We found a strong dose-response relationship between the number of cigarettes smoked daily and ischemic stroke among young men. Although complete smoking cessation is the goal, even smoking fewer cigarettes may reduce the risk of ischemic stroke in young men.

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Sweet syndrome (SS), or acute febrile neutrophilic dermatosis, is a rare painful skin condition that is characterized by hyperpyrexia, peripheral blood and skin neutrophilia, and edematous skin lesions. Necrotizing SS (NSS) is a severe and locally aggressive condition that histopathologically resembles a necrotizing soft tissue infection. As opposed to necrotizing soft tissue infections, NSS responds to systemic steroids. SS is divided into three subtypes: classical SS, malignancy-associated SS, and drug-induced SS. Within the malignancy-associated SS subtype, both solid tumor and hematologic malignancies have been precursors to developing SS. Here, we present a case of acute myeloid leukemia-associated NSS.

Epithelioid hemangioma (EH) is a benign vascular lesion, typically consisting of small vascular channels lined by epithelioid endothelial cells and associated with a dense lymphocytic infiltrate with eosinophils. Here, we report a rare case of EH involving large arteries. The patient presented with a 9-month history of an asymptomatic nodule on the forehead, which was thought to be an epidermal inclusion cyst. Skin biopsy revealed large arteries with clusters of epithelioid cells in the vascular walls and lumen. Scattered eosinophils were noted in the walls.Adjacent areas showed groups of small-caliber vessels lined by prominent endothelial cells and associated with a dense lymphoid infiltrate with eosinophils. No significant cytologic atypia was noted. Given the presence of the classic smallvessel involvement, along with CD31 reactivity for the epithelioid cells in the large vessels, the findings are classified as EH involving large arteries, which is an uncommon subtype. There have only been a handful of such cases reported in the literature.

Introduction: There is a strong dose-response relationship between smoking and risk of ischemic stroke (IS) in young women, but there are few data examining this association in young men. We examined the dose-response relationship between the quantity of cigarettes smoked and the odds of developing an IS in men under age 50. Methods: The Stroke Prevention in Young Men Study is a population-based case-control study of risk factors for IS in 1145 men ages 15-49. Controls were identified by random-digit dialing and were balanced to cases for geographic region of residence, age, and ethnicity. Logistic regression models were used to calculate the odds ratio for IS occurrence comparing smokers to never smokers. In the first model, we adjusted solely for age. In the second model, we adjusted for potential confounding factors, including age, race, education, hypertension, myocardial infarction, angina, diabetes mellitus and body mass index. Interaction terms were used to examine potential effect modification by other risk factors. Statistical tests were 2-tailed and P-values less than 0.05 were considered statistically significant. Results: The table shows that IS risk increased with amount of current smoking and that 2 packs per day current smokers had over a 5-fold increased risk of IS. There were no significant interactions with other risk factors. Conclusions: We found a strong dose-response relationship between the number of cigarettes smoked daily and IS among young men. While complete smoking cessation is the goal, even reducing the number of cigarettes smoked may reduce the risk of IS in young men.