Pyoderma gangrenosum (PG) is frequently associated with constitutional symptoms as part of a nonspecific inflammatory response. However, extracutaneous discrete aseptic neutrophilic infiltrates are extremely rare. We report a patient with idiopathic PG with splenic and psoas muscle involvement. His disease was extremely aggressive and was unresponsive to conventional immunosuppressive therapy. His cutaneous and extracutaneous PG cleared with infliximab and adalimumab.

Our study has demonstrated a very high point prevalence (62.2%) of skin disease in rural Nepal. This study represents the first formal survey of skin disease in Nepal and demonstrates a large burden of disease, in particular treatable infections.

Background: Chronic atopic eczema is not regarded as a precursor of malignancy, and, to our knowledge, there has been only one previous case report of CD30 + cutaneous lymphoma in association with atopic dermatitis.Observations: We report 4 cases of CD30 + lymphoproliferative disease in young adult patients with active atopic eczema dating from early childhood. Three patients developed primary cutaneous anaplastic large cell lymphoma, of whom 2 developed systemic disease and 1 died. The other patient developed lymphomatoid papulosis type A, which resolved after withdrawal of cyclosporine therapy. No other patient had received immunosuppressive therapy.

The use of digital cameras by clinicians is increasing, and raises issues concerning patient consent and confidentiality. An online survey of members of the British Association of Dermatologists was conducted using an anonymous questionnaire. In total, 339 individuals completed the survey, a response rate of 37.6%. The survey shows that there are variations in the type of consent obtained by clinicians taking digital images of patients, and the methods used to store images are not always compliant with current UK legislation. Guidelines would help to improve and standardize the practice of clinicians who take digital images of patients.

Although solitary pilomatricomas are relatively common, multiple pilomatricomas occur rarely, in 2-3.5% of reported cases. The majority of cases of familial multiple pilomatricomas occur in association with myotonic dystrophy. The occurrence of multiple familial pilomatricomas in patients who are otherwise well is extremely rare. We describe a 29-year-old man with multiple pilomatricomas whose father and brother also had similar lesions. There is no history of myotonic dystrophy.