Photo quiz. Erythema infectiosum.
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Biomedical subjects
Publications and source records attributed to D M Elston.
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Granuloma faciale is a chronic benign vasculitis that generally affects the skin of the face. The lesions are commonly refractory to therapy. A patient with long-standing granuloma faciale refractory to topical corticosteroid and dapsone therapy had an excellent response to treatment with the pulsed dye laser.
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Agave americana is a low growing, thick, long-leaved, subtropical plant used for medicinal, commercial, and ornamental purposes. The plant's sap contains calcium oxalate crystals, acrid oils, saponins, and other compounds. Despite these known irritants, Agave-induced irritant dermatitis has rarely been reported. Previous case reports have noted a papulovesicular eruption consistent with an irritant contact dermatitis. We report a case of Agave-induced purpura in an otherwise healthy patient. Histopathology was consistent with an evolving leukocytoclastic vasculitis.
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Head lice remain a common problem worldwide. As resistance to available therapeutic agents can emerge rapidly, there is a need for continued research to find new and better agents. Until better agents are available, clinicians may find that rotational therapy, using different agents, may help to slow the emergence of resistance. Physical modalities, such as mechanical nit and louse removal and occlusive agents to asphyxiate the lice, should not be ignored, especially in light of our limited therapeutic armamentarium. All therapeutic agents are doomed to failure if infestation is allowed to recur. Classmates, playmates, and family members of infested children should be inspected for head lice. Efforts should be directed at fomite control and nit removal. Louse infestation must be addressed as a community-wide problem. Body lice remain important vectors of disease. War, natural disaster, and poverty favor the spread of body lice. As we work to solve these seemingly eternal problems, we must develop better agents to treat infestation and prevent the spread of body lice.
Cutaneous squamous cell carcinomas may cause death by metastasis or by local extension. We describe a deeply invasive cutaneous squamous cell carcinoma that caused death by direct extension into the brain.
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Nevoid basal cell carcinoma syndrome (NBCCS) is rare in black persons. We describe an 11-year-old black boy with NBCCS who presented with exotropia and a painful, expanding, cystic mass in the left posterior alveolar ridge. Further examination revealed odontogenic keratocysts with palmar and plantar pitting. Less than 5% of reported patients with NBCCS are black. To our knowledge, this is the first report of a black patient with NBCCS presenting with exotropia and an impacted molar displaced into the orbit by an odontogenic keratocyst.