The range of empiric topical and systemic treatments used gives unsatisfactory results, in LPP patients.

MTX seems to be an effective and safe second-line treatment for patients with moderate-to-severe atopic dermatitis. A randomized, controlled study is warranted.

We suggest that when NDM infection is found in the first culture, the patient should be re-examined in a subsequent visit in which three separate samples are taken from the affected nail. If NDM is confirmed in all three cultures, the diagnosis of NDM is established. Treatment should be recommended in patients who show positive results in all three cultures.

No abstract

Nail changes in patients with psoriasis have been reported with varying prevalence. Onychomycosis has been reported in up to 47% of the psoriasis patients. The purpose of this study was to determine the prevalence of nail abnormalities, onychomycosis in psoriasis and response to itraconazole treatment. We evaluated 312 patients suffering from psoriasis for nail changes and onychomycosis. Patients having laboratory confirmation of onychomycosis were treated with three courses of itraconazole (400 mg day(-1) for 1 week). Of 312 patients with psoriasis, 67 (21.5%) patients had nail changes, 23 (34%) of them suffered from onychomycosis. Complete cure (clinical and mycological) was achieved in 30% of the patients with onychomycosis. The response to treatment of onychomycosis with itraconazole in psoriasis patients was found to be lower than in the general population. Considering the low response to onychomycosis systemic therapy in psoriatic patients and the potential side-effects of the treatment, the rationality of this treatment is questionable.

Background: Unilesional mycosis fungoides (MF) is a rare variant of cutaneous T-cell lymphoma (CTCL), characterized by a solitary lesion clinically and by histopathological features indistinguishable from those of MF, and typically having a benign course. Objective: To describe the clinicopathological features of a series of patients with unilesional MF. Methods: The records of cases of unilesional MF identified during a 10-year period in two medical departments were reviewed. Results: There were 7 patients: 6 males, 1 female; mean age at the time of diagnosis: 32 years; age range: 12–58 years; 3 were below the age of 18 years. The mean pretherapy follow-up period was 9 years (range: 2–20 years). In 5 patients, the eruption consisted of a characteristic patch or plaque of MF located on the trunk or upper extremity; in 2 it was atypical – in 1, a hypopigmented patch, and in 1, a plaque indistinguishable from MF-associated follicular mucinosis. Histopathologically all the lesions exhibited features characteristic of MF, with CD3+ lymphoid cells. In 6 cases (with available fresh frozen tissue) there was a predominance of CD3+ CD4+ cells; in 1 of 5 there was deletion of CD7, and in 3 of 5 there was an overexpression of IL-2 receptor. T-cell receptor γ gene rearrangement was found in 1 of 4 cutaneous lesions tested; in 2 cases it was found in the blood but not in the skin. Treatment modalities included localized electron beam, excision, topical nitrogen mustard or topical steroids and sunbathing, resulting in all cases in a sustained complete clinical response. In 1 patient, however, there were 2 local recurrences and in yet another patient there was distant cutaneous spread 3.5 years after therapy. Conclusions: Unilesional MF is a rare variant of CTCL, has heterogeneous clinical manifestations and can affect any age group, including children. The histopathological and immunophenotypical features are in general indistinguishable from those observed in multilesional MF. Although it is a unifocal event, there may occasionally be cutaneous spread with the appearance of noncontiguous lesions, even a long time after therapy. Whether all cases represent minimal-stage IA MF or whether some are actually T-cell pseudolymphoma remains to be clarified.

The cohort demonstrated genetic heterogeneity with no mutation cluster along the gene, and a high prevalence of psychiatric disorders. Although no clear genotype-phenotype correlation was found, the results point to a major effect of genetic background on psychiatric phenotype, together with other modifiers.

increase in androgen receptor levels or their distribution between lesional and normal skin. In the present study, the expression of androgen receptors within lesional skin was not increased. Our findings cannot rule out the possibility of an endocrine influence at the microvascular level and we believe that unopposed androgenic stimulation might still contribute to the pathogenesis of rosacea. 3 Feldman SR, Hollar CB, Gupta AK, Fleischer AB Jr. Women commonly seek care for rosacea: dermatologists frequently provide the care. Cutis 2001; 68 : 156 -160. 4 Thibout DM. Acne rosacea. Am Fam Physician 1994; 50 : 1691-1697. 5 Schmidt JB, Raff M, Spona J. Do sexual steroids contribute to the pathomechanism of rosacea? A study of estrogen and androgen receptors in acne rosacea. Acta Derm Venereol (Stockh) 1983; 63 : 64 -66. 6 Spirov G, Berova N, Vassilev D. Effect of oral inhibitors of ovulation in treatment of rosacea and dermatitis perioralis in women. Aust J Dermatol 1971; 12 : 149 -154. 7 Zuber TJ. Rosacea. Primary Care 2000; 27 : 309 -318. 8 Mauss J. Cyproterone therapy of papulopustular rosacea in women. Hautarzt 1981; 32 : 94 -95. 9 Koulinas GT. Treatment of acne with oral contraceptives: criteria for pill selection. Cutis 2000; 66 : 281-286. 10 McPhaul MJ, Young M. Complexities of androgen action.