The causes of nail apparatus pigmentation presenting to a melanoma screening clinic a prospective study.

Background: Advanced stage primary cutaneous malignant melanoma (PCMM) has a high mortality. PCMM may affect any area of the skin, including the nail apparatus (malignant melanoma or subungual melanoma). Although nail apparatus malignant melanoma (NAMM) is rare, delayed diagnosis carries a poor prognosis.

Cutaneous manifestations of phosphate solution extravasation.

Extravasation injuries are common in patients receiving multiple intravenous infusions. Although such injuries are closely associated with the infusion of cytotoxic chemotherapy, they have also been been associated with extravasation of noncytotoxic drugs. Extravasation injuries can lead to skin ulceration and nerve and tendon damage, and therefore to permanent disability.

Effect of tissue shrinkage on histological tumour-free margin after excision of basal cell carcinoma.

Background: Histology reports of skin tumour excisions frequently describe a histological margin significantly less than the planned surgical excision margin.

Objectives: A novel method of marking visible tumour margin was devised. This allowed us to evaluate the accuracy of tumour detection and to compare tissue contraction of the clinically normal perilesional skin with that of tumour tissue following excision and fixation.

Do antineutrophil cytoplasmic antibodies (ANCA) play a key role in neutrophilic dermatoses? A case of propylthiouracil-induced neutrophilic dermatosis with positive perinuclear ANCA.

We report a case of neutrophilic dermatosis caused by propylthiouracil (PTU), with positive perinuclear antineutrophil cytoplasmic antibodies (p-ANCA). PTU is well known to cause vasculitis associated with positive ANCA titres, and this typically occurs late in the treatment (after months to years). PTU rarely causes neutrophilic dermatoses (three case reports).

Perioperative international normalized ratio level is a poor predictor of postoperative bleeding complications in dermatological surgery patients taking warfarin.

Background: When planning dermatological surgery with patients on warfarin, clinicians must balance the risk of bleeding complications against that of a thrombotic event if anticoagulation is interrupted.

Objectives: To evaluate the frequency of bleeding complications in warfarinized subjects undergoing cutaneous surgery, and to correlate the risk of bleeding with the international normalized ratio (INR) at the time of surgery.

Methods: In this prospective controlled observational study, 65 patients on warfarin underwent excision of 70 cutaneous tumours.

Cutaneous extramedullary hemopoiesis in chronic myeloproliferative and myelodysplastic disorders.

Cutaneous extramedullary hemopoiesis (EMH) is a rare complication of chronic myeloproliferative and myelodysplastic disorders. Chronic idiopathic myelofibrosis (CIMF) is the most common underlying condition. To date, fewer than 30 cases have been reported in the literature and there has been significant confusion with regard to the proposed pathogenesis.

Spontaneous clinical improvement in HIV-associated follicular syndrome.

Since 1991 infrequent reports have described a distinctive triad of nodulocystic acne, striking follicular spines and an eruption resembling pityriasis rubra pilaris (PRP) in HIV-positive patients. It has been suggested that this may represent a subtype of PRP, or alternatively that it should be viewed as a unique HIV-associated follicular occlusion triad. Clinical manifestations may be severe, and in several cases have been ultimately fatal, with death occurring due to complications of cutaneous sepsis.