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A physician-based case-control study of non-melanoma skin cancer was conducted to test the hypothesis that employment in the petroleum industry increased the risk of basal cell carcinoma (BCC), squamous cell carcinoma (SCC), or both (BCC+SCC). Other potential risk factors were also investigated. There were 174 cases of BCC, 59 cases of SCC, 72 cases of both and 229 controls completing a self-administered questionnaire. The most important risk factors common to all skin cancer categories were a family history of skin cancer and time spent outdoors. Employment in the petroleum industry showed a slight association with BCC+SCC, but only in the multivariate model. Further study is needed to evaluate whether this association is causal, or due to chance, bias or confounding.

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BACKGROUND: Sweet syndrome (acute febrile neutrophilic dermatosis) may occur as a cutaneous paraneoplastic syndrome. This condition has been associated with hematologic malignancies and, to a lesser extent, with solid tumors. METHODS: The authors report two patients with malignancy-associated Sweet syndrome: a 66-year-old man in whom the onset of Sweet syndrome preceded the diagnosis of an adenocarcinoma of unknown primary by 3 months and a 69-year-old woman in whom a workup after the appearance of Sweet syndrome skin lesions revealed an unsuspected recurrent squamous cell carcinoma of the larynx. The authors review the reports of the other 39 patients with solid tumor-associated Sweet syndrome that have been published in the world literature. RESULTS: The most common malignancies were carcinomas of the genitourinary organs (37%), breast (23%), and gastrointestinal tract (17%). Typical clinical features and laboratory findings in these patients included tender erythematous plaques located on the upper extremities (97%); elevated erythrocyte sedimentation rate (95%); anemia (83%); fever (79%); and neutrophilia (60%). The symptoms and lesions of Sweet syndrome resolved after treatment with corticosteroids, potassium iodide, or colchicine. Sweet syndrome preceded the initial diagnosis of cancer or the detection of asymptomatic metastatic, persistent, or recurrent tumor, or a hematologic malignancy (in an individual with a previously diagnosed solid tumor) in 61% of the patients. In the other 39% of patients, diagnosis of Sweet syndrome followed the development of a solid tumor. CONCLUSION: The search for a neoplasm of the genitourinary organs and breast cancer in women and a gastrointestinal tract carcinoma in men should be emphasized in the evaluation for a solid tumor in patients with Sweet syndrome without a prior diagnosis of malignancy.

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Sweet's syndrome (acute febrile neutrophilic dermatosis) and erythema nodosum are reactive dermatoses whose pathogenesis is currently undefined. Although there are several associated conditions that both of these disorders have in common, the appearance of Sweet's syndrome and erythema nodosum in the same person is rare. Only 8 individuals with biopsy confirmed lesions of both dermatoses were described in the world literature. We describe a 30-year-old woman with biopsy confirmed lesions of Sweet's syndrome on her hand and erythema nodosum on her legs. She had been taking an oral contraceptive and an appetite suppressant during the 5 months before these dermatoses appeared. Both cutaneous lesions rapidly responded to topical corticosteroid ointment and have not recurred since her medications were discontinued. The association of Sweet's syndrome and erythema nodosum is reviewed, their similarities discussed, and a pathogenesis is proposed.

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Systemic lupus erythematosus, a multisystemic disorder, is considered a prototype of the autoimmune diseases. Although its cause remains unknown, a viral etiology has been proposed. We report that a rapid and sensitive messenger RNA in situ hybridization technique detected hybridizing sequences to the human immunodeficiency virus type in the peripheral blood cells of a woman with systemic lupus erythematosus in whom the presence of acquired immuno-deficiency syndrome was reasonably excluded.

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Nocardiosis is an increasing clinical problem, especially in immunocompromised patients. The offending species is almost always Nocardia asteroides. Cryptococcosis is also an increasing problem in the immunosuppressed. We describe a patient with probable disseminated cryptococcosis followed by disseminated Nocardia brasiliensis infection. Only eight patients with disseminated N brasiliensis infection have been described, to our knowledge, in the United States.

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Histologic, pharmacologic, and exchange transplant studies were performed on a patient with nevus anemicus. Histologic examination disclosed no abnormalities. The only pharmacologic stimulus that produced erythema within the nevus was the alpha-blocking agent, phentolamine mesylate. Results of the transplant studies demonstrated donor dominance. This suggests that the defect in the nevus anemicus is attributable to increased sensitivity of the blood vessels to catecholamines rather than to increased alpha-adrenergic stimulation.

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Spectinomycin hydrochloride, a new parenteral antibiotic prepared from Streptomyces spectabilis, was compared with standard U.S. Public Health Service-recommended dosages of aqueous procaine penicillin G in the treatment of uncomplicated gonorrhea in 353 men and 314 women. Of the 314 women, 130 had a pretreatment positive rectal culture. All diagnoses were proven by culture on Thayer-Martin selective medium. Minimal inhibitory concentrations of both drugs were determined. Single doses of 2 and 4 g of spectinomycin were compared with 2.4 million units of procaine penicillin in males and with both 2.4 and 4.8 million units of procaine penicillin in females. Both spectinomycin schedules, 2.4 million units of penicillin in males and 4.8 million units of penicillin in females, resulted in cure rates in excess of 90%. There were no failures at the rectal site only in those women with positive rectal cultures. There was no advantage to using the larger amount of spectinomycin in either sex.

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