The use of antibacterial sulfonamides, anticonvulsant agents, oxicam NSAIDs, allopurinol, chlormezanone, and corticosteroids is associated with large increases in the risk of Stevens-Johnson syndrome or toxic epidermal necrolysis. But for none of the drugs does the excess risk exceed five cases per million users per week.

No abstract

The CORRESPONDENCE department of the Archives is meant to provide a forum for exchange of ideas about cutaneous medicine and surgery, and is divided into two sections. The COMMENTS AND OPINIONS section is intendedfor responses to articles previously published in the journal or for comments on philosophic and practical issues pertaining to dermatology. If an Archives article is discussed, the letter should contain this reference and be received within two months of the article's publication. The VIGNETTES section contains ministudies, very short case reports, rapid publications, and preliminary observations that lack the data to qualify as fulljournal articles.We encourage submission of letters for publication in the CORRESPONDENCE section. Acceptance is contingent on editorial review and space available. Correspondence should be double\x=req-\ spaced, submitted in triplicate, and be clearly marked "forpublication."Correspondence should not exceed 500 words, contain more than five references and two figures, and must include a copyright transfer statement (see Information for Authors and Readers) when submitted. Bacteria in Epidermal CystsTo the Editor.-Brook' provides an interesting tabulation of the microbiology of inflamed and allegedly "infected" epi¬ dermal cysts. He defines an infected cyst as one that has

Objective To study the association of a variety of dermatological manifestations related to vascular abnormalities with antiphospholipid antibodies in patients with suspected primary antiphospholipid syndrome.Method Case-control study. Consecutive patients referred to the coagulation and haemostasis service of a general hospital for the first determination of antiphospholipid antibodies (lupus anticoagulant and anticardiolipin antibodies) and newly diagnosed disorders (for example, thrombocytopenia, thrombotic disorders, and unexplained repeated abortions) were selected. Patients were examined by two dermatologists according to predefined criteria, and information about general characteristics and relevant dermatological and medical histories were coliected using an ad hoc questionnaire. The study was limited to patients without evidence of systemic lupus erythematosus. A total of35 patients was examined; 13 subjects were positive for lupus anticoagulant or anticardiolipin antibodies, or both (cases), and 22 were negative (controls).Results Moderate to severe livedo reticularis and acrocyanosis were significantly associated with antiphospholipid antibodies, with relative risks of 13-1 (95°/0 confidence interval 1.1 to 149-0) and 8-6 (950/o confidence interval 1-1 to 65.1). Capillaritis was also associated with the antibodies. Histories of Raynaud's phenomenon and superficial thrombophlebitis were more common in cases than controls.Conclusions This study provides quantitative evidence of the association of antiphospholipid antibodies with several cutaneous diseases in which vascular abnormalities seem to play a major part.The study suggests that these manifestations might appear early in the development of the antiphospholipid syndrome.

We report a case of malignant melanoma that appeared in a 56-year-old man with mycosis fungoides (stage la) during treatment with PUVA. The cumulative UVA dose was 1 177 J/cm2. The pigmented lesion was removed and PUVA therapy discontinued. Histological examination revealed a superficial spreading malignant melanoma (1.77 mm thick, Clark level IV). The delayed-type cutaneous hypersensitivity was studied. The presence of a second malignancy after mycosis fungoides and PUVA therapy may have been coincidental. Nevertheless, this case suggests that the immunosuppression induced by mycosis fungoides and by PUVA therapy might be a pathogenetic factor in the development of malignant melanoma.