bluuebunny/crossref_metadata_2025 huggingface dataset:
Urticarial Papular and Plaque Eruptions A Noneczematous Manifestation of Allergic Contact Dermatitis
Authors: M.Med. C. L Goh
Published: May 2007

A noneczematous eruption associated with allergic contact dermatitis is described. Five patients had disseminated erythematous urticarial papular and plaque eruptions secondary to contact allergy to two substances (four to proflavine and one to a permanent waving lotion). The eruption appeared to be similar to the previously described “erythema multiforme‐like eruption” associated with allergic contact dermatitis. A review of the previous report indicated that the eruptions currently being reported do not have the typical clinical and histologic features of erythema multiforme. The term “urticarial papular and plaque eruption of contact allergy” is suggested to describe the eruption. The exact mechanism of the eruption remained speculative.
Morphea After Bromocriptine Therapy
Authors: Leshin Barry , Piette Warren W. , Caplan Richard M.
Published: May 2007

A 57‐year‐old man developed morphea while taking bromocriptine. This drug is a semisynthetic ergot alkaloid, one of a class of drugs that is associated with fibrotic disorders. Other agents known for such association are serotonin (5‐hydroxytryptamine) and p‐adrenergic blockers. A common pathogenesis to link these agents to fibrosis remains uncertain.
Epidemiologic Characteristics of Scabies in the Israel Defense Force
Authors: Kimchi Nimrod , Green Manfred S. , Stone David
Published: May 2007

Scabies is not a notifiable disease in most countries. As a result the data on its epidemiologic characteristics are limited. In the Israel Defense Force, compulsory reporting of individual cases has been required for years, and in this study the epidemiology of the disease is examined for the years 1968–1988. A moderate epidemic occurred between 1969 and 1973, and was followed by a return to the previous low incidence. In 1982 a massive outbreak began, and peaked from 1985–1986. From 1987 to 1988, the incidence of infestation has markedly declined. A seasonal pattern of morbidity was evident during epidemic periods only; maximum incidence occurred during the winter months. These data are compared with those described in other countries and provide a more complete picture of the epidemiology of scabies based on individually reported cases.
Intrauterine Herpes Simplex Virus Infection. Hydranencephaly and a Nonvesicular Rash in an Infant
Authors: Parish Wendy R.
Published: May 2007

ABSTRACT: Herpes simplex virus (HSV) infection in a pregnant woman may have profound adverse effects on the fetus or neonate. A rare congenital syndrome has been associated with intrauterine infection with HSV. An infant with the congenital herpes syndrome is described, the characteristic clinical and laboratory features associated with this syndrome are summarized, and other possible manifestations of herpes virus infection in the newborn are reviewed.
Double‐Blind Comparison of Itraconazole with Griseofulvin in the Treatment of Tinea Corporis and Tinea Cruris
Authors: Bourlond A. , Lachapelle J. M. , Aussems J. , Boyden B. , Campaert H. , Conincx S. , Decroix J. , Geeraerts Ch. , Ghekiere L. , Porters J. , Speelman G. , Tennstedt D. , Kint T. , Vandaele R. , Van Den Haute V. , Van Lint L. , Willocx D.
Published: May 2007

Seventy‐eight patients with tinea corporis or tinea cruris participated in a double‐blind study with either 100 mg itraconazole or 500 mg ultramicromized griseofulvin for 15 consicutive days. Clinical outcome was significantly in favor of itraconazole at completion of treatment (72% responce rate vs. 51%) and at the follow‐up visit(91% response vs. 64%). The most important difference berween both treatment was the mycologic outcome, for which itraconazole showed a cure rate oc 87% compared to 57% for griseofulvin 2 weeks after comparison of therapy. It is suggested that 100 mg of itraconazole orally daily is significantly more effective than 500 mg of griseofulvin once daily for 15 days in the treatment of glabrous skin infections. Both drugs were well tolerated.
Basal Cell and Squamous Cell Carcinoma of the Skin in Finland
Authors: Karjalainen Sakari , Salo Hannu , Teppo Lyly
Published: May 2007

Long‐term survival of patients with basal cell (BCC) and squamous cell carcinoma (SCC) of the skin and site distribution of the lesions were studied using ample nationwide cancer registry data. The material consisted of 23,975 patients with BCC and 2,927 patients with SCC diagnosed in Finland from 1967 to 1981. The proportion of patients with lesions in the head and neck region was 77.5% in men and 81.4% in women for BCC and, 75.7% in men and 75.8% in women for SCC. The 5‐ and 10‐year relative survival rates (RSRs) of patients with BCC were very close to 100%. The 5‐year RSR of patients with SCC diagnosed from 1974 to 1981 was 87.7% in men and 84.0% in women. In patients with SCC the worst prognosis was for lesions of the scalp and neck in men (80.2%) and for those of the ears in women (73.2%).
Malignant Angioendotheliomatosis
Authors: Drobacheff C. , Blanc D. , Zultak M. , Humbert P. , Carbillet J. P. , Dupond J. L. , Laurent R.
Published: May 2007

A 70‐year‐old woman with chronic edema of the lower limbs was diagnosed as having a “malignant angioendotheliomatosis,” because histologic examination showed a strict intravascular location of a malignant proliferation. Immunochemical studies actually disclosed the lymphomatous origin of malignant cells. The recent literature regarding the nosology of this rare condition is reviewed.
Plasminogen Activators and Antiplasmin Activity in Atopic Dermatitis
Authors: Lotti T. , Battini M. L. , Brunetti L. , Fabbri P. , Panconesi E.
Published: May 2007

