Search

We have described a 38-year-old white American woman who had a 7-year history of pain in the left anterior chest, neck, right wrist, and buttocks. The pain fluctuated in severity and appeared to coincide with worsening of her skin condition, palmoplantar pustulosis (PPP). She manifested the typical skeletal features of an arthritic condition referred to as pustulotic arthro-osteitis, which is frequently associated with the characteristic rash of PPP. This is an infrequently described disorder in the United States, possibly reflecting lack of familiarity or confusion with related disorders.

A diagnosis of systemic lupus erythematosus (SLE) was established in a 54-year-old woman with a compatible history, as well as patchy alopecia, anemia, arthralgias, and a positive LE cell preparation. Sixteen months later bilateral hilar and mediastinal lymph nodes appeared on chest roentgenogram. Sarcoidosis was diagnosed when hypercalcemia and noninfectious, noncaseating epithelioid granulomas were found in the skin and liver. The sarcoidosis remitted with corticosteroid therapy, but slowly advancing renal failure ultimately resulted in the patient's death. We believe the concurrence of SLE and sarcoidosis had not been previously reported in the English literature. Immune mechanisms are discussed.

Yeasts belonging to the genus Torulopsis, though generally considered saprophytes, are capable of causing serious illness in compromised patients. Torulopsis infections in patients with no apparent underlying disease are rare. We have described a previously healthy man who had osteomyelitis due to Torulopsis holmii as a complication of a penetrating hand injury. Despite in vitro susceptibility of the organism to amphotericin B and flucytosine and prolonged therapy with these agents, the infection relapsed after an apparent initial response.

INFECTION of articular and paraarticular tissue by Mycobacterium marinum is reported infrequently. In a recent review of atypical mycobacterial joint infections, 1 only one was diagnosed and treated without surgery. Even in that case, drug therapy (aminosalicylic acid, isoniazid, and streptomycin sulfate) was considered "empirical" and probably not related to healing. 2 In our case, the diagnosis was made without surgical biopsy, and excellent response was obtained through drug therapy alone. Report of a Case A 55-year-old man, previously in good health, sustained a puncture wound over the palmar surface of the second digit of the right hand at the site of the metacarpophalangeal (MCP) joint from a fish fin (red snapper, saltwater fish, nonfrozen). The wound occurred during his work in a meat market and subsequently healed. One week after injury, swelling, erythema, and increased temperature developed on the dorsal surface of the second right MCP joint. Within another