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Several observational studies have assessed the correlation between Merkel cell carcinoma and Merkel cell polyomavirus with variable results. The objective of this systematic review was to determine whether there is a correlation between Merkel cell carcinoma and Merkel cell polyomavirus. Studies assessing the relationship between Merkel cell carcinoma and Merkel cell polyomavirus from January 2008 to August 2014 were pooled from Medline, Embase, PubMed, Cochrane Database of Systemic Reviews and Google Scholar. From each study we collected the first author's last name, publication year, country of origin, type of study design, characteristics of participants, possible variables incorporated into the multivariable analyses and the risk ratio (RR) for Merkel cell carcinoma associated with Merkel cell polyomavirus combined with the corresponding 95% confidence interval (CI). Methodological assessment of the study was evaluated using the Newcastle-Ottawa scale. Crude RR was calculated from the data provided in each article. Meta-analyses for the global RR and for the proportion of positives in both case and control samples were performed. In addition, in order to explore the sources of heterogeneity among the studies, meta-regression and sensitivity analyses are also provided. A total of 22 studies were identified for the analysis. The pooled RR from random-effects analysis was determined to be 6.32 (95% CI, 4.02-9.93). Global proportions of positive samples were 0.79 (95% CI, 0.72-0.84) and 0.12 (95% CI, 0.08-0.19) in the case and control groups, respectively. The findings support the association between Merkel cell carcinoma and Merkel cell polyomavirus. However, a non-negligible percentage of positive results have been identified in controls. Some caution must be taken in the interpretation of these results because heterogeneity between studies was found.

Influence of environmental temperature on the occurrence of non-necrotizing cellulitis of the leg SIR, Non-necrotizing cellulitis of the leg is a common cutaneous bacterial infection whose risk factors include venous insufficiency, lymphoedema and toe-web intertrigo. The role of environmental temperature remains controversial. 1 To study the relationship between environmental temperature and the frequency of non-necrotizing cellulitis of the leg, we reviewed all patients hospitalized with nonnecrotizing cellulitis of the leg in a university hospital in a temperate region of France during a 4-year period, and correlated findings with the local environmental temperature during the same period.Patients included in this study were consecutive patients referred for non-necrotizing cellulitis of the leg from January 1995 to December 1998 in the Departments of Dermatology, Internal Medicine and Infectious Diseases of the Rouen University Hospital. The diagnosis of cellulitis of the leg was retrospectively identified using the database of the Medical Information System. The mean and maximum temperatures of each the 8 days prior to the date of hospital admission were obtained from the local meteorological unit for each case. Correlations between the mean and maximum daily temperature of each day from day ) 8 to the admission day (lag 0-8 days) and the daily number of patients hospitalized for cellulitis of the leg were studied using a nonparametric Poisson regression model to adjust for time trends and days of the week (generalized additive model). 2 Eight hundred and ninety-eight patients with cellulitis of the leg [342 men (38%) and 556 women (62%)] were

Necrobiosis lipoidica (NL) is a disease of collagen. Squamous cell carcinomas developing in areas of chronic ulceration and scarring have been well documented in a variety of skin diseases but rarely in areas of necrobiosis lipoidica. The case history of a 76-year-old female is presented, whose squamous cell carcinoma appeared 30 years after the diagnosis of necrobiosis lipoidica. The clinical and histopathological picture is described, stressing the importance of the unusual association of the two pathologies in the prognostic.