Cutaneous deposits of fibrinogen, fibrinolytic activity in lesional skin, plasmatic fibrinolytic activity, and anti‐plasmin activity (α2 macroglobulin, αl antitrypsin and antithrombin III) were evaluated in a group of ten patients with atopic dermatitis and in a sex‐ and age‐matched control group. Plasma fibrinolytic activity was increased in the acute phase of the disease (p < 0.05). The levels of circulating antiplasmins appeared similar in the patients and the control group. Cutaneous fibrinolytic activity was increased in the acute phase of the disease in 5 of 5 cases, suggesting a role of the fibrinolytic system in the amplification of the inflammatory phenomenon in that phase of the disease. In the chronic lichenified phase, CFA was decreased in 3 of 5 cases leading to an excessive deposit of fibrin in the skin. This could be correlated with the abnormal vascular response (blanching phenomenon). On the basis of these data, the therapeutic use of the antifibrinolytic agents only seems rational in the acute phase of the disease.
Senile Erythroderma with Serum Hyper IgE
Authors: Asai Toshiya , Horiuchi Yasuhiro
Published: May 2007

ABSTRACT: Eight patients with senile erythroderma with serum hyper IgE were studied. Characteristic laboratory findings were persistently elevated IgE levels, high peripheral‐blood eosinophils, and high lactic dehydrogenase (LDH). Immunologic analysis using immunoglobulin antibodies showed frozen sections of inguinal lymph nodes to stain with anti‐IgE antibody, particularly in the germinal center. Five of the patients had an atopic history, suggesting hereditary factors.
Oral Manifestations of Cutaneous T Cell Lymphoma
Authors: Kasha Edwin E. , Parker Colleen M.
Published: May 2007

ABSTRACT: Oral manifestations of cutaneous T cell lymphoma (CTCL) have received little attention in the dermatologic literature. The authors report two patients with lingual lesions. The histologic features are similar to those of the glabrous skin. A review of the 22 previously reported cases indicate a shortened survival. A retrospective review of 82 patients with CTCL treated at the authors' medical center identified only three with oral involvement. Radiation therapy offers effective palliation for these lesions.
Subungual Leukemia Cutis
Authors: Simon Claude A. , Daniel Su W. P. , Li Chin‐Yang
Published: May 2007

Abstract: A 79‐year‐old man had generalized humping of the nails and subungual tumors involving several fingers and the left big toe. Findings on histologic study of the tumor, together with the pattern on the peripheral blood smear, established the diagnosis of chronic lymphocytic leukemia. To the best of our knowledge, this is the first reported case of chronic lymphocytic leukemia involving the subungual area. The authors' observation emphasizes the importance of taking a biopsy specimen in the differential diagnosis of subungual tumors.
Keratotic Melanocytic Nevus
Authors: Gurbuz Oya , Hurwitz Robert M.
Published: May 2007

Thirty‐five percent of 363 melanocytic nevi were found to have a keratotic epithelial architectural pattern that was mostly infundibular and not previously emphasized. Keratotic melanocytic nevi were commonly from the trunk of women, and most were associated with an intradermal melanocytic nevus. The clinical and histopathologic features as well as a review of the literature of these keratotic melanocytic nevi are presented.
The Role of Cutaneous Sensory Nerves in the Maintenance of Psoriasis
Authors: Farber Eugene M. , Lanigan Sean W. , Boer Jurr
Published: May 2007

This is a case report of two patients with chronic plaque psoriasis in whom cutaneous nerve damage resulted in clearance of the disease at that site. In both patients reappearance of the psoriasis occurred with recovery of cutaneous sensation. The role of cutaneous sensation in the maintenance of skin disorders and, in particular, the role of neuro‐peptides in the pathogenesis of psoriasis are discussed.
Balanitis of Zoon
Authors: Nishimura Masayuki , Matsuda Tetsuo , Muto Masahiko , Hori Yoshiaki
Published: May 2007

A patient with an eruption of clinical and histologic features typical of plasma cell orificial mucositis of the glans penis is reported. Immunohistologically, IgE and IgG are found to be major immunoglobulin classes in the plasma cellular infiltrate. Although specific allergen has not been identified yet, the present findings suggest that this condition is not‘a nonspecific inflammatory response but is related to immediate hypersensitivity.
Relationship Between Capillary and Muscle Damage in Dermatomyositis
Authors: Casademont J. , Grau J. M. , Estruch R. , Pedro‐Botet J. C. , Urbano‐Márquez A.
Published: May 2007

To assess the pathogenetic importance of capillary damage and its relationship with degenerating muscle fibers in dermatomyositis (DM), an electron microscope study of eight muscle biopsy specimens (adult and juvenile forms) and seven muscle specimens from patients with other neuro‐muscular diseases was conducted. There was a 49% reduction of capillaries in the muscle specimens of DM patients. Capillary damage also was more frequent in the DM group than in control group (p<0.001). We found a striking relation between capillary and muscle damage in the DM group (p<0.002) but not in the control group. The diagnostic value of undulating tubules within endothelial cells is also discussed.
Acrokeratoelastoidosis
Authors: Shbaklo Zuhair , Jamaleddine Nazek F. , Kibbi Abdul‐Ghani , Salman Salah M. , Zaynoun Shukrallah T.
Published: May 2007

ABSTRACT: Two cases of acrokeratoelastoidosis comprised of smooth shiny papules on the hands, feet and legs, are reported. Focal acral hyperkeratosis, degenerative collagenous plaques of the hands and keratoelastoidosis marginalis of the hands are three closely related conditions.
Skin Zinc Concentrations in Patients with Varicose Ulcers
Authors: Ackerman Zvi , Loewenthal Elia , Seidenbaum Moshe , Rubinow Alan , Gorodetsky Raphael
Published: May 2007

