients younger than 50 years, 37.5% of the patients over 60 years died, as compared with a mortality rate of zero in patients younger than 50. This is in accordance with data found by others. Adjuvant therapy with azathioprine was found to improve the prognosis. Patients receiving azathioprine in addition to steroids had a significantly lower mortality rate and fewer exacerbations. Patients with involvement of the mucosa alone had a higher mortality rate than patients with involvement of the skin only and those with involvement of both skin and mucosa had the highest mortality rate.

Conclusions Early treatment of pemphigus does not improve the prognosis. Therefore, immediate high‐dose treatment in every case of pemphigus doesn't seem absolutely essential any more.
Consumption of pain medication by hospitalized patients with acute herpes zoster
Authors: Haas Norbert , Kraus Sigurd , Czarnetzki Beate M.
Published: August 2010

Background The effect of acyclovir on inpatients with acute herpetic pain has been examined in only few studies.

Aim To examine the effect of acyclovir on intensity and course of herpes zoster‐associated neuralgia in hospitalized patients.

Method Two groups of patients (50 each) hospitalized for acute herpes zoster in 1983/84 (before acyclovir was available) and in 1989/90 (when acyclovir was given for at least 5 days intravenously) were evaluated for pain and consumption of pain medication.

Results The score for pain intensity did not differ significantly in acyclovir‐related patients compared to patients who did not receive the drug.

Conclusion This study fails to demonstrate a beneficial effect of acyclovir on acute herpetic neuralgia.
Hepatitis C: a professional risk for dermatosurgeons
Authors: Gelati Gianmario , Muzio Gianfranco , Rebora Alfredo
Published: August 2010

Background Health care workers (HCW) in close contact with blood or serum are at risk for professional contagion with HCV. Among such personnel, the dermatosurgeon is on the firing line. We tried to quantitate such risk.

Design One hundred consecutive out‐patients seeking dermatosurgical advice for cutaneous neoplasms were studied for serologic markers for HCV infection.

Results Only 34 patients had not contracted any of the known hepatitis viruses, and 8% of the patients were anti‐HCV‐positive.

Conclusion On the basis of these findings and of data in the literature, we conclude that in Genoa HCW run a high risk of acquiring HCV infection due to needle stick injury1. Patients should undergo serologic investigation for HCV infection before surgery, even a minor one, is performed.
A double‐blind comparison of itraconazole and fluconazole in tinea pedis and tinea manuum
Authors: Difonzo E.M. , Papini M. , Cilli P. , Calandra P. , Panconesi E.
Published: August 2010

Background It has been reported that azole derivatives are useful in the treatment of dermatophytoses, also in tinea pedis and tinea manuum.

Aim The aim of the present multicentre, randomized, double‐blind study was to compare the efficacy and safety of oral itraconazole with fluconazole in the treatment of tinea pedis and tinea manuum.

Patients and methods In this multicenter, double‐blind, comparative study, 37 patients with tinea pedis or tinea manus were randomized to receive treatment with itraconazole (100 mg/day) or fluconazole (50 mg/day) for 30 days.

Results Two patients were not evaluable for efficacy. Both treatments reduced the number of patients with positive mycological findings, so that at the end of treatment. 64.7% of patients receiving itraconazole and 61.1% of those treated with fluconazole had negative results. Both drugs also resulted in a marked improvement in, or elimination of all clinical symptoms; however the improvement appeared to occur more rapidly with itraconazole. The overall assessment at the end of the 6 week follow‐up showed that 88.2% of patients treated with itraconazole and 72.2% of those treated with fluconazole were cured with negative mycological tests. Adverse events were reported by one patient treated with itraconazole and 5 subjects receiving fluconazole. The only changes in laboratory parameters were elevated SGOT and SGPT values in one patient in the fluconazole group, who dropped out from the study.

