bluuebunny/crossref_metadata_2025 huggingface dataset:
Iododerma: An Unusual Side Effect of Iodide Ingestion
Authors: Alpay Koksal , Kürkçüoǧlu Nazif
Published: March 2008

A 13‐month‐old girl developed multiple pruritic, 1‐ to 7‐cm, vegetating and ulcerative masses on the neck, extremities, and trunk after a one‐week course of an antibiotic and an expectorant that contained potassium iodide, prescribed for treatment of a respiratory tract infection. Clinical and histopathologic findings were consistent with the diagnosis of iododerma. A thorough search for an underlying disease was negative. On cessation of potassium iodide and administration of oral prednisolone 1 mg/kg/day, a dramatic response was achieved.
Management of Nevus Spilus
Authors: Casanova D. , Bardot J. , Aubert J. P. , Andrac L. , Magalon G.
Published: March 2008

Abstract: Nevus spilus Is clinically defined as a pigmented skin lesion composed of a light brown macule on which darker, circumscribed macular or papular lesions appear at a later stage. Histologically, nevus cells have been found both in pigmented spots and in the background stain. Cases of transformation into melanoma have been reported in the literature and the excision of these lesions is therefore justified. We discuss surgical techniques used in seven patients with nevus spilus and define their indications with respect to the characteristics of the lesion.
Histopathology and Immunofluorescence of Discoid Lupus Erythematosus in Children
Authors: George Pierre M. , Hood Antoinette F. , Rest Ellen B.
Published: March 2008

Abstract: The histopathology and immunofluorescence of discoid lupus erythematosus (DLE) are well documented In adults, but in children they have not been studied systematically. We reviewed nine skin biopsy specimens from six children with DLE. Only three specimens showed the well‐developed epidermal changes seen in lesions of adults with DLE, and in the other six, these changes were either mild or absent. All nine specimens showed some degree of vacuolar alteration of the basal layer, ranging from focal and mild to severe. They all had a moderate to heavy lymphocytic dermal infiltrate in a perivascular and periadnexal distribution. Direct immunofluorescence performed on five specimens of lesional skin was weakly positive for IgM or IgG in three cases, negative in one, and strongly positive for IgM, IgG, IgA, and C3 in one. This study indicates that the range of histologic and immunofluorescence features in children with DLE is similar to that in adults. The histologic findings are distinctive enough to be useful in establishing the diagnosis, although clinico‐pathologic correlation is required.
Idiopathic Eruptive Macular Pigmentation: Report of Five Patients
Authors: De Galdeano C. Sanz , Léauté‐Labrèze C. , Bioulac‐Sage P. , Nikolic M. , Taïeb A.
Published: March 2008

Abstract: We report the occurrence of idiopathic eruptive macular pigmentation in four children and one adolescent. This condition appears to be a distinct clinicopathologic and histologic entity. It is characterized by asymptomatic, pigmented macules involving the neck, trunk, and proximal limbs. All patients or their families denied the patients' having taken any drug before the eruption. In all of the patients the first sign was a pigmented spot without preceding erythematous, papular, or hypopigmented lesions. Histologic study showed enhanced epidermal basal layer pigmentation with pigmentary incontinence, a mild perivascular lympho‐histiocytic infiltrate, and many melanophages in the papillary dermis. Electron microscopy showed an increased number of melanosomes in basal and suprabasal keratinocytes as well as clustered melanosomes in dermal melanophages. Treatment of this asymptomatic condition is unnecessary because spontaneous resolution of the lesions is to be expected within several months to a few years.
Fox‐Fordyce Disease in Two Prepubertal Girls: Histopathologic Demonstration of Eecrine Sweat Gland Involvement
Authors: Ranalletta Maria , Rositto Alicia , Drut Ricardo
Published: March 2008

Abstract: This report presents two prepubertal girls with Fox‐Fordyce disease, The pruritic papules extensively affected the areas where apocrine glands are distributed (axillae, periareolar and Jntermammary zones, pubes, Infraumbilical midline), and also extended to the neck and face near the external angle of the eyes in one child. Analyses of several biopsy specimens showed that the main lesion was a spongiotic vesicle containing inflammatory ceils and keratlnocytes affecting the hair in‐fundibuia and acrosyringia, together, with hyperkeratosis of both adnexa, The cause of the disease remains elusive, but the microscopic findings may explain the good results obtained with keratolytic agents.
Treatment of Molluseum Contagiosum with Oral Cimetidine: Clinical Experience in 13 Patients
Authors: Dohil M. , Prendiville J. S.
Published: March 2008

Abstract: Our purpose was to determine if oral cimetidine, a histamine‐receptor antagonist, might be of benefit in the treatment of extensive molluseum contagiosum in children. We present 13 pediatric patients in whom conventional treatment modalities for molluseum contagiosum were unsuccessful or difficult to apply. They were treated with a two‐month course of oral cimetidine 40 mg/kg/day. All but three children who completed treatment experienced clearance of all lesions. These children had no new lesions but had persistance of several lesions. One child did not take the drug and did not clear. No adverse effects were observed. We conclude that oral cimetidine may be of benefit in the management of widespread or facial molluseum contagiosum in immunocompetent children.
The Efficacy of Treatment with Triamcinolone Acetonide in Calcinosis Cutis Following Extravasation of Calcium Gluconate: A Preliminary Study
Authors: Ahn Sung Ku , Kim Kyun Tae , Lee Seung Hun , Hwang Sang Min , Choi Eung Ho , Choi Sooim
Published: March 2008

