bluuebunny/crossref_metadata_2025 huggingface dataset:
EFFECT OF NAFTIDROFURYL OXALATE (PRAXILENE) ON PERIPHERAL CIRCULATION MEASURED BY CALORIMETRY*
Authors: Tan O. T. , Gaylarde P. M. , Sarkany I.
Published: June 2007

Summary

Naftidrofuryl oxalate (Praxilene), defined as a vasoactivator by Becker1 has been claimed to improve the circulation, particularly in patients with severe circulatory impairment. Several clinical studies2,3,4 have claimed improvement in circulatory disorders both as a result of oral and parenteral administration of Praxilene. In view of claims that Praxilene is devoid of side effects, such as hypotension and flushing produced by other vasodilators in general use, we decided to measure changes in blood flow in response to this preparation.
THE MOST COMMON TYPE OF FRACTURED HAIR IN ALOPECIA AREATA IN CHILDREN: ANOTHER CAUSE OF “BLACK DOT DISEASE”.
Authors: Keipert James A.
Published: June 2007

Summary

Exclamation mark hairs are usually described as the typical type of fractured hair in alopecia areata, but hairs that are fractured close to the scalp are more common in alopecia areata in children. They appear as black dots, similar to those seen in black dot ringworm. The only specific reference to this condition that was found in 40 text books of dermatology is in a book published in 1906.
AN UNUSUAL EPITHELIAL‐CONNECTIVE TISSUE NAEVUS WITH PERIFOLLICULAR MUCINOSIS*
Authors: Becke R. F. A. , Musso L. A.
Published: June 2007

Summary

Two pigmented lesions (one on each cheek of an adolescent boy) have been examined histologically on two occasions at an interval of eighteen months. The lesions had appeared following exposure to strong sunlight. Epithelial thickening with increased pigmentation, perifollicular mucin, absence of sebaceous glands and increased elastic tissue were found. Some comments are offered to explain these changes. It appears that the lesions are of naevoid origin.
RETICULAR ERYTHEMATOUS MUCINOSIS (REM SYNDROME) OF STEIGLEDER: ITS RELATIONSHIP TO OTHER MUCINOSES AND TO CHRONIC ERYTHEMATA*
Authors: Kocsard E. , Munro V. F.
Published: June 2007

Summary

The reticular erythematous mucinosis syndrome of Steigleder is a macular erythema‐tous form of inflammatory mucinosis. Clinically and histopathologically it has many similarities with the plaque‐like mucinosis of Perry. Transitional forms between the two conditions exist. The histopathological picture of the syndromes is not diagnostic and is indistringuishable from that of the lymphocytic infiltration of the skin described by Jessner and Kanof and from some of the chronic inflammatory dermatoses. The clinical picture in combination with the histopathological changes is, however, sufficiently characteristic to define the mucinosis of Steigleder and Perry as a clinical entity.
MYCETOMA CAUSED BY MADURELLA MYCETOMII IN MADRAS
Authors: Taralakshmi V. V. , Pankajalakshmi V. V. , Arumugam S. , Subramanian S.
Published: June 2007

Summary

Biopsy specimens of 102 patients with mycetoma were examined histologically and Madurella mycetomii was found in 29 cases. Four cases of mycetoma pedis and a single case of mycetoma of the hand from which M. mycetomii has been isolated in culture are described. In all cases, the characteristic black granules were seen.

The geographic distribution of the organism and its incidence and prevalence in India are discussed.
FIXED DRUG ERUPTION*
Authors: Comens Chris
Published: June 2007

Summary

The enigma of fixed drug eruption has fascinated dermatologists for over eighty years. The clinical features and investigative studies suggest that many immunopathogenic mechanisms may be involved. Fixed drug eruption offers a unique opportunity to study the early events of inflammation and the factors controlling localizations of skin disease.
LANGERHANS CELL AND MELANOCYTE DISTRIBUTION IN “NORMAL” HUMAN EPIDERMIS
Authors: Scheibner A. , McCarthy W. H. , Milton G. W. , Nordlund J. J.
Published: June 2007

Summary

Langerhans cells and melanocyte distribution was determined in 18 different body sites in 76 cadavers, 44 men and 32 women, within 24 hours of death. The Langerhans cell and melanocyte counts were inversely related so that in sun‐exposed (tanned) epidermis Langerhans cell numbers were lower and melanocyte numbers were higher than in non‐exposed (non‐tanned) epidermis. Langerhans cell and melanocyte densities were similar in men and women on non‐exposed (non‐tanned) epidermis when matched by age. In any one subject Langerhans cell densities were even throughout the body except on sun‐exposed (tanned) areas, where Langerhans cell counts were not only significantly lower but the cells were also unevenly distributed. Langerhans cell counts for all body areas decreased with age in both men and women.
SQUAMOUS CELL CARCINOMA OF THE LUNG AND A BULLOUS DERMATOSIS: REPORT OF A CASE
Authors: Menz Jennifer
Published: June 2007

Summary

A case of an unclassified bullous dermatosis associated with carcinoma of the lung is described. The link between these two conditions is explored.
SHOE DERMATITIS*
Authors: Freeman Susanne
Published: June 2007

Summary

Foot dermatitis can be an extremely disabling problem. Blistering and weeping feet may become secondarily infected and painful fissuring often occurs, resulting in inability to walk. The diagnosis of contact dermatitis due to shoes should be considered in every case of persistent foot dermatitis. It is only by careful patch testing that this diagnosis can be made. The so‐called typical clinical pattern of shoe contact dermatitis is often not present. A shoe contact dermatitis can be superimposed on an endogenous foot dermatitis.
“BLACK SPOTS” IN PAPUA NEW GUINEA DEFENCE FORCE PERSONNEL: REPORT OF 12 CASES*
Authors: Talwat E. N.
Published: June 2007

Summary

A fixed drug eruption related to the ingestion of Maloprim is described in Papua New Guinea Defence Force members and their dependants. Provocation tests using the two constituents of Maloprim indicated that dapsone was the cause. A fixed drug eruption caused by dapsone was reported in 1964 in deeply pigmented leprosy patients in Africa. This eruption has not been reported in Papua New Guinean leprosy patients on dapsone therapy.
THE PREVALENCE AND ACCURACY OF DIAGNOSIS OF NON‐MELANOTIC SKIN CANCER IN VICTORIA*
Authors: Ponsford M. W. , Goodman G. , Marks R.
Published: June 2007

Summary

Surveys of Victorian dermatologists and pathologists were undertaken to determine the number of patients attending medical practitioners with non‐melanotic skin cancers and solar keratoses. Results suggest that at least 1,000 patients per week are attending for diagnosis and treatment.