ABSTRACT: The concentration of zinc in the skin has been determined noninvasively in patients with varicose vein ulcers. The examinations were performed with the use of diagnostic x‐ray spectrometry, a method based on x‐ray fluorescence for in vivo noninvasive evaluation of trace elements. Four skin foci were examined: at the periphery of the ulcer and control areas in a nonulcerated area in the diseased leg, in the noninvolved leg, and in the proximal inner surface of the arm. Zinc levels around the ulcer (mean ± SD, 9·8 ± 4·0 μg of zinc in 1 g of wet tissue) were higher than those in the nonulcerated skin in the diseased leg (6·9 ± 3·0 μg/g, p>0·05) and those in the noninvolved leg (5·4 ± 2·0 μg/g, p<0·01). The concentration of zinc in the inner proximal surface of the arm (9·8 ± 2·8 μg/g) was significantly higher than those of a control group (5·3 ± 1·9 μg/g, P<0·01). These results suggest a defect of zinc distribution in patients with varicose vein ulcers.
Carcinoma Cuniculatum Originating from Intertriginous Lesions
Authors: Melo Carlos R. , Melo Ivanir S.
Published: May 2007

Abstract: Three cases of long‐standing carcinoma cuniculatum originating from intertriginous lesions, which resembled athlete's foot in their initial stages, were reported. The authors suggest cutaneous malignancy to be considered in the differential diagnosis of intertriginous lesions unresponsive to usual therapeutic measures.
The Treatment of Melasma 20% Azelaic Acid versus 4% Hydroquinone Cream
Authors: Baliña Luis M. , Graupe Klaus
Published: May 2007

Abstract: The efficacy of 20% azelaic acid cream and 4% hydroquinone cream, both used in conjunction with a broad‐spectrum sunscreen, against melasma was investigated in a 24‐week, double‐blind study with 329 women. Over the treatment period the azelaic acid cream yielded 65% good or excellent results: no significant treatment differences were observed with regard to overall rating, reduction In lesion size, and pigmentary intensity. Severe side effects such as allergic sensitization or exogenous ochronosis were not observed with azelaic acid.
Benign Human Papillomavirus Infection in Renal Transplant Recipients
Authors: Dyall‐Smith Delwyn , Trowell Helen , Dyall‐Smith Michael L.
Published: May 2007

Abstract: Warts and cutaneous squamous cell carcinomas are common complications of immunosuppression. We studied a total of 189 renal transplant recipients clinically for such lesions. The incidence of warts increased steadily after transplant, such that of patients transplanted for more than 5 years, 92% were found to have warts and 65% had more than five warts each. DNA extracted from scrapings of their warts showed they carried the same human papillomavirus types as the general population, and not the unique set found on patients with epidermodysplasia verruciformis (who share with transplant recipients an increased incidence of warts and squamous cell carcinomas).
Rosacea‐Like Lesions due to Familial Mycobacterium avium‐intracellulare Infection
Authors: Nedorost Susan T. , Elewski Boni , Tomford John Walton , Camisa Charles
Published: May 2007

Abstract: Mycobacterium avium‐intracellulare (MAI) is a non‐tuberculous, nonlepromatous or “atypical” mycobacterium now seen frequently in patients with acquired immunodeficiency syndrome (AIDS). In the past decade, the incidence appears to have increased in non‐AIDS patients. Although cutaneous involvement is rare, two brothers without detectable immune defects who both presented with cutaneous MAI infection are described; the older brother also has disseminated disease. The cutaneous presentation of MAI, as well as immune and genetic defects that may predispose to mycobacterial infection, are discussed.
HLA in Bullous Pemphigoid
Authors: Schaller J. , Feleke W. , Haustein U. F. , Baldauf C. , Kunze G.
Published: May 2007

ABSTRACT: The frequency of HLA‐class l and DR antigen frequencies were studied in 38 (class 1) and 19 (DR) patients with bullous pemphigoid, respectively, and compared with controls. There was no important difference in the frequency of HLA‐A,B,C and DR antigens between patients and controls. An increase in the HLA‐B7 frequency in poor responders to immunosuppressants (50% vs. 27% in the control group and vs. 13% in the group of all patients) was noticed, and the possible role of this antigen as a marker for poor responders to therapy was suggested.
Treatment of Behçet Disease with Indomethacin
Authors: Simsek Halis , Dundar Semra , Telatar Hasan
Published: May 2007

ABSTRACT: Thirty patients with Behçet disease (BD) were treated with oral indomethacin 25 mg four times daily for 3 months as an open label study. The study population consisted of 13 women and 17 men from 15 to 45 years of age (mean 27 years). At the initiation of the therapy, 28 patients had oral aphthous lesions, 23 had joint involvement, 13 had genital ulcerations, 8 had cutaneous lesions, and 4 had eye involvement. Eighty‐eight percent of patients with skin lesions, 80% with joint involvement, 43% with oral aphthous lesions, and 38% with genital ulcerations responded to indomethacin therapy. In three patients indomethacin was changed to the suppository form due to gastrointestinal side effects. Although it is difficult to assess the efficacy of indomethacin in BD because of the intermittent nature of symptoms, the majority of patients showed improvement in their symptoms of arthritis and skin lesions. This study indicates that indomethacin can be used as effective therapy particularly in patients with joint involvement.
Treatment of Squamous Cell Carcinoma with Interferon
Authors: Ikić Drago , Padovan Ivo , Pipić Nedim , Knez̆ević Mirko , Djaković Nikola , Rode Bojan , Kos̆utić Iva
Published: May 2007

ABSTRACT: Human natural leukocytic interferon and recombinant HulFN alpha 2c can be used in the therapy of squamous cell carcinoma. The duration of treatment was 3‐6 weeks. A single dose was 400,000‐5,000,000 units given weekly for 3‐6 weeks. Clinically and histologically 19 of 32 patients were cured and tumor cells were not found in the material taken after interferon treatment for the second biopsy. In ten patients tumor size was reduced 25‐90%, and in three patients tumor size was not reduced according to clinical findings. With recombinant HulFN alpha 2c therapy given 5 times per week for 4 weeks. Four of ten patients with similar tumors were cured clinically and histologically clinical findings. In five patients tumor size was reduced 25–90%, while in one patient there was no reduction in tumor size. Both types of interferons are effective in the treatment of squamous cell carcinoma. Side reactions were mild.
MICROBIOLOGY OF SECONDARILY INFECTED DIAPER DERMATITIS
Authors: BROOK ITZHAK
Published: May 2007