Abstract: Neonatal hypocalcemia is not an uncommon condition, especially in the premature neonate. It is effectively treated by intravenous administration of calcium gluconate. Complications of extravasation during intravenous infusion include localized calcification and occasionally necrosis. When this occurs, however, there is no specific mode of treatment except supportive management and skin graft. This experiment was designed to evaluate the efficacy and safety of treatment with triamcinolone acetonide in calcinosis cutis following extravasation of calcium gluconate. Initally, 2 cc of 10% calcium gluconate was injected subcutaneously into two rabbits at seven sites on the shaved skin of the back. Another two rabbits were injected at the same sites with 0.5 cc of triamcinolone acetonide (10 mg/dl) after injection of 2 cc of 10% calcium gluconate. As a control, 2 cc of normal saline was injected into another rabbit in the same manner. These five rabbits were observed over the next 7 weeks and underwent pathologic examination at various intervals (on days 1, 3, 8, 15, 30, 37, 45). In the 10% calcium gluconate injected rabbits, nodules and large ulcerated lesions developed after 15 days. Multiple, linear, ulcerative and indurated masses were noted on day 37. The lesions healed progressively with a decrease in ulceration, and after 2 months, the masses disappeared gradually. Histologically, on day 15 calcium deposits were seen in the walls of the arteries, veins, dermis, and muscle fibers and epidermal necrosis was seen at the injection sites. From day 37 discharge of calcium deposits began to take place by means of transepidermal elimination. After 2 months, the calcium and mucin deposition was observed focally in the dermis. In the rabbits injected with 10% calcium gluconate and triamcinolone acetonide, mild erythema and induration were seen after day 15 at the injection sites; this gradually disappeared. After 30 days the injection sites were normal in appearance. Histologically, at day 15 calcium deposition was seen in the upper dermis, but after 1 month the injection sites were histologically normal. We suggest that intralesional injection of triamcinolone acetonide for the treatment of calcinosis cutis following extravasation of calcium gluconate is effective, probably due to its antlinflammatory effect and its role in facilitating the resorption of caicium in the tissue.
Lichen Planus in a Child Requiring Circumcision
Authors: Aste Nicola , Pau Monica , Ferreli Caterina , Biggio Pietro
Published: March 2008

Abstract: Lichen planus is a rare disorder in infants and children where it usually has the classical cutaneous pattern and only exceptionally involves the mucosa and skin appendages. A 9‐year‐old boy was referred to our department with a 4‐month history of erythematous keratotic papules on the trunk and the upper and lower limbs. There were no signs of mucosal involvement. Subsequently white papules and striae, occasionally forming a lace like pattern, appeared on the penis and prepuce which quickly led to phimosis necessitating circumcision. Histologic examination of skin biopsy specimens and genital mucosa fragments confirmed the clinical diagnosis of lichen planus.
Diagnosis and Treatment of Pustular Disorders in the Neonate
Authors: Van Praag M. C. G. , Van Rooij R. W. G. , Folkers E. , Spritzer R. , Menke H. E. , Oranje A. P.
Published: March 2008

Abstract:The diagnosis of a pustular dermatosis occurring during the first months of life is usually based on clinical findings. However, some cases may require simple investigations including microscopic examination of pustular content, cultures, and skin biopsies. The main benign transient neonatal types of pustulosis include erythema toxicum neonatorum, infantile acropustulosis, transient neonatal pustular melanosis, and neonatal acne. The most common causes of infectious pustular skin lesions include bacterial infections, which may be initially localized(Staphylococcus aureus)or septicemic (withListeria monocytogenesas the leading causitive agent); viral infections(herpes simplex, varicella‐zoster,andcytomegalovlrusinfections); fungal infections (candidiasis); or parasitic disorders (scabies). The main objective of this article is to propose a systematic approach to pustular eruptions in the neonate. The need for investigating every neonate with pustules for an infectious disease is emphasized. The Tzanck smear, the Gram's stain, and a potassium hydroxide preparation are the most important quick diagnostic tests. The Tzanck smear is a very easy, rapid, and sensitive test for detection of a herpetic infection (multinucleated giant cells) as well as noninfectious pustular eruptions (eosinophils, neutrophils). Therefore the Tzanck smear should be the first test performed. Moreover, a Gram's stain and potassium hydroxide preparation should be performed in cases of neonatal pustular disorders to detect bacterial and fungal infections. The goal of this diagnostic approach is to spare a healthy neonate with a benign transient condition an invasive evaluation for sepsis, potentially harmful antibiotic therapy, and prolonged hospitalization, with its own inherent morbidity.
MANAGEMENT OF NEVUS SPILUS WITH LASER
Authors: VAN LEEUWEN ROBERT L. , BASTIAENS MAARTEN T. , GREVELINK JOOP M.
Published: March 2008

Abstract: Letters to the Editor are welcomed tor publication (subject to editing). Letters must be signed by all authors, typewritten double spaced, and must not exceed tuo pages of text including references. Two copies of all letters should be submitted. Letters should not duplicate material submitted or published in other journals. Prepublication proofs will not be provided.
Superficial Hemangiomas: Associations and Management
Authors: Enjolras Odile , Gelbert Françisc
Published: March 2008

