Search

The cutaneous signs of diabetes have been reviewed in the past. This review shpeds new light on old associations. Some skin signs of diabetes are questioned and additional cutaneous manifestations of diabetes are described herein.

Eosinophilic fasciitis (EF, a diffuse fasciitis with eosinophilia) is a recently recognized connective tissue disorder. It consists of deeply indurated, bound-down plaques of skin and subcutaneous tissue, most commonly present on the extremities. It is associated with peripheral eosinophilia, hypergammaglobulinaemia and an elevated sedimentation rate. There is usually no evidence of Raynaud's phenomenon, acral sclerosis or visceral involvement. Antinuclear antibodies are usually absent. The abnormal histopathology primarily involves the lower subcutis and the fascia. The clinical and laboratory features usually improve following the administration of systemic corticosteroids. Serious haematological abnormalities have been associated with eosinophilic fasciitis (EF) and have been discussed in detail. The similarities and distinctions between eosinophilic fasciitis and scleroderma have been discussed.

An awareness of the cutaneous signs of diseases of the pancreas is extremely valuable. They alert the astute examiner to several life-threatening problems that result from both benign and malignant islet cell tumors, adenocarcinomas of the pancreas, and pancreatic endocrine and inflammatory diseases. Many of the cutaneous manifestations of pancreatic disease are discussed in detail, with emphasis on both the clinical presentation and pathogenesis.

Hydroa vacciniforme is a rare, chronic photodermatosis with onset in childhood. Multiple exposures to UV-A reproduced the symptoms and the vesicular and scarring lesions typical of the sun-induced disease in our patient. Treatment with hydroxychloroquine sulfate, but not indomethacin, reduced the photosensitivity both to sunlight and to artificial UV-A light. Serum complement levels were low while the disease was active and returned to normal after treatment of the patient with hydroxychloroquine.

A method is presented for the separation of epidermal strata by the successive elimination of either the basal or basal and spinous cells with 0.24 M NH4Cl at pH 9.5. Histologic evidence suggests that the residual epidermal strata obtained after incubation of the skin with NH4Cl are reproducible; hence, this technique circumvents loss of granular layer histidine-rich protein inherent with trypsin separation and provides an effective procedure for biochemical analysis of arginine-rich and lysine-rich proteins in the various differentiating epidermal cells.

An awareness of various dermatoses which reflect internal malignancy will facilitate the physician's ability to recognize or even anticipate malignant disease. There have been several previous reports on this subject. This review emphasizes the nonspecific cutaneous changes associated with malignancy. New skin markers of cancer are also discussed.