Accuracy of clinical diagnosis studies suggest that the correct diagnosis of these tumours isbeing made clinically in approximately 70% of cases by experienced clinicians. It is suggested that histology be obtained in all lesions in which a clinical diagnosis of skin cancer is considered. The incidence of squamous cell carcinoma compared to that of basal cell carcinoma is seen to rise where histological examination is performed.
CLINICO‐HISTOPATHOLOGICAL STUDY OF EPIDERMAL NAEVI
Authors: Submoke S. , Piamphongsant T.
Published: June 2007

Summary

The clinical and histopathological features of epidermal naevi from 75 patients were reviewed. In approximately two‐thirds of the patients, these lesions were not present at birth. Five classical clinical varieties and ten histopathological patterns were observed. It was only possible to determine the types of histopathological patterns by the examination of the clinical features alone in the cases of linear porokeratosis and linear naevus comedonicus. A further clinical type of inflammatory linear verrucous epidermal naevus was revealed in this study. This consisted of asymptomatic short linear brownish plaques in which the lesions did not resemble the classical itching linear erythematous plaques.
DISORDERED CYCLIC NUCLEOTIDE METABOLISM–A BASIC DEFECT IN ATOPIC DERMATITIS*
Authors: Butler James M.
Published: June 2007

Dysfunction in a wide variety of cellular immune mechanisms occurs in atopic dermatitis and contributes to the clinical presentation of the condition.

The increased incidence of cutaneous viral and fungal infections, observed clinically in atopic dermatitis, suggests altered T‐lymphocyte function and elevated serum IgE levels suggest deregulation of B‐lymphocyte function. The clinical features of pruritus and erythema raise the possibility of increased release of inflammatory mediators into the circulation. In vitro studies have confirmed abnormalities in T‐lymphocyte subset numbers and function as well as increased releasability of histamine from blood basophils in atopic dermatitis.

Recent studies have revealed abnormalities in the metabolism of cyclic AMP, an important mediator in cellular regulatory mechanisms, in atopic dermatitis. Leucocyte cyclic AMP responses to a variety of agonists are blunted in atopic dermatitis and are due, at least in part, to increased cyclic AMP phosphodiesterase activity. It is unclear at present whether this enzyme abnormality is genetically determined or whether it is induced by increased circulating levels of inflammatory mediators. A number of the in vitro abnormalities in atopic dermatitis appear to correlate with the increase in phosphodiesterase activity.

Further research aimed at finding ways to inhibit phosphodiesterase activity in atopic dermatitis and consequently reversing other abnormalities in cellular function, will hopefully open up new avenues of therapy for this common and disabling condition.
PHOTOCONTACT ALLERGY TO OCTYLDIMETHYL PABA
Authors: Weller Paul , Freeman Susanne
Published: June 2007

Summary

A case of photocontact allergy to a sunscreen product containing octyldimethyl paraaminobenzoic acid (O‐PABA) with cross sensitivity to isobutyl PABA is presented. A discussion of sunscreen products follows, including the properties of the active ingredients and the vehicles. A list of commercial products grouped according to sunscreen type follows.
A CASE OF MYCOSIS FUNGOIDES TREATED WITH ETRETINATE
Authors: Wargon Orli , Downie David
Published: June 2007

Summary

A 64 year old man with refractory stage II cutaneous T‐cell lymphoma was treated with etretinate (RO109359) at 2 mg/kg/day with near clearing of nodules, plaques and pruritus in eight weeks. There were minimal side effects and no flare of his disease in five months on maintenance treatment with etretinate 1 mg/kg/day.
ERYTHEMA MULTIFORME: EPIDEMIOLOGY, CLINICAL CHARACTERISTICS AND NATURAL HISTORY IN FIFTY‐NINE PATIENTS
Authors: Ting H. C. , Adam B. A.
Published: June 2007

Summary

In this paper we report fifty‐nine patients with erythema multiforme. Thirty‐four of the patients were classified as erythema multiforme major (EM major) or Stevens‐ Johnson syndrome and the other twenty‐five erythema multiforme minor (EM minor). The overall features of this group of fifty‐nine patients are discussed and the significant differences between the two sub‐groups (EM major and EM minor) highlighted.
UNUSUAL SKIN MANIFESTATIONS OF DRUG PHOTOSENSITIVITY
Authors: Burry John N.
Published: June 2007

Summary

Photosensitivity from drugs does not always present in a classical fashion involving all areas of exposure. The area of involved skin may be limited and cause confusion in diagnosis. Drug photosensitivity causes both transient and persistent light reactions. The cases described in this paper illustrate in a clinical fashion, the manner in which the diagnosis of drug eruptions can be complicated in our daily clinical work.
FACIAL GRANULOMA
Authors: Frost Felicity A. , Heenan Peter J.
Published: June 2007

