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Human scabies (infestation with the mite Sarcoptes scabiei var hominis) causes a significant disease burden worldwide, yet there are no agreed diagnostic guidelines. We aimed to determine whether a consistent approach to diagnosing scabies has been used for published scabies therapeutic trials. The data sources used were the MEDLINE, Embase and Cochrane databases, from 1946 to 29 August 2013. Eligible studies were trials of therapeutic interventions against scabies in human subjects, published in English, enrolling patients with scabies, and using various therapeutic interventions. Language was a limitation of this study as some relevant trials published in languages other than English may have been excluded. Each study was reviewed by two independent authors, who assessed the clinical examination and testing approaches used for scabies diagnosis in the included studies. We found that of 71 included trials, 40 (56%) specified which clinical findings were used for diagnosis, which were predominantly rash, rash distribution, pruritus and mite burrows. Parasitological testing was used in 63% of trials ( n = 45) and was used more frequently in clinic-based than in field studies. Nearly one-quarter of trials (24%, n = 17) did not define the diagnostic method used. Overall, the diagnostic approaches were poorly described, prohibiting accurate comparison of existing studies. This review further supports the need for consensus diagnostic guidelines for scabies. [ABSTRACT FROM AUTHOR]

The aim of this study was to examine trends in the presentation of cutaneous malignant melanoma at King's College Hospital (KCH) over the last three decades (1970–2000). KCH was one of seven centres that participated in the 1987 Cancer Research Campaign (CRC) publicity campaign aimed at promoting earlier self-recognition of melanoma. Data included patient age at presentation, sex, tumour site, Breslow thickness and histological subtype. The late 1980s saw a threefold increase in the annual number of melanomas and an eightfold increase in thin melanomas compared to the 1970s. The increase occurred in both sexes and was particularly marked after the CRC campaign but numbers had already begun to increase prior to this. The increase has predominantly been thin (Breslow < 1.5 mm) tumours of the superficial spreading variety with a resultant fall in mean Breslow thickness. There has been a decline in the annual number of melanomas since the peak in 1992 which is not explained by increased proportion of in situ tumours. The CRC campaign may have contributed to the documented increase in thin tumours but this trend had begun prior to 1987 suggesting factors other than public awareness and earlier presentation are important. It is encouraging that the number of melanomas has declined over the last 5 years at KCH but it is yet to be seen whether this reflects a real decrease in the incidence of melanoma. [ABSTRACT FROM AUTHOR]

A 4-year-old girl presented with a linear, indurated area of dusky erythema and hyperpigmentation down the left leg, present since birth. Histology suggested syringomata. The clinical course and appearances suggest a novel entity for which we have coined the term ‘linear syringomatous hamartoma’. [ABSTRACT FROM AUTHOR]

Summary Fixed drug eruption is characterized by recurrent well-defined lesions appearing in the same location each time the drug responsible is taken. A number of agents have been implicated. Metronidazole, a nitroimidazole agent widely used for its antibacterial and antiprotozoal activity, has been reported only rarely as the causative agent. We describe a patient with FDE due to metronidazole in whom we were able to induce the clinical and histological features of FDE by topical provocation testing. In agreement with the published literature we commend the use of topical provocation testing as a possible first-line investigation in the diagnosis of FDE. This may avoid the need for subsequent oral provocation testing and therefore the prevention of possible adverse sequelae. [ABSTRACT FROM AUTHOR]

The article presents a case study of 20-year-old man presented with a unilateral, hyperpigmented, papular, scaly eruption on his trunk, following the lines of Blaschko. The patient underwent histological examination which revealed a burnt-out lichenoid dermatosis, with subsequent pigment incontinence. He was diagnosed with a linear lichenoid drug eruption secondary to isotretinoin.

A letter to the editor is presented which describes a case of sebaceous gland hyperplasia (SGH) due to the highly active anti-retroviral therapy (HAART) in a 48-year-old HIV-positive Ugandan woman.

A case study of a 46 year old Jamaican car painter presented with an 8 month history of pain and swelling over the left side of his chin, which sometimes discharged purulent material. On examination there were three hard, indurated foci over the left chin. Inspection of the oral cavity revealed severe, chronic periodontal disease involving the lower left premolar teeth. Scanning of the jaw revealed periodontal disease with overlying soft tissue inflammation and evidence of marrow change consistent with low-grade osteomyelitis. It was diagnosed to be cervicofacial actionmycosis. Actinomyces israelii is a Gram-positive anaerobic bacillus which comprises a heterogeneous group related to mycobacteria but resembling fungi.