Abstract: The vast majority of hemangiomas, the most common skin tumor of infancy, are small lesions, easily recognized by their clinical features, and left to involute spontaneously. Hemangiomas also grow In a number of visceral locations, although rarely. In addition, associated malformations are reported. We analyzed 175 cases of severe superficial hemangiomas that represented approximately 10% of all hemangiomas evaluated from 1980 to 1995. In this particular group of severe hemangiomas, with marked female preponderance (6.6:1), symptomatic visceral hemangiomas were present in 20 of 175 patients (11.4%) and associated malformations were present in 12 patients (6.9%), with both present in 4 patients. We describe these associations and discuss which hemangiomas required active treatment and which therapeutic modalities can be used. Progress has been made in the management of problem hemangiomas.
Psychosocial Stress and Adaptive Functioning in Children and Adolescents Suffering from Hypohidrotic Ectodermal Dysplasia
Authors: Hummel Peter , Guddack Silke
Published: March 2008

Abstract: in its fully manifest form, hypohidrotic ectodermal dysplasia (HED) leads to a typical dysmorphia of the face, referred to as “old man” facies. Few studies have been conducted on how children and adolescents deal with and adapt to the effects of this illness. The psychosocial stress and adaptive functioning of such patients was investigated by means of a semistructured interview conducted on a sample of 14 children and adolescents with varying degrees of this disease. The results revealed that adaptive functioning is not only dependent on the severity of symptoms. The child's intellectual potential and personality, how the disease is dealt with within the family, and reactions from the child's environment influence adaptive functioning in different ways.
Microbiology of Nonbullous Impetigo
Authors: Brook Itzhak , Frazier Edith H. , Yeager Josef K.
Published: March 2008

Abstract: Our objective was to establish the aerobic and anaerobic microbiology of nonbullous impetigo (Nl) in children. We used a retrospective review of clinical microbiology laboratory and patients'records. Specimens were obtained from 40 patients with Nl lesions and showed bacteriai growth. Aerobic or facultative anaerobic bacteria only were present in 24 patients (60%), strict anaerobic bacteria only in 5 patients (12.5%), and mixed anaerobic‐aerobic flora was present in 11 patients (27.5%). Sixty‐four isolates were recovered (1.6 per specimen): 43 aerobic or facultative, and 21 anaerobic. The predominant aerobic and facultative bacteria were Staphylococcus aureus (29 isolates). Group A beta hemolytic streptococcus (GABHS) (13 Isolates), and Escherichia coli (1 isolate). The predominant anaerobes were Peptostreptococcus spp. (12), pigmented Prevotella spp. (5), Fusobacterium spp. (2), and Bacteroides fragilis (1). Single bacterial isolates were recovered in 17 patients (42.5%), 13 of which were S. aureus. S. aureus alone or mixed with GABHS or Peptostreptococcus spp. were isolated from all body sites. Mixed flora of Peptostreptococcus spp. with Prevotella spp. or Fusobacterium spp. was mostly found in infections of the head and neck, while E. coli mixed with B. fragills and Peptostreptococcus spp. were isolated from one infection of the buttocks area. Thirty‐three organisms isolated from 32 patients (80%) produced the enzyme beta‐lactamase. This study demonstrates the polymicrobial aerobic‐anaerobic microbiology of Nl lesions.
Granulomatous Slack Skin in Childhood
Authors: Camacho Francisco M. , Burg Günter , Moreno Jose C. , Cámpora Ricardo G. , Villar Jose L.
Published: March 2008

Abstract: Granulomatous slack skin is an uncommon cutaneous T‐ helper cell lymphoma closely related to mycosis fungoides. To the best of our knowledge this disease has not been previously described in children. We report on an 11‐year‐old boy who presented with painless slack skin masses in the neck, right axilla and arm, anterior wall of the abdomen, both inguinal regions, and the malleolar and dorsal aspects of the feet. The disease started 3 years earlier with erythematous lesions on the neck and wrists. Histologic examination of a specimen from the abdominal mass revealed an extensive lymphoid Infiltrate with scattered multinucleated giant cells extending from the papillary dermis to the subcutis. The lymphoid cells showed the following immunophenotype: CD43+ (MT1), CD45+, CD45RO+, CD20‐. The phenotype of the giant cells was lysozyme positive, CD68+ and Mac387–. The tumoral lymphoid cells had clonal rearrangement for the gene of the beta chain of the T‐cell receptor (CβTCR). The disease could be controlled with systemic glucocorticoids. Due to the presence of many histiocytes arranged in aggregates in the papillary and mid‐dermis, this case was initially considered to be a cutaneous form of histiocytosis. We recommend deep and extensive biopsies in patients with slack skin disease.
Fish Tank Granuloma in a 14‐Month‐Old Girl
Authors: Speight E. Lucy , Williams Hywel C.
Published: March 2008

Abstract: A 14‐month‐old girl developed a persistent ulcerated nodule on her right lower leg associated with further nodules along the thigh. A clinical diagnosis of fish tank granuloma was suspected because of tropical fish tanks at home. The diagnosis was confirmed when Mycobacterium marinum was isolated from low‐temperature culture of skin tissue. The child made a complete recovery following treatment with rifampicin for 6 months despite in vitro sensitivity tests reporting resistance. M. marinum infection is uncommon in children, but the diagnosis should be considered in children presenting with chronic skin lesions spreading in a sporotrichoid pattern.
Demodicidosis in an Immunodeficient Child
Authors: Castanet J. , Monpoux F. , Mariani R. , Ortonne J. P. , Lacour J. Ph.
Published: March 2008