Summary

The clinical and pathological features of six patients with facial granuloma are presented. Of a total of 11 lesions biopsied, only one was correctly diagnosed clinically, eight other lesions being regarded as basal cell carcinomas. Histological diagnosis was delayed in one patient with multiple and extrafacial lesions, emphasizing the importance of early diagnosis. Facial granuloma should be considered in the differential diagnosis of any mixed inflammatory dermal infiltrate with an eosinophil component occurring in sun‐exposed skin.
ALLERGIC CONTACT DERMATITIS TO DIMER ACID PRODUCT—A FLEXIBILIZING EPOXY RESIN HARDENER
Authors: Wall Leon M.
Published: June 2007

Summary

A case is reported of allergic contact sensitivity to dimer acid product—a hot‐cure flexibilizing epoxy resin hardener Dimer acid product would appear to be allergenic potential despite its widespread usage.
ISOLATION OF DERMATOPHILUS CONGOLENSIS FROM TWO NEW ZEALAND CASES OF PITTED KERATOLYSIS
Authors: Woodgyer A. J. , Baxter M. , Rush‐Munro F. M. , Brown J. , Kaplan W.
Published: June 2007

Pitted keratolysis is a skin disease characterized by the appearance of pitted lesions on the pressure‐bearing areas of the soles of the feet and less often affecting the palms of the hands. A coccofilamentous bacterium is consistently seen in microscopic preparations from the lesions and may be the causative agent of the disease. However, there has been some dispute as to the organism's identity because of the isolation of a number of different micro‐organisms, including Streptomyces spp. and a Corynebacterium sp. from previously reported cases. On the basis of histopathological evidence, it has also been suggested that the actinomycete Dermatophilus congolensis might be associated with the condition. In the present study, investigations into the prevalence and laboratory diagnosis of the condition resulted in the isolation of D. congolensis from two cases. The two isolates differed from those usually recovered from cases of dermatophilosis in humans and animals and may represent a hitherto unrecognized biotype of the species.
FAMILIAL PORPHYRIA CUTANEA TARDA *
Authors: Rogers Maureen , PouLos Victor
Published: June 2007

The results of erythrocyte uroporphyrinogen decarboxylase estimations of members of the family of a child with porphyria cutanea tarda are reported.
SUBUNGUAL MALIGNANT MELANOMA: A DISEASE ENTITY SEPARATE FROM OTHER FORMS OF CUTANEOUS MELANOMA
Authors: Milton G. W. , Shaw H. M. , McCarthy W. H.
Published: June 2007

The characteristics and results of treatment of 30 patients with subungual malignant melanoma treated at the Sydney Melanoma Unit were studied. It was found that in several major respects subungual melanoma differed from other forms of cutaneous melanoma. Patients with subungual melanoma were considerably older than those with either superficial spreading or nodular melanoma and there was a preponderance of men with subungual melanoma of the upper extremity. Independent prognostic factors (such as tumour thickness) which are important in determining survival in patients with superficial spreading or nodular melanoma, had little consequence in patients with subungual melanoma. Despite the fact that the vast majority of subungual melanomas were very thick and ulcerated due to the delay in correctly diagnosing the disease clinically, overall survival rate was reasonably good, providing patients had an amputation of the entire digit together with either a prophylactic or therapeutic lymph node dissection. These findings indicate that subungual melanoma is a disease entity separate from other forms of cutaneous melanoma and that radical surgery is essential in all subungual melanoma patients.
CEMENT BURNS: RARE OR RARELY REPORTED?
Authors: Fischer Gayle , Commens Chris
Published: June 2007

Summary

Prolonged contact with ready mixed cement is a rare cause of severe chemical burns. A 15 year old boy required debridement and skin grafting to a burn on his knee caused by contact with cement. Asa result he lost five weeks from school. We discuss the factors that predispose to this unusual event and pose the question as to why we hear of it so infrequently.
EPIDERMOLYSIS BULLOSA—A NEW SUBGROUP
Authors: Eisenberg M. , Shorey C. D. , de Chair‐Baker W.
Published: June 2007

Summary

A patient aged 16 years with a new mechanobullous disease is described. He had suffered from trauma‐induced bullae since birth. The lesions increased in hot weather and healed without scarring. The clinical picture was suggestive of Weber‐Cockayne or a mild Köbner type of epidermolysis bullosa simplex. Ultrastructural investigation of afresh blister revealed intraepidermal blister formation via cytolysis of basal cell cytoplasm at or above the hemidesmosomes to which were attached clumps of tonofilaments. On the floor of the blister the basal lamina and anchoring fibrils were normal. This type of blister morphology is characteristic of epidermolysis bullosa herpetiformis of Dowling‐Meara so that this patient has either a mild atypical form of the above disease or his case represents an example of a new subgroup of epidermolysis bullosa produced by a spontaneous allelic mutation.
EUMYCOTIC MYCETOMA DUE TO Madurella grisea
Authors: Muir D. B. , Pritchard R. C.
Published: June 2007

Summary

Eumycotic mycetoma due to Madurella grisea was diagnosed In an 81 year old female Australian Aborigine. This is the first reported isolation of this fungus from Australia.
DAPSONE AND SULFAPYRIDINE THERAPY OF PEMPHIGOID DISEASES
Authors: Rogers Roy S.
Published: June 2007

Summary

Since 1974, dapsone and sulfapyridine have been used to treat 30 patients with localized oral pemphigoid, 36 with cicatricial pemphigoid, and 11 with cicatricial pemphigoid limited to the eyes; 7 of these 77 patients were less than 50 years of age. Follow‐up was J to 12 years (mean, 4.8 years). Of the 30 patients with localized oral pemphigoid, half were in remission and off treatment at a mean follow‐up of 5 years. Of 25 patients with cicatricial pemphigoid who received dapsone therapy as initial treatment, 15 (60%) had a successful result. Sulfapyridine was successful in three patients and dapsone in six additional patients after other therapy. Thus, dapsone or sulfapyridine therapy was successful in 24 of 34 patients (71%). In 30 patients with pemphigoid limited to the ocular mueosa or cicatricial pemphigoid with ocular manifestations, 25 (83%) responded successfully to dapsone or sulfapyridine; there were no treatment failures among these 30 patients with ocular pemphigoid. Overall, of the 77 patients, of 55 who underwent an evaluable eotirse of dapsone or sulfapyridine therapy, 47 (85%) responded successfully.
THE MYSTERY OF ITCHING TELEPHONISTS
Authors: Anderson F. E.
Published: June 2007

