bluuebunny/crossref_metadata_2025 huggingface dataset:
FIXED DRUG ERUPTION DUE TO METHAQUALONE
Authors: Heng Madalene C. Y.
Published: June 2007

Summary

A patient with a fixed drug eruption due to methaqualone ingestion is described. Attention is focused on the involvement of identical areas of the skin in two previous episodes, on the progressive increase in extent and severity with each episode, and on the shortening of the time interval between the ingestion of the drug and the development of clinical symptoms and lesions. These findings, together with the pain which preceded the appearance of the clinical lesions, and the presence of many neutrophils in the dermal infiltrate, support the current theory of antibody‐dependent cytotoxic mechanisms in the pathogenesis of fixed drug eruptions.
ARE IMMUNOSUPPRESSED KIDNEY TRANSPLANT RECIPIENTS PHOTOSENSITIVE?
Authors: Kelly G. , Sheil A.G.R. , White A.S.
Published: June 2007

Summary

The erythemal response of skin to an ultraviolet light source (290–420nm) was measured in control subjects and kindney transplant recipients treated with azathioprine/prednisone or with cyclosporine A/prednisone. There was no difference in the mean minima erythemal dose between the three groups. It is concluded that kidney transplant recipients receiving either form of immunosuppressive drug therapy are not photosensitized to a degree which is clinically detectable.
IMMUNE MECHANISMS IN ATOPIC DERMATITIS: STUDIES AND HYPOTHESIS
Authors: Beran D. , Kossard S. , Freeman S. , Vasak E. , Paver K. , Penny R.
Published: June 2007

Summary

The pathogenesis of atopic dermatitis remains uncertain. The aim of this study was to correlate blood and skin findings with respect to analysis of immunoregulatory T cells in 18 patients with severe atopic dermatitis.

Circulating T lymphocytes were characterised by flow cytometry, and in situ infiltrates of acute skin lesions identified by the immunoperoxidase technique. Analysis of peripheral blood T lymphocyte sub‐sets failed to reveal any difference from normal controls. Skin infiltrates were strongly positive for T11 – the pan T lymphocyte marker. The majority of these cells both in the dermis and epidermis were of the T4 helper‐inducer sub‐set, while a smaller proportion of cells were of the T8 suppressor‐ cytotoxic T cell sub‐set. T6 positive Langerhans cells were markedly increased in the dermis of affected skin, compared with normal skin.

The finding of increased numbers of helper‐inducer T lymphocytes' in association with increased numbers of Langerhans cells, which function as antigen presenting cells, suggests a strong immunological mechanism in disease pathogenesis, and may yield knowledge both with respect to origin of skin damage and elevation of IgE.
TOPICAL THERAPY OF ACNE
Authors: Auld John
Published: June 2007

Summary

This article reviews current literature on the external agents used to treat acne including the theoretical and practical aspects of the subject.
ELECTRON MICROSCOPIC FINDINGS IN ICHTHYOSIS SECONDARY TO SARCOIDOSIS
Authors: Heng Madalene C. Y. , Chan Carol , Kloss Suni G.
Published: June 2007

Summary

Acquired ichthyosis has been associated with a number of benign and malignant infiltrative lesions. However, the mechanisms responsible for this clinical lesion remain unknown. We report electron microscopic changes in two patients, which may help to clarify this subject.
CONTACT PHOTOALLERGY TO MUSK AMBRETTE
Authors: O'Brien T. J.
Published: June 2007

Summary

Photoallergic dermatitis due to musk ambrette is reported in six patients, and the literature on this sensitivity is reviewed. The condition presents with a typical pattern involving the neck and cheeks, and the diagnosis can be confirmed by photopatch testing with musk ambrette.
ZOON'S VULVITIS
Authors: Nedwich Judith A. , Chong Kew C.
Published: June 2007

Summary

Zoon's vulvitis is reported in a 37 year old woman. Although this condition is very uncommon, diagonisis was definite on histopathological features. Treatment has failed to relieve severe discomfort which has been the main symptom.
SQUAMOUS CARCINOMAS DEVELOPING IN BILATERAL LESIONS OF NECROBIOSIS LIPOIDICA
Authors: Kossard Steven , Collins Eileen , Wargon Orli , Downie David
Published: June 2007

Summary

Squamous cell carcinomas developed in bilateral pretibial lesions of necrobiosis lipoidica in a 39 year old non‐diabetic male. The tumours and areas of necrobiosis were successfully excised and repaired with full thickness skin grafts. Despite the chronic scarring and at times ulcerative nature of necrobiosis lipoidica, complicating squamous cell carcinomas have infrequently been reported.
IMIDAZOLIDINYL UREA (GERMALL 115) CAUSING COSMETIC DERMATITIS
Authors: O'Brien T J.
Published: June 2007

Summary

Imidazolidinyl urea is a preservative used commonly in cosmetics. Although there have been few reports of contact sensitivity, it does seem to be an important contact allergen. Sensitivity should be considered in any woman with dermatitis of the face.
DERMATOMYOSITIS AND POLYMYOSITIS UPDATE ON CURRENT CONTROVERSIES
Authors: Callen Jeffrey P.
Published: June 2007

Summary

Polymyositis and dermatomyositis are syndromes of unknown aetiology which are systemic in their nature involving prominent skin disease and prominent muscle disease. Classification is important particularly since dermatomyositis may be associated with malignancy more frequently than polymyositis, and certain subsets such as overlap syndromes less frequently harbour malignancy. Poor prognosic signs include pulmonary disease, the presence of malignancy, the severity of the weakness, and the presence of oesophageal disease. Therapy with corticosteroids is generally effective. In those patients who develop steroid side effects, immunosuppressive agents may be of use. Cutaneous disease may be controlled with hydroxychloroquine therapy.
CONTRACEPTION AND THE SKIN
Authors: Kovacs Gabor , Marks Robin
Published: June 2007

Summary

The use of contraceptives gives rise to numerous skin diseases. Like all drugs, oral contraceptives seem capable of producing almost any skin problems, some being more common than others. Oral contraceptives also have the potential to improve some diseases including acne and hirsutism.