Abstract: A 15‐month‐old girl developed acute lymphoblastic leukemia. Chemotherapy had induced a complete remission and she was continued on maintenance therapy. At 3 years of age, she developed an eruption consisting of excoriated papules and pustules on the face. Demodex folliculorum seemed to be the cause. Topical treatment with metronidazole applied twice a day over a period of 2 weeks resulted in partial improvement. The dermatosis finally cleared gradually with oral erythromycin therapy and one overnight application of 1% lindane cream per week for 2 successive weeks.
Congenital Syphilis Associated with Hyperlipoproteinemia
Authors: MeŠtrović J. , Krželj V. , Balarin L. , Meštrovič M. , Škrabič V.
Published: March 2008

Abstract: An infant with congenital syphilis associated with transient disturbances of lipoprotein metabolism is reported. The dominant clinical sign was hepatosplenomegaly. Laboratory investigation upon admission revealed hyperimmunoglobulinemia and hyperchylomlcronemia. After the administration of penicillin, the chylomicronemia ceased, but an increase of very low density lipoprotein fraction was observed. As the infant recovered, all the laboratory findings returned to normal. Hyperchylomicronemia was attributed to hyperimmunoglobulinemia. Absorption of immunoglobulins to lipoproteins can inhibit lipoprotein lipase activity. The increase in the very low density lipoprotein fraction was probably caused by the increase in serum lipoprotein production and the decrease in lipoprotein clearance that are frequently seen in patients with infectious diseases.
Proteus Syndrome: New Findings in Seven Patients
Authors: Rosario Barona‐Mazuera María del , Hidalgo‐Galván Luis René , Orozco‐Covarrubias María de la Luz , Durán‐McKinster Carola , Tamayo‐Sánchez Lourdes , Ruiz‐Maldonado Ramón
Published: March 2008

Abstract: Seven children with Proteus syndrome (PS) are reported. The majority of clinical findings coincide with what is reported in the literature. New findings were blue sclerae, telecanthus, epiblepharon, endotropy, hemimegaly of the optic nerve, occipital dysmyelination and compression of the corpus callosum, craneosynostosis, decalcification and thinning of the cortical layer of long bones, and talipes equinus. The clinical findings, possible etiology, differential diagnosis, and treatment of PS are discussed.
Xp Microdeletion Syndrome Characterized by Pathognomonic Linear Skin Defects on the Head and Neck
Authors: Paulger Brent R. , Kraus Eric W. , Pulitzer Donald R. , Moore Charleen M.
Published: March 2008

Abstract: We describe a new case of a rare syndrome characterized by ocular abnormalities and pathognomonic linear skin defects. This syndrome is the result of an unbalanced translocation resulting in a deletion of the distal end of the short arm of the X chromosome. We report the thirteenth case and review the clinical and cytogenetic aspects of this disorder. In addition we discuss new findings pertaining to the histopathology of the skin lesions.
Diffuse and Bilateral Lichen Striatus
Authors: Aloi F. , Solaroli C. , Pippione M.
Published: March 2008

Abstract: A 5‐year‐old girl had a papulo‐squamous dermatosis arranged in a Blaschko line pattern of 1 month's duration. The skin lesions were asymmetrically distributed bilaterally on the face, neck, trunk, and limbs. Histologically there was a lichenoid infiltrate with foci of spongiosis. The dermatosis cleared spontaneously with hypopigmentation 16 months later. Lichen striatus usually occurs in a solitary and unilateral fashion. Its diffuse and bilateral distribution is an uncommon presentation.
Sun Smart Day: A Pilot Program for Photoprotection Education
Authors: Buller Mary Klein , Goldberg Gerald , Buller David B.
Published: March 2008

Abstract: Excessive exposure to the sun's ultraviolet radiation (UVR) contributes to the etiology of melanoma and nonmelanoma skin cancers. Many behaviors that increase lifetime risk of skin cancer—sun exposure, sunburn, and lack of sun protection—occur early in childhood. A 1‐day school‐based skin cancer prevention effort—Sun Smart Day—was implemented and evaluated in three elementary schools to improve fourthgraders'knowledge, attitudes, and behaviors related to skin cancer prevention. A classroom‐based skin cancer prevention lesson was compared to an Interactive sun safety fair as vehicles for promoting comprehensive photoprotection. Sun Smart Day interventions had their greatest impact on fourth‐graders'awareness and knowledge of skin cancer and children's Increased knowledge persisted through the summer break. While both the classroom curriculum and the health fair boosted awareness and knowledge of sun safety among fourth graders, the classroom curriculum demonstrated a slight immediate advantage over the health fair on these outcomes. Also the curriculum was less difficult to implement, but the health fair was more engaging. A Sun Smart Day program may be an important first step in increasing public awareness and understanding of skin cancer and its prevention.
Gianotti‐Crosti Syndrome Associated with Epstein‐Barr Virus Infection
Authors: Hofmann Benedikt , Schuppe Hans‐Christian , Adams Ortwin , Lenard Hans‐Gerd , Lehmann Percy , Ruzicka Thomas
Published: March 2008

