Figure 1.
Summary of Case Finding and Study Enrollment Efforts, Unexplained Dermopathy, Calilfornia.
Figure 2.
Geospatial Mapping of UD Cases By Place of Residence, California.
Table 1.
Age-and Sex-specific Prevalence Rates of Unexplained Dermopathy, California, July 2006–June 2008.
Figure 3.
Distribution of Case-patients by Self-reported year of Onset, California.
Table 2.
Prevalence of Fair or Poor Self-rated Health Among Case-patients Completing Web-based Survey, Unexplained Dermopathy, California.
Figure 4.
Representative skin lesions detected on clinical examination.
A. Three erythematous scaly plaques with a fourth more proximal eroded and crusted plaque. B. Close-up of the eroded plaque in image 4A showing blue fibers. C. Excoriated erythematous papules suggestive of arthropod bites, dermatitis or possible excoriated folliculitis. D. Close-up of excoriated lesion in image 4C.
Figure 5.
Representative histopathologic features of case-patient skin lesions.
A. Epidermal hyperplasia with compact orthokeratosis and hypergranulosis and perivascular inflammatory infiltrates in the dermis consistent with lichen simplex chronicus. B. Focal erosion with superficial ulceration and scale-crust consistent with excoriation. C. Mixed perivascular inflammatory cell infiltrates comprised of lymphocytes, neutrophils and eosinophils, suggestive of arthropod bite or drug reaction. D. Suppurative folliculitis comprised of eosinophils and neutrophils. Hematoxylin and eosin stain, original magnifications ×25 (A, B), ×100 (C), and ×50 (D).
Figure 6.
Superficial infectious processes identified in impetiginous skin lesions of case patients.
A. Superficial and deep perivascular dermatitis with epidermal hyperplasia and prominent scale-crust. A heavy growth of Stenotrophomonas maltophilia was obtained in culture of this site. B. Ulcerated skin with purulent exudates and serum-crust containing numerous colonies of coccoid bacteria (C) that stain intensely by using an immunohistochemical technique for Streptococcus pyogenes D and E. Purulent serum-crust from an impetiginous lesion, with abundant colonies of gram-positive coccoid bacteria (F). A heavy growth of Staphylococcus aureus was obtained in culture of this site. Hematoxylin and eosin stain (A, B, C, F), immunoalkaline phosphatase with naphthol fast-red and hematoxylin counterstain (D), and Lillie-Twort stain (F). Original magnifications ×12.5 (A), ×25 (B), ×50 (C), ×100 (D, E), and ×158 (F).
Figure 7.
Spectral characteristics of fibers/materials.
A. Photograph of formalin-fixed material with the IR spectral characteristics of cellulose consistent with a cotton fiber. B. Upper panel IR spectrum obtained from unidentified fiber, lower panel spectrum is a cellulose reference.