Discussion The results suggest that itraconazole is at least as effective as fluconazole in the treatment of tinea pedis and tinea manus, the onset of improvement in clinical symptoms is more rapid an prolonged after cessation of therapy with itraconazole, and that itraconazole appears to be better tolerated.
Activity of cefixime against Neisseria gonorrhoeae
Authors: Kohl Peter K. , Tu Yating , Hostalek Ulrike , Petzoldt Detlef
Published: August 2010

Background In most gonococcal populations, penicillin‐resistant strains have increased dramatically and penicillin can no longer be recommended for the treatment of gonorrhoea. Cefixime is the first oral third generation cephalosporin and represents an alternative therapeutical approach.

Objective To evaluate the in vitro activity of cefixime against a gonococcal population in Germany.

Material 203 Neisseria gonorrhoeae strains, isolated in the area of Heidelberg between 1986 and 1990, including 14 penicillinase‐producing Neisseria gonorrhoeae (PPNG) strains and five strains with chromosomally mediated penicillin resistance (CMPR).

Methods Determination of minimal inhibitory concentration (MIC) of cefixime was performed by standard agar dilution technique. Auxotype/serovar (A/S) classification was performed by using Neisseria defined agar and 12 gonococcal outer membrane porin specific monoclonal antibodies in a coagglutination assay.

Results The MIC range reached from 0.00025 μg/ml to 0.125 μg/ml cefixime. For both penicillin sensitive‐ and penicillin‐resistant strains, the geometric mean MIC was 0.0048 μg/ml, MIC 50 0.002 μg/ml and MIC 90 0.008 μg/ml. Among gonococcal strains with an MIC of 0.001 μg/ml cefixime strains belonging to A/S class (P)AH(U)/1A‐1/2 were significantly more frequent (p < 0.0001) than among strains having an MIC of > 0.001 μg/ml.

Conclusion Cefixime showed very high antimicrobial activity against Neisseria gonorrhoeae. All tested gonococcal strains were susceptible to cefixime. The A/S class composition of a tested gonococcal population influences very strongly the range of MICs.
Menkes' kinky hair disease: Report of a case and distribution of sulfhydryl residues and disulfide bonds in kinky hair
Authors: Yamada Hiromichi , Taneda Akio , Takamori Kenji , Ogawa Hideoki
Published: August 2010

We report here a case of a male infant with Menkes’ kinky hair disease. The patient, at the age of 3 months, exhibited slow growth, convulsions, hair abnormalities such as pili torti and dusty gray hair, and low levels of serum copper and ceruloplasmin. After intravenous administration of CuSO4 and administration of a copper acetate suppository, the level of serum copper and ceruloplasmin elevated to within normal limits. The fluorescence of the kinky hair cortex with disulfide bonds was less than that of the normal control. The copper content of the kinky hair was also lower than that of normal control. Accordingly, we suggest that kinky hair formation results from low activity of sulfhydryl oxidase in hair.
Pachydermodactyly: Report of a case
Authors: Balassiano Vivian , Sodré Celso Tavares , Ramos‐e‐Silva Marcia
Published: August 2010

We report a case of pachydermodactyly, a rare entity characterized by acquired diffuse swelling of the lop and sides of the fingers.
Granuloma faciale treatment with clofazimine 1
Authors: Bajanca Rui , Leite Luiz , Lobo Lurdes , Capitão‐Mor Manuela , Rodrigues J.C. Fernandes
Published: August 2010

The authors report the case of a 70‐year‐old Caucasian woman who, for the last seven years, has suffered outbreaks of facial macular and nodular lesions unresponsive to multiple medical and surgical therapies.

Some of the biopsies done at different times involving different lesions evidenced findings suggestive of granuloma faciale. The laboratory and imagiologic findings were within normal limits.

Therapy with clofazimine initially associated with oral and intralesional corticosteroids led to the regression of the facial nodules.
Multiple glomus tumours in an octuagenarian
Authors: Betti R. , Palvarini M. , Inselvini E. , Crosti C.
Published: August 2010

There have been very few reports of multiple glomus tumours developed in adult life, with only five cases having been described up to now. We report the case of an 82‐year‐old woman presenting disseminated multiple glomus tumours but without underlying malignancy.
The role of human papilloma virus in skin cancer – current status
Authors: McKenna D.B. , O'Connor D. , Kay E. , Leader M. , Murphy G.M.
Published: August 2010