Skin disease associated with mechanical or barrier contraceptives is infrequent. Allergies to rubber condoms and/or diaphragms have been reported, as have a variety of skin changes possibly related to copper in medicated intrauterine contraceptive devices.
MYCOBACTERIUM ULCERANS INFECTION IN VICTORIA: CELEBRATION OF A GOLDEN JUBILEE?
Authors: Hayman John
Published: June 2007

Summary

Mycobacterium ulcerans infection was first described in 1948 as a clinical entity in six patients from Victoria, Australia. Since that time the disease has been described in at least 25 areas throughout the world, and the disease may be regarded as the third most important mycobacterial disease of man. Some thirty further cases are known to have occurred in Victoria, and the features of these cases together with a review of the original six are presented in this paper. An explanation is proposed for the distribution of the disease and the pathogenesis of the infection.
SKIN SIGNS OF INTERNAL MALIGNANCY
Authors: Callen Jeffrey P.
Published: June 2007

Summary

In order to analyze those diseases which are presumed to be markers of internal malignancy we must use a uniform set of criteria which reliably predict the presence of malignancy. This paper will define and stress these criteria as they apply to skin disease. The criteria were suggested by the late Dr Helen Curth, and are as follows: concurrent onset —when the skin disease occurs it is possible to discover the cancer; parallel course —treatment of the malignancy results in a change in the cutaneous disease: recurrence of cancer leads to re‐appearance or exacerbation of the skin disease; uniform malignancy—the skin disease is associated with a specific site or type of cancer: statistical association —demonstrated by valid analysis; and genetic association — the cancer and associated symptoms and signs occur as an inherited trait. In addition to discussing these criteria, we will also analyze the necessary evaluation of the patient for cancer.
ALLERGIC CONTACT DERMATITIS TO MACE TEAR GAS
Authors: Goh C. L.
Published: June 2007

Summary

Contact allergy to tear gas among law enforcement personnel is uncommon. This report records a prison warder who developed allergic contact dermatitis to a tear gas, mace. The dermatitis developed on the abdomen and chest where he carried the tear gas canister. Mace appears to be a potent sensitiser as contact allergy developed rapidly following brief exposure in this patient.
CUTANEOUS HEPARIN NECROSIS ASSOCIATED WITH GLOMERULONEPHRITIS
Authors: Jones Bernard. F. , Epstein Martin. T.
Published: June 2007

Summary

Cutaneous heparin necrosis was complicated by glomerulonepbritis, nephrotic syndrome and renal failure. Despite spontaneous resolution of skin lesions, glomerulonephritis progressed and was treated witb cyclophosphamide and prednisone with a good response. Glomerulonephritis complicating anticoagulant induced skin necrosis bas not been described previously, and may be due to vasculitis. Routine monitoring of renal function in this condition may reveal further cases.
TREATMENT OF PITYRIASIS VERSICOLOR: COMPARISON OF SULCONAZOLE NITRATE 1% SOLUTION AND CLOTRIMAZOLE 1% SOLUTION
Authors: Tham S. N.
Published: June 2007

Summary

Treatment with topical sulconazole nitrate 1% solution once daily was compared with topical clotrimazole 1% solution twice daily for three weeks in patients with pityriasis versicolor. Both groups showed significant improvement judged by medical and patient evaluation. After six weeks clinical improvement was maintained in the majority of patients and negative microscopy was maintained in 79% and 92% of those using sulconazole and clotrimazole, respectively. Sulconazole applied once each day appears to be equivalent in efficacy and safety to clotrimazole applied twice daily.
ACROCHORDON: A CUTANEOUS SIGN OF CARBOHYDRATE INTOLERANCE
Authors: Agarwal Jugal K. , Nigam Pramod K.
Published: June 2007

Summary

Oral glucose tolerance studies were carried out In 118 non‐hospitalised patients with acrochordon. 36 (30.5%) patients had overt diabetes mellitus while impaired glucose tolerance was observed in 12 (10.1%) cases. There was no distinct correlation between the localisation, size, colour and number of the skin tags with glucose intolerance.
HOW MANY DERMATOLOGISTS?– 1973 REVISITED
Authors: Taft Eric H.
Published: June 2007

Summary

Within the broad criteria of the current private practice fee‐for‐service medical system, the present paper attempts to produce definitive concepts for dermatological training posts and numbers within Australia. The suggested dermatologist: population ratio of 1:80,000, adopted as a guideline in 1973, was based upon our own experience, together with comparative figures from other countries with similar economic systems and standards. Experience since that time suggests that this recommended ratio may already need upward revision.

The present pattern of full‐time training, usually undertaken in the first five years after graduation, can result in inordinate difficulties for females – a steadily increasing proportion of medical graduates. Together with the possible reduction in governmental funding of training posts, there would seem to be an urgent need for introducing flexibility into the current training programme including the acceptable alternatives of a greater component of accredited overseas training and the establishment of part‐time and shared training posts.
HYPEREOSINOPHILIC SYNDROME WITH CUTANEOUS BLISTERS AND BOWEL NECROSIS
Authors: Parker Colin J.
Published: June 2007

Summary

A 44 year old man presented with a bullous eruption associated with gross eosinophilia. Before effective treatment was instituted he developed abdominal pain and subsequently extensive bowel necrosis. The criteria for hypereosinophilic syndrome were met by persistent eosinophilia without an established cause, in association with multiple organ system involvement.
PALMOPLANTAR KERATODERMA WITH NORMAL INTELLIGENCE IN TYROSINAEMIA II
Authors: Danks David M. , Callan Noel J.
Published: June 2007

