A purple plaque in a patient with systemic sclerosis

We present the case of a 43-year old woman with anti-U3 ribonucleoprotein antibody-positive systemic sclerosis presenting with an enlarging purple plaque on the left upper arm. The skin was not sclerotic; however, there had been a cluster of long-standing telangiectases preceding the plaque. Histology and immunohistochemistry confirmed an angiosarcoma. There are five reported cases in the literature about angiosarcoma arising in the skin of patients with systemic sclerosis; however, to our knowledge, this is the first to have arisen from non-sclerotic skin. We would urge clinicians to adopt a high index of suspicion for atypical vascular tumours presenting in patients with systemic sclerosis

Spatiotemporal processing of somatosensory stimuli in schizotypy

Unusual interaction behaviors and perceptual aberrations, like those occurring in schizotypy and schizophrenia, may in part originate from impaired remapping of environmental stimuli in the body space. Such remapping is contributed by the integration of tactile and proprioceptive information about current body posture with other exteroceptive spatial information. Surprisingly, no study has investigated whether alterations in such remapping occur in psychosis-prone individuals. Four hundred eleven students were screened with respect to schizotypal traits using the Schizotypal Personality Questionnaire. A subgroup of them, classified as low, moderate, and high schizotypes were to perform a temporal order judgment task of tactile stimuli delivered on their hands, with both uncrossed and crossed arms. Results revealed marked differences in touch remapping in the high schizotypes as compared to low and moderate schizotypes. For the first time here we reveal that the remapping of environmental stimuli in the body space, an essential function to demarcate the boundaries between self and external world, is altered in schizotypy. Results are discussed in relation to recent models of 'self-disorders' as due to perceptual incoherence

A slowly enlarging purple nodule on the arm

A 50-year-old Caucasian gentleman presented with a one-year history of a gradually enlarging pigmented lump on the right forearm. On examination there was a 1 cm blue-purple nodule, which was hard in consistency (Figure 1). A mobile dermal cystic component was palpated after lateral pressure. Further dermoscopic examination revealed a homogeneous blue-purple pigmentation surrounded by a subtle brown hyperpigmentation and a central white area with fine linear whitish structures. No pigment network was noticed (Figure 2). Histopathological examination was performed to exclude melanoma. It revealed an ill-defined nodular dermal proliferation of spindle-shaped fibroblasts and myofibroblasts arranged as short intersecting bundles. There were multiple dilated vascular channels and numerous hemosiderin-laden macrophages (Figure 3)

Estrogen receptor-α immunoreactivity predicts symptom severity and pain recurrence in deep endometriosis

To determine the relationship between steroid receptor expression and pain symptoms in endometriosis