Papillomaviruses are the causative agents of the common wart. Although the human papillomavirus is strongly associated with certain dysplastic and malignant lesions, its exact role in tumour development remains to be determined. This review examines the role of human papilloma virus as a potential oncogenic agent in human mucosal and non‐mucosal squamous cell carcinoma.
Treatment of cutaneous T‐cell lymphoma with extracorporeal photochemotherapy
Authors: Konstantinow Alexander , Balda Bernd‐Rüdiger
Published: August 2010

Background Cutaneous T‐cell lymphoma (CTCL) and its leukemic erythrodermic form (Sézary syndrome) are malignancies cies of CD4+ T lymphocytes. Extracorporeal photochemotherapy (ECP) selectively affects autoreactive as well as malignant T lymphocytes. The efficacy of ECP depends strongly upon adequate serum/buffy coat levels of the photosensitizer 8‐methoxypsoralen (8‐MOP). The resorption of orally applied 8‐MOP vanes inter‐ and intraindividually within a broad range, meaning that adequate therapeutic drug levels cannot always he achieved. Therefore, since July 1994 we have exclusively used a liquid 8‐MOP preparation which is added directly into the buffy coat fraction of the ECP circuit, resulting in constant high drug levels of approximately 190 ng/ml. Twelve CTCL‐patients (six with Sézary syndrome, six with mycosis fungoides received between six and 25 ECP treatments. Some of them had undergone previous therapy without success.

Results All patients with Sézary syndrome declared a distinct reduction in intensity of pruritus. Three patients who received liquid 8‐MOP extracorporeally showed a partial remission on the basis of skin scores. Of the patients receiving 8‐MOP orally, two remained clinically unchanged and one showed a progression of the disease. In these cases, subtherapeutic 8‐MOP plasma levels were often found. Of the six mycosis fungoides patients one achieved complete and two partial remission: another two patients showed minor response. These five patients were treated with liquid 8‐MOP. One patient showed no change in skin lesions; he had received 8‐MOP orally and achieved subtherapeutic photosensitizer plasma levels.

Conclusion Our treatment protocols confirm the beneficial effects of ECP on CTCL at any stage, but it seems that adequate ECP efficiency is ensured only when an 8‐MOP solution is applied extracorporeally.
Prevalence of skin diseases in school children in rural and urban communities in the Illubabor province, south‐western Ethiopia: a preliminary survey
Authors: Figueroa Jose I. , Hawranek Thomas , Abraha Aynalem , Hay Roderick J.
Published: August 2010

Background Skin disease is usually the second most common reason for consultation by children in rural clinics in developing countries. The majority of epidemiological studies published so far are based on the analysis of medical records from specialised centres. These, however, account for expressed needs only and do not portray the real prevalence of paediatric skin disease at the community level.

Aim To determine the prevalence of skin disease in unselected paediatric populations from rural and urban communities in the Illubabor province, south‐west Ethiopia.

Patients and methods A cross‐sectional prevalence survey of 219 junior school children in three schools was performed. Ninety‐one children (42%) from two rural communities and 128 (58%) from an urban settlement were examined clinically and asked to complete a simple questionnaire.

Results Three hundred and eighty‐two cutaneous findings were present in 212 (96.8%) children. Parasitic infestations, particularly pediculosis capitis, and infections, of which fungal infections affected at least one in four children, were the most prevalent skin conditions in both environments.

Conclusions Community based epidemiological data are needed for monitoring early changes in disease patterns in children so that health care programmes can be expeditiously modified accordingly.
Skin lesions in carbonmonoxide intoxication
Authors: Palali Zeki , Saricaoǧlu Hayriye , Acar Ahmet
Published: August 2010

A patient with carbonmonoxide (CO) intoxication who developed extensive cutaneous lesions with bullae formation is presented. The finding of cranial computerized tomography together with the history of the patient and clinical and dermatological signs support the diagnosis of CO intoxication.
Intraepidermal IgA pustulosis
Authors: Mat M. Cem , Gökler Gökhan , Demirkesen Cuyan , Kotogyan Agop
Published: August 2010

Background Intraepidermal IgA pustulosis is a rare vesiculopustular condition characterized by intercellular IgA deposits, neutrophilic, infiltration and mild acantholysis. This condition is usually reported in middle‐aged or elderly people. We present the clinical, histological and immunofluorescence data of a child with this condition.