Summary

A patient with tyrosinaemia type II presented early in childhood with palmoplantar keratoderma and interstitial keratitis. Diagnosis of the metabolic defect and dietary treatment led to prompt resolution of all lesions and she is now well and mentally normal at 21 years. The fact that mental retardation is not a constant, or even frequent, feature of this condition is emphasized.
TREATMENT OF PSORIASIS WITH 6‐THIOGUANINE
Authors: Zackheim Herschel S. , Maibach Howard I.
Published: June 2007

Summary

Fifty‐four patients with Psoriasis were treated with the antimetabolite, 6‐thioguanine (TG). Three were early drop‐outs due to side effects. Of 48 evaluable patients with plaque‐type lesions, mostly extensive, 79% achieved over 75% improvement as an initial response, 8% had over 50% improvement and 13% had less than 50% improvement. 65% retained at least 50% improvement in follow‐up periods of up to 21 years, median 13 months. Two of three patients with palmar‐plantar pustular psoriasis had over 50% improvement. Myelosuppression was the most common side effect, occurring in 57% of the patients. One woman experienced pancytopenia from which she recovered. One man developed an acute, short‐lived hepatitis. In general, TG was better tolerated than methotrexate (MTX) and was more effective than MTX in the majority of patients who had changed from MTX due to inadequate response or side effects. TG should be considered as an alternative therapy for MTX, retinoids, or PUVA failures or exclusions.
ACRODERMATITIS ASSOCIATED WITH ZINC DEFICIENCY: FEATURES AND POSTULATED MECHANISM
Authors: Heng Madalene C Y , Allen Suni G , Heng Siang Yang , Wasserman Ronald , Nelson Greg Jon , Song Moon K
Published: June 2007

Summary

It is currently unexplained why zinc deficiency should result in a cutaneous eruption of such a distinctive and characteristic distribution (acrodermatitis), affecting the groin, periorificial surfaces and periungual areas of fingers and toes. In this study, we provide ultrastructural evidence suggestive of excessive damage of the epidermis by neutrophils, with other features resembling tissue damage from free radicals. We propose that these changes are consistent with a deficiency of superoxide dismutase, a zinc metalloenzyme, which is mainly responsible for neutralizing the destructive effects of the reactive oxygen species released by neutrophils. The various zymosans on many yeast cells, including Candida, activate complement, resulting in the generation of C5a, a potent chemattractant for neutrophils, and the location of the eruption in the characteristic sites in zinc deficiency may be explained by the natural occurrence of Candida albicans in these areas.
SURGERY FOR RHINOPHYMA: A CASE REPORT
Authors: Carroll Raymond L.
Published: June 2007

Summary

Severe rhinophyma treated by excision with replacement by a full thickness skin graft is described. This technique, although unfashionable, can produce a most satisfactory cosmetic result.
CLINICAL TRIAL OF EGOCORT 1% CREAM
Authors: Nagreh Dauit S.
Published: June 2007

Summary

A double blind clinical trial was conducted with Egocort 1% Cream and plain aqueous cream applied to each half of the body in ten patients with eczema. The patients were assessed for erythema, papules, vesicles, scaling and pruritus at the beginning of treatment, after 7‐14 days and again after a further 7‐14 days.

The results show that Egocort 1% Cream is more effective in treating eczema than plain aqueous cream. The preparation was found pleasant to use and no side‐effects were noted.
UNILATERAL FACIAL ACTINIC ELASTOTIC PLAQUE‐A NEW CLINICAL VARIANT OF ACTINIC ELASTOSIS
Authors: Wittal Richard A. , Georgouras Katherine E. , Baird Phillip J. , Cleary Edward G. , Henderson Marilyn
Published: June 2007

Summary

The case is reported of an 82‐year old woman with a four month history of an erythematous indurated plaque on the left cheek. Light and electron microscopy demonstrated the presence of solar elastosis alone. We believe that this is a new clinical variant of solar elastosis.

The spectrum of cutaneous actinic damage is reviewed.
NECROBIOTIC PERNIO
Authors: Scurry James P. , Cowen Peter S.J.
Published: June 2007

Summary

A 21 year old man complained of pain and burning sensation on the helices of both ears, precipitated by cold weather. Examination showed tender erythematous nodules. Biopsies of both ears showed the characteristic vascular and inflammatory changes of pernio. In addition, in the left ear, there were foci of necrotic collagen surrounded by palisaded histiocytes. The presence of necrobiosis in pernio has not been reported previously. In this case, necrobiosis would appear to have a vascular basis.
A FIVE YEAR RETROSPECTIVE STUDY ON PEMPHIGUS AND PEMPHIGOID
Authors: Kyriakis K. , Tosca A. , Lehou J. , Hatzis J. , Vareltzidis A , Stratigos J.
Published: June 2007

Summary

In a five year period 73 cases of pemphigus vulgaris (PV) and 94 of bullous pemphigoid (BP) were studied to investigate important parameters for these diseases. From the results it was found that the incidence of PV was higher in women whereas that of BP was almost equal in both sexes. The incidence of PV was highest in the sixth decade but was highest in the eighth decade for BP.

