Onset of disseminated cutaneous nodules following toe amputation in heart transplant patient

Alternaria spp. infections are rare, but organ transplant recipients and immunosuppressed patients are particularly at risk of developing cutaneous alternariosis. Although cutaneous alternariosis is well-defined, instances of disseminated infection are exceedingly rare. We report a case of disseminated Alternaria infection in an immunocompromised patient from a primary focus of ungual phaeohyphomycosis

Generalized linear IgA dermatosis with palmar involvement

Linear IgA bullous dermatosis (LABD) is a sub-epidermal blistering disorder characterized by deposition of IgA along the basement membrane zone (BMZ) as detected by immunofluorescence microscopy. The diagnosis is made by clinicopathologic correlation with immunofluorescence confirmation. Differentiation from other bullous dermatoses is important because therapeutic measures differ. Prompt initiation of the appropriate therapies can have a major impact on outcomes. We present three cases with prominent palmar involvement to alert the clinician of this potential physical exam finding and to consider LABD in the right context

Generalized linear IgA dermatosis with palmar involvement

Linear IgA bullous dermatosis (LABD) is a sub-epidermal blistering disorder characterized by deposition of IgA along the basement membrane zone (BMZ) as detected by immunofluorescence microscopy. The diagnosis is made by clinicopathologic correlation with immunofluorescence confirmation. Differentiation from other bullous dermatoses is important because therapeutic measures differ. Prompt initiation of the appropriate therapies can have a major impact on outcomes. We present three cases with prominent palmar involvement to alert the clinician of this potential physical exam finding and to consider LABD in the right context

CD30⁺ Reversible Lymphoid Dyscrasia (Pseudolymphoma) Following HIDA Scintigraphy and the [Ring1]-[Ring2]-[C=O] Generalized Structure Hypothesis

To the Editor: Eighteen days after hepatobiliary iminodiacetic acid (HIDA) scintigraphy, an 81-year-old woman presented with pruritic, painful, discrete, tender papules in a generalized distribution (Fig 1). She noted onset of the eruption shortly after the HIDA scan. Biopsy specimen of 2 papules from the right thigh showed an infiltration of mitotically active lymphocytes (Fig 1, top inset) confined to the upper dermis. The lymphocytes were predominantly CD3+ T cells; occasional scattered CD20+ B cells were present. CD4 and CD8 were present in an approximately 2:1 ratio, and both cell types were noted within the epidermis. Small aggregates of large CD3+/CD30+ lymphocytes were present, comprising less than 25% of the lymphoid population (Fig 1, bottom inset). The histopathology and immunostaining supported a diagnosis of CD30+ plasma cell dyscrasia (pseudolymphoma)

African Tick Bite Fever

The purpose of this study was to determine whether wearable activity trackers are effective tools to promote change in adult users. Individuals who wear activity trackers and also have been or are currently in physical therapy were interviewed to determine if the tracker and its features of goal setting, graphs, tracking mechanisms, and challenges motivated them to be more physically active, lose weight, or help them transition into a regular physical activity program that their physical therapist promoted. The three psychological needs of autonomy, competence, and relatedness were assessed in the interviews to determine if the tracker met these needs. The individual’s use of different features on the tracker and how they use it daily was also assessed to determine how their motivation has changed since using the tracker. The information was used to determine if the tracker was an effective tool that helped the individual make a change in their level of physical activity

miRNA expression profiles of premalignant and malignant arsenic-induced skin lesions.

Arsenic, a naturally occurring element, contaminates the drinking water of over 200 million people globally. Chronic arsenic exposure causes multiple cancers including those originating from skin, lung and bladder, and is associated with liver, kidney, and prostate cancers. Skin is the primary target organ for arsenic toxicity; chronic toxicity initially manifests as non-malignant hyperkeratoses (HK) and subsequently advances to malignant lesions, including squamous cell carcinoma (SCC) and basal cell carcinoma (BCC). In this study, we evaluate the miRNA expression profiles of premalignant (3 HK) and malignant (3 BCC and 3 SCC) skin lesions from individuals chronically exposed to high levels of arsenic (59-172 ppb) in their drinking water in West Bengal, India. The lesions were histologically complex requiring histopathologic identification of keratinocytes to be isolated for RNA analyses. Keratinocytes were harvested using Laser Capture Microdissection and miRNA expression profiles were determined using TaqMan® Array Human MiRNA A Card v2.0. Thirty-five miRNAs were differentially expressed among the three lesion types analyzed. Two miRNAs (miR-425-5p and miR-433) were induced in both BCC and SCC relative to HK indicating their association with malignancy. Two other miRNAs (miR-184 and miR-576-3p) were induced in SCC relative to both BCC and HK suggesting selective induction in tumors capable of metastasis. Six miRNAs (miR-29c, miR-381, miR-452, miR-487b, miR-494 and miR-590-5p) were selectively suppressed in BCC relative to both SCC and HK. In conclusion, the differential miRNA expression was both phenotype- and stage-related. These miRNAs are potential biomarkers and may serve as therapy targets for arsenic-induced internal tumors