1/4. Three hong kong Chinese cases of pretibial epidermolysis bullosa: a genodermatosis that can masquerade as an acquired inflammatory disease.Three patients in two families presented with many years' history of fragile skin, blisters, erosions and scars affecting almost exclusively the shin areas, accompanied by a variable degree of itching. Two of the patients also had toenail dystrophy. skin biopsy revealed dermal-epidermal blister formation and milia but no immunohistochemical evidence of immunoglobulin or complement deposition. Electron microscopic study of the lesional and perilesional skin showed very sparse or absent anchoring fibrils. Immunolabelling for type VII collagen using LH 7.2 monoclonal antibody revealed a bright, linear staining pattern at the dermal-epidermal junction. The clinicopathological features were thus compatible with pretibial epidermolysis bullosa, a subtype of dystrophic epidermolysis bullosa. Of note, the inflammatory nature of the skin lesions, and their resemblance to nodular prurigo and hypertrophic lichen planus, had caused diagnostic difficulties in all cases in the past. A high degree of awareness of this rare subtype of epidermolysis bullosa is important to establish the correct diagnosis, to allow for genetic counselling and to plan clinical management.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/4. The Laugier-Hunziker syndrome.Laugier and Hunziker described a syndrome consisting of asymptomatic benign areas of hyperpigmentation affecting the lips, buccal mucosa and, in 50%, the fingernails. We report a 67-year-old woman with the clinical features of Laugier-Hunziker syndrome in association with vulval pigmentation. histology, immunohistochemistry and electron microscopy from the various areas of pigmentation on the body confirmed the benign nature of the pigmentation. We review potential causes of oral and genital pigmentation, and suggest an expansion of the original syndrome described by Laugier and Hunziker to include more widespread areas of benign hyperpigmentation, which may associated.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/4. Conditions of the toenails.athletes are susceptible to developing toenail problems because of the speed or intensity of play (runners), the starting and stopping nature of the sport (tennis, racquetball), and the type of activity and shoes they wear or do not wear (ballet dancers, gymnasts). They may also have other conditions, such as hallux valgus, claw toes, gout, diabetes, arthritis, or fungus infection of the nails, that may influence the decision on the type of treatment recommended. Nail trauma that could result in osteomyelitis; secondary effects of arthritis, such as the development of a mucous cyst; and the infected ingrown toenail are seen frequently in the athlete and can be satisfactorily treated by the orthopedist.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/4. Regressing nevoid nail melanosis in childhood.The natural course of nail pigmentation was documented in 4 Japanese children. Although initial progression of melanosis concerning size and degree of pigmentation was noted, all cases showed a tendency to fade during the follow-up period. The published cases of nevoid nail melanosis in childhood were reviewed, and we concluded that they were essentially benign. However, should there be any suspicion of malignant changes, punch biopsy is indicated for medico-legal reasons. Management of growing pigmented nail streaks in childhood is one of the most difficult and delicate problems facing dermatologists, as they can be precursors of malignant melanoma. There is a condition of the nail known as longitudinal melanonychia or naevus striae unguis, possibly of nevoid nature. prevalence rates of nevoid diseases showing pigmentation of the skin vary depending on the ethnic origin. In order to understand the natural course of nail area pigmentation in childhood, we have followed 4 Japanese children with such a condition. We report our observations and review the literature.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |