SummaryDendritic cells (DCs), monocytes, and macrophages are leukocytes with critical roles in immunity and tolerance. The DC network is evolutionarily conserved; the homologs of human tissue CD141hiXCR1+CLEC9A+ DCs and CD1c+ DCs are murine CD103+ DCs and CD64−CD11b+ DCs. In addition, human tissues also contain CD14+ cells, currently designated as DCs, with an as-yet unknown murine counterpart. Here we have demonstrated that human dermal CD14+ cells are a tissue-resident population of monocyte-derived macrophages with a short half-life of <6 days. The decline and reconstitution kinetics of human blood CD14+ monocytes and dermal CD14+ cells in vivo supported their precursor-progeny relationship. The murine homologs of human dermal CD14+ cells are CD11b+CD64+ monocyte-derived macrophages. Human and mouse monocytes and macrophages were defined by highly conserved gene transcripts, which were distinct from DCs. The demonstration of monocyte-derived macrophages in the steady state in human tissue supports a conserved organization of human and mouse mononuclear phagocyte system.

Prescribing for pregnant or lactating patients and male patients wishing to father children can be a difficult area for dermatologists. There is a lack of review articles of commonly used systemic medications in dermatology with respect to their effects on developing embryogenesis and their potential transfer across the placenta, in breast milk and in seminal fluid. This paper aims to provide an up to date summary of evidence to better equip dermatologists to inform patients about the effects of systemic medications commonly used in dermatology to treat conditions such as atopic dermatitis, psoriasis and acne, on current and future embryogenesis and fertility.

Patients with eczema attending a hospital clinic have been shown to have high levels of AUD of a similar level to patients with psoriasis and higher than patients with noninflammatory skin diseases.

In the original publication of this article, the name of an author was inadvertently misspelled. The corrected author name is Diego Miranda-Saavedra. The spelling is now correct in the online version of the study. The authors apologize for the inconvenience.

SummaryExtravasation injuries are common in patients receiving multiple intravenous infusions. Although such injuries are closely associated with the infusion of cytotoxic chemotherapy, they have also been been associated with extravasation of noncytotoxic drugs. Extravasation injuries can lead to skin ulceration and nerve and tendon damage, and therefore to permanent disability. We report three cases of phosphate solution extravasation leading to unusual cutaneous manifestations.Extravasation injuries commonly occur in patients receiving intravenous (IV) infusions. There is a wide range of clinical responses to leakage of infusate, ranging from local irritation to necrosis and permanent damage leading to disability.1 Hypophosphataemia is associated with a range of medical conditions, including poor dietary phosphate intake, decreased intestinal absorption, increased urinary excretion and renal disorders.2 Most patients with hypophosphataemia are asymptomatic, although severe hypophosphataemia can lead to rhabdomyolysis, muscle weakness, cardiac arrhythmias and respiratory dysfunction.2 To our knowledge, there are no published reports of extravasation injury associated with IV phosphate replacement solutions. We present three cases of unusual cutaneous manifestations following IV phosphate solution extravasation. ReportPatient 1 was a 62-year-old woman, who was admitted to a medical ward following an episode of syncope. On admission, biochemical tests revealed profound hypophosphataemia and hypomagnesaemia. She was treated with a single infusion of IV phosphate and magnesium solutions (at a rate of 9 mmol over 12 h). During the phosphate IV administration, the IV access located in the patient's right antecubital fossa was dislodged, causing intense pain and localized erythema, followed by the development of a yellow plaque with central ulceration in the area of administration. On physical examination, a pale-yellow, indurated plaque with erythema and central ulceration was found on the right forearm, and smaller satellite lesions were present on the right forearm and right posterior forearm (Fig. 1a,b). An incisional biopsy, taken through the centre of the lesion, showed diffuse proliferation of fibroblastic spindle cells in the dermis, exhibiting a storiform arrangement and mainly lymphocytic dermal inflammation with multinucleated giant cells and areas of early mineralization (Fig. 2a,b). The patient was managed conservatively, and although the ulceration healed within a few weeks, the yellow indurated plaque persisted during the 6-month follow-up period.Patient 2 was a 69-year-old man, who underwent elective craniotomy for removal of a meningioma. In the postoperative period, peripheral vascular access was required for the administration of phosphate replacement solution (10 mmol over 6 h). The peripheral access line was dislodged during the administration, leading to the development within 2 weeks of a slowly expanding, yellow, indurated plaque (approximately 5 mm in diameter) on the dorsum of the patient's ...