Summary

Manual assistants in two country telephone exchanges have complained of itching, Every employee has been involved and despite thorough investigation itching has continued. The cause has not been found.
HYPERTROPHIC LUPUS ERYTHEMATOSUS: DIFFERENTIATION FROM SQUAMOUS CELL CARCINOMA
Authors: Vinciullo Carl
Published: June 2007

Summary

Hypertrophic lupus erythematosus (HLE) may be more common as a variant of discoid lupus erythematosus (DLE) than is reported in the literature. Differentiation from neoplastic transformation of a lesion of DLE to squamous cell carcinoma (SCC) is crucial because of the metastatic potential of this type of SCC. A man is described in whom hypertrophic lesions of LE accompanying lesions of classic DLE were interpreted histopathologically as SCC. The problem of differentiating true HLE from SCC arising within DLE is discussed with a review of the relevant literature.
CONTACT DERMATITIS TO EPOXY RESIN IN ILEOSTOMY BAG
Authors: O'Brien Timothy J.
Published: June 2007

Summary

Dermatitis under an ileostomy bag and speading to other areas was found to be due to epoxy resin in the bag. This problem has been reported by other authors.
THREE CASES OF HYPOMELANOSIS OF ITO
Authors: Tham S. N. , Chan H. L. , Tan T.
Published: June 2007

Summary

Three cases of hypomelanosis of Ito are presented showing variations in the pattern seen. Two patients showed no other abnormalities, but the third patient had conditions of endocrine and autoimmune type.
HYPERTRICHOSIS LANUGINOSA ACQUISITA AND ADENOCARCINOMA OF THE COLON
Authors: Dyall‐Smith Delwyn , Varigos George , Thomas Robert
Published: June 2007

Summary

We report the case of a 48 year old man who developed hypertrichosis lanuginosa acquisita in association with adenocarcinoma of the colon. All laboratory investigations were normal. We present a literature review of this rare but important paraneoplastic sign which is most commonly associated with malignancies of the gastrointestinal tract.
TREATMENT OF PSEUDALLESCHERIA BOYDII INFECTION WITH ORAL KETOCONAZOLE AND TOPICAL MICONAZOLE
Authors: Willsteed Elizabeth , Regan William
Published: June 2007

Summary

Skin infection in a man immunosuppressed by corticosteroid treatment was found to be due to Pseudallescheria boydii. Although treatment is often unsatisfactory, infection in this patient responded well to oral ketoconazole and topical miconazole.
KERATITIS, ICHTHYOSIS AND DEAFNESS (KID SYNDROME)
Authors: Singh Kamlender
Published: June 2007

Summary

A boy with ichthyosiform erythroderma also suffered from sensorineural deafness, superficial punctate keratitis and acanthosis nigricans. Histopathology revealed basket weave hyperkeratosis, hydropic degeneration of the basal layer, melanin incontinence and moderate mononuclear infiltrate. Typical histological changes were found in clinical lesions of acanthosis nigricans.
BENIGN CEPHALIC HISTIOCYTOSIS
Authors: Commens Chris , Jaworski Richard
Published: June 2007

Summary

A 3 year old boy had an asymptomatic pigmented maculopapular eruption on his face for 2½ years. This rash partially resolved in summer and remitted in winter. Skin biopsy and ultrastructural studies showed a histiocytic infiltrate with “comma shaped” cytoplasmic inclusions, confirming the diagnosis of Benign Cephalic Histiocytosis. We review the features of this condition and compare it with other self healing histiocytotic conditions.
TRICHOTHIODYSTROPHY – BIOCHEMICAL AND CLINICAL STUDIES
Authors: Gillespie J. Morton , Marshall Robert C. , Rogers Maureen
Published: June 2007

Summary

We are reporting the clinical examination of two children with abnormal hair together with a microscopic and biochemical examination of their hairs. A diagnosis of trichothiodystrophy (TTD) is suggested since both hair samples are cystine‐deficient and contain abnormal patterns of amino acids and proteins. The cystine deficiency was found to be due to a reduction in the amount and cystine content of the high‐sulphur (HS)* protein fraction. An electrophoretic study of the two samples of HS protein gave patterns which differed in a major way from the pattern of a normal HS fraction with the loss of most normal components including the ultra‐high‐sulphur fraction. The pattern of spots of the two abnormal HS proteins not only differed from the normal but from each other and from a third sample of protein from a previously studied TTD hair. It is suggested that this may provisionally support the concept of heterogeneity of TTD.
ONSET OF PSORIASIS COINCIDENT WITH TETRACYCLINE THERAPY
Authors: Tsankov Nikolai K. , Vassileva Snejina V. , Lazarova Aneta Z. , Berowa and Newena V. , Botev‐Zlatov Nikola
Published: June 2007

Summary

Psoriasis developing after treatment with tetracyclines in a 40 year old female is described with exacerbation after re‐exposure to Doxycycline. The authors emphasize the need for further observations on the influence of antibiotics and especially the tetracycline group on the course of psoriasis.
SPECTACLE FRAME DERMATITIS DUE TO PARAPHENYLENEDIAMINE
Authors: Doherty Emilija , Freeman Susanne
Published: June 2007

