Maternal ventilation and sedation for H1N1 influenza resulting in fetal bladder rupture and urinary ascites

Urinary ascites in a newborn infant is unusual and most commonly results from bladder perforation following umbilical arterial catheterisation or obstructive uropathy. The following report describes a case of fetal bladder rupture with urinary ascites in a mother ventilated and sedated with narcotics and benzodiazepines for H1N1 influenza. This was associated with a unique biochemical profile of hyponatraemia and elevated serum urea and creatinine characteristic of urinary autodialysis in the neonate.     

Association of β-Defensin Copy Number and Psoriasis in Three Cohorts of European Origin

A single previous study has demonstrated significant association of psoriasis with copy number of β-defensin genes, using DNA from psoriasis cases and controls from Nijmegen and Erlangen. In this study, we attempted to replicate that finding in larger new cohorts from Erlangen (N=2,017) and Michigan (N=5,412), using improved methods for β-defensin copy number determination based on the paralog ratio test, and enhanced methods of analysis and association testing implemented in the CNVtools resource. We demonstrate that the association with psoriasis found in the discovery sample is maintained after applying improved typing and analysis methods (P=5.5 × 10(-4), odds ratio (OR)=1.25). We also find that the association is replicated in 2,616 cases and 2,526 controls from Michigan, although at reduced significance (P=0.014), but not in new samples from Erlangen (1,396 cases and 621 controls, P=0.38). Meta-analysis across all cohorts suggests a nominally significant association (P=6.6 × 10(-3)/2 × 10(-4)) with an effect size (OR=1.081) much lower than found in the discovery study (OR=1.32). This reduced effect size and significance on replication is consistent with a genuine but weak association.     

Atypical case of periapical adenomatoid odontogenic tumour

The Adenomatoid Odontogenic Tumour (AOT) is a progressively growing asymptomatic benign non-invasive lesion. A rare subvariant of the extrafollicular type of AOT may mimic periapical disease radiographically. We report a 45-year-old male with a periapical radiolucent lesion affecting maxillary central incisor tooth. Initially suspicious of periapical pathology, although clinical findings seemed to indicate a nonendodontic cause. The lesion was surgically explored and histopathological examination revealed the presence of AOT. This particular subvariant is very rare indeed, as available literature only 8 cases have been reported.     

Invasive dermatophytosis with lymph node involvement in an immunocompetent patient

A 23-year-old man presented with annular and arcuate, hyperpigmented, itchy, scaly plaques over the trunk and lower extremities for 5 years progressing to verrucous papules and nodules for the last 1.5 years. He also had nontender, inguinal and axillary lymphadenopathy. Skin and lymph node biopsies showed granulomatous inflammation and special stains demonstrated long septate hyphae. Tissue cultures grew Trichophyton verrucosum. The patient was treated with itraconazole 100 mg twice daily for 8 months, resulting in complete clearance of the lesions.     

An unusual nail presentation in Marfan's syndrome

Skin and nail lesions are very rare in Marfan's syndrome. We reported a 14-year-old boy who presented with pterygium in the nails of both the upper and lower limbs with chest deformity along with other features of Marfan's syndrome. Histopathological findings revealed hyperkeratosis with a scant perivascular inflammatory infiltrate. It was not clear whether this case is the first presentation of pterigium in Marfan's syndrome or congenital lichen planus. To our knowledge, this kind of feature is the first Marfan's syndrome case of its kind.