A single masked trial of cyclosporin A 5 mg/ kg/day versus monthly 1 g intravenous boluses of cyclophosphamide was conducted among 23 patients with Behset's syndrome and active, potentially reversible uveitis. The trial was unmasked after a mean of 12 (SD 2) months for the cyclosporin A group (n= 12) and a mean of 10 (SD 3) months for the cyclophosphamide group (n=I1). During the initial 6 months the visual acuity significantly improved (p<0 001) in the cyclosporin A group whereas this was not observed in the cyclophosphamide group. The subsequent follow-up of patients up to 24 months suggested that the initial improvement in visual acuity with cyclosporin A was not sustained. More extensive and especially longterm studies of cyclosporin A in the uveitis of Beh4et's syndrome are warranted.

The results demonstrate that treatment of verrucae with 5-FU + LE mixture is safe and effective.

We present a 42-year-old circumcised man with a 10-cm firm, irregular penile mass associated with multiple penile ulcers, voiding difficulty, and erectile dysfunction. He reluctantly admitted that 8 months previously, he had multiple mineral-oil (vaseline) self-injections to the penis, for penile enlargement purposes. Histopathological examination revealed the condition was consistent with mineral-oil granuloma (paraffinoma). The patient did not accept surgical intervention; therefore, we performed local therapy (intralesional triamcinolone) and hot-water baths. Paraffinoma results from mineral-oil injections. Such injections are rare; however, they are still being performed in some countries in Eastern Europe and the Far East such as Korea. Increased physician and public awareness are needed for prevention and treatment of complications of this physically and psychologically debilitating and destructive problem.

A 37‐year‐old man was first seen in November 1998 with a unilateral painful eruption of grouped small vesicles at the right side of his thorax. His general health was good. He was diagnosed as having herpes zoster, which was successfully, treated with oral acyclovir 800 mg, five times a day. Five months later, and after complete resolution of the herpes zoster, he developed a pustular eruption on exactly the same area of his first herpetic lesion. There was a diffuse distribution of pustules on the dorsal part of the dermatome, and a grouped pattern on the ventral side ( Fig. 1). A punch biopsy was performed for differential diagnosis of recurrent herpes zoster and folliculitis. Methicillin‐resistant Staphylococcus aureus colonies were isolated from the bacterial culture of the pustular content. Cefadroxil monohydrate 500 mg twice a day and the application of fucidic acid ointment were prescribed. There was no improvement at the end of the second week of therapy. 1 Clinical appearance A histopathologic study demonstrated hyperkeratosis, acanthosis, focal accumulation of neutrophils and bacteria in the epidermis, and a perivascular and perifollicular infiltration of eosinophils, lymphocytes, and histiocytes in the dermis ( Fig. 2). After the diagnosis of eosinophilic pustular dermatosis was histopathologically confirmed, fungal folliculitis and immunosuppressive conditions were investigated. Routine blood tests were within the normal ranges. The human immunodeficiency virus (HIV), hepatitis C virus (HCV), and anti‐hepatitis B surface antibody (anti‐HBs) tests were negative, but the hepatitis B surface antigen (HBsAg) test was positive. Abundant fungal hyphae were seen in potassium hydroxide under direct microscopic examination of the pustule content, and a fungal culture was performed. Although no evidence of fungal infection was demonstrated in repeated periodic acid–Schiff (PAS) staining of punch biopsy specimens, Trichophyton rubrum was isolated from fungal culture. The patient was then given a regimen of itraconazole pulse therapy (400 mg/day, for 7 days a month, repeating the monthly cycle three times) and cycloproxolamine cream. Two months later, at the end of therapy, only a few pustules remained, and these completely disappeared after another 5 months. 2 Eosinophilic pustular folliculitis: dense eosinophilic infiltration within and around the hair follicle (hematoxylin and eosin, × 400)

BackgroundSarcoidosis is a systemic disease characterized by the formation of noncaseating granulomas in various tissues. Cutaneous involvement occurs in 20 to 35 percent of the patients and may be the initial manifestation of the disease. Our study was performed to discriminate the clinical, laboratory, and prognostic differences between patients with specific and nonspecific cutaneous involvement. The second aim was to asses the diagnostic usefulness of punch biopsy in sarcoidosis.MethodsThe clinical, laboratory, pathological features, and skin biopsy results of 120 patients with cutaneous sarcoidosis were evaluated. The patients fulfilled clinical, radiologic or both features of sarcoidosis supported by the histopathologic evidence of noncaseating granulomas.Skin involvement was the initial finding in 30% of the patients. Erythema nodosum and lupus pernio were the most common skin lesions. Almost all of the patients with LP were either stage 0 or 1. Respiratory symptoms occurred in 72.2% of the patients with specific skin involvement. BronchoalveolarLavage (BAL) lymphocytosis, high ratio of CD4/CD8 and elevated serum Angiotensin Converting Enzyme (ACE) were more frequent in patients with specific cutaneous lesions. The frequency of progressive disease was significantly higher in this group. Punch skin biopsy was diagnostic in 81.6% of the patients with a complication rate of 4%.ConclusionsSpecific cutaneous lesions along with BAL lymphocytosis, high CD4/CD8 ratio and elevated serum ACE levels may be predictors of progressive disease in sarcoidosis. Punch biopsy is a simple technique with a high diagnostic yield and a low complication rate for cutaneous sarcoidosis.