Observation Our case is an 11‐year‐old girl who presented a pruritic vesiculupustular eruption involving the trunk, upper extremities. face and oral mucosa, Histopathologic examination revealed an intraepidermal pustule formation composed of neutrophils and some eosinophils and acantholytic cells in the spinal layer. Direct immunofluorescent test showed the deposition of IgA in the intercellular spaces throughout the whole of the epidermis. No circulating IgA anti‐intercellular antibodies were detected by indirect immunofluorescence. She was treated with prednisolone 30 mg/daily. After discontinuation of corrticosteroid treatment, we did not observe any skin lesions during a follow‐up period of 2 years.

Conclusion We consider this eruption intraepidermal IgA pustulosis (historically intraepidermal neutrophilic type) based on clinical and histopathological findings. Intraepidermal IgA pustulosis should be considered in the differential diagnosis of eruption in childhood.
Chronic urticaria associated with autoreactivity to progesterone
Authors: de Sousa Pinto J.M. , Campos Luis B. , de Ascensão A. Cabral
Published: August 2010

Autoimmune progesterone dermatitis is a rarely recognized cutaneous disorder revealed by recurrent and cyclic skin eruption with variable morphology, during the luteal phase. We report the case of a 42‐year‐old woman with chronic urticaria since the age of 38 with premenstrual exacerbation. Intradermal progesterone tests revealed a strong reactivity against this hormone. Treatment with thalidomide was effective but induced a peripheral neuropathy. Oophorectomy was performed with clearing of the cutaneous lesions.
Lymphangioma‐like pattern and anaplastic evolution in a case of classic Kaposi's sarcoma
Authors: Masia Ina Maria , Mugoni Maria Grazia , Massarelli Giovannino , Rovasio Severino , Cottoni Francesca
Published: August 2010

Background Usually, classic Kaposi's sarcoma (KS) is clinically characterized by maculae, plaques and nodules and histologically by a proliferation of irregularly‐shaped blood vessels, spindle cells and extravasated erythrocytes. The course is indolent. Very rarely, cases have been reported in which malignant transformation occurred with subsequent visceral diffusion.

Observations A case of classic KS in an 82‐year‐old man is reported. Clinically, the lesion appeared lo be a nodule which grew rapidly to become an exophytic tumour mass. Histopathologically, it was characterized at the beginning by a lymphangioma‐like pattern with subsequent frank anaplasia. The diagnosis of KS was based on lymph node examination which showed typical features. The patient died after 1 year.

Conclusions Taking into account these unusual patterns we emphasize their importance in the differential diagnosis of KS from other angiomatous and anaplastic lesions.
Multifaceted dermatitis artefacta caused by garlic
Authors: Hallel‐Halevy D. , Zlotogorski A. , Grunwald M.H. , Halevy S.
Published: August 2010

Dermatitis artefacta is a self inflicted dermatosis without a precise and rational motive. A 19 year old patient presented with a peculiar multiform eruption induced by local application of garlic. The disorder of garlic dermatitis artefacta is discussed.
Chemical peeling: How, when, why?
Authors: Ghersetich I. , Teofoll P. , Gantcheva M. , Ribuffo M. , Puddu P.
Published: August 2010

General description Chemical peeling is a procedure frequently used lo treat unaesthetic cutaneous alterations such as photoageing, actinic keratosis, chloasma, senile lentigo, and post‐acneic scars as well those of a non‐strictly aesthetic nature such as seborrhoeic keratosis and flat warts. Several chemical agents are used depending on the depth of peeling to be obtained. The most commonly used agents are: alpha‐hydroxy‐acids, resorcinol, Jessner's solution, and trichloroacetic acid. In the present study the characteristics of the individual substances, technical procedure, and applications are taken into consideration. Finally, the main risks and side‐effects, depending on the depth of peeling, are considered.