Specimens obtained from 67 infants with secondarily infected diaper dermatitis were cultured for aerobic and anaerobic bacteria. Bacteria growth was obtained in 58. Aerobic facultative bacteria or Candida sp. only were present in 28 patients (48%), anaerobic bacteria only in 11 (19%), and mixed anaerobic with aerobic, facultative, or yeast flora was present in 19 (33%). Ninety‐one bacterial or fungal isolates were recovered (1.6 per specimen), 54 (0.9 per specimen) aerobic or facultative bacteria, 8 (0.1 per specimen) Candida sp., and 31 (0.6 per specimen) strict anaerobes. The predominant aerobic and facultative bacteria were Staphylococcus aureus (23 isolates), Streptococcus sp. (16), and Escherichia coli (6). The predominant anaerobes included Bacteroides sp. (12, including 9 Bacteroides fragilis group) and Pepto‐streptococcus sp. (11). Single bacterial isolates were recovered in 32 (55%) patients, 18 of which were S. aureus. Twenty‐five beta‐lactamase‐producing bacteria were detected in 22 (51%) of the 43 tested patients. These included 16 S. aureus and 6 B. fragilis group. These data highlight the importance of anaerobic bacteria in the polymicrobial nature of secondarily infected diaper dermatitis.
TERBINAFINE: EFFICACY AND SAFETY IN THE TREATMENT OF DERMATOPHYTOSIS
Authors: TÜZÜN YALÇIN , KOTOGYAN AGOP , OGUZ OYA
Published: May 2007

A double‐blind study with terbinafine was performed in 39 patients with dermatophyte infection, between 1987 and 1989, to compare the safety and efficacy of two dosage schedules of 125 mg twice daily versus 250 mg once daily. Mycologic assessments were negative by microscopic examination and Sabouraud's culture in 59% and 100% of patients in the first and the fourth weeks of treatment, respectively. There was no statistically significant difference between the two groups of patients receiving 125 mg b.i.d. and 250 mg q.d. with respect to the safety and efficacy of the treatment; however, the differences between the sums of clinical scores before and after the treatment were statistically significant. There were no adverse effects, and the drug was well tolerated.
SAPERCONAZOLE IN THE TREATMENT OF SYSTEMIC AND SUBCUTANEOUS MYCOSES
Authors: FRANCO LILIANA , GOMEZ IVAN , RESTREPO ANGELA
Published: May 2007

In a 2‐year period, 30 patients with culture‐proven mycoses (chromoblastomycosis, sporotrichosis, and paracoccid‐ioidomycosis) were treated with the new orally administered triazole, saperconazole (SPZ) (R66905). The daily dose varied from 100 to 200 mg. All patients responded to treatment; the mean time required to heal the lesions and convert the cultures to negative was 3.5 months for sporotrichosis, 4.6 for paracoccidioidomycosis, and 9.0 for chromoblastomycosis. Evaluation by a scoring system indicated that 36.6% of the patients achieved complete resolution of the pretherapy abnormalities, while the remaining (63.3%) experienced major improvement. No colateral effects were reported; there were no bone‐marrow or liver toxicities. SPZ is an effective drug for the treatment of the above‐mentioned mycoses and appears to be suitable for the control of chromoblastomycosis.
LIVER BIOPSY VERSUS ULTRASOUND IN METHOTREXATE‐TREATED PSORIASIS: A DECISION ANALYSIS
Authors: VERSCHUUR ARNAUD C. , VAN EVERDINGEN JANNES J.E. , COHEN ERNST B. , CHAMULEAU ROB A.F.M.
Published: May 2007

Before starting methotrexate therapy for cases of recalcitrant psoriasis, a liver biopsy has been usual in order to exclude cirrhosis and moderate or severe fibrosis, which are contraindications for methotrexate treatment. As mortality and morbidity of liver biopsy are not negligible, and as this invasive procedure is unpleasant for the patient and urges clinical admission, we evaluated the possibility of ruling out severe liver pathology by means of ultrasonography, which we compared to liver biopsy. We made this comparison by means of a decision tree. The advantages of this analysis are the clear definition of the decision problem and its alternatives, and the possibility of calculating the risk of each alternative, thus being able to choose the best diagnostic method. In this study, the results of various research groups are discussed, in which liver biopsy and liver ultrasound were compared. In our decision tree we used some of these results and other assumptions, based on comparable studies. We varied the biopsy mortality and the sensitivity of ultrasound to show the change in the risk of each alternative. Our analysis shows that the differences of expected values between the liver biopsy branch and the ultrasonography branch are relatively small. Therefore, we advise each center, which has at its disposal a specialist in liver ultrasonography, to re‐evaluate its guidelines with regard to the detection of severe liver pathology before starting methotrexate for the treatment of psoriasis.
PORPHYRIA CUTANEA TARDA AND HUMAN IMMUNODEFICIENCY VIRUS INFECTION
Authors: BLAUVELT ANDREW , ROSS HARRIS H. , HOGAN DANIEL J. , JIMENEZ‐ACOSTA FRANCISCO , PONCE ISMAEL , PARDO RUBE J.
Published: May 2007

Porphyria cutanea tarda (PCT), a relatively uncommon disease, has recently been reported in patients infected with the human immunodeficiency virus (HIV). Although PCT and HIV infection may co‐exist by chance, the increasing number of reported cases suggest that HIV or an associated factor triggers the development of PCT in predisposed individuals. We report four additional cases of PCT in HIV seropositive patients and review the previously reported cases. The possible links between PCT and HIV are discussed. We believe the diagnosis of PCT should prompt investigation for HIV infection in all patients.
CONFLUENT AND RETICULATED PAPILLOMATOSIS: CLINICAL, LIGHT AND ELECTRON MICROSCOPIC STUDIES
Authors: JIMBOW MIHOKO , TALPASH OREST , JIMBOW KOWICHI
Published: May 2007