Summary

We report spectacle frame dermatitis due to paraphenylenediamine and present a review of other agents which have been identified as causes of allergic contact dermatitis due to spectacle frames.
PUVA THERAPY OF CHRONIC ACTINIC DERMATITIS
Authors: Sinclair Susan E. , Hindson Colin
Published: June 2007

Summary

A modified PUVA regime was used to treat five men with long‐standing chronic actinic dermatitis. They are all now symptom free on monthly maintenance PUVA therapy and no longer react abnormally to ultra‐violet radiation, with consequent improvement of their quality of life.
SPIRONOLACTONE THERAPY IN HIRSUTISM AND ACNE
Authors: Callan Annette W.
Published: June 2007

Summary

Spironolactone has been found to have anti‐androgenic properties and to be useful in the treatment of female hirsulism. Benefits have also been noted in the treatment of mature age onset or persistent acne in females. The mechanism of action of this drug is mainly via a peripheral anti‐androgenic effect but it may also result in decreased androgen production. The results of a number of clinical studies are discussed with particular reference to the side effects of spironolactone. Guidelines for treatment of hirsutism and female mature age acne are given.
HUMAN PAPILLOMA VIRUS INDUCED EPIDERMAL PROLIFERATIONS OF THE ANOGENITAL REGION
Authors: Heenan Peter J.
Published: June 2007

Condyloma acuminatum and bowenoid papulosis are squamous ceil papillomas of the anogenital region probably induced by human papillomavirus of different types. Although both lesions appear to be essentially benign, both have been linked by clinical, virological and epidemiological evidence with the development of anogenital cancer, thus making their precise identification more important than consideration of their purely local effects would indicate. Bowenoid papulosis presents diagnostic problems, particularly in its distinction from Bowen's disease, but the clinical and histological features considered together make a characteristic presentation.
SWEET'S SYNDROME ASSOCIATED WITH ADENOCARCINOMA OF THE PROSTATE
Authors: Dyall‐Smith Delwyn , Billson Virginia
Published: June 2007

Sweet's syndrome can occur in association with malignancy, in particular acute myeloid leukaemia. It has rarely reported with solid tumours. A case of recurrent Sweet's syndrome in a 75 year old man with metastatic prostatic carcinoma is presented.
TREATMENT OF ALOPECIA AREATA WITH DIPHENCYPRONE
Authors: Hatzis J. , Georgiotouo K. , Kostakis P. , Anastasiadis G. , Tosca A. , Varelzidis A. , Straigos J.
Published: June 2007

Forty‐five patients with extensive alopecia areata were treated by local application of diphencyprone. Only eleven had satisfactory regrowth of hair. Six had moderate regrowth, and of the remaining 28 some showed regrowth of vellus hair and others had no response. The side effects of the treatment consisted of intense allergic or irritant reactions, febrile reactions, anaphylactic reaction with fainting, and vitiligo. In twelve patients progressive desensitisation was observed. As the effectiveness of this treatment is low and side effects are common and sometimes severe, we conclude that diphencyprone has no advantage in the treatment of alopecia areata.
LOCALIZED HEAT URTICARIA (HEAT CONTACT URTICARIA)
Authors: Freeman Paul A. , Watt Geoffrey C.
Published: June 2007

Summary

Localized heat urticaria (heat contact urticaria) is reported The literature is reviewed, and treatment is discussed.
DRUG ERUPTIONS WITH LICHENOID HISTOLOGY PRODUCED BY CAPTOPRIL
Authors: Rotstein Eva , Rotstein Harvey
Published: June 2007

Summary

Three cases are presented with a rash due to captopril which, on histology, showed a lichenoid pattern of bandlike upper dermal infiltrate of lymphocytes and histiocytes, together with hydropic degeneration of the basal layer of the epidermis producing Civatte bodies and pigmentary incontinence.

The rash presented either as a pityriasis rosea‐like picture which appeared about three to six months after the onset of treatment in patients taking tow doses, or alternatively, as lichenoid plaques which appeared three to six months after commencement of medication in patients taking high doses.

Although both clinical patterns produced a “saw tooth” pattern of the epidermal rete ridges, hypergranulosis and acanthosis were seen only with the lichenoid plaques.
LICHEN NITIDUS CONFINED TO ONE PALM
Authors: Bear Colin L. , Willsteed Elizabeth M. , Zagarella Samuel S.
Published: June 2007

Summary

Lichen nitidus is an unusual dermatosis which tends to involve the trunk, penis and forearms of children and young adults.1 It is usually bilaterally symmetrical. We report a case of unilateral palmar lichen nitidus in an elderly man.
INHIBITION OF THE INDUCTION OF CONTACT HYPERSENSITIVITY BY AN EPITHELIAL CELL‐DERIVED INTERLEUKIN‐1 INHIBITOR
Authors: Walsh Laurence J. , Au Tony W. , Seymour Gregory J.
Published: June 2007

Summary

Interleukin‐1 (IL‐1) is the central hormone of acute inflammation. Previous studies have demonstrated that an Interleukin‐1 inhibitor (ILS) derived from human gingival epithelial cell cultures abrogates the effect of IL‐1 on human Langerhans cells and murine thymocytes in vitro. The present study investigated the effect of ILS on the induction and elicitation of contact hypersensitivity (CHS) to 2,4‐dinitro‐1‐fluorobenzene (DNFB). Systemic administration of ILS 6 days prior to sensitisation significantly blocked the induction of CHS to DNFB in Balb/c mice. In addition, i.v. injection of ILS 24 or 48 hours prior to the elicitation of CHS produced a reduction in ear swelling, but the suppressive effect was less profound than when ILS was administered prior to sensitisation. Thus, ILS production by epithelial cells is a possible mechanism for the down‐regulation of cutaneous immune responses.
GIANT PARAPOX INFECTION IN A TWO YEAR OLD CHILD
Authors: Rogers Maureen , Bale Patricia , De Silva Lakshman M. , Glasson Martin J. , Collins Eileen
Published: June 2007