Learning objective The reader will have learned what a chemical peeling is, what chemical agents are available, and how to perform chemical peeling in the office. The mechanism of action of different chemical agents, expectations from this procedure, potential risks and complications are also reviewed with insight into criteria for selecting patients.
Rating clothing for sun protection: current status in Australia
Authors: Stanford Duncan G. , Georgouras Katherine E. , Pailthorpe Michael T.
Published: August 2010

Clothing has been promoted as a major sun protection measure for some time, yet its performance in this role has only recently been studied. The principal test methods for measuring the photoprotectiveness of clothing are: in vitro testing, in which ultraviolet transmission through a garment is measured; and in vivo testing, where protection by the garment from human skin erythema is assessed. Our research team has been studying the fabric properties and design factors involved in photoprotection by clothing so that more effective products can be developed. Fabric properties identified include: the construction and fibre type used, the stretch and hydration states, and ultraviolet‐absorbing dyes and chemicals incorporated. An exciting innovation has been the use of an ultraviolet absorber which dramatically improves a garment's rating. In Australia, we are about to have the world's first standard for rating sun‐protective clothing.
Dermatomyositis with normal muscle enzymes: a single blind study of the diagnostic value of thallium‐201 scanning
Authors: Soni Bhavik P. , Stonecipher Marcus R. , Jorizzo Joseph L. , Ball James
Published: August 2010

Background It is well documented that the classic cutaneous lesions of dermatomyositis can precede the onset of muscle involvement or may occur in the absence of any detectable muscle disease by current diagnostic criteria. Thallium scanning has been reported to be a useful test in the evaluation of muscle disease in patients with dermatomyositis.

Objective Our purpose was to examine the utility of thallium scanning in patients with dermatomyositis with normal muscle enzymes.

Methods In this single blind study we used thallium‐201 scanning to evaluate 5 patients who presented with classical clinicopathologic dermatomyositis but with normal levels of serum muscle enzymes. A positive control patient with active myositis and a negative control patient were also examined.

Results All patients had muscle groups with decreased signal intensity on thallium scanning. Even the negative control patient demonstrated marked asymmetry of several different muscle groups. These results are very different from those previously reported.

Conclusions Non‐invasive radiologic examinations clearly have a role in the evaluation of patients with dermatomyositis sine myositis or dermatomyositis. We have previously reported that magnetic resonance imaging and ultrasound are useful adjunctive tests. However, thallium scanning does not seem to be useful in the evaluation of patients with dermatomyositis with normal muscle enzymes. Thallium scanning appears to be a very sensitive test. However, the abnormal findings on every patient, including the negative control patient, suggest a very low specificity.
The plasma level of sICAM‐1 in the chosen inflammatory dermatoses
Authors: Lecewicz‐Toruń Barbara , Krasowska Dorota , Kozioł Maria , Chodorowska Grażyna
Published: August 2010

We have determined the plasma levels of sICAM‐l in 11 patients with generalized lichen planus, 19 with psoriasis, 10 with acrosderoderma. 4 with mycosis fungoides and 14 patients of the control group. All the investigated groups displayed mean values significantly higher than those of the controls (199.5 ± 97.7 ng/ml), and values in generalized lichen planus subjects were much higher (426.8 ± 145.5 ng/ml) than in those with acrosderoderma (360.8 ± 121.7 ng/ml), psoriasis (356.9 ± 175.6 ng/ml) and mycosis fungoides (329.4 ± 142.3 ng/ml). These data suggest that the level of sICAM‐l in plasma increases during different immunological skin diseases. Soluble ICAM‐I is a sensitive marker of inflammatory states in the course of the investigated diseases.
Chromoblastomycosis – a case report
Authors: Munn S.E. , Basarab T. , Papadavid E. , Chu A.C.
Published: August 2010

Chromoblastomycosis is a chronic cutaneous and subcutaneous fungal infection in man most commonly occurring in tropical and sub‐tropical climates. It is rarely seen in the United Kingdom. Response to treatment is slow but there have been recent reports of successful treatment with itraconazole. We report a case in a 70‐year‐old Bangladeshi man who presented with a recurrence of a long‐standing lesion on his forearm.
Salicylate intoxication from topically applied salicylic acid
Authors: Jabarah Adnan , Gilead Leon T. , Zlotogorski Abraham
Published: August 2010

