Preliminary study of a Mycobacterium leprae bacterin vaccine in a human volunteer population in a nonendemic area

Seventeen volunteers who had never resided in areas with significant transmission of leprosy (Hansen's disease) were inoculated intradermally with 1.5 X 10(8) killed, purified armadillo-derived Mycobacterium leprae in a standardized preparation being tested for possible vaccine use. The peak of local skin responses, consisting of induration with or without ulceration similar to the post-lepromin Mitsuda reaction, occurred between the 21st and 28th days after injection. The maximum mean induration diameter was 17.2 mm, the minimum, 6.1 mm. Sera tested with the ELISA technique revealed no humoral response to either the sonicated bacilli, M. leprae-specific phenolic glycolipid I antigen, or three semi-synthetic analogues reactive with lepromatous patients' sera. The dose of M. leprae inoculated appeared to be safe and without unacceptable reactions at the injection site. One volunteer developed a generalized skin rash parallel to the local reaction, but the relationship of the former to the inoculation was unclear.     

Dermatofibroma in a black tattoo: report of a case

Tattooing has been associated with a variety of complications including inflammatory and granulomatous reactions, transmission of infections, and neoplasms. We report a case of a 24-year-old male who presented with a 2-month history of an erythematous nodule involving a newly made tattoo on the right leg. An excisional biopsy was performed and the histopathological evaluation was consistent with dermatofibroma. Only three cases of dermatofibroma associated with tatooing were reported in litetature. We report an additional case and review the literature regarding cutaneous reactions to tattoos.     

Molecular diagnosis of a benign proliferative nodule developing in a congenital melanocytic nevus in a 3-month-old infant

Small and intermediate congenital melanocytic nevi have a lifetime risk of developing melanoma estimated to range from 0% to 5%. Secondary benign melanocytic proliferations commonly arise in congenital melanocytic nevi; however, some are difficult to definitively distinguish from malignant melanoma based on clinical features and conventional histology. Herein, we describe the use of comparative genomic hybridization in supporting the diagnosis of a deep penetrating nevus developing within a congenital melanocytic nevus of a 3-month-old infant.     

上海某社区雄激素源性秃发患病率调查

目的 了解上海地区雄激素源性秃发（AGA）的患病率、脱发类型。方法 采用整群抽样的方法。按照统一制定的表格,对上海市长宁区北新泾社区居民进行问卷调查,并由皮肤科医生进行诊断确认,对雄激素源性秃发患者采用Norwood-Hamilton和Ludwig标准分级。所有数据录入EpiData数据库,运用SPSS11.5软件进行统计学分析。结果 本次调查回收有效问卷7056份（男3519份,女3537份）,应答率72.5%。确诊AGA患者809例,其中男701例,平均年龄（64.16 ± 11.98）岁,年龄范围19 ～ 91岁,女108例,平均年龄（70.46 ± 18.89）岁,年龄范围35 ～ 91岁。总标化患病率为9.47%,男性和女性标化患病率分别为15.73%和2.73%,两者间差异有统计学意义（χ2 = 356.00,P < 0.001）。52.7%的患者有AGA家族史,其中男为55.78%,女为32.41%。男性AGA患者70岁以上年龄脱发类型以Ⅵ级最多,而20 ～ 70岁年龄脱发类型以Ⅲv级最多。女性AGA脱发类型以Ⅰ级和Ⅱ级最多。结论 上海地区男性雄激素源性秃发患病率显著高于女性,男性和女性雄激素源性秃发的患病率随年龄增长而增加。     

Identification of a novel mutation in keratin 1 in a family with epidermolytic hyperkeratosis

Epidermolytic hyperkeratosis (EHK) is a hereditary skin disorder typified by blistering due to cytolysis. One in 100,000 individuals is affected by this autosomal-dominant disease. The onset of the disease phenotype is typically at birth. Histological and ultrastructural examination of the epidermis shows a thickened stratum corneum and tonofilament clumping around the nucleus of suprabasal keratinocytes. Linkage studies localized the disease genes on chromosomes 12q and 17q which contain the type II and type I keratin gene clusters. Recently, several point mutations in the genes encoding the suprabasal keratins, K1 and K10, have been reported in EHK patients. We have investigated a large kindred affected by EHK and identified a new point mutation in the 2B region of keratin 1 (I107T), resulting from a T to C transition in codon 478.     

Primary cutaneous inoculation tuberculosis in a healthcare worker as a result of a surgical accident

In May 2004, a 48-year-old male surgeon, resident in Bucaramanga, Colombia, suffered a superficial cut with a scalpel to the lateral aspect of the mid-phalanx of the second finger of the left hand while performing a pulmonary decortication surgical procedure for tuberculous empyema with pulmonary entrapment. The injury healed normally but, approximately 2 weeks after the event, an erythematous, nonpainful papule of approximately 3 mm in diameter developed, and increased progressively to 7 mm 3 days after its initial appearance. At this time, the papule showed spontaneous secretion of a clear liquid and superficial ulceration (Fig. 1). Approximately 3 weeks after the injury, a Gram stain of the liquid was performed; it showed no bacteria but a moderate leukocyte reaction. Because of the high suspicion of possible tuberculous infection, bacilloscopy of the liquid was performed, and was positive (++) for acid-fast bacteria (Fig. 2). The liquid was cultured and grew Mycobacterium tuberculosis. The culture was sent to the Laboratory of Mycobacteria at the National Institute of Health, Bogota, Colombia for drug resistance testing. Susceptibility was demonstrated against streptomycin, isoniazid, rifampicin, and ethambutol. During this time, the patient presented an ipsilateral painful axillary adenopathy of about 2.5 cm in diameter. The patient consulted with an infectologist, who initiated a Directly Observed Therapy Short Course (DOTS) regimen [first phase (8 weeks): daily, except Sundays, streptomycin 1 g intramuscularly, pyrazinamide 1500 mg orally, isoniazid 300 mg, and rifampicin 600 mg; second phase (18 weeks): twice weekly rifampicin 600 mg and isoniazid 500 mg], accompanied by daily pyridoxine to prevent secondary effects from isoniazid. After 3 weeks of treatment, the finger lesion had disappeared. Treatment was undertaken as described above, with the patient reporting symptoms of vertigo, nausea, epigastralgia, and mild myalgia as the adverse effects of medication. A chest x-ray was taken and reported to be normal. The axillary adenopathy disappeared approximately 6 months after the injury. Nearly 3.5 years after the incident, the patient has not presented any type of symptomatology.     

Neurodermatitis in primates: a case description of a female gorilla

Neurodermatitis or atopic dermatitis appears to be more widespread among animals than has been assumed hitherto. We report on a female gorilla in Saarbrücken Zoo; after years of captivity the animal developed recurrent eczema in the crooks of the elbows and knees. An interesting aspect of this case is that apparently psychological factors stemming from a partner conflict led to manifestation of the disease. We discuss the feasibility of determining the presence of IgE.