Summary

We report the case of a two year old boy who developed a large tumour on his face. The lesion resembled a pyogenic granuloma clinically and histologically. Viral studies indicated a parapox infection and a bovine source was supported on epidemiological grounds. The lesion was removed by shave excision and the area healed without significant scarring.
PHYTOPHOTODERMATITIS: DIFFERENTIATION FROM JELLYFISH STINGS
Authors: Burnett Joseph W. , Vi Nguyen Thuy
Published: June 2007

Summary

A patient with phytophotodermatitis secondary to topical application of lime juice for relief of pain from a recent marine sting is reported. The absence of pain over the entire lesion and the failure of the patient to develop immune specific antibodies to common local coelenterates aided in establishing the diagnosis.
CUTANEOUS ABNORMALITIES IN ANOREXIA NERVOSA
Authors: Marshman Gillian M. , Hanna Marshall J.D. , Ben‐Tovim David I. , Walker M. Kay
Published: June 2007

Summary

Anorexia Nervosa (A.N.) is a relatively common eating disorder with well recognized psychological and physiological features. A study of 14 female patients with A.N. revealed a number of dermatological disorders, including lanugo hair, xeroderma and hyperpigmentation.

Laboratory investigations revealed various abnormalities including elevated Beta‐carotene levels, abnormal sex hormone and thyroid function. An unusual finding was the development of acne in a small subset of patients at the time of weight gain, during recovery from A.N.

Anorexia Nervosa represents a useful model for the interaction between eating disorders, endocrine function and the skin.
OYSTERS, IRON OVERLOAD AND VIBRIO VULNIFICUS SEPTICAEMIA
Authors: Tefany Frances J. , Lee Stephen , Shumack Stephen
Published: June 2007

Summary

A case of Vibrio vulnificus septicaemia complicated by cutaneous leg ulceration is described. A 74 year old man with haemochromatosis and sideroblastic anaemia developed an acute febrile illness with cutaneous manifestations 24 hours after ingesting raw oysters. The presence of blistering should be considered an important clue to the diagnosis of Vibrio vulnificus septicaemia, and this can facilitate prompt effective antimicrobial therapy. Clinicians should be aware of this infection because of its high case fatality rate, especially in patients with iron overload states.
ACTINOMADURA MADURAE MYCETOMAS
Authors: Venugopal Pankajalakshmi V. , Venugopal Taralakshmi V.
Published: June 2007

Summary

Actinomycetomas are localised, chronic, suppurative and progressive infections of the skin, subcutaneous tissues and bones caused by aerobic actinomycetes. They are characterised by subcutaneous granulomas and abscesses with in duration, formation of sinus tracts and production of granules which are the microcolonies of the causative agents.
DO ALL MELANOMAS COME FROM “MOLES”? A STUDY OF THE HISTOLOGICAL ASSOCIATION BETWEEN MELANOCYTIC NAEVI AND MELANOMA
Authors: Marks Robin , Dorevitch Abe P. , Mason Graham
Published: June 2007

Summary

Histological examination of 1101 melanomas (990 superficial spreading and HI nodular melanomas) from 1098 people revealed that 23.3% showed an associated melanocytic naevus. Of these, 56.5% were classified histologically as common acquired, 37.7% as dysplastic and 5.8% as congenital. Of the superficial spreading melanomas, 25.7% showed an associated naevus. By contrast, only 2.7% of nodular melanomas showed histological evidence of a coexisting naevus.

When the superficial spreading melanomas were analysed by level, the presence of a naevus varied from 31.3% of level I melanomas to 21.3% of level IV melanomas. When thickness was measured, an associated naevus was found in 27.0% of superficial spreading melanomas less than 1.0mm thick, and 14.8% of melanomas with a thickness of 1.0mm or greater.

These data suggest that most melanomas do not arise in pre‐existing naevi, and accordingly public educational programs for the early detection of melanoma should focus on looking for changes in previously normal skin as well as in pre‐existing moles.
GENERALISED ERUPTIVE SYRINGOMA‐A PAPULAR DERMATOSIS
Authors: Dyall‐Smith Delwyn J. , Connors Terence J. , Scurry James
Published: June 2007

Summary

Generalized eruptive syringoma is a rare condition characterised by multiple papules over the anterior trunk, sometimes extending on to the flexural aspects of the arms and thighs. A 22 year old Ethiopean woman with this disorder is presented.
SPOROTRICHOID CUTANEOUS INFECTION DUE TO MYCOBACTERIUM CHELONEI IN A RENAL TRANSPLANT PATIENT.
Authors: Jopp‐McKay Andrea G. , Randell Peter
Published: June 2007

Summary

Atypical mycobacterial infections are becoming more common in dermatological practice due to increasing numbers of immunosuppressed patients. A case of cutaneous Mycobacterium chelonei infection wwith sporotrichoid spread in a renal transplant patient is described, and the current literature regarding clinical spectrum, histopathology and management of infection with this pathogen is reviewed.
WHITE PIEDRA
Authors: Palungwachira Piti , Chongsathien Supimol , Palungwachira Pranee
Published: June 2007

Summary

A 39‐year‐old Thai man had eczema on the left groin accompanied by asymptomatic white nodules on the pubic hair for two weeks. Examination with the Wood's lamp, microscopic examination, culture and biochemical testing showed organisms compatible with Trichosporon beigelii. The diagnosis of “White Piedra” was made, and this is the first case of White Piedra to be reported in Thailand.
PRIMARY LOCALISED CUTANEOUS AMYLOIDOSIS IN MALAYSIANS
Authors: LOOI Lai Meng
Published: June 2007

Summary

A review of consecutive biopsies from 85 Malaysian patients with primary localized cutaneous amyloidosis (PLCA) revealed 63 with papular amyloidosis (PA) and 22 with macutar amyloidosis (MA). PLCA appeared to affect the Chinese more frequently than the other major ethnic groups but MA was more common than expected among the Indians. Of patients with PA, one had systemic lupus erythematosus, one scleroderma and in another, connective tissue disease was suspected. MA was not found to be associated with any other disease.