A 42‐year‐old patient with psoriasis developed salicylism while being treated with topical salicylic acid. The clinical and biochemical abnormalities in salicylism are reviewed.
The final challenge: ageing, dying, individuation
Authors: Carvalho Richard
Published: August 2010

Abstract: This paper1is about the psychotherapy of a woman who passed from whatWaddell (1998)would term ‘older age’ to ‘later life’, by which latter I mean the inevitable decline into dying and death. However unwelcome these developments may be to the individual, they are none the less activities of the soma, and therefore activities of the self—deintegrates. Much of the work of the psychotherapy centred around the task of enabling the patient to relate to and accept the bodily and emotional correlates of this process, which she tended to want to disown and deny by means of a split between mind and body along the lines of a long‐standing internal depressive relationship. Permitting her contact with herself allowed her a much greater sense of internal company and peace, and arguably facilitated an easier process of dying, involving a self reconciled with itself rather than one at odds. Technically, the approach involved a greater concentration on the intrapsychic relationship rather than on the relationship between patient and analyst, and this is briefly discussed in terms of the work of Armando Ferrari who had himself died, shortly before the paper was first presented, and to whom therefore it is in part a homage.
Managerial Ownership and Accounting Conservatism in Japan: A Test of Management Entrenchment Effect
Authors: Shuto Akinobu , Takada Tomomi
Published: August 2010

Abstract:  We examine the effect of managerial ownership on the demand for accounting conservatism in Japan. We find that within the low and high levels of managerial ownership, managerial ownership is significantly negatively related to the asymmetric timeliness of earnings, which is consistent with the implication of the incentive alignment effect. We also find a significant positive relationship between managerial ownership and the asymmetric timeliness of earnings for the intermediate levels of managerial ownership, as suggested by the management entrenchment effect. These evidences suggest the possibility that accounting conservatism contributes to addressing the agency problem between managers and shareholders.
Compensation Vega, Deregulation, and Risk‐Taking: Lessons from the US Banking Industry
Authors: Belkhir Mohamed , Chazi Abdelaziz
Published: August 2010

Abstract:  This study examines three issues related to the sensitivity of bank CEO compensation to risk, or vega: (1) its relevance compared with CEO compensation vega in industrial firms; (2) its determinants; and (3) its effect on bank risk‐taking. Using a sample of 156 US bank holding companies (BHCs) and a benchmark sample of 544 industrial firms over the period 1993–2006, we find that the vega of CEO compensation in banking is of a much smaller magnitude than the vega of CEO compensation in industrial firms, despite an effort by BHCs to increase it since the mid‐1990s. We also find that larger BHCs with better investment opportunities and those that operate in a deregulated environment reward their CEOs with a compensation that has a higher sensitivity to risk. Finally, our analyses show that BHCs in which CEOs receive a higher compensation vega assume a higher risk.
Do healthy preterm children need neuropsychological follow‐up? Preschool outcomes compared with term peers
Authors: DALL’OGLIO ANNA M , ROSSIELLO BARBARA , COLETTI MARIA F , BULTRINI MASSIMILIANO , DE MARCHIS CHIARA , RAVÀ LUCILLA , CASELLI CRISTINA , PARIS SILVANA , CUTTINI MARINA
Published: August 2010

Aim  The aim of this study was to determine neuropsychological performance (possibly predictive of academic difficulties) and its relationship with cognitive development and maternal education in healthy preterm children of preschool age and age‐matched comparison children born at term.

Method  A total of 35 infants who were born at less than 33 weeks’ gestational age and who were free from major neurosensory disability (16 males, 19 females; mean gestational age 29.4wk, SD 2.2wk; mean birthweight 1257g, SD 327g) and 50 term‐born comparison children (25 males, 25 females; mean birthweight 3459g, SD 585g) were assessed at 4 years of age. Cognition was measured using the Griffiths Mental Development scales while neuropsychological abilities (language, short‐term memory, visual–motor and constructive spatial abilities, and visual processing) were assessed using standardized tests. Multivariable regression analysis was used to explore the effects of preterm birth and sociodemographic factors on cognition, and to adjust neuropsychological scores for cognitive level and maternal education.