Abstract: Gianotti‐Crosti syndrome (GCS) is a distinct exanthematic, acrolocated eruption of childhood caused by a variety of infectious agents. Historically hepatitis B antigen positive (HBsAG+) papular acrodermatitis of childhood and HBsAg negative (HBsAg‐) papulovesicular acrolocated syndrome have been distinguished. Here we characterize the spectrum of associated infectious agents in seven patients with confirmed GCS seen in our departments in the years 1994–1995. Where available, stored frozen serum samples were reanalyzed for antiviral antibodies. The mean age of the two girls and five boys was 22.5 months with a range of 8 to 53 months. None of the patients was HBsAG+. Four patients showed serologic evidence of an acute infection and one patient of a recent Epstein‐Barr virus (EBV) infection. In two additional children vaccination preceded the appearance of GCS. In these two patients serologic investigations revealed no evidence of recent infection with most common viruses. Our results underline the role of viral infections other than hepatitis B in the etiology of GCS. EBV infection was the most commonly associated viral disease in our population. We agree with other authors that we should avoid using the terms papular acrodermatitis of childhood and papulovesicular acrolocated syndrome in describing HBsAg+ and HBsAg‐ forms of GCS.
Phylloid Pigmentary Pattern with Mosaic Trisomy 13
Authors: Horn Denise , Rommeck Marisa , Sommer Dietlind , Körner Hannelore
Published: March 2008

Abstract: In most patients with hypomelanosis of Ito, the hypopigmentation is characterized by narrow bands following the lines of Blaschko. We report a 13‐year‐old severely retarded girl with leaf‐shaped patches of hypopigmentation on the back together with short stature, scoliosis, facial dysmorphism, and asymmetrical leg length. The cytogenetic examination of both lymphocytes and fibroblasts demonstrated a mosaicism of 46,XX/47,XX,+13. This result was confirmed by in situ hybridization using a chromosome 13‐specific library in interphase cells. The pigmentary disturbance of our patient was similar to the phylloid pattern (type 3) of the classification of pigmentary patterns postulated by Happle. This type has been described in four patients so far, along with additional anomalies and a chromosomal mosaisicm in two patients.
Cutaneous Leiomyosarcoma in a Child
Authors: Yanguas Ignacio , Goday Jaime , González‐Giiemes Magdalena , Lozano Matías , Soloeta Ricardo
Published: March 2008

Abstract: Superficial leiomyosarcomas are infrequent tumors that are very rare in childhood. We report on a 12‐year‐old white boy with a cutaneous leiomyosarcoma of his left groin. Immunohistochemical study revealed positive immunostaining with antibodies to vimentin, desmin, and smooth muscle actin. The tumor was removed with wide surgical margins.
Pulmonary Hemorrhage: An Often Fatal Complication of Henoch‐Schoenlein Purpura
Authors: Paller Amy S. , Kelly Kay , Sethi Ruchi
Published: March 2008

Abstract: Two patients with Henoch‐Schoenlein purpura developed pulmonary hemorrhage. One patient survived after treatment with intravenous methylprednisolone and cyclophosphamide; the other patient died from cardlopulmonary arrest before therapy could be initiated. Although rare, pulmonary complications of Henoch‐Schoenlein purpura can lead to rapid demise unless immediate supportive treatment is initiated.
Linear IgA Disease with Clinical and Immunopathological Features of Epidermolysis Bullosa Acquisita
Authors: Mutasim Diya F. , Cummings Miriam P.
Published: March 2008

Abstract: 10‐year‐old boy had a 3‐month history of urticarial plaques and vesicles. Histologic and immunofluorescence testing confirmed the diagnosis of linear IgA disease. Immunoelectron microscopy revealed IgA deposits in the sublamina densa area similar to those seen in epidermolysis bullosa acquisita. Milia developed after resolution of the lesions, similar to lesions of epidermolysis bullosa acquisita.
Congenital Wells Syndrome
Authors: Garty Ben‐Zion , Feinmesser Meora , David Michael , Gayer Shraga , Danon Yehuda L.
Published: March 2008

Abstract: We describe a girl with eosinophilic cellulitis (Wells syndrome) in whom the disease appeared immediately after birth with subcutaneous nodules on t he scalp and trunk, followed by the characteristic skin swelling and erythema at the age of 6 months. The lesions disappeared after a few weeks, but recurred several times. The mother had consumed large quantities of medications during the pregnancy, including iron, vitamins, and “natural remedies.” Based on time of onset, this may be regarded as a unique case of congenital Wells syndrome. Its relation to the medications taken by the mother remains speculative. Subcutaneous nodules may be the presenting sign of Wells syndrome in children.
Common Association of HPV 2 with Anogenital Warts in Prepubertal Children
Authors: Handley J. , Hanks E. , Armstrong K. , Bingham A. , Dinsmore W. , Swann A. , Evans M. F. , McGee J. O. D. , O'Learj J.
Published: March 2008

Abstract: Anogenital (AG) warts in 31 prepubertal children were HPV typed by nonisotopic in situ hybridization (NISH) using digoxigenin labeled probes for human papilloma virus (HPV) types 1–5, 6,11,16,18, 31, and 33. Mode of transmission was determined from historical, clinical, and laboratory data independent of HPV typing. HPV 2 was detected most commonly (13/31 warts) followed by HPV 6 (7/31), HPV 11 (5/31), and HPV 16 (1/31). Although not reaching statistical significance, our results suggested that a mucosal HPV type (6,11,16) in a child's AG warts implied transmission from mucosal warts and conversely cutaneous HPV 2 transmission from warts at a cutaneous site. HPV typing provided no helpful information regarding actual mode of transmission of AG warts In these children. The high prevalence of HPV 2 in children's AG warts and the low prevalence of sexual abuse (2 of 31 children) found in this study suggest innocent auto‐ or heteroinoculation from cutaneous warts may be a common means by which children acquire AG warts.
Disseminated Bacillus Calmette‐Guerin Infection in an HIV‐Infected Child: A Case with Cutaneous Lesions
Authors: Ratón J. A. , Pochevitie Itziar , Vicente José M. , Gonzalez Ricardo , Hilhao Ibon , Gutierrez Carmen , Diaz‐Perez José L.
Published: March 2008