Histologically, PA differed from MA by the larger size of amyloid deposits in the papillary dermis. There was no difference in their tinctorial and immunohistochemical characteristics. Deposits were permanganate‐resistant and negative for AA protein, immunoglobulin light chains and keratin. A few cases exhibited positively for cytokeratin. Strong immunoreactivity for AP protein was observed. PA and MA appear chemically similar and are likely to be of epidermal origin.
LINEAR IgA DERMATOSIS WITH SEVERE ARTHRALGIA
Authors: Hepburn David J. , Davis Anne L. , Pigeon And Grant B. , Begg Evan J.
Published: June 2007

Linear IgA dermatosis with severe arthralgia is a rare clinical syndrome. Streptococcal infection may be important in its pathogenesis. The rash and arthralgia respond to dapsone although additional treatment with non‐steroidal anti‐inflammatory drugs and/or corticosteroids may be necessary. A case is presented which illustrates these features.
OUTPATIENT TREATMENT OF CHRONIC VENOUS ULCERS IN A SPECIALIZED CLINIC
Authors: Jopp‐McKay Andrea G. , Stagey Michael C. , Rohr James B. , Baker Steven R. , Thompson Pamela J. , Hoskin Susan E.
Published: June 2007

Chronic leg ulcers have many different causes and therefore need an accurate diagnosis in order to give the most effective treatment. A specialized clinic was set up in Fremantle Hospital in July 1988 with the aims of performing a thorough clinical and laboratory assessment to establish the cause of ulceration in every patient, and treating patients according to the cause of ulceration. Patients with arterial, neoplastic or dermatological conditions were treated as appropriate for their diagnosis and patients with other chronic ulcers were managed as outpatients where possible.

Patients were seen between July 1988 and July 1989. Only 43% had purely venous ulcers, 32.6% had a venous component plus some other abnormality, and 5.2% were purely arterial. Using an outpatient treatment regimen, 67% of all ulcerated limbs and 73.7% of limbs with purely venous ulcers were healed within 6 months. Only 11 patients with venous ulceration (15 limbs) failed on this therapy and required admission during the observation period. The initial ulcer size was shown to influence the time to total healing of the limb.

The healing rates achieved compare favourably with studies from other specialized centres and suggest that the majority of patients with chronic leg ulcers can be treated successfully using ambulatory outpatient dressing techniques.
ALPHA‐1 ANTITRYPSIN DEFICIENCY IN A PATIENT WITH WIDESPREAD PRURIGO NODULARIS
Authors: Heng Madelene C.Y. , Allen Suni G. , Kim Alyssa , Lieberman Jack
Published: June 2007

Skin lesions associated with alpha1‐antitrypsin deficiency are becoming better defined and understood. Deficiency in this major antiproteinase, which neutralizes multiple proteolytic enzymes ranging from collagenases and elastases to trypsin and chymotrypsin, thus results in significant tissue autodigestion. This anti‐proteinase is secreted by activated lymphocytes and macrophages, suggesting the existence of homeostasis which titrates the release of proteolytic enzymes by these cells, and the adequate neutralization of these proteases in order to prevent excessive tissue autodigestion each time these inflammatory cells are activated. We report a patient with alpha1‐antitrypsin deficiency who, following insect bites and cellulitis developed widespread itching and scratching, leading to widespread lesions of prurigo nodularis. The colonization of his multiple skin lesions with Staphylococcus aureus and the release of potent T cell mitogens, such as Protein A and enterotoxin A from the bacterial cell membrane may have resulted in the release of additional proteolytic enzymes by the activated lymphocytes and macrophages, without the concomitant secretion of alpha1‐antitrypsin with subsequent aggravation of his pruritus. These concepts are supported by electron microscopic evidence of excessive tissue autodigestion, and by immunocytochemical data identifying the presence of T helper and T cytotoxic/suppressor lymphocytes as well as macrophages within the upper dermis.
SUPERFICIAL MYCOSES IN SAUDI ARABIA
Authors: Venugopal Pankajalakshmi V. , Venugopal Taralakshmi V.
Published: June 2007

Summary

Between June 1988 and December 1990, 1018 cases of superficial mycoses were investigated. Diagnosis was confirmed by microscopic examination in 503 cases and the causal agent was isolated in 490 cases. Tinea capitis accounted for 47.7% (92.5% in children below 10 years of age). The frequency of other clinical types in descending order was pityriasis versicolor 25.8%, tinea corporis 9%, onychomycosis 5.8%, tinea pedis 4%, intertrigo 3.9% and tinea cruris 2.8%. Erythrasma was encountered three times and mixed piedra and trichomycosis axillaris once.

Microsporum canis was the commonest aetiologial agent, responsible for 46.9% of ringworm infections. Malassezia furfur was the next most common agent (26.5%) followed by, Candida albicans (8.6%) and Trichophyton violaceum (8.2%). Other species were found less frequently. T.simii was isolated from four cases of tinea cruris and one each of tinea capitis and tinea corporis, and Piedraia hortae and Trichosporon beigelii from a case of mixed piedra infection.
THE EFFECT OF BACTERIAL COLONIZATION ON VENOUS ULCER HEALING
Authors: Halbert Anne R. , Stacey Michael C. , Rohr James B. , Jopp‐Mckay Andrea
Published: June 2007

Summary

To determine the effect of bacterial colonization on venous ulcer healing, 82 patients with 100 venous ulcerated limbs were each studied prospectively for six months. Despite bacteriological swab results, topical or systemic antibiotics were not administered unless cellulitis supervened. Initial ulcer size, length of ulcer history and time to complete healing of colonized and uncolonized ulcers were determined and compared.