Results  The mean total Griffiths score was significantly lower in preterm than in term children (97.4 vs 103.4; p<0.001). Factors associated with higher Griffiths score were maternal university education (β=6.2; 95% confidence interval [CI] 0.7–11.7) and having older siblings or a twin (β=4.0; 95% CI 0.5–7.6). At neuropsychological assessment, preterm children scored significantly lower than term comparison children in all tests except lexical production (Boston Naming Test) and visual‐processing accuracy. After adjustment for cognitive level and maternal education, differences remained statistically significant for verbal fluency (p<0.05) and comprehension, short‐term memory, and spatial abilities (p<0.01).

Interpretation  Neuropsychological follow‐up is also recommended for healthy very preterm children to identify strengths and challenges before school entry, and to plan interventions aimed at maximizing academic success.
A possible association of responsiveness to adrenocorticotropic hormone with specific GRIN1 haplotypes in infantile spasms
Authors: DING YING‐XUE , ZHANG YING , HE BING , YUE WEI‐HUA , ZHANG DAI , ZOU LI‐PING
Published: August 2010

Aim  Adrenocorticotropic hormone (ACTH) has been used as the major therapy for infantile spasms since 1958 because it effectively suppresses seizures; it also normalizes the electroencephalogram in the short‐term treatment of infantile spasms. G protein‐regulated inducer of neurite outgrowth 1 (GRIN1, also known as N‐methyl‐d‐aspartate receptor 1, NMDAR1), a glutamate receptor, is the main component of functional N‐methyl‐d‐aspartic acid receptors that are involved in the glucocorticoid‐induced neuronal damage. Thus, it may be a candidate gene to be tested for responsiveness to ACTH in infantile spasms. In the present study, polymorphisms in the GRIN1 gene in infantile spasms were investigated using a case–control design.

Method  Twelve single nucleotide polymorphisms in the GRIN1 gene were genotyped in a Chinese case–control set consisting of 97 unrelated patients with infantile spasms (60 males, 37 females; mean age 6.4mo, SD 2.7) and 96 healthy individuals (63 males, 33 females; mean age 7.3mo, SD 3.8). Association analysis was performed on the genotyped data.

Results  Five estimated haplotypes with a frequency of more than 3% were detected. Results of the study showed that responsiveness to treatment with ACTH in homozygous carriers of the CTA haplotype was higher than that in heterozygous carriers and non‐carriers (p=0.022). Furthermore, CTG, a rare haplotype, was strongly associated with infantile spasms (p=0.013).

Interpretation  The results suggest that haplotypes of GRIN1 may influence responsiveness to ACTH. The findings necessitate further study for confirmation.
Self‐care and mobility skills in children with cerebral palsy, related to their manual ability and gross motor function classifications
Authors: ÖHRVALL ANN‐MARIE , ELIASSON ANN‐CHRISTIN , LÖWING KRISTINA , ÖDMAN PIA , KRUMLINDE‐SUNDHOLM LENA
Published: August 2010

Aim  The aim of this study was to investigate the acquisition of self‐care and mobility skills in children with cerebral palsy (CP) in relation to their manual ability and gross motor function.

Method  Data from the Pediatric Evaluation of Disability Inventory (PEDI) self‐care and mobility functional skill scales, the Manual Ability Classification System (MACS), and the Gross Motor Function Classification System (GMFCS) were collected from 195 children with CP (73 females, 122 males; mean age 8y 1mo; SD 3y 11mo; range 3–15y); 51% had spastic bilateral CP, 36% spastic unilateral CP, 8% dyskinetic CP, and 3% ataxic CP. The percentage of children classified as MACS levels I to V was 28%, 34%, 17%, 7%, and 14% respectively, and classified as GMFCS levels I to V was 46%, 16%, 15%, 11%, and 12% respectively.

