No abstract

Gianotti-Crosti syndrome (GCS) is a self-limiting, papular or papulovesicular, symmetric, acral exanthem that typically presents subsequent to viral infection, bacterial infection, or immunization in a child 1 to 4 years old. The rash can persist for 2 to 10 weeks. Recent infection with Epstein-Barr virus is the most common serologic finding in patients who have developed GCS. The diagnosis is often made after the child has been unsuccessfully treated for a more common cause of an acral rash (eg, scabies). There are no pathognomonic laboratory or histopathologic findings. GCS, therefore, is still a clinical diagnosis of exclusion. The rash is self-limited, and treatment is usually not necessary. However, topical corticosteroids are anecdotally reported to reduce duration of rash. Oral antihistamines can be used to treat pruritus. Parents should be assured that resolution is almost always complete, scarring seldom occurs, and recurrence is rare.

Although a majority of PCPs in academia and the community acknowledge the positive effect of chemotherapy, the benefit of systemic therapy for early-stage lung cancer is less appreciated as compared with breast cancer. Patients' preferences influence PCPs significantly in the decision to refer patients to an oncologist.

W. D., male, aged 56, of English parentage, returned to England fifteen years ago, after living in S. Rhodesia for ten years. In hospital three years ago, with a compression fracture of first lumbar vertebra caused by a shutter falling on his back. According to the records there was then no pigmentation. Since accident has not been in good health and has complained of pain in back. Latterly has had shortness of breath, polyuria, loss of weight and increasing weakness. Bowels open thrice daily for last five months; motions looser than normal. No vomiting. Admitted to hospital October 18, 1933, having collapsed in street. On examination.-Fairly well nourished; intelligent but memory rather unreliable; tends to sleep for considerable periods of the day; generalized bronzing with scattered flecks of dark pigment, especially on arms and lower part of trunk; also patches on otherwise unduly pale buccal mucosa. Evening pyrexia up to 99-6 until eucortone treatment was begun. Heart: No enlargement. Hiemic systolic bruit (now absent). Blood-pressure 110/60 to 126/64. Lungs and abdomen: No abnormality. Skiagram of chest: No abnormality. Nervous system: Pupils slightly irregular on contraction. Right ankle-jerk absent. Skiagram of lumbar region.-Old compression deformity of first lumbar vertebra. No evidence of calcification of suprarenals. Urine: Quantity 70 to 100 oz. in twenty-four hours. No abnormal constituents. Blood-count. Marked secondary anemia.