Our study shows several new aspects of IAPP. Clinically, the lesions were most commonly hypopigmented and involved predominantly the extremities. Histologically, IAPP exhibited a spectrum of alterations in elastic fibers. The most prevalent form of IAPP in our country seems to be unassociated with morphea.

We conclude that MA is a primary idiopathic cutaneous lymphocytic arteritis that is limited to the skin.

Superficial morphea, a newly described variant of morphea, manifests clinically with hypopigmented or hyperpigmented patches that lack induration. The lesions show on biopsy dermal sclerosis in the superficial to mid-reticular dermis. So far, all cases reported in the literature were skin limited. In this report, we describe a 24-year-old female patient who developed at the age of 4 years plaques characteristic, both clinically and histologically, of superficial morphea. The patient developed later on psoriasis vulgaris. Although the association of scleroderma and psoriasis is rarely reported in the literature, most reports describe a progressive systemic course of scleroderma whenever the two diseases co-exist. This is the first report to describe superficial morphea in association with psoriasis and to provide a 20-year follow-up period during which the superficial morphea remained relatively stable with no evidence of systemic involvement.

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A 9-year-old previously healthy boy presented with a 3-d history of progressive mildly itchy lesions over the whole body associated with low grade fever. Lesions initially started over the abdomen and then spread to involve the extremities and face with sparing of the mucosa. Physical examination revealed a generalized rash consisting of vesicles on erythematous bases as well as large tense and flaccid bullae on the lower extremities (Figs 1 and 2). Two biopsies were taken, one from a vesicle and the other from a tense bulla, which also included part of the normal skin (Fig. 3). Both specimens revealed

A 48-year-old woman presented with isolated sixth cranial nerve palsy. She subsequently developed systemic lupus erythematosus (SLE) based on clinical and laboratory parameters. Three years later, she presented again with sixth cranial nerve palsy affecting the contralateral eye. Within 2 weeks of steroid initiation, complete recovery occurred. The unusual rare presentation of SLE in the current patient, as well as the pathogenesis and treatment of cranial neuropathy in SLE are discussed.

A 3-year-old boy presented with a 3-month history of multiple asymptomatic skin lesions on his forehead and limbs, which had been increasing in number. No associated fever or any systemic symptoms were noted. The child was otherwise healthy and on no medications. He had been born after an uncomplicated pregnancy and delivery, and his growth and development were appropriate for his age. On physical examination, multiple skin-coloured to erythematous, mildly tender papules and nodules, 10-30 mm, were found, mainly on the forehead, the proximal interphalangeal joints, and the periarticular areas near the elbow and knee joints (Fig. 1). Except for mild erythema, the overlying skin was normal. No other abnormalities were found. Laboratory studies, including haematological and blood chemistry tests, anti-streptolysin O titre, erythrocyte sedimentation rate, serum and urine protein electrophoresis, urinalysis, and levels of C-reactive protein, liver transaminases, serum aldolase, creatinine, thyroid-stimulating hormone and antinuclear antibodies were all within normal limits. A skin biopsy specimen was obtained from a nodule over the elbow (Fig. 2).

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