Immunoglobulin A (IgA) Vasculitis, more commonly known as Henoch-Schönlein Purpura (HSP), is a disorder which causes inflammation and bleeding in the small blood vessels of the skin, joints, intestines, and kidneys. We report 2 cases of IgA vasculitis found in a rural emergency department: 1) HSP in an 8-year-old male who was initially misdiagnosed with insect bites 2) HSP in an adult male patient. We present both cases and a literature review, indicating that low incidence may be secondary to under diagnosis, arguing for a need of further education on the subject.

A nineteen year old girl presented with rashes of chicken pox and inability to close both eyes properly for two days. She had difficulty in eating and smiling. Vesicular non pruritic rashes were visible in various stages of healing over face and body except palm and soles. She complained of bilateral headaches but no vomiting, or weakness in her limbs or alteration of her taste sensation. She was alert and cooperative with normal speech and memory. B/L lower motor neuron type of facial nerve palsy was found. Routine blood work up, serology for HIV and Lyme disease, chest x ray, CSF study and MRI brain were normal.

Ne-(carboxymethyl) lysine (CML), an advanced glycation end product (AGE), is an aging factor produced by glycation of protein. Higher levels of AGE in skin tissue are related to skin elasticity, but how CML that has accumulated in the skin affects hair follicle formation is unclear. This study constructed a simple model that mimics accumulated glycation from feeding by intradermally injecting Ne-(carboxymethyl) lysine (CML), and examined the effects on the morphogenesis of hair follicles (HF). The results showed weakening of the hair shaft and HF formation by CML. The in vitro inhibitory effect of CML on wound healing of dermal papilla cells (DPC) suggested that the mechanism influences the proliferation and migration of DPC, which are essential for HF morphogenesis. In addition, CML in DPC inhibited the expression of sonic hedgehog (Shh), a factor of tissue morphogenesis, in a NF-kB-independent manner. The findings suggest that the delay in HF formation was due to CML inhibiting proliferation and migration in DPC by inhibiting Shh expression.

Psoriasis is a chronic infl ammatory skin disease that affects 2% to 4% of the population. Infl ammatory arthritis develops in approximately 30% of patients with psoriasis and can have a major effect on activities of daily living and quality of life. Peripheral joint involvement in patients with psoriatic arthritis can be oligo articular or poly articular and can cause joint destruction.

Background: Mycosis fungoides (MF) is an indolent behavior cutaneous T-cell lymphoma. Most patients present a slowly progressive course, over many years. However, some patients evolve early towards advanced stages of the disease, despite adequate treatment, having therefore, a worse prognosis. Increasing knowledge of risk factors that contribute to a better prognostic evaluation is considered of interest.