Fibroblasts from patients with active NFD are either activated to synthesize elevated levels of HA or contain another cell type, possibly derived from circulating fibrocytes. In both disorders, there is additionally a serum-derived factor that stimulates production of sulphated GAGs and HA by fibroblasts.

Schistosomiasis is endemic in many parts of the tropics and subtropics with an estimated 200 million people, at least, infected worldwide. The symptoms and signs of vesical and gastrointestinal forms are readily recognized but ectopic forms are rare even in endemic areas and present a greater diagnostic challenge, particularly when they are encountered in nontropical climes. We now report two cases of cutaneous schistosomiasis presenting in Edinburgh with subtle, but remarkably similar, skin lesions.

A C-insertion polymorphism in the NOD2 gene (3020insC) on chromosome 16 is a rare mutation associated with Crohn's disease. Crohn's disease and psoriasis are more commonly observed together than expected by chance. Furthermore a susceptibility locus for psoriasis has been identified on chromosome 16q which overlaps the recently identified susceptibility locus for Crohn's disease. Thus, NOD2 may potentially be important as a candidate susceptibility gene for psoriasis. We tested this hypothesis by genotyping psoriasis patients for the C-insertion polymorphism using the Taqman ABI 7700 sequencing system. No statistically significant differences were observed between psoriasis vulgaris (n = 216), palmo-plantar pustular psoriasis (PPP) (n = 100), guttate psoriasis (n = 118) and the control group (n = 283). In both patient and control groups, no mutant homozygotes were observed and approximately 4% were heterozygotes. This particular insertion mutation in the NOD2 gene does not appear to contribute to the genetic susceptibility of psoriasis vulgaris, PPP or guttate psoriasis. However, other mutations exist in the NOD2 gene, which may potentially have a role in psoriasis susceptibility.

Therapeutic options for cutaneous T cell lymphoma (CTCL) include topical steroids, topical chemotherapy and phototherapy. Patients with limited disease that is unresponsive to these therapies present a particular challenge. We report successful treatment of a patient with two plaques of CTCL using topical photodynamic therapy (PDT). 5-aminolaevulinic acid (5-ALA) was applied 6-24 h preillumination with 100 J/cm2 red light. Treatment was repeated on four occasions with clinical and histological clearance. ALA-PDT may be a useful addition to the therapeutic options for CTCL. Further studies are required to define optimal treatment protocols.