Organisms were cultured from 83 limbs prior to commencement of treatment, the commonest isolates being Staptiytococcus aureaus (48%), mixed coliforms (28%), Pseudomonas aeruginosa (21%) and anaerobes (17%). When compared with ulcers with no bacterial growth, colonized ulcers were of longer duration (P◂0.01), had a larger initial size (p◂0.001) and had significantly longer healing time (p◂0.001). When analysed individually beta‐haemolytic streptococci, anaerobes, Staptiylococcus aureus and coliforms were associated with delayed healing. Delayed healing was not found with Pseudomonas aeruginosa, although pseudomonas‐colonized ulcers were significantly larger and of longer duration than uncolonized ulcers.

Bacterial colonization is associated with delayed venous ulcer healing. To further clarify the pathogenicity of colonizing bacteria, however, the effect of their eradiction on healing of venous ulcers needs to be established.
CARBON DIOXIDE LASER TREATMENT OF PERIUNGUAL AND SUBUNGUAL VIRAL WARTS
Authors: Lim J.T.E. , Goh C.L.
Published: June 2007

Summary

This is a restrospective study of the cure rates of forty patients with subungual and periungual viral warts treated with carbon dioxide laser vapourisation (total of 69 lesions). 70.6% (48/68) lesions had failed treatment with cryotherapy and/or electrocautery treatment previously. 20/68 were treated with CO2 laser vapourisation as a first line treatment.

The overall cure rate over 10 months follow‐up period was 57.4% (39/68). Most recurrences (24/25) occurred within the first 3 months of vapourisation. The carbon dioxide laser vapourisation cure rate for warts in which previous cryotherapy and/or electrocautery had failed was 47.9% whereas those treated with carbon dioxide laser vapourisation as a first line treatment had a cure rate of 80% (p = 0.043). Subungual warts responded slightly better with a cure rate of 64.7% compared with periungual warts (54.9%) (n.s.). The carbon dioxide laser vapourisation cure rate for recurrent subungual and periungual warts (which failed previous carbon dioxide laser vapourisation) was 73.3% (11/15).

Our findings appeared to indicate that periungual and subungual warts can be eradicated by CO2 laser vapourisation. Recurrent warts can be effectively eradicated by further vapourisation. Recalcitrant periungual and subungual warts which have previously failed to respond to cryotherapy and/or electrocautery can be effectively eradicated with CO2 laser vapourisation.
RECURRENT CUTANEOUS ERYTHRALGIA AND ARTHRALGIA
Authors: Georgouras Katherine E. , Wittal Richard A. , Baird Phillip J.
Published: June 2007

Summary

Two cases are reported of Vietnamese men who presented in young adult life with recurrent, painful, erythematous patches (which we have termed “erythralgia”) over and adjacent to Joints and accompanied by marked constitutional symptoms of malaise and lethargy, arthralgia and in one patient, fever In the other, from the onset of the disease there were nodules over the bony prominences and in the interphalangeal regions of the fingers. The duration of the disease was over 12 years, the duration of each episode without therapy was one week and the interval between episodes was one to two weeks. In addition the patients showed a raised ESR and peripheral neutrophil leucocytosis of over 70%. There was a rapid response, within hours, to non‐steroidal anti‐inflammatory agents.

Skin biopsies taken at varying stages of the disease episode failed to demonstrate neutrophils thereby failing to satisfy one major criterion of Sweet's Syndrome. Direct immunofluorescence studies were negative. Biopsy of the nodules did not show rheumatoid pathology. The serum rheumatoid factor was negative. Investigations failed to demonstrate any recognised pattern of cutaneous or rheumatologic disease; infections such as borreliosis were excluded. Both patients showed evidence of past hepatitis B infection.

As recurrent painful cutaneous erythema is an uncommon phenomenon in dermatology except where the patient is suffering from recurrent cellulitis of the lower limbs, the patients reported here exhibit a pattern of disease not previously described.
A COMPARATIVE STUDY OF GLUCONOLACTONE VERSUS BENZOYL PEROXIDE IN THE TREATMENT OF ACNE
Authors: Hunt Michelle J. , Barnetson Ross StC
Published: June 2007

Summary

Alpha hydroxy acids (AHA's) or “fruit acids” are a special group of organic acids found in many natural foods. They have been described in the literature for the treatment of a number of conditions in which abnormal keratinization consistently contributes to pathogenesis. These include the icthyoses, warts, psoriasis, eczema and acne. We have performed a double‐blind clinical trial on 150 patients to evaluate the efficacy and skin tolerance of the alpha hydroxy acid gluconolactone 14% in solution (NuvodermTM lotion) in the treatment of mild to moderate acne when compared with its vehicle (placebo) and 5% benzoyl peroxide lotion. The results of this study showed that both gluconolactone and benzoyl peroxide had a significant effect in improving patients'acne by reducing the number of lesions (inflamed and non‐inflamed). Furthermore, fewer side‐effects were experienced by patients treated with gluconolactone when compared with benzoyl peroxide.
CONGENITAL INCLUSION DERMOID CYSTS OF THE SCALP
Authors: Sinclair Rodney D. , Darley Charles , Dawber Rodney P.R.
Published: June 2007

Summary

The natural history of congenital inclusion dermoid cysts of the scalp is unknown. We report three cases of this condition, which has been followed from birth for up to ten years. Dermoids are congenital subcutaneous cysts, which gradually flatten and scar over a number of years. The lesions are covered with skin showing focal alopecia but they may be surrounded by a collar of hypertropic hair. Later in life flattened cysts may be mistaken for aplasia cutis, but the history of a cyst at birth allows the clinician to distinguish these two conditions. As these cysts have a potential for intracranial extension, this is an important clinical entity.