Nevus leiomyomatosus systematicus

Leiomyomas of the skin are classified as pilar, genital, or angioleiomyoma depending on the site of origin. Pilar leiomyomas are the most common form, and usually multiple tumors are found in a single patient. An unusual variant of multiple pilar leiomyoma is nevus leiomyomatosus systematicus, a descriptive term used when tumors are wide-spread and patterned, suggesting a nevoid condition. Many of the large pilar tumors are painful and require surgical excision for relief of symptoms.

Hair implant complications

Four men who underwent hair implantation for pattern baldness were treated for complications such as infection, foreign-body reaction, pruritus, and scarring. The complications were similar to those reported with synthetic modacrylic fiber implants that have been used for the same purpose. Although we believe this is the first article to report complications from hair implants, the illogical basis of the procedure suggests that complications will occur in many unsuspecting patients who undergo hair implantation.

Fiber implantation for pattern baldness. Review of complications in forty-one patients

Forty-one patients who underwent one technic of fiber implantation for pattern baldness were studied. Complications were frequent and included rejection of fibers, infection, facial swelling, pain, pruritus, and scarring. In addition, patients incurred risks of carcinogenesis from deeply embedded bits of fiber and also loss of their own natural hair. Fiber implantation is an unsuccessful method of hair restoration, and its use has been discouraged by state and federal agencies.

Cutaneous macroglobulinosis

A patient with Waldenström's macroglobulinemia had firm, translucent papules and nodules on the extremities. Clinically, the skin lesions were suggestive of amyloidosis cutis. Histologically, a homogeneous eosinophilic material was observed in the upper dermis and encasing the hair follicles. Special histochemical stains, electron microscopy, and immunofluorescence microscopy identified the material as IgM.

Annular elastolytic giant cell granuloma. A clinicopathologic study of five cases and a review of similar entities

Five patients with annular lesions of the face, scalp, and other exposed surfaces were studied using the radial triple zone biopsy technic. Interestingly, one of the patients had necrobiosis lipoidica diabeticorum (NLD) and another had systemic sarcoidosis. Clinically, the lesions were annular patches with erythematous borders and hypopigmented centers. The histopathology of the lesions showed many multinucleated giant cells, (often with prominent asteroid bodies), histiocytes, lymphocytes, scattered epithelioid cells, total lysis of elastic tissue, no necrobiosis, and absence of both mucin and lipid. This entity can be differentiated from granuloma annulare (GA), NLD, and cutaneous sarcoidosis. It is identical with several previously described entities; we propose a more appropriate term: "annular elastolytic giant cell granuloma (AEGCG)."

Combination therapy for psoriasis. Psoralens plus long-wave ultraviolet radiation with betamethasone valerate

In the treatment of psoriatic patients with psoralens plus long-wave ultraviolet radiation (PUVA), clearing of psoriatic lesions was obtained more quickly and with smaller doses of ultraviolet light when topically applied corticosteroid therapy was added. Twelve patients with symmetrical plaque-type psoriasis were given PUVA on one side of the body and PUVA plus betamethasone valerate on the other side in a paired comparison study. Ten of the patients had faster clearing of lesions on the side that was treated with PUVA and betamethasone than on the side treated with PUVA alone. The other two patients had equal clearing on both sides. All patients remained clear of lesions during maintenance with PUVA alone for at least five months after steroid therapy was discontinued. Combination therapy may save the patient time, expense, and unnecessary exposure to radiant energy.

Fiber implantation for pattern baldness

Examination of 20 patients who had fiber implantation for the treatment of pattern baldness showed that nearly all the fibers had fallen out by ten weeks. Complications observed were facial swelling, infection, foreign-body granulomas, scarring, and permanent hair loss. Scanning electron microscopy identified the fibers as modacrylic fibers. The complications, high monetary cost, and ultimate futility of fiber implantation make it an unacceptable procedure.

Treatment with benzoyl peroxide of ulcers on legs within lesions of necrobiosis lipoidica diabeticorum

A lotion of 20% benzoyl peroxide was applied to ulcers on legs from necrobiosis lipoidica diabeticorum. The ulcers healed rapidly and uneventfully, leaving firm, yellow scars. The efficacy and simplicity of use of topical benzoyl peroxide therapy is discussed.

Mycobacterium marinum infections treated with tetracycline

Five cases of Mycobacterium marinum skin infections were successfully treated with 2 gm of tetracycline hydrochloride daily for periods from four to 12 weeks. In each case, the isolated M marinum was sensitive in vitro to tetracycline at levels from 25 to 50 microgram/ml. Tetracycline is recommended as treatment for extensive or sporotrichoid M marinum infections.