Abstract: A boy bom to a mother with unknown HIV infection was immunized with BCG In his first month of life. Seven months later axillary adenopathy developed. At the age of 10 months, 2 months after HIV Infection had been diagnosed, papular skin lesions appeared all over his body. Mycobacterium bovis, BCG strain, was cultured from a lymph node and blood. Ziehl‐Neelsen stain of a skin biopsy specimen showed histiocytes loaded with numerous acid‐fast bacilli. The patient died 10 days later, before the infection was confirmed. This is the first reported case of disseminated BCG infection in an HIV‐infected child presenting with cutaneous lesions.
Clear Cell Papulosis: Case Report and Literature Review
Authors: Kim You‐Chan , Bang Dongsik , Cinn Yong‐Woo
Published: March 2008

Abstract: Clear cell papulosis is a newly described skin disease characterized by multiple white papules. Histopathologically, diagnostic clear cells were seen among the basal cells of the epidermis. We report clear cell papulosis on the lumbar area and buttocks of a 1‐year‐old girl.
RESOLVING EVOLUTIONARY RELATIONSHIPS AMONG THE BROWN ALGAE USING CHLOROPLAST AND NUCLEAR GENES1
Authors: Phillips Naomi , Burrowes Renaud , Rousseau Florence , De Reviers Bruno , Saunders Gary W.
Published: March 2008

The brown algae are one of the largest and most important groups of primary producers in benthic coastal marine environments. Despite their biological importance, consensus regarding their taxonomic or evolutionary relationships remains elusive. Our goal was to produce a taxon‐rich two‐gene (rbcL and LSU rDNA) phylogeny. Key species were sequenced to represent each order and family in the analyses across all 19 orders and ∼40 families, including selected outgroups Schizocladiophyceae and Xanthophyceae. Our results are in sharp contrast to traditional phylogenetic concepts; the Ectocarpales are not an early diverging clade, nor do the Fucales diverge early from other brown algae. Rather, Choristocarpus is sister to the remaining brown algae. Other groups traditionally considered to have primitive features are actually recently diverged lineages, turning traditional phylogenetic concepts upside down. Additionally, our results allow for the assessment, in the broadest context, of many of the historical and more recent taxonomic changes, resulting in several emended groups along with proposals for two new orders (Onslowiales, Nemodermatales) and one new family (Phaeosiphoniellaceae).
DIURNAL CELL DIVISION REGULATED BY GATING THE G1/S TRANSITION IN ENTEROMORPHA COMPRESSA (CHLOROPHYTA)1
Authors: Kuwano Kazuyoshi , Sakurai Ryousuke , Motozu Yoshitaka , Kitade Yukihiro , Saga Naotsune
Published: March 2008

The cell‐cycle progression of Enteromorpha compressa (L.) Nees (=Ulva compressa L.) was diurnally regulated by gating the G1/S transition. When the gate was open, the cells were able to divide if they had attained a sufficient size. However, the cells were not able to divide while the gate was closed, even if the cells had attained sufficient size. The diurnal rhythm of cell division immediately disappeared when the thalli were transferred to continuous light or darkness. When the thalli were transferred to a shifted photoperiod, the rhythm of cell division immediately and accurately synchronized with the shifted photoperiod. These data support a gating‐system model regulated by light:dark (L:D) cycles rather than an endogenous circadian clock. A dark phase of 6 h or longer was essential for gate closing, and a light phase of 14 h was required to renew cell division after a dark phase of >6 h.
Environmental Impact and Added Value in Forestry Operations in Norway
Authors: Michelsen Ottar , Solli Christian , Strømman Anders Hammer
Published: March 2008

The forestry sector is experiencing an increasing demand for documentation about its environmental performance. Previous studies have revealed large differences in environmental impact caused by forestry operations, mainly due to differences in location and forestry practice. Reliable information on environmental performance for forestry operations in different regions is thus important. This article presents a case study of forestry operations in Norway. Environmental impact and value added of selected operations were assessed. This was done with a hybrid life cycle assessment (LCA) approach. Main results, including a sensitivity analysis, are presented for a set of four impact categories. The production chain assessed included all processes from seedling production to the delivery of logs to a downstream user. The environmental impact was mainly caused by logging, transport by forwarders, and transport by truck. These three operations were responsible for approximately 85% of the total environmental impact. The contribution to value added and total costs were more evenly distributed among the processes in the value chain. The sensitivity analysis revealed that the difference in environmental impact between the worst case scenario and the best case scenario was more than a factor of 4. The single most important process was the transport distance from the timber pile in the forest to the downstream user. The results show that the environmental impact from forestry operations in boreal forests was probably underreported in earlier studies.
Dynamic Eco‐Efficiency Projections for Construction and Demolition Waste Recycling Strategies at the City Level
Authors: Bohne Rolf André , Brattebø Helge , Bergsdal Håvard
Published: March 2008

