A patient with erythema elevatum diutinum (EED) developed pyoderma gangrenosum (PG). Investigation revealed an IgA kappa monoclonal gammopathy. Previous reports of PG in association with EED are reviewed and the spectrum of the neutrophilic dermatoses discussed.

Ticks are blood-sucking parasites of vertebrates that may embed in human skin and are therefore of clinical relevance to dermatologists and their medical colleagues. Depending on the species involved, consequences of tick attachment vary from minor local reactions to significant systemic sequelae. It is possible to minimize morbidity by removing the tick in its entirety as soon as it is detected. Some techniques to achieve this are described. This review will aid clinicians in the recognition and practical management of tick bites in Australia.

Four Afghani refugees with cutaneous leishmaniasis presented to the dermatology clinic at the Women's and Children's Hospital in Adelaide. Three of the patients had biopsy-proven cutaneous leishmaniasis that was treated initially with topical and then oral ketoconazole, without success. Intralesional sodium stibogluconate was then used for these patients with good results. The fourth patient had several plaques of biopsy-proven cutaneous leishmaniasis, for which cryotherapy was used. This was quite efficacious; however, a small area of recurrence required re-treatment. Leishmaniasis is rarely seen in Australia, but an index of suspicion is warranted when treating persons with typical clinical features who are from endemic regions.

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The clinical features of 35 cases of Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP) seen over an 8 year period were reviewed with regard to age and gestational stage of onset, evolution and severity of disease and response to therapy. The histologic features in biopsies from 15 patients were analysed for pattern and extent of inflammatory change and the composition of the inflammatory cells were studied with a panel of monoclonal antibodies. This study confirmed PUPPP to be a well defined clinical entity mainly occurring in young primagravidas in the third trimester and usually responsive to topical treatments. Histologically, perivascular upper and mid-dermal inflammatory changes were present in all biopsies with epidermal spongiosis and vesiculation a prominant feature in many cases. The inflammatory infiltrate was composed of an admixture of T lymphocytes and macrophages.Keywords: Pruritic urticarial papules and plaques of pregnancy (PUPPP); Clinical histologic features; Monoclonal antibodies 0926-9959/96/515.00 © 1996 Elsevier Science B.V. All rights reserved SSDI 0926-9959(95)00108-5