Indirect immunofluorescence (IIF) was more sensitive in PV whereas direct immunofluorescence (DIF) was more sensitive in BP. The present study provides a basis for comparison with results of previous or future studies in Greek and other populations.
PHAEOHYPHOMYCOSIS DUE TO PHIALOPHORA RICHARDSIAE
Authors: Tam Margaret , Freeman Susanne
Published: June 2007

Summary

Phaeohyphomycosis, an infection characterised by dematiaceous yeast‐like cells, hyphae and pseudohyphae in tissue, is an uncommon condition, often affecting immunosuppressed patients. A sixty four year old boat‐builder, receiving treatment with prednisone and azathioprine developed multiple cutaneous nodules on the extremities. Histology showed a mixed dermal inflammatory infiltrate with scattered spores and hyphae. Culture revealed two organisms, Phialophora richardsiae and Exophiala jeanselmei. Fluorocytosine was initially given but the organism was found to be resistant. Since side effects have been associated with long term ketoconazole therapy, a less toxic and more potent triazole compound, itraconazole, was used. After three months, the lesions had completely resolved without adverse clinical or biochemical changes.
UNILESIONAL MYCOSIS FUNGOIDES: CLINICAL, MICROSCOPIC AND IMMUNOPHENOTYPIC FEATURES
Authors: Oliver G. Fergus , Winkelmann R.K. , Banks Peter M.
Published: June 2007

Summary

Seven cases are reviewed in which the histologic and immunohistologic features were those of mycosis fungoides, although the patients presented with solitary lesions which did not recur after local therapy (excision in six, radiotherapy in one), with follow‐up of 10 months to 18 years. Immunophenotypic staining of paraffin‐embedded tissue revealed a predominant T‐lymphocyte proliferation in all cases, with a t‐helper proliferation confirmed by immunostaining of frozen tissue in three cases. None of the four cases studied for BER‐H2(Ki‐1) were positive, in contrast to the “activated” types of spontaneously regressing lymphoid lesions, lymphomatoid papulosis and “Ki‐1” lymphoma. Electron microscopy in one case demonstrated the highly convoluted nuclei of the T cells within the infiltrate. These seven cases represent examples of unilesional mycosis fungoides in which the disease has not recurred after therapy, despite features indistinguishable from those of typical generalised mycosis fungoides‐type of cutaneous T‐cell lymphoma.
PORPHYRIA CUTANEA TARDA WITH CUTANEOUS “SCLERODERMA” AND CALCIFICATION
Authors: Wilson Perry R.
Published: June 2007

Summary

An unusual case of porphria cutanea tarda (PCT) with sclerodermoid changes is reported. This case is remarkable for the extent of sclerodermoid changes and the presence of gross dystrophic calcification and ulceration in the sclerotic areas. The pathogenesis of this condition is discussed.
INFANTILE ACROPUSTULOSIS
Authors: Palungwachira Piti
Published: June 2007

Summary

Infantile acropustulosis (IA) is a well‐recognised syndrome described primarily among black male infants, which may also occur among white and East Asian children. The eruption occurs mainly on the distal areas of the extremities and is characterised by recurrent crops of 1 to 2 mm pruritic papules and pustules in infants from 2 to 10 months of age. We report one patient with infantile acropustulosis and a history of atopic dermatitis and abnormally high IgE serum value. Immunofluorescent studies of involved skin gave negative results. Infantile acropustulosis has been reported by several authors within recent years1,5The clinical and histological features and differential diagnosis of infantile acropustulosis are discussed. This disease is uncommon but not rare, and persists for about two years.
PSYCHOLOGICAL PROFILE OF THE ATOPIC ECZEMA PATIENT
Authors: White Angela , Horne David J. De L. , Varigos George A.
Published: June 2007

Summary

A survey of 40 patients with long‐standing atopic eczema was carried out to test for the presence of certain psychological traits which had been reported in studies in earlier decades. A series of standardised personality tests was administered to these patients and the results compared with the findings for a normal group for each test. It was demonstrated that atopic eczema patients do have significantly high levels of anxiety and problems in dealing with anger and hostility. Whether such findings make any contribution to understanding the aetiology of this disorder is debatable, but they do have implications for treatment and management, and some of these are discussed.
PROLIFERATION OF HIV IN LYMPHOCYTE – ASSOCIATED MACROPHAGES WITH CYTOPATHIC CHANGES IN AIDS ERYTHRODERMA.
Authors: Heng Madalene C.Y. , Lambertus Mark , Goetz Matthew B.
Published: June 2007

Summary

Latency of the Human Immunodeficiency Virus (HIV) has been demonstrated in both helper T‐Lymphocytes and cells of the macrophage/monocyte series. Although mitogendependent amplification of HIV infection within lymphocytes and monocytes/ macrophages has been demonstrated to occur in vitro, in vivo evidence of such a phenomenon has been lacking. We have performed electron microscopic and immunocytochemical evaluation of skin biopsies from a patient with the Acquired Immunodeficiency Syndrome (AIDS) with chronic erythroderma. These biopsies provided evidence of proliferation of HIV in macrophages interacting with activated lymphocytes (CD3+). These macrophages were undergoing morphologic changes characteristic of cytopathicity and contained numerous viral particles, many of which were actively budding from plasma membranes. Cutaneous macrophages which were not interacting with lymphocytes did not demonstrate cytopathicity or evidence of viral multiplication. These in vivo data substantiate the concept that activation of cells which harbour latent HIV promotes viral replication as well as subsequent cytopathicity.
KAWASAKI SYNDROME
Authors: Esterly Nancy B. , Wortmann Dorothy W.
Published: June 2007

Summary

Kawasaki syndrome is an acute multisystem inflammatory disease of young children first described by Tomasaku Kawasaki in the Japanese literature in 19671 He reported 50 cases of this entity under the rubric of acute febrile mucocutaneous lymph node syndrome, a designation that has more recently been superseded by the eponym Kawasaki syndrome. The disorder was further delineated and brought to the attention of American pediatricians in 19742. Recognition of the syndrome followed rapidly, and Melish, Hicks and Larson published the first series of American cases from Hawaii in 19763. Subsequently, Kawasaki syndrome has been documented worldwide. Although the disorder is known to be a systemic vasculitis with predilection for the coronary arteries, the etiology has remained obscure despite intense investigative efforts.
RETINOID‐INDUCED HAEMORRHAGIC BULLAE IN DARIER'S DISEASE
Authors: Gebauer K. , Holgate C. , Navaratnam A.
Published: June 2007

Summary

Haemorrhagic epidermal bullae developed in a patient with Darier's disease undergoing long term treatment with the retinoid, etretinate. We suggest that these lesions result from cumulative toxic effects of long term retinoid therapy upon the abnormal keratinocyte found in Darier's disease.
EXTRAMAMMARY PAGET'S DISEASE AND PROSTATIC CARCINOMA
Authors: Gudmundsen Ken J. , Smith James M. , Dervan Peter A. , Powell Frank C.
Published: June 2007

Summary

A patient with perianal extramammary Paget's disease (EMPD) occuring simultaneously with prostatic adenocarcinoma is presented. Four previously reported cases of genital EMPD associated with prostatic carcinoma are reviewed. The use of immunohistologic techniques to help establish the diagnosis in some cases, and the relationship of EMPD to underlying adenocarcinoma of sweat glands and of the lower urinary and gastrointestinal tracts is discussed. The importance of a directed search for internal malignancy in the individual patient with EMPD is emphasised.
A NEUTROPHILIC REACTION OF SWEET'S SYNDROME TYPE ASSOCIATED WITH THE ORAL CONTRACEPTIVE
Authors: Tefany Frances J. , Georgouras Katherine
Published: June 2007

Summary

A case is presented of a Sweet's syndrome‐like eruption in association with the oral contraceptive. A 46 year old Caucasian woman developed recurrent episodes of erythematous tender plaques on her trunk six weeks after commencement of the oral contraceptive (OC). Her condition clinically and histologically resembled Sweet's dermatosis. On cessation of the OC there was complete resolution of her lesions and she remains well 12 months later. This is the first report, to our knowledge, of a neutrophilic reaction to the oral contraceptive, and we believe that drugs may be implicated in the aetiology of atypical neutrophilic reactions simulating Sweet's syndrome in patients who are otherwise well.
CARBON DIOXIDE LASER IN THE TREATMENT OF CUTANEOUS DISORDERS
Authors: Sinclair And Robert J. , Sinclair Peter J.
Published: June 2007

Experienced gained with the Carbon Dioxide Laser over a two year period is documented. This laser modality has been used successfully for many indications. We believe it is the treatment of choice for conditions such as resistant verrucae, extensive actinic cheilitis or labial leukoplakia, and for the cosmetic removal of widespread facial tumours, some keloid scars and rhinophyma.
SKIN REACTIONS TO DILTIAZEM
Authors: Wittal Richard A. , Fischer Gayle O. , Georgouras Katherine E. , Baird Phillip J.
Published: June 2007

Summary

A survey of Australian dermatologists was conduted into skin reactions observed to diltiazem. These have included: erythema multiforme, subcorneal pustular dermatosis, photosensitive erythroderma, macular exanthem, allergic vasculitis and urticarial vasculitis. The range of clinical and histopathological features are described. A review of the literature is presented. Photosensitive erythroderma and urticarial vasculitis have not, to our knowledge, been reported in the literature previously.
FAMILIAL NON‐DIABETIC NECROBIOSIS LIPOIDICA
Authors: Ho Kenneth K‐L , O'Loughlin S. , Powell F. C.
Published: June 2007

Summary

Necrobiosis lipoidica (NL) is a cutaneous disorder with distinctive clinical and morphologic characteristics. It is associated with diabetes mellitus in two thirds of cases. The aetiology and pathogenesis of NL are unknown but familial cases of NL seem to be extremely rare. We report the occurrence of NL in two sisters with normal glucose tolerance.
INFANTILE PYODERMA GANGRENOSUM
Authors: Sood Jaideep , Singh Mohan , Chaturvedi Pushpa
Published: June 2007

Summary

A six month old female infant with pyoderma gangrenosum is reported. Pyoderma gangrenosum in an infant is rare. The child responded to pulse therapy with intravenous dexamethasone and intralesional triamcinolone acetonide.
CUTANEOUS CRYPTOCOCCOSIS: RECURRENCE FOLLOWING ORAL FLUCONAZOLE TREATMENT
Authors: Cooper Celia M. , Gordon David L. , Reid Catherine , Philpot C. Ross
Published: June 2007

Summary

A case of recurrent cutaneous cryptococcosis in an immunocompromised patient is described. The patient presented with a non‐healing cutaneous ulcer due to infection with Cryptococcus neoformans. Extensive investigation failed to reveal any evidence of associated systemic cryptococcosis. Treatment with oral fluconazole resulted in complete resolution of the ulcer but after several months a second cutaneous cryptococcal lesion appeared, strongly suggesting dissemination from an underlying systemic focus. This case illustrates the hazards associated with making a diagnosis of isolated cutaneous cryptococcosis and the necessity for prolonged follow‐up of patients who present in this way.
ETRETINATE THERAPY OF SOLAR‐RELATED KERATO ACANTHOMA
Authors: Watson Alan B.
Published: June 2007

Summary

Nineteen patients with a total of 22 keratoacanthomas were treated in this trial with lmgm/kg/day of etretinate for six weeks. The patients had predominantly solitary keratoacanthoma, all associated with severe solar damage. There was a provision for reduction of dose and also for extension of length of treatment time for lesions which had responded but had not completely disappeared at the end of six weeks.

Sixteen of the nineteen patients cleared without recurrence. Two patients had therapy stopped because of side effects and in these, further treatment was required. These side effects were severe paronychia and elevation of serum lipids. Other side effects were almost exclusively muco‐cutaneous.

Keratocanthomas on the head, neck and upper limbs had cleared completely at the end of six weeks therapy, with a variable degree of ridged scarring. Lesions on the lower legs almost invariably required treatment times which were longer than six weeks and could be up to twelve weeks.

Etretinate therapy of solar related keratoacanthoma should be considered for large lesions, multiple lesions, lesions in areas which are difficult to treat, and lesions in patients unsuited for destructive therapy or surgery.
TREATMENT OF EUMYCETOMA WITH KETOCONAZOLE
Authors: Venugopal Pankajalakshmi V. , Venugopal Taralakshmi V.
Published: June 2007

Summary

Ten patients with eumycetoma were treated with oral ketoconazole in the dosage of 400mg/day for 8 to 24 months. In eight cases the foot was affected: four were due to Madurella mycetomatis and one each due to M grisea, Pyrenochaeta romeroi, Acremonium kiliense and A falciorme. One mycetoma which affected the back and perineum was due to A kiliense, and one case presented with multiple sebaceous cysts and the scalp and M mycetomatis was isolated from the lesion. Clinical and laboratory tests showed excellent tolerance to the drug, with no adverse reactions. Complete cure was obtained in six patients and two showed good responses. The cured patients were followed up for a period ranging from three months to two years without any evidence of recurrence.
BULLOUS PEMPHIGOID IN AN ABORIGINE
Authors: Lo Sydney , Mollison Lindsay C. , Kumar Ajay
Published: June 2007

Summary

Objective: To present the first case of bullous pemphigoid in an Australian Aborigine.

Clinical features: A 47 year old female aborigine presented with a three week history of a generalised skin eruption consistent with bullous pemphigoid. Immunohistological examination confirmed the diagnosis. Therapy required high dose oral steroids, azathioprine and erythromycin as well as topical agents. Treatment was complicated by isolation and poor compliance but was ultimately successful in inducing and retaining remission.

Conclusion: This is the first description of bullous pemphigoid in an Australian Aborigine. We recommend early biopsy to confirm diagnosis and plan therapy, and careful attention to patient education to encourage compliance.
SOUTHERN BLOT ANALYSIS OF SKIN BIOPSIES FOR HUMAN PAPILLOMAVIRUS DNA: RENAL ALLOGRAFT RECIPIENTS IN SOUTH‐EASTERN QUEENSLAND
Authors: Trenfield Karen , Salmond Carol A. , Pope John H. , Hardie Ian R.
Published: June 2007

Summary

The 104 skin biopsies from 34 patients who attended a Renal Transplant Unit in Brisbane over 12 months included 40 squamous cell carcinoma (SCC), 22 solar keratoses, 4 hyperkeratoses, 18 warts and 11 basal cell carcinoma (BCC). Human papillomavirus (HPV) DNA was identified by Southern blot hybridisation using, as individual probes, purified insert DNA from recombinant HPV 1, 2, 3 or 3/10, 4, 5 or 5/8, 7, 11, 16, 18 and 41 under relaxed conditions and characterised by restriction enzyme analysis and Southern blot hybridisation under more stringent conditions. Genomic HPV DNA was characterised in 7 skin biopsies from 4 renal allograft recipients (RARs): HPV 1A in a SCC (20 copies/cell) and a BCC (10 copies/cell) from the one patient, HPV 36 (20 copies/cell) in a SCC, HPV 1A (1000 copies/cell) in a wart and HPV 2B (200‐800 copies/cell) in 3 warts from the one patient. Only HPV 1A in the SCC exhibited a significant degree of subtype variation. HPV DNA was identified in another 5 skin biopsies from another 4 RARs: HPV 3A in a wart and a hyperkeratosis, HPV3/10‐related DNA in 2 solar keratoses and HPV5/8‐related DNA in another (20‐50 copies/cell). The incidence of HPV 5 (or 5‐related HPVs) in RAR SCC was very low and that of HPV DNA in RAR warts was lower than that recorded elsewhere but this was not due to insensitivity of the assays. There was no evidence for a role for HPV in the aetiology of skin cancer in RARs in south‐eastern Queensland but the possibility remains that as yet unidentified HPV types are involved.
HISTOLOGICAL EVALUATION OF THE EFFECT OF 0.05% TRETINOIN IN THE TREATMENT OF PHOTO DAMAGED SKIN
Authors: Kossard Steven , Anderson Phil , Davies Alison , Cooper Alan
Published: June 2007

Summary

In a randomised double‐blind vehicle controlled trial of 0.05% tretinoin cream in the treatment of photodamaged skin, the histological results of paired biopsies from 28 individuals who applied tretinoin for 26 weeks are compared with 28 paired biopsies from a control group applying vehicle alone. There was a significant increase in epidermal thickness in the tretinoin‐treated group (P.001). Epidermal atrophy was reversed in ten patients applying tretinoin cream.

Baseline biopsies obtained from participants in Melbourne, Victoria (38° latitude) showed significantly less elastosis than those in Sydney (34° latitude) and Newcastle in N.S.W., although the two groups did not show significant differences in age or sex, and the differences could not be correlated with skin type. Tretinoin cream had no effect on the degree of solar elastosis after 26 weeks application. Tretinoin cream appears effective in reversing epidermal atrophy and clinically diminishes fine wrinkling, mottled hyperpigmentation and skin roughness. Tretinoin cream may not offer a solution to the gross solar damage seen in the Australian population who have marked solar elastosis as a principal, clinical and histologie finding. However it is possible that dermal repair and reversal of solar elastosis may require topical application of tretinoin cream for a longer period than the six months used in this trial.
ONYCHOMYCOSIS DUE TO PITYROSPORUM
Authors: Crosier William J. , Wise Keith A.
Published: June 2007

Summary

Ten cases of onychomycosis due to Pityrosporum are reported. The epidemiology, clinical features and treatment of these cases are described in detail. These cases are reported to alert medical practitioners and mycologists that Pityrosporum can cause onychomycosis in our community.
CYCLOSPORIN TREATMENT OF ATOPIC DERMATITIS: FIVE CASE STUDIES AND LITERATURE REVIEW
Authors: Stephens Robert B. , Lee May‐Lian , Cooper Alan
Published: June 2007

Summary

This study reports on five adult patients with severe atopic dermatitis who were treated in our department with a three month course of cyclosporin* All patients demonstrated significant clinical improvement with minimal side effects. We conclude that provided safety guidelines are observed, cyclosporin can be used with good effect in those patients where conventional treatment is unsatisfactory. This paper also reviews the use of cyclosporin in atopic dermatitis and includes a brief discussion of how it may alter pathophysiologic mechanisms.
CUTANEOUS MANIFESTATIONS OF LONG‐TERM HYDROXYUREA THERAPY
Authors: Kelly Robert I. , Bull Richard H. , Marsden Alan
Published: June 2007

Summary

Skin changes associated with long term hydroxyurea therapy have only rarely been reported and are not widely known. This report concerns a patient in whom extensive and debilitating skin changes developed secondary to hydroxyurea therapy. In addition to previously reported manifestations such as ichthyosis, a dermatomyositis‐like eruption on the dorsal hands, facial erythema and accelerated development of premalignant and malignant skin lesions, the patient developed an erosive eruption on the glans penis. He also developed a rapidly enlarging viral wart which clinically resembled a squamous cell carcinoma and histologically showed marked cytological atypia. It is possible that hydroxyurea caused accelerated photoageing and also contributed to the rapid growth of the viral wart and the atypical histological features. The time course of the clinical changes suggests that they result from direct toxicity of hydroxyurea on the basal layer of the epidermis and mucosal surfaces.
ANONYCHIA OF ALL TOES WITH ABSENCE OF PHALANGEAL BONES
Authors: Hatzis John , Soulacos Panayotis N.
Published: June 2007

Summary

A ten year old girl suffered from anonychia of all toes, present from birth. The absence of nails was accompanied by absence of one or two phalangeal bones in toes other than the big toes. Other abnormalities consisted of short toes, incomplete syndactyly of the 2nd and 3rd toes of each foot and transfer of the dermatoglyphics from the plantar to the dorsal surface of the digits. The combined defect of the nails and the phalangeal bones can be explained by the close relationship of the two structures during the morphogenesis of the digits.
FAMILIAL JUVENILE ELASTOMA
Authors: Huilgol Shyamala C. , Griffiths W. A. D. , Black M. M.
Published: June 2007

Summary

Two cases of familial juvenile elastoma are reported with a review of the literature concerning juvenile elastoma and the Buschke‐Ollendorff syndrome of connective tissue naevi in association with osteopoikilosis.
SWEET'S SYNDROME AND HYPOTHYROIDISM
Authors: O'Brien Timothy J. , Darling John A.
Published: June 2007

Summary

Hypothyroidism and Sweet's syndrome occurring together were diagnosed in a 33 woman. This association is uncommon, but may be underdiagnosed and underreported.
CYCLOSPORINE, AZATHIOPRINE AND LOCAL THERAPY FOR PYODERMA GANGRENOSUM
Authors: Duffill Mark B.
Published: June 2007

A markedly obese 54 year old woman with seropositive rheumatoid arthritis, anaemia, dyspepsia, controlled hypothroidism and depression presented with a seven month history of large pyoderma gangenosum ulcers on the shins. Routine dressings for the ulcers had been ineffective. Her arthritis was being treated with azathioprine and NSAID's. Initial treatment with clobestasol proprionate and disodium cromoglycate under occlusion produced only partial healing. Introduction of Cyclosporin A and continuation of topical therapy, with the addition of triamcinolone acetonide injections, led to progressive healing which was complete after seven months. There has been no relapse to date. Cyclosporine can be combined with azathioprine and local therapy for successful treatment of pyoderma gangrenosum.
PROTEOLYTIC ENZYMES IN WOUND HEALING: THE ROLE OF ENZYMATIC DEBRIDEMENT
Authors: Sinclair And Rodney D. , Ryan Terence J.
Published: June 2007

Proteolytic enzymes are a family of proteins that serve to degrade necrotic debris derived from cell breakdown. They are produced endogenously often as precursor proteins whose activation is precisely regulated. These activated enzymes serve many functions in normal as well as pathological situations. In particular they are involved in the regulation of cell maturation and multiplication; collagen synthesis and turnover; the development and removal of the perivascular fibrin cuffs found in venous insufficiency and leg ulceration as well as the removal of dead tissues following inflammation. As a limited number of enzymes perform all these functions, it is difficult to predict the effects of applying synthetic proteolytic enzymes to a wound. Many such enzymes are currently commercially available and being promoted as alternatives to surgical wound debridement. It is important for their use to be considered in the context of their interaction with endogenous proteases, their physiological role in tissue, their ability to reach a desired target and the stage of wound healing at the time they are applied.
Bullous pemphigoid and burns: The unveiling of the attachment plaque?
Authors: Wagner Godfrey H , Ive F Adrian , Paraskevopoulos Stavros
Published: June 2007

Two patients with bullous pemphigoid (BP) associated with burns are described. The case with BP lesions that were localized is the first to be described in the literature and generalized BP has been described on only one occasion previously. Both cases exhibited the clinical features of BP and settled with the use of oral prednisolone. Many extrinsic precipitants of BP have been described; however, the precise trigger of the autoimmune process is not yet understood. The authors discuss the hypothesis that as burns expose BP antigen, the association of BP with advancing years arises through exposure of BP antigen during the process of involution of the basement membrane zone seen in the normal process of ageing. BP should be considered in cases of burns associated blistering, particularly blisters occurring at distant sites, but also involving affected skin.
Multiple clear cell acanthomas treated by cryotherapy
Authors: Kavanagh Gina M , Marshman Gillian , Burton John L
Published: June 2007

Clear cell acanthoma is usually a solitary lesion. We report a patient with multiple lesions demonstrating the typical clinical and histological features of clear cell acanthoma, which responded well to treatment with liquid nitrogen.
Loose anagen syndrome
Authors: Haskett Martin
Published: June 2007

A case of loose anagen syndrome presenting in an 8 year old girl as a 3 year history of unruly, slowly growing hair is dicussed.
Neonatal lupus erythematosus
Authors: Hogan Peter A
Published: June 2007

A brief review of the clinical manifestations of this rare disorder and its association with maternal autoantibodies and disease is presented.
Female androgenetic alopecia: An update
Authors: Callan Annette W , Montalto Joseph
Published: June 2007

Androgenetic alopecia is an androgen dependent disorder occurring in genetically susceptible individuals. The pattern of hair loss in women differs from that of classical male pattern alopecia, being more diffuse and with retention of the frontal hair line in most cases. Characteristic histopathological changes occur but biopsy is rarely helpful in diagnosis. Although research has shown subtle alterations in the androgen status of women with androgenetic alopecia, most patients presenting with this disorder are normal endocrinologically. Anti‐androgen therapy will result in some improvement in up to 50% of patients after 6 to 12 months of therapy, but in practice will usually only decrease the rate of hair loss and not result in new hair growth.
Bazex syndrome (acrokeratosis paraneoplastica)
Authors: O'Brien Timothy J
Published: June 2007

A 67 year old woman with an extensive oropharyngeal carcinoma developed acrokeratosis paraneoplastica. She suffered severe pain in the fingers and toes and experienced some symptomatic relief with psoralen ultraviolet A therapy.
Keratotic basal cell carcinoma of the upper eyelid
Authors: Foley Peter , Mason Graham
Published: June 2007

A 62 year old woman presented with two large slowly growing pedunculated tumours. These were excised from the lateral aspect of the upper eyelid and were found to be keratotic basal cell carcinomas.
Cutaneous vasculitis and cutaneous vasculopathies
Authors: Kelly Robert I
Published: June 2007

Cutaneous involvement may occur with virtually all syndromes of vasculitis. This can occur primarily as a dermatologic disorder or as a manifestation of a potentially life threatening systemic vasculitis. In this review article, classification, clinical manifestations, pathogenesis and therapy of cutaneous vasculitis will be discussed. Disorders which are primarily vascular in origin but lack a well defined inflammatory phase, referred to as ‘vasculopathies’ will also be discussed.
Quantification of hair follicle parameters using computer image analysis: A comparison of androgenetic alopecia with normal scalp biopsies
Authors: Lee May‐Sen , Kossard Steven , Wilkinson Barbara , Doyle John A
Published: June 2007

Computer image analysis enables large numbers of hairs to be measured in an automated fashion. In this study, we examined horizontal scalp biopsies from 10 patients with a histological diagnosis of androgenetic alopecia and 10 normal control subjects. The density of hair follicles and the ratio of terminal to vellus hairs were determined. Hair shaft, hair canal and hair follicle diameter, inner root sheath width and outer root sheath area were measured using the Chromatic Colour Image Analysis program. This study showed a statistically significant progressive decrease in size of hair canal diameters from normal terminal hairs (85.93 ± 10.07 μm) through to androgenetic alopecia terminal (68.83 ± 13.60 μm) and vellus hairs (28.67 ± 5.60 μm). This pattern is also seen with hair follicle diameters; normal terminal (268.41 ± 24.88 μm), androgenetic alopecia terminal (236.34 ± 17.23 μm), and vellus hairs (130.88 ± 19.96 μm). Outer root sheath areas, hair shaft diameters and ratio of terminal to vellus hairs were significantly larger in normal (18500 ± 4222 μm2; 82.71 ± 13.79 μm; 36:1; respectively) compared with androgenetic alopecia scalp biopsies (8403 ± 3322 μm2; 61.11 ± 14.42 μm; 3:1; respectively), whereas inner root sheath width and density did not vary significantly. Computer image analysis can be adapted for use in clinical trials where large numbers and objectivity are critical in determining the efficacy of hair growth promoters.
Ehlers‐Danlos syndrome Type II: Importance of recognition
Authors: Stanford Duncan G , Georgouras Katherine E
Published: June 2007

We report a case of Ehlers‐Danlos syndrome Type II presenting with subtle clinical features and discuss the importance of early recognition of this disorder. A 16 year old Caucasian schoolgirl presented with soft tissue swellings on her fingers. There was a history of poor wound healing and prematurity and a family history of miscarriages. Clinical examination revealed hypermobile joints, hyperelastic skin and a ‘cigarette paper’ scar at the site of a previous minor surgical excision. Management consisted of genetic counselling and advice concerning career choice, recreational activities, as well as future pregnancy and surgery. This subtype of Ehlers‐Danlos syndrome is probably fairly common in the community. While it may present with subtle clinical features, recognition is important so that counselling can be offered at a young age in order to avoid the major consequences that may arise during pregnancy and surgery.
Lymphocutaneous sporotrichosis
Authors: Whitfeld Margot J , Faust Holly B
Published: June 2007

Lymphocutaneous sporotrichosis presented in a 10 year old child 1–2 weeks after an abrasion. A series of nodules, two of which ulcerated, appeared along the arm with tender unilateral axillary lymphadenopathy in the absence of systemic symptoms. Biopsy showed a granulomatous infiltrate but failed to reveal the organism; however, culture was positive for Sporothrix schenckii. The primary lesion healed with a scar after 3 months of systemic therapy with potassium iodide.