bluuebunny/crossref_metadata_2025 huggingface dataset:
Smoldering HTLV‐1‐induced T‐cell lymphoma localized within the skin; a radiation‐resistant tumor
Authors: Germain Marguerite , Williams John , Skelton Henry G. , Smith Kathleen J.
Published: March 2003

Abstract

Background  Human T‐cell lymphotrophic virus type 1 (HTLV‐1)‐induced lymphoproliferative disease occurs in approximately 3–5% of people in endemic areas who have been HTLV‐1 positive for decades. Lymphoproliferative disease may present as four subtypes, including an acute adult T‐cell leukemia/lymphoma (ATLL), an aggressive HTLV‐1 lymphoma, chronic ATLL, and smoldering ATLL.

Materials and methods  A 72‐year‐old HTLV‐1+ Haitian woman presented with a 2‐year history of a cutaneous eruption localized to the right arm. The eruption had evolved into multinodular lesions over the past 6–7 months. Peripheral blood and cutaneous biopsy specimens were evaluated. Immunohistochemical studies for lymphoid markers were performed on the cutaneous biopsy material, and polymerase chain reaction (PCR) and Southern blot assay were evaluated for the presence and integration of HTLV‐1 within the genome.

Results  The biopsy specimen showed a pleomorphic T‐cell infiltrate with epidermotrophism, and an immunohistochemical phenotype showing CD3+, CD4+, CD8–, CD25, CD30–, HLDA‐DR+ cells. PCR and Southern blot assay evaluation showed a single clonal integration of HTLV‐1 provirus within a monoclonal tumor cell population. The patient had no abnormal lymphoid forms on peripheral smear at presentation, and no evidence of other organ involvement.

Conclusions  Smoldering HTLV‐1‐induced lymphoma is uncommon even in endemic areas. In previously reported cases, the smoldering variant was accompanied by abnormal forms in the peripheral blood and/or by other signs of systemic disease. This case illustrates that smoldering disease may be localized to the skin with no detected morphologic abnormalities on peripheral smear.
Dendritic epidermal γ/δ T cells (DETC) activated in vivo proliferate in vitro in response to Mycobacterium leprae antigens
Authors: Kaminski Marek J. , Mroczkowski Tomasz F. , Krotoski Wojciech A
Published: March 2003

Abstract

Background  γ
/
δ T‐cell receptor (TCR)+ dendritic epidermal T cells (DETC) are part of a primitive defense system in the skin; they are capable of responding only to a limited number of antigens. The aim of the present study was to test whether DETC can proliferate in vitro in response to antigens of Mycobacterium leprae.

Methods  DETC were obtained from CBA mouse ear skin by trypsinization and Histopaque gradient centrifugation. The resulting epidermal cell suspension contained up to 20% DETC, as analyzed by the fluorescence activated cell sorter (FACS) after staining with anti‐Thy‐1 or anti‐γ/δ TCR monoclonal antibodies (mAbs). The freshly isolated cells, or DETC cultured up to 4 weeks with interleukin‐2 (IL‐2), were exposed in vitro for up to 6 days to varying doses of the following M. leprae antigens: (1) integral (live) M. leprae bacilli; (2) Dharmendra antigen; and (3) PGL‐1 (phenolic glycolipid of M. leprae). The DETC response was assessed by tritiated thymidine (3H‐TdR) incorporation.

Results  The freshly isolated DETC, or DETC cultured up to 4 weeks with IL‐2, did not respond significantly to any of the M. leprae antigens, although at the same time they were able to respond vigorously to concanavalin A (Con A), as positive control. If, however, DETC were isolated from skin, painted 7 days before with croton oil (10 μL/cm2 to cause irritant dermatitis, they were able to respond to all M. leprae antigens by a 3–4‐fold incrase in the 3H‐TdR uptake. The most effective stimulator was a 1 : 1 mixture of Dharmendra and PGL‐1 (0.01 μg/mL), which was as effective as 10‐fold higher doses of either antigen alone. Cell counts confirmed that increased DNA synthesis was associated with cell proliferation. Experiments employing α/β‐TCR CBA murine spleen cells and epidermal cell suspension treated with anti‐γ/δ or antiα/β mAbs + C′ proved that only the γ/δ DETC were the responder cells to M. leprae antigens.

Conclusions  The results suggest that activation of DETC in vivo may make them responsive to M. leprae antigens. A significant increase in the number of class II major histocompatibility complex (MHC) positive, nondendritic cells was observed in the croton oil‐treated epidermis. We hypothesize that croson oil‐induced upregulation of class II MHC expression, which endows epidermal cells with antigen‐presenting capabilities, might be an important factor in vivo in delivering an immunogenic signal to resident DETC in the skin.
Tinea manus treated with 1‐week itraconazole vs. terbinafine
Authors: Gupta Aditya K. , De Doncker Piet , Degreef Hugo
Published: March 2003

A double‐blind, prospective, comparative, randomized study was conducted to determine the efficacy and safety of itraconazole (pulse) given for 1 week against a 2‐week course of terbinafine (continuous) for the treatment of tinea manus. The inclusion criteria were that the clinical diagnosis of tinea manus had to be confirmed by positive mycