Antibacterial activity of lidocaine in combination with a bicarbonate buffer.

Background: The antibacterial properties of lidocaine have been previously described. Recent reports indicated that the addition of NaHCO3 to lidocaine reduces the pain associated with the injection. This study was conducted to determine the antibacterial activity of lidocaine buffered with NaHCO3.

Scleredema and smoldering myeloma.

A 46-year-old white man had classic findings of scleredema; subsequently, a monoclonal immunoglobulin G lambda light chain was detected in his serum. Findings of a bone marrow biopsy specimen revealed that he had an increased percentage of plasma cells, some of which were atypical. A diagnosis of scleredema and smoldering myeloma was made.

Acanthosis nigricans and a rectal carcinoid.

Malignant acanthosis nigricans is often related to adenocarcinomas of the gastrointestinal tract, but it has also been found to coexist with tumors of the amine precursor uptake and decarboxylation system. It can precede, accompany, or follow the appearance of the underlying tumor. Evaluation of our patient's new-onset acanthosis nigricans led to the discovery of an asymptomatic rectal carcinoid tumor.

Lichenoid drug eruption secondary to propranolol.

Propranolol, a widely prescribed beta-adrenergic receptor blocker, has occasionally been associated with adverse cutaneous reactions. We present a case of ulcerative lichenoid drug eruption of the penis secondary to propranolol therapy. This unusual clinical presentation has not been described previously in the literature.