Results  Children classified as MACS and GMFCS levels I or II scored higher than children in MACS and GMFCS levels III to V on both the self‐care and mobility domains of the PEDI, with significant differences between all classification levels (p<0.001). The stepwise multiple regression analysis verified that MACS was the strongest predictor of self‐care skills (66%) and that GMFCS was the strongest predictor of mobility skills (76%). A strong correlation between age and self‐care ability was found among children classified as MACS level I or II and between age and mobility among children classified as GMFCS level I. Many of these children achieved independence, but at a later age than typically developing children. Children at other MACS and GMFCS levels demonstrated minimal progress with age.

Interpretation  Knowledge of a child’s MACS and GMFCS level can be useful when discussing expectations of, and goals for, the development of functional skills.
Adolescents' soft drinks consumption in family environment: a case study in Northern Greece
Authors: Sdrali Despina , Anisiadou Melina , Goussia‐Rizou Maria , Costarelli Vassiliki
Published: August 2010

Studies have shown that high levels of consumption of sugar‐containing soft drinks by adolescents are associated with increased risk of obesity, dental carries, hyperactivity and mental health problems in this group. Research has also shown that parental influences and family environment are key determinants in the formation of children's eating habits. The purpose of the current study was to explore the role of home environment on Greek adolescents' soft drinks consumption, and especially cola drinks. A total of 149 adolescents, aged 13–16 years old, have been recruited from two public high schools in a semi‐urban area of Northern Greece. The adolescents completed a general background questionnaire and a specially designed food frequency questionnaire assessing soft drinks consumption. The collected data were analysed using descriptive statistics and logistic regression analysis.

The results showed that most adolescents in this sample consume soft drinks, especially cola drinks with sugar, and they have access to these beverages in their home environment. The majority of the adolescents, however, reported that their parents do not serve soft drinks during their meals, do not approve of soft drinks consumption and do not consume high levels of soft drinks themselves.

Results also indicated that taste seems to be a strong determinant of soft drinks consumption. In the case of cola drinks, statistical analysis has revealed that gender, general eating habits, soft drink‐related knowledge and a number of family environment variables, such as single‐parent family and maternal educational level, together with parental practices, such as parents' approval of soft drinks consumption and parental soft drinks consumption, are significant determinants of cola drinks intake in this age group.

Future studies investigating predictors of soft drinks consumption with emphasis on the role of home food environment and on adolescents' response to reduced availability, may identify the next steps towards improving the diets of adolescents and hence their general health and well‐being.
Addressing the professional development needs of teachers working in the area of special education/inclusion in mainstream schools in Ireland
Authors: O'Gorman Elizabeth , Drudy Sheelagh
Published: August 2010

This paper gives an account of one aspect of a recent research project that explored dimensions of inclusion in mainstream schools in Ireland. In particular, the working lives of teachers who have specific responsibility for students with disabilities and/or special educational needs (SEN) in mainstream schools were explored. In Ireland, such teachers are known as learning support or resource or SEN (LS/R/SEN) teachers. The nearest UK equivalent role is that of SEN co‐ordinator, but the responsibilities of the Irish LS/R/SEN teacher role are not as formalised and tend to vary in different school contexts. A key aspect of the research project was to explore the professional development requirements of these teachers. The contention emerges that the professional development requested by teachers was supportive of traditional practices and that these practices more properly belonged to a medical model‐influenced, deficit approach to special education rather than to an inclusive approach to education. As a consequence, it is argued that, instead of responding to gradually evolving change, an alternative, more revolutionary approach to professional development could be adopted to challenge ‘conventional wisdom’ and promote a truly inclusive education system in Ireland.
From discrete to transformed? Developing inclusive primary school teacher education in a Finnish teacher education department
Authors: Naukkarinen Aimo
Published: August 2010

This paper describes the primary school teacher education curriculum reform currently under way in the Department of Teacher Education at the University of Jyväskylä, Finland. A general overview of the Finnish context and relevant inclusive education policy issues are presented. The process of developing inclusive education in the curriculum and the organisational culture of the department of teacher education is discussed in relation to the collaborative teacher education research framework developed by Pugach and Blanton. Areas for future development are identified.