Eleven infants, 4 to 5 months old, treated for napkin (diaper), seborrhoeic or atopic dermatitis with topical fluorinated steroids, developed granulomatous lesions in the napkin area. Seven patients were followed up for more than 6 months: in four of them the granulomatous lesions regressed leaving lax atrophic scars. It is suggested that fluorinated steroid creams and plastic pants are the precipitating causes.While the pathogenesis of granuloma infantum (Tappeiner & Pfleger, 1971) still remains to be fully elucidated, most authors {Bazex et al., 1972;Delacretaz et al., 1972;Uyeda et al.^ 1973) believe that the use of topical fluorinated steroids is a major precipitating factor.The occurrence of eight new cases in 1979 and the persistence of atrophic lax scars in the first cases which we were called upon to treat in 1975, prompted us to review the subject. Case reportsCase I. An infant boy, was referred to us in 1975 at the age of 4 months, with an erythematous dermatitis in the napkin area and with reddish blue, cord-like nodular perianal lesions, which had been treated for long periods with fluorinated steroids. Mycological investigations showed the presence of Candida albicans. Following treatment with wet compresses, the lesions disappeared in 2 months. Case 2. An infant boy, was referred to us at the age of 5 months in 1975. From the second month of life he had severe seborrhoeic dermatitis involving the inguinal regions and was 0307-6938,81 0100-0023 S02.00 0 1981 Blackwell Scientific Publications 23 E.Bonifazi et al.

The intestinal mucosa contains most of the total lymphocyte pool and plays an important role in viral transmission, but only slight attention has been given to the immunological and virological aspects of human immunodeficiency virus-1 (HIV-1) infection at this site. In this study, before initiating or changing antiretroviral therapy, paired blood samples and rectal biopsies (RB) were obtained from 26 consecutive HIV-infected subjects. HIV-1 isolation and biological characterization, DNA, and HIV-1 RNA titration were assessed, as were in vitro tumor necrosis factor-alpha (TNF-alpha) and interleukin-beta (IL-1beta) spontaneous production. The rate of HIV-1 isolation from peripheral blood mononuclear cells (PBMCs) and RBs was 75% and 58%, respectively. All RB-derived isolates were nonsyncytium inducing (NSI), independent of the phenotype of blood-derived isolates. Proviral DNA and detectable HIV-1 RNA levels were measured in 100% and 77% of RBs, respectively. A statistical correlation was observed between HIV-1 DNA and HIV-1 RNA levels in rectal mucosa (P = 0.0075), whereas no correlation was found between these levels in blood samples (P > 0.05). Antiretroviral treatment did not seem to influence HIV-1 detection in RBs. Higher levels of in vitro proinflammmatory cytokine production were found in the RBs of most infected patients when compared with healthy controls. Therefore, the rectal mucosa is an important HIV-1 reservoir that demonstrates a discordant viral evolution with respect to blood. Both the virus type and the mucosa pathway of immunoactive substances might have important implications for therapeutic decision-making and monitoring and could influence the bidirectional transmission of HIV-1 in mucosal surfaces.

A staged histological study of skin changes induced in rabbits by daily application of five bases used for topical medicaments and cosmetics, namely glycols, petrolatum, Modulan, Acetulan and Amerchol L 101, over periods of 100 days, is reported. Sections obtained every 10 days were examined for changes in the epithelium, in the character of the dermal infiltrate and in the superficial collagen fibers. Glycols showed no particular effects on the skin; petrolatum produced acanthosis and vacuolization in the epidermis, and mononuclear cell infiltration of the dermis but evident collagen changes. Lanolin derivatives produced acanthosis and vacuolization of the epidermis, with lymphomonouclear infiltration of the dermis and with dissociation of collagen; examination around the 30th day showed a tendency to basal layer disorganization by the infiltrate.

The authors present four cases of infection due to Anisakis in an area where people are prone to infectious diseases transmitted by raw fish, but in which the presence of this parasite has never been reported. Three of four cases were discovered accidently during surgical procedures for co-existing abdominal pathologies. Raw fish was apparently not involved in all patients. Characteristics of the patients are discussed.

Twenty subjects with allergic contact dermatitis were patch tested with the responsible allergen applied to four fixed points on the back. Skin biopsies of the four sites were obtained after 6, 12, 24 and 48 hours, fixed in neutral formalin and stained with hematoxylin-eosin, Giemsa and toluidine blue. Sections were examined and lymphomonocytes, mast cells, eosinophils and basophils counted. In all cases the infiltrate consisted mainly of lymphomonocytes (80-82%); mast cells (5%) and basophils (0.2%) do not present clear variations within the given time. Eosinophils showed a definite numerical increase in six cases out of 20.