In this article we have elaborated a consistent framework for the quantification and evaluation of eco‐efficiency for scenarios for waste treatment of construction and demolition (C&D) waste. Such waste systems will play an increasingly important role in the future, as there has been for many years, and still is, a significant net increase in stock in the built environment. Consequently, there is a need to discuss future waste management strategies, both in terms of growing waste volumes, stricter regulations, and sectorial recycling ambitions, as well as a trend for higher competition and a need for professional and optimized operations within the C&D waste industry. It is within this framework that we develop and analyze models that we believe will be meaningful to the actors in the C&D industry. Here we have outlined a way to quantify future C&D waste generation and have developed realistic scenarios for waste handling based on today's actual practices. We then demonstrate how each scenario is examined with respect to specific and aggregated cost and environmental impact from different end‐of‐life treatment alternatives for major C&D waste fractions. From these results, we have been able to suggest which fractions to prioritize, in order to minimize cost and total environmental impact, as the most eco‐efficient way to achieve an objective of overall system performance.
Perspective: The Stage‐Gate® Idea‐to‐Launch Process—Update, What's New, and NexGen Systems*
Authors: Cooper Robert G.
Published: March 2008

Stage‐Gate has become a popular system for driving new products to market, and the benefits of using such a robust idea‐to‐launch system have been well documented. However, there are many misconceptions and challenges in using Stage‐Gate. First, Stage‐Gate is briefly outlined, noting how the system should work and the structure of both stages and gates. Next, some of the misconceptions about Stage‐Gate—it is not a linear process, nor is it a rigid system—are debunked, and explanations of what Stage‐Gate is and is not are provided. The challenges faced in employing Stage‐Gate are identified, including governance issues, overbureaucratizing the process, and misapplying cost‐cutting systems such as Six Sigma and Lean Manufacturing to product innovation. Solutions are offered, including better governance methods such as “gates with teeth,” clearly defined gatekeepers, and gatekeeper rules of engagement, as well as ways to deal with bureaucracy, including leaner gates. Next‐generation versions of Stage‐Gate are introduced, notably a scalable system (to handle many different types and sizes of projects), as well as even more flexible and adaptable versions of Stage‐Gate achieved via spiral development and simultaneous execution. Additionally, Stage‐Gate now incorporates better decision‐making practices including scorecards, success criteria, self‐managed gates, electronic and virtual gates, and integration with portfolio management. Improved accountability and continuous improvement are now built into Stage‐Gate via a rigorous postlaunch review. Finally, progressive companies are reinventing Stage‐Gate for use with “open innovation,” whereas others are applying the principles of value stream analysis to yield a leaner version of Stage‐Gate.
Growth and Development of a Body of Knowledge: 16 Years of New Product Development Research, 1989–2004*
Authors: Page Albert L. , Schirr Gary R.
Published: March 2008

In this study, a content analysis was performed on 815 articles focused on new product development (NPD) published in 10 selected leading marketing, management, NPD, and research and development (R&D) journals from 1989 to 2004. Journals selected were a combination of leading journals in the discipline and publications that included NPD articles. NPD articles were classified by a series of key attributes including methodology employed, domains of knowledge utilized, and broad topics explored. The resulting data were then studied to discern trends over time or common characteristics within domains, methodologies, or journals. The study of NPD has grown since the Journal of Product Innovation Management (JPIM) was launched in 1984. This study shows strong growth in the number of articles on NPD in each category of journal selected. The research in the articles has changed: The early focus on a few selected success factors or a staged development process has evolved and broadened over the 16‐year period. More variables and more sophisticated models are being studied in NPD articles. The study found a continuing evolution in research topics and increased sophistication in quantitative techniques over the 16‐year period. Overall this review of the NPD literature uncovers encouraging signs of a maturing discipline. However, there are concerns about continuing issues in methodology, insufficient study of service innovation, and continued focus on process characteristics instead of other antecedents of NPD success. The service sector seems to be understudied, even as the reality of a service economy is generally acknowledged. The call in a recent meta‐analysis to focus more on market and product characteristics and less on process characteristics has not yet been heeded, even by marketing researchers.
Flexible Product Development: Building Agility for Changing Markets by Preston G. Smith
Authors: Nelson Beebe
Published: March 2008

Books reviewed in this issue:

Flexible Product Development: Building Agility for Changing Markets

The Leader's Guide to Lateral Thinking Skills: Unlocking the Creativity and Innovation in You and Your Team

Service Is Front Stage: Positioning Services for Value Advantage

Involving Customers in New Service Development

Project Sponsorship: Achieving Management Commitment for Project Success

Please note that the editor in chief of the Journal of Product Innovation Management (JPIM), Anthony Di Benedetto, was solely responsible for all editorial work on the first book review, since this is an assessment of the newest book by JPIM's book review editor, Preston Smith. To assure objectivity in the review process, Di Benedetto identified the reviewer, solicited and edited the review, and submitted the accepted review directly to the publisher. Smith did not see the review until it was completed and accepted for publication.
Environmental Stress, Erythrocyte Dysfunctions, Inflammation, and the Metabolic Syndrome: Adaptations to CO2 Increases?
Authors: Zappulla Donatella
Published: March 2008

In the Western world, the prevalence of the metabolic syndrome is increasing exponentially. Chronic subacute inflammation characterizes the syndrome, suggesting that inflammation might be a common denominator that links obesity to its pathologic sequelae. Potential mechanisms for the activation of inflammation include current air pollution inhalation and/or excess food intake. Both of these environmental factors have, in fact, been shown to promote oxidation followed by the release of proinflammatory cytokines. Potential sources of systemic inflammation include oxidized erythrocytes. Increased exogenous or endogenous CO2 deoxygenates hemoglobin, thereby increasing the fraction of hemoglobin reacting with nitrite to form methemoglobin together with release of superoxide and nitric oxide. These may form peroxynitrite, which may oxidize erythrocytes. Macrophages may then recognize and engulf these cells, thereby releasing proinflammatory cytokines. Therefore, studies should focus on the red blood cell and its proteins to finely target and appropriately treat a world pandemic ominously related to CO2 increases.
Reversal of Diuretic‐Associated Impaired Glucose Tolerance and New‐Onset Diabetes: Results of the STAR‐LET Study
Authors: Bakris George , Molitch Mark , Zhou Qian , Sarafidis Pantelis , Champion Annette , Bacher Peter , Sowers James R.
Published: March 2008

Reversal of new‐onset diabetes secondary to thiazide diuretic use remains questionable. STAR‐LET was a 6‐month extension of the Study of Trandolapril/Verapamil SR and Insulin Resistance (STAR), which assessed the effects of a fixed‐dose renin‐angiotensin system inhibitor (RASI)/hydrochlorothiazide (HCTZ) combination on changes in 2‐hour oral glucose tolerance test (OGTT) results. STAR‐LET explored whether the glycemic impact of HCTZ could be reversed by conversion to a RASI/verapamil combination. The primary outcome was change in 2‐hour OGTT results. Fifty‐one percent of the STAR patients were enrolled in STAR‐LET. The 2‐hour OGTT value (mmol/L) was unchanged from STAR baseline in the RASI/verapamil group (7.7±2.4 vs 8.1±3.3; P=.18) and improved in those who were switched from RASI/HCTZ to RASI/verapamil (8.5±3.0 vs 7.2±2.3; P<.001). This exploratory study suggests that the impairment in glycemic control seen with use of a thiazide diuretic combined with a RASI can be reversed by switching to a regimen that does not include a diuretic.
The Yin‐Yang of tumor‐associated macrophages in neoplastic progression and immune surveillance
Authors: Allavena Paola , Sica Antonio , Garlanda Cecilia , Mantovani Alberto
Published: March 2008

Summary: An intrinsic (oncogene‐driven) pathway and an extrinsic (microenvironment‐driven) pathway connect inflammatory reactions and cancer. M2‐polarized tumor‐associated macrophages and the related myeloid‐derived suppressor cells are key prototypic components of smoldering inflammation driving neoplastic progression. However, mononuclear phagocytes can exert anti‐tumor activity by killing tumor cells and eliciting tissue disruptive reactions (M1), a likely scenario in the early phases of carcinogenesis of immunogenic tumors and following therapeutic intervention. Shifting the macrophage balance represents a viable therapeutic target. Herein, the ‘macrophage balance’ is discussed in the context of the apparent paradox of tumor promotion by innate immunity‐driven inflammation and the seemingly opposed tumor surveillance by adaptive immune responses.
Arginine regulation by myeloid derived suppressor cells and tolerance in cancer: mechanisms and therapeutic perspectives
Authors: Rodríguez Paulo C. , Ochoa Augusto C.
Published: March 2008

Summary: Patients with cancer have an impaired T‐cell response that can decrease the potential therapeutic benefit of cancer vaccines and other forms of immunotherapy. l‐arginine (l‐Arg) is a conditionally essential amino acid that is fundamental for the function of T lymphocytes. Recent findings in tumor‐bearing mice and cancer patients indicate that increased metabolism of l‐Arg by myeloid derived suppressor cells (MDSCs) producing arginase I inhibits T‐lymphocyte responses. Here we discuss some of the most recent concepts how MDSC expressing arginase I may regulate T‐cell function in cancer and other chronic inflammatory diseases and suggest possible therapeutic interventions to overcome this inhibitory effect.
Indoleamine 2,3‐dioxygenase in T‐cell tolerance and tumoral immune escape
Authors: Katz Jessica B. , Muller Alexander J. , Prendergast George C.
Published: March 2008

Summary: Indoleamine 2, 3‐dioxygenase (IDO) degrades the essential amino acid tryptophan in mammals, catalyzing the initial and rate‐limiting step in the de novo biosynthesis nicotinamide adenine dinucleotide (NAD). Broad evidence implicates IDO and the tryptophan catabolic pathway in generation of immune tolerance to foreign antigens in tissue microenvironments. In particular, recent findings have established that IDO is overexpressed in both tumor cells and antigen‐presenting cells in tumor‐draining lymph nodes, where it promotes the establishment of peripheral immune tolerance to tumor antigens. In the normal physiologic state, IDO is important in creating an environment that limits damage to tissues due to an overactive immune system. However, by fostering immune suppression, IDO can facilitate the survival and growth of tumor cells expressing unique antigens that would be recognized normally as foreign. In preclinical studies, small‐molecule inhibitors of IDO can reverse this mechanism of immunosuppression, complementing classical cytotoxic cancer chemotherapeutic agents' ability to trigger regression of treatment‐resistant tumors. These results have encouraged the clinical translation of IDO inhibitors, the first of which entered phase I clinical trials in the fall of 2007. In this article, we survey the work defining IDO as an important mediator of peripheral tolerance, review evidence of IDO dysregulation in cancer cells, and provide an overview of the development of IDO inhibitors as a new immunoregulatory treatment modality for clinical trials.