Perianal streptococcal dermatitis (PSD) is a recently described cutaneous entity caused by group A beta-hemolytic streptococci. It is characterized by perianal erythema, sometimes associated with functional disturbances. We describe four children (2 boys, 2 girls) who had acute guttate psoriasis and also PSD. One of these patients also had balanoposthitis. A fifth patient experienced an association of PSD and balanoposthitis without psoriasis. To our knowledge, the association between guttate psoriasis and PSD has only been reported in five children, and the one with balanitis has not been previously reported.

A 23-year-old girl affected by Papillon-Lefèvre syndrome developed, during Etretinate therapy (1 mg/kg/day), two liver abscesses caused by pyogenic bacteria and a subphrenic abscess. The immunological effects of retinoids may precipitate severe infections in patients with Papillon-Lefèvre syndrome, who probably have a basic, even though not always evident, defect of PMN chemotaxis.

Cancer continues to be one of the most important health problems worldwide, and the identification of novel drugs and treatments to address this disease is urgent. During recent years, marine organisms have proven to be a promising source of new compounds with action against tumoral cell lines. Here, we describe the synthesis and anticancer activity of eight new 3-alkylpyridine alkaloid (3-APA) analogs in four steps and with good yields. The key step for the synthesis of these compounds is a Williamson etherification under phase-transfer conditions. We investigated the influence of the length of the alkyl chain attached to position 3 of the pyridine ring on the cytotoxicity of these compounds. Biological assays demonstrated that compounds with an alkyl chain of ten carbon atoms (4c and 5c) were the most active against two tumoral cell lines: RKO-AS-45-1 and HeLa. Micronucleus and TUNEL assays showed that both compounds are mutagenic and induce apoptosis. In addition, Compound 5c altered the cellular actin cytoskeleton in RKO-AS-45-1 cells. The results suggest that Compounds 4c and 5c may be novel prototype anticancer agents.

The cases of 2 women with pyoderma gangrenosum (PG) and undifferentiated seronegative spondylarthropathy (SPA) are described. These 2 cases, together with the recently reported case of PG and B27-positive psoriatic spondylarthropathy, suggest that PG may also occur in association with forms of seronegative SPA that are different from primary ankylosing spondylitis (AS) and AS associated with inflammatory bowel disease.Pyoderma gangrenosum (PG) is a rare, chronic, ulcerating, inflammatory cutaneous lesion of unknown etiology (1-3). It starts as a painful nodule or sterile pustule that breaks down to form a progressively enlarging ulcer with a necrotic base and raised, rugged, violaceous, undermined edges, surrounded by a peripheral zone of intense erythema. The lesions may be solitary or multiple and may develop anywhere, but are most frequently located on the legs. Often, they develop at sites of skin injury (pathergic phenomenon). Despite distinctive clinical features, the histopathology is not specific.PG has been found in association with systemic diseases, including inflammatory bowel diseases (IBD), a variety of hematologic disorders, and arthritis (1-3). Both rheumatoid arthritis and ankylosing spondylitis (AS) have been reported in patients who have PG, with or without IBD (1-4). Recently, Smith and White reported the case of a B27-positive man with PG and psoriatic arthritis, which suggests that PG may also occur Supported in part by a research grant from the AISpA (Associazione Italiana Spondiloktrite).Ignazio Olivieri, MD, Angela Maria Costa, MD, Raffaela Marini, MD, Silvio Ferri, MD: S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy; Fabrizio Cantini, MD, Laura Niccoli, MD: Hospital of Prato, Prato, Italy.Address reprint requests to Ignazio Olivieri, MD, Servizio di Reumatologia, Policlinico S. Orsola-Malpighi, Via Massarenti 9, Bologna 40138, Italy.Submitted for publication April 27, 1995; accepted in revised form February 12, 1996. in association with other forms of seronegative spondylarthropathy (SPA) (5). We describe here the cases of 2 B27-positive women with PG and undifferentiated SPA. CASE REPORTSPatient 1. The patient, a 66-year-old woman, was referred to the Rheumatic Disease Unit of Prato Hospital in July 1990 for evaluation of arthritis of the left wrist and metacarpophalangeal (MCP) joints, which had begun 2 months before.Her medical history revealed that she had had a painful, large, skin ulcer of her right leg for 35 years that was attributed to venous insufficiency. The lesion did not respond to various topical treatments, including fullthickness skin grafting. In the previous 10 years, she had experienced short episodes of mechanical low back pain.Her family history revealed that her son had ulcerative colitis and that a sister living in a different city had been diagnosed as having a rheumatic inflammatory disease.Physical examination showed soft tissue swelling, tenderness, and warmth of the left wrist and MCP joints. Spine movement and chest expansion were norm...