A case of a 17‐year‐old Japanese‐Canadian boy with a 2‐year history of skin lesions relevant to confluent and reticulated pa‐pillomatosis (CRP) is reported with electron microscopic findings. He had scattered skin lesions of brownish‐colored, rough‐surfaced, fine‐scaled patches and plaques distributed on the nape, shoulders, and both flanks, extending to the chest and back. Importantly, they showed reticular or confluent arrangement. There was no family history of the same skin lesions. The histology showed epidermal papillomatosis and mild acanthosis with a marked hyperkeratosis. Electron microscopically, the skin lesions consisted of the following abnormal findings: (1) a marked alteration of cornified cell structures showing snake coil‐like, or triangle‐like stacks, (2) a marked increase in the number of lamellar granules in the granular layer, (3). an increased number of melanosomes in the horny layers, and (4) no significant fine structural changes of epidermal melanocytes. This is the first electron microscopic report on CRP suggesting that the pathophysiology of this disease is related to abnormal keratinocyte differentiation.
RHABDOID TUMOR OF THE SKIN
Authors: SANGUEZA OMAR P. , MESHUL CHARLES K. , SANGUEZA PASTOR , MENDOZA RAUL
Published: May 2007

A tumor in the skin of a 42‐year‐old man was analyzed by light and electron microscopic study and immunohistochemistry. The tumor cells were large and contained eosinophilic, periodic acid‐Schiff (PAS)‐positive inclusions in the cytoplasm. Immunohistochemically, the neoplasm was positive for intermediate filaments, cytokeratin, vimentin, desmin, and alpha‐1‐antichimotrypsin, and negative for S‐100 and leukocyte common antigen (LCA). Ultrastructurally, the cytoplasm and cellular processes of the cells were inundated with intermediate filaments, some of which were tightly bundled. Junctional complexes and secretory granules were absent. These features suggest a rhabdoid tumor: a malignant tumor of uncertain origin.
JOINT COMPLAINTS IN PSORIASIS PATIENTS
Authors: ZANOLLI MICHAEL D. , WIKLE JOHN S.
Published: May 2007

Four hundred and fifty‐nine psoriasis patients seen at the Department of Dermatology, Bowman Gray School of Medicine of Wake Forest University, responded to a questionnaire concerning current or past joint complaints. Of these, 17% reported a previous diagnosis of psoriatic arthritis, and over 53% had a current or past history of arthralgias. Additional information on those patients reporting arthralgias focused on the cutaneous sites of involvement with psoriasis and which joints were most likely to be involved in patients with various types of arthritis. Previous treatments for skin involvement with psoriasis were more aggressive in those patients with a diagnosis of psoriatic arthritis. A significant proportion of patients presenting to dermatologists for treatment of psoriasis have joint complaints, and the percentage of patients with psoriatic arthritis is greater than generally appreciated by non‐dermatologists.
DERMATOLOGY IN A WAR ZONE: A PERSIAN GULF EXPERIENCE
Authors: PEHR KEVIN , KORNFELD BRUCE W.
Published: May 2007

The clinical experience of two US Army dermatologists during the recent Gulf War (Operation Desert Shield/Storm) are presented, with comparison with dermatologic experience in previous wars and in civilian practice.
SYSTEMIC KETOCONAZOLE TREATMENT FORFUSARIUMLEG ULCERS
Authors: LANDAU MARINA , SREBRNIK AVIGDOR , WOLF RONNI , BASHI EDNA , BRENNER SARAH
Published: May 2007

Fusarium oxysporumwas isolated from a large foot ulcer in an otherwise healthy 69‐year‐old man. Although tissue invasion could not be proven histologically, systemic antifun‐gal treatment was administered with satisfactory response.

Fusariumspecies are common soil‐inhabiting organisms and plant pathogens. In humans,Fusariumis considered an opportunistic agent in skin ulcers, interdigital spaces, and burned skin, but can also cause mycotic keratitis, onychomycosis, and rarely deep‐seated or disseminated infections, especially in an immunocompromised host. The distinction between skin infection and saprophytic growth, as well as optimal treatment regimens for the two types of infection, have not been clearly defined.

We describe a case of leg ulcers caused byFusarium oxysporumin a 69‐year‐old man treated successfully with oral ketoconazole. “Silent” immunologic disturbances were found in this apparently healthy patient. The case illustrates a relatively benign infection caused byFusariumthat responded to systemic antifungal drug treatment.
DIFFUSE CUTANEOUS LEISHMANIASIS WITH ATYPICAL ASPECTS
Authors: BITTENCOURT ACHILÉA L. , HARRAL ALDINA , COSTA JACKSON M.L. , CRISTINA SALDANHA ANA , BADARO FERNANDO , BARRAL‐NETTO MANOEL , FREITAS LUIZ A.R.
Published: May 2007

A 16‐year‐old man had long‐standing diffuse cutaneous leishmaniasis with the following characteristics: diffuse infiltrated lesions rich in amastigotes, absence of mucosal involvement, and lack of parasite‐specific cell‐mediated immune response. In situ identification of Leishmania mexicana amazonensis was achieved by the use of monoclonal antibodies. Clinically, as an atypical finding there was deep and extensive ulceration in the lower limbs. Histologically, an atypical characteristic was the presence of a high number of eos‐inophils in the infiltrate predominantly in the ulcerated lesion. Ultrastructurally, parasitized and lysed eosinophils with dispersion of their granules were seen in the vicinity of parasitized or lysed macrophages.
PYODERMA GANGRENOSUM TREATED WITH HYPERBARIC OXYGEN THERAPY
Authors: WASSERTEIL VIVIAN , BRUCE SUZANNE , SESSOMS SANDRA L. , GUNTUPALLI KALPALATHA K.
Published: May 2007

The management of pyoderma gangrenosum often requires systemic drug therapy, such as corticosteroids, sulfones, or immunosuppressants, either alone or in combination. Inconsistent response to therapy is a source of frustration to both patient and physician. Several reports in the literature document the successful treatment of pyoderma gangrenosum with hyperbaric oxygen therapy. In our patient, a woman with severe rheumatoid arthritis and diabetes mellitus, hyperbaric oxygen therapy not only promoted healing of pyoderma gangrenosum but permitted reduction of systemic corticosteroids.
EXPRESSION OF T6 ANTIGEN ON KERATINOCYTES IN ALOPECIA AREATA
Authors: LOTTI TORELLO , KNOEPFEL BIRGIT , ZANGHERI MARCELLO , PANCONESI EMILIANO
Published: May 2007

The expression of T6 antigen within hair follicles in alopecia areata was studied using the APAAP technique (alkaline phosphatase monoclonal anti‐alkaline phosphatase method). Scalp biopsies were taken from 15 subjects with alopecia areata, nine in an active stage and 6 in a stationary stage of the disease. Six‐micrometer‐thick frozen sections were stained with OKT6 antiserum. OKT6 are monoclonal antibodies raised against human thymocytes; they cross‐react with epidermal Langerhans ceils and are a highly specific marker. Nine of the specimens displayed T6 staining on keratinocytes in the bulb matrix, and all nine were from the subjects presenting the active stage of disease. The specimens from the other six biopsies, from subjects in a stationary stage, did not show T6 staining of bulbar keratinocytes. Moreover, in four of the active‐stage cases we found T6 staining also on epidermal keratinocytes.
ERYTHROMYCIN VERSUS CEEADROXIL IN THE TREATMENT OF SKIN INFECTIONS
Authors: HESKEL NEIL S. , SIEPMAN NANCY C. , PICHOTTA PHILIP J. , GREEN ELIZABETH M. , STOLL RALPH W.
Published: May 2007

Erythromycin is often overlooked for the treatment of skin and skin structure infections. We evaluated the efficacy and safety of erythromycin particles in tablets and of cefadroxil in 164 patients with skin infections; both treatments were given as 500 mg twice daily. One hundred percent of erythromycin and 96% of cefadroxil patients were clinically cured or improved, and 98% of susceptible pathogens were eradicated in both groups. Only three erythromycin patients and one cefadroxil patient left the study early because of GI‐related adverse events. Erythromycin, therefore, was as effective and safe as cefadroxil in the treatment of mild‐to‐moderate skin infections.
ELEPHANTISIS
Authors: ROUTH HIRK BEHARI
Published: May 2007

Elephantisis is the enormous enlargement of various parts of the body. While this term usually refers to grotesque fibrosis of the legs, it can also describe similar devastating changes of the arm, chest, and even genitalia. Massive swelling, especially of the legs, c uses deformity and ultimately difficulty in normal movement and function. This review focuses mainly on the most common types of elephantiasis, their process of development, and the appropriate management.
ELECTROTRICHOGENESIS: FURTHER EVIDENCE OF EFFICACY AND SAFETY ON EXTENDED USE
Authors: MADDIN W. STUART , AMARA INGRID , SOLLECITO WILLIAM A.
Published: May 2007

These data represent a subset of data from the original 36‐week study conducted by Maddin et al.,1 which was in itself a preliminary study of a pulsed electrical stimulation device in male subjects alone. The extension phase of this study, which is summarized here, was undertaken to gather data on longer‐term efficacy and safety and to study clinical effects in control subjects who were then switched to active treatment. Thirteen subjects had active treatment for 70 weeks, and 14 subjects were included in the crossover group, which had sham treatment for 36 weeks followed by active treatment for 30 additional weeks. On average, terminal hair counts increased from 82 to 276 in the active treatment group. Among those in the crossover group, a mild increase, from 124 to 160, was observed during the sham treatment period and a more notable increase, from 160 to 249, occurred during the subsequent active treatment period. The results presented here provide evidence of the efficacy and safety of this device during extended use; however, the generalizability of these findings is limited by the small subset of subjects for whom complete data are available.
CUTIS MARMORATA TELANGIECTATICA CONGENITA
Authors: KENNEDY CORNELIS , ORANJE ARNOLD P. , KEIZER KOOS , VAN DEN HEUVEL MARY M. , CATSMAN‐BERREVOETS CORIENE E.
Published: May 2007

The authors describe ten cases of cutis marmorata telangiectatica congenita (CMTC). All of these cases were sporadic. The incidence of associated anomalies was relatively low, and three patients had skin manifestations (cutaneous atrophy and nevus telangiectaticus). In two patients, the right leg was shorter and thinner. Another two showed neurologic symptoms without lasting neurologic damage. New associated anomalies, such as tendinitis stenosans and bowing of the lower legs, did not provide additional information regarding the cause of CMTC. The authors suggest that Happle's lethal gene hypothesis for Klippel‐Trenaunay and Sturge‐Weber syndromes also could be applied to CMTC.
OCCUPATIONAL OR EXTRINSIC STIMULATION FACTORS AND INITIAL SIGNS OF PROGRESSIVE SYSTEMIC SCLEROSIS
Authors: MAEDA MANABU , MORI SHUNJI
Published: May 2007

Forty‐eight patients with progressive systemic sclerosis (PSS) (man‐woman ratio, 7:41) were studied, and detailed questionnaires were used to clarify the relationship between occupational stresses and the initial signs of PSS. All of the patients were right‐handed. Raynaud sign was seen in 37 of the 48 patients (77.1%) as the predominant initial sign of PSS, and it first was noticed on the right index and middle fingers. Three sets of extrinsic aggravating factors, vibration stress, fine hand work with mental stress, and exposure to cold, were believed to be related closely to the development of the initial signs because the initial signs appeared after long‐term exposure to the extrinsic factors.
ULTRASTRUCTURAL CHANGES IN ACQUIRED PERFORATING DERMATOSIS
Authors: PATTERSON JAMES W. , BROWN PATRICIA C.
Published: May 2007

