No abstract

We report a case of a 51-year-old man with yellow nail syndrome (YNS).1 During a 23-week period of study, the dynamics of thumbnail growth were compared between one affected thumb and the normal contralateral thumb. Longitudinal nail growth was normal (0.46 mm/week) in the normal thumb and double that of the affected thumb (0.23 mm/week). Thickness of nail at the free edge in the affected thumb (0.97 mm) was twice that of the normal thumb (0.57 mm). Within the nail plate in the dorso-ventral axis there were 50% more cells in the affected thumb (358) in comparison with the contralateral control (242). This case illustrates that rate of longitudinal growth does not necessarily reflect nail plate production.

No abstract

No abstract

Reproducibility of patch test reactions is an important aspect of patch testing. Thin layer rapid use epicutaneous tests (TRUE Test) are preloaded with allergen, whereas Finn Chambers are empty discs that have allergen applied from a syringe. The amount of allergen applied to each Finn Chamber is therefore potentially variable depending on technique. This may increase the risk of non-reproducibility of reactions. We have performed an audit of patch test preparation in our department looking at weight variation of both individual Finn Chambers and 3 completed panels before and after allergen application. We found that the variance in weight was not significant for 2 of the 3 panels and single Finn Chambers with allergen in petrolatum. The variance in weight was significant for single Finn Chambers with allergen in solution and the third panel, which contains an allergen in solution. The clinical significance of these results is unclear.

Ropivacaine has a rapid onset and long duration of action. Ropivacaine produces vasoconstriction which may be clinically relevant. Even at maximum strength ropivacaine is less painful to inject than lidocaine with epinephrine.

Pili annulati is a rare hair shaft abnormality of unknown pathogenesis which gives a gross beading effect. An association with alopecia areata has been reported. We present a 13-year-old girl who had alopecia areata and coincidentally was found to have pili annulati. Her mother also had pili annulati which had become more noticeable as her hair had become paler with age. We discuss the possible pathogenesis of pili annulati and relate that to the microscopic banding appearance of the hair shaft. We note the relevance of the condition becoming more apparent with age. We also discuss the probable coincidental association with alopecia areata.Pili annulati (PA) is a rare hair shaft abnormality consisting of alternating light and dark sections occurring at random rather than cyclically in relation to specific periods of growth (1). The bands extend from the root sheath to the distal quarter of the hair shaft. Histologically the abnormal areas are dark. This hair shaft abnormality was first described by Erasmus Wilson in 1867 (2). We report a case of pili annulati coincident with alopecia areata. CASE REPORTA 13-year-old Caucasian girl had a 6 month history of alopecia areata confined to the scalp. There was no response to potent topical steroid therapy and the hair loss was so extensive as to necessitate prescription of a wig. As her hair began to regrow spontaneously it was noted that both the new and the longstanding hair had an unusual beaded appearance (Fig. 1). No scalp abnormality was seen, nor were there abnormalities elsewhere. Examination of her mother revealed the same abnormality of scalp hair. The mother reported that the beaded appearance of her hair had become more apparent with age and with the development of white hair. There was no history of alopecia areata in the mother.Light microscopy of plucked hair from the daughter showed periodic banding along the length of the hair shaft, often interpreted as an intermittent medulla (Fig. 2). The anagen root and shaft cuticle were normal, and the hair had a normal cross-sectional appearance.

No abstract