Persistent lip enlargement: An unusual presentation of lupus erythematosus

Macrocheilia is a challenging problem with a variety of underlying causes that are both local and systemic, and granulomatous causes underlie the majority of cases. In this study, we report on a 31-year old man who presented with a chronic lower lip enlargement and a nodular submental erythematous lesion. He was otherwise clinically healthy. Laboratory test results were within the normal limit except for a positive anti-double stranded DNA test result. A diagnosis of cutaneous lupus erythematosus was made on the basis of histopathology and direct immunofluorescence. The lesions resolved dramatically after treatment with hydroxychloroquine. Lupus erythematosus should be considered when examining patients who present with chronic lip swelling.

A study of familial aggregation of depression, dementia and Parkinson's disease

Depression is often accompanied by other disorders including Alzheimer's disease and Parkinson's disease. We studied the familial aggregation of these disorders in order to examine the possibility of a shared genetic origin. In a population-based study of 6596 subjects, we studied the association of self-reported depression, which required treatment by a psychiatrist, to family history of psychiatric disease, dementia, and Parkinson's disease. A family history of psychiatric disease was significantly associated with overall depression as well as with unipolar (n = 303 patients) and bipolar (n = 27 patients) depression. The risk of unipolar depression was associated with the presence of two or more demented individuals among their first degree relatives (e.g. parents, siblings and children). Since there was no evidence for familial aggregation in subjects with only one demented relative, our study suggests that unipolar depression may be associated specifically to a strongly familial, form of dementia. The risk of bipolar depression was increased for those with one or more relatives with dementia and, perhaps, for those with relatives with Parkinson's disease. The familial aggregation of depression with dementia and perhaps Parkinson's disease suggests that there may be shared susceptibility gene(s) underlying these diseases. Our study indicates further that there may be differences in the genetic etiology between unipolar and bipolar depression.

Lipophilin (PLP) gene in X-linked myelin disorders

There are several X-linked diseases in animals and at least one in man in which there is a failure of CNS myelination. We have recently cloned cDNAs for lipophilin (PLP) with which PLP sequences were localized to a region of the long arm of the X chromosome (Xq13-q22 in man) close to the jimpy (jp) locus in that mouse mutant. The present communication pursues the postulate that some of this class of diseases may involve mutations at the PLP locus. Blot hybridization analysis of PLP mRNA levels revealed a five-to tenfold reduction in the brains of hemizygous jp/Y mice. The major PLP mRNA species of those mice was also reduced in size. However, Southern blots of jp DNA digested with many different restriction enzymes failed to detect major deletions or other rearrangements in the PLP gene. A human PLP cDNA was isolated and employed to similarly analyze DNA from four patients diagnosed as having Pelizaeus-Merzbacher disease. In one of these four a significant rearrangement of the PLP gene was found. These findings suggest that there may be alterations in the PLP gene in both jp mouse and Pelizaeus-Merzbacher disease.