We performed ultrastructural studies of skin lesions in seven adults with acquired perforating dermatosis. Three of the patients had diabetes mellitus and two were undergoing hemodialysis. Lesions in an early stage showed exocytosis of inflammatory cells and alteration of elastic fibers. Lesions in an intermediate stage featured discontinuities of the basement membrane and aggregates of electron‐dense material lateral to the perforated focus, together with dermal edema, scattered macrophages, and densely aggregated collagen fibers that focally filled the papillary dermis. Later‐stage lesions showed fibroblasts in the dermis and degenerated elastic fibers within transepidermal channels. In most cases there was a single large epidermal channel lined by flattened epithelial cells, and containing a variety of cellular and extracellular materials. Small “secondary” channels without abnormal keratinization were also observed within the epidermis. The findings suggest that altered keratinization is limited to the immediate vicinity of well‐formed transepidermal channels, and that exocytosis of inflammatory cells and alterations of elastica are early and possibly key changes in lesion development. The unexpected discovery of hair fragments in one case suggests that curled hairs may play a role in the pathogenesis of some cases of acquired perforating dermatosis.
SUBSTANCE P PROVOKES CUTANEOUS ERYTHEMA AND EDEMA THROUGH A HISTAMINE‐INDEPENDENT PATHWAY
Authors: CAPPUGI PIETRO , TSAMPAU DIONIGI , LOTTI TORELLO
Published: May 2007

Substance P is a neuropeptide (contained in/and released from the Aδ and C nerve fibers of the skin), which provokes erythema, edema, and pruritus after intradermal injection. Local pretreatment with capsaicin produces decreased substance P‐dependent erythema, with edema similar to that observed before pretreatment with capsaicin. We injected histamine and, in a parallel experiment, substance P in five volunteers before and after local treatment with capsaicin, with 48/80, after 5 days of hydroxyzine. The injection of sp provoked erythema centered by a wheal. After treatment with 48/80, sp provoked increased erythema and a wheal. After hydroxyzine treatment, the injection of histamine produced no erythema or edema in four of the five subjects, while sp provoked erythema in all five subjects and edema similar to that observed before treatment with hydroxyzine. These data support the hypothesis that substance P provokes erythema and edema both with histamine‐dependent and histamine‐independent pathways.
VITILIGO IN CHILDREN
Authors: JAISANKAR TELANSERI JAYAKAR , BARUAH MANIK CHANDRA , GARG BHAGAT RAM.
Published: May 2007

In our study the relative incidence of vitiligo among new patients was 2.6%. Twenty percent were children and 74% were adults. Of the 90 children, 38.9% were boys, and 61.1% were girls. This sex difference was statistically highly significant. The adult sex‐ratio was not statistically significant. The relative incidence of the clinical subtypes in children and adults was compared, and the difference was found to be statistically highly significant only in the case of vitiligo vulgaris and segmental vitiligo. On the basis of the difference in the sex‐ratio and in the relative incidence of the subtypes of vitiligo vulgaris and segmental vitiligo, we feel that childhood vitiligo is a distinct subtype of vitiligo.
MULTIPLE BASAL CELL CARCINOMA IN TROPICAL AUSTRALIA
Authors: CZARNECKI D. , COLLINS N. , CHOW P. , NICHOLSON I. , TAIT B.
Published: May 2007

No association between HLA DP1 and the development of multiple basal cell carcinomas (BCC) was found among patients who had lived at least two‐thirds of their lives in the tropics. The percentage of patients with multiple BCCS increased with age; this was different from what has been found in people living in the temperate zone of Australia.
NEW APPROACHES TO ASSESS TOPICAL CORTICOSTEROID BIOEQUIVALENCE: PHARMACOKINETIC EVALUATION
Authors: PERSHING LYNN K.
Published: May 2007

An ideal method for measuring the bioavailability of topical corticosteroids should be simple, accurate, and adaptable to a variety of settings and should not require extensive special training to perform. Drug uptake into the stratum corneum, measured by tapestripping, is correlated with the pharmacodynamic response of skin blanching, observed in the vasoconstrictor assay. Differences in stratum corneum drug uptake can be objectively quantitated as a function of time, occlusion, dose applied, and vehicle. Tapestripping measurements are reproducible within individual subjects, but large interindividual variabilities may exist. The chromameter, a new technology, objectively quantitates color numerically and can be used to measure skin blanching as part of the pharmacodynamic response to topical corticosteroids. The chromameter offers an easy, objective method with which to quantitate the pharmacodynamic response of topical corticosteroids. Both methods allow a more mechanistic approach than currently used methods to investigate topical drug pharmacokinetics and pharmacodynamics.
HEMOSTASIS AND PLATELET AGGREGATION IN I'URPURIC PIGMENTED ANGIODERMATITIS ERUPTIONS
Authors: VIGNALF RAUL , RIZZO MARGARITA GARCIA
Published: May 2007

Ten patients with chronic purpuric and pigmented angiodermatitis in the extremities and two patients with acute and disseminated eczematoid‐like purpura angiodermatitis were studied with current hemostasis parameters: (I) platelet aggregation, (2) platelet circulating aggregates, (3) clotting factor measurements and high molecular weight kininogen (HMWK) in their coagulation fraction. The results showed: (I) reactional thrombocytosis with morphologic changes; (2) increased levels of platelet circulating aggregates; (3) increased response of platelet aggregation to different agonists, especially at very low doses, and also when we used washed platelets resuspended in normal plasma; (4) delayed activation of the contact system; (5) decrease of the activity of the fibrinolysis activators; and (6) diminished function activity of the HMWK coagulation fraction. As a physiopathogenic hypothesis In these patients, there is a cutaneous pathology that could be entailed to these hematologic alterations of the platelet‐HMWK‐endothelial cellskinins‐coagulation‐fibrinolysis system.
ITRACONAZOLE IN THE TREAMENT OF CHROMOBLASTOMYCOSIS DUE TO FONSECAEA PEDROSOI
Authors: QUEIROZ‐TELLES FLÁVIO , PURIM KHATIA S. , FILLUS JOSE N. , BORDIGNON GISELE F. , LAMEIRA ROSÁNGELA P. , VAN CUTSEM JAN , CAUWENBERGH GERT
Published: May 2007

The efficacy and tolerability of itraconazole in chromoblastomycosis due to Fonsecaea pedrosoi were evaluated in a non‐comparative open clinical trial in 19 Brazilian patients with histopathologically and mycologically proven active chromoblastomycosis. Patients were classified in terms of severity and received itraconazole at the dosage of 200 to 400 mg per day until previously described criteria of cure have been reached. Clinical, mycologic, histopathologic, and laboratory evaluations were performed before, during, and after therapy. The plasma levels of itraconazole and the in vitro susceptibility of the isolates were determined in 15 cases. Clinical and biologic cure were achieved by eight patients (42%) having mild to moderate disease, after a mean duration of therapy of 7.2 months (3.2–29.6 months). Sterile scarred lesions were observed in a post‐therapy follow‐up lasting on average 9.6 months that was carried out in this subgroup. Clinical cure alone occurred after a mean period of 25.1 months of treatment (16–30.5 months) in seven patients (36%) with moderate to severe disease. Finally, clinical improvement was obtained in four patients (21%) with severe lesions after a mean treatment time of 17.6 months (10.7–22.5 months). All patients responded favorably to itraconazole therapy. No significant side effects nor biochemical alteration during this trial were important enough to interrupt the treatment. Our results support those of previous trials, suggesting that itraconazole is an effective compound against chromoblastomycosis due to Fonsecaea pedrosoi.
URINARY RETENTION ASSOCIATED WITH HERPES ZOSTER INFECTION
Authors: COHEN LISA M. , FOWLER JOSEPH F. , OWEN LAFAYETTE G. , CALLEN JEFFREY P.
Published: May 2007

Background. Herpes zoster infection particularly involving the sacral dermatomes has been associated with bladder and bowel dysfunction, most commonly urinary retention.

Case Reports. We report two patients who developed acute urinary retention, one of whom also had constipation, within days of herpes zoster skin lesions of the S2‐S4 dermatomes.

Conclusions. Herpes zoster is a reversible cause of neuro‐genic bladder and bowel dysfunction and should be considered in a patient that presents with acute urinary retention and/or constipation. Sensory abnormalities and flaccid detrusor paralysis are most likely involved in the pathogenesis.
CLINICAL AND LABORATORY EVALUATION OF AIDS TRICHOPATHY
Authors: SADICK NEIL S.
Published: May 2007

Background. The present study reports the incidence of trichocutaneous disorders studied in 500 patients infected with HIV I in a large university‐based setting. Correlation of these findings with immunologic function at the time of diagnosis is presented. Unusual presentations and therapeutic interventions are discussed. Prognosis as related to various trichocutaneous disorders is elaborated.

Methods. All patients in this study were hivi positive by Western blot assay. T‐cell subsets were evaluated by monoclonal antibodies against T‐cell surface markers. Hair disorders were analyzed by means of light hair pull test, hair mount, polarizing microscopy, trichogram, scalp biophsy, and cultures for bacteria, fungi, and mycobacteria as indicated. Trichologic manifestations were classified based upon immunologic correlation of absolute level of helper T cells/mm3.

Results. The majority of hair disorders in the study population occurred with helper T cell numbers of less than 150/mm3. Papulosquamous problems including seborrheic dermatitis and psoriasis were most commonly noted followed by disorders of cell growth cycle regulation and trichokeratinization, i.e., telogen effluvium and loose anagen syndrome.

Conclusions. Multiple trichocutaneous disorders occur in the setting of retroviral infection. Most of these disorders occur in the setting of progressive immunoincompetence. The awareness of the disorders described here will aid the clinician in both the recognition and management of pilar aberrations in the appropriate clinical setting.
MALIGNANT MELANOMA IN CHILDREN
Authors: CHUN KEVIN , VÁZQUEZ MIGUEL , SANCHEZ JORGE L.
Published: May 2007

Background. While significant risk factors for malignant melanoma may initially develop or are first seen in childhood, the actual occurrence of this neoplasm in prepubertal children is uncommon.

Methods. A retrospective study of malignant melanoma in Puerto Ricans up to 16 years of age occurring from 1973 to 1990 was carried out by identifying those cases in the Puerto Rico Cancer Registry.

Results. A total of seven cases were found consisting of three boys and four girls with ages ranging from 22 months to 16 years and comprising 0.94% of the total melanomas. In three of the seven cases, there was a history of a previously existent small congenital melanocytic nevus on the area. Three cases were Clark's level I, two level II, and in two cases with proved metastatic disease, Clark's level of invasion were not reported. Those cases with Clark's level I and II had a 100% 5‐year survival.

Conclusions. Although rare, malignant melanoma in children can be as aggressive as in adults. Among the known factors predisposing to malignant melanoma, three out of seven cases developed within a small congenital nevus, two of which occurred during the first decade of life. Due to the rarity of this event in our population, it appears unreasonable to excise all small congenital nevi during the first decade of life. Even for those who advocate excision of all small congenital nevi, the evidence at present suggests that such small nevi very rarely undergo malignant change before puberty and therefore a policy of observation in childhood and offering excision around the time of puberty is perfectly logical.