Germline mutation in ATR in autosomal- dominant oropharyngeal cancer syndrome.

ATR (ataxia telangiectasia and Rad3 related) is an essential regulator of genome integrity. It controls and coordinates DNA-replication origin firing, replication-fork stability, cell-cycle checkpoints, and DNA repair. Previously, autosomal-recessive loss-of-function mutations in ATR have been demonstrated in Seckel syndrome, a developmental disorder.

Subacute cutaneous lupus erythematosus exacerbated or induced by chemotherapy.

Background: Subacute cutaneous lupus erythematosus (SCLE), characterized by nonscarring, photodistributed, annular or papulosquamous plaques, is occasionally induced by medication. It has been strongly associated with antihypertensive medications and terbinafine hydrochloride.

Observation: We describe 3 women with breast cancer who developed SCLE-like eruptions after being administered doxorubicin hydrochloride and cyclophosphamide.

African tick bite fever: a not-so-uncommon illness in international travelers.

Background: African tick bite fever is a rickettsial illness that has recently emerged as a significant disease among international travelers. The vector is the Amblyomma tick, which is endemic to sub-Saharan Africa and parts of the eastern Caribbean.

Observations: We describe a middle-aged woman who returned from a mission trip to Zimbabwe with an influenzalike illness and inoculation eschar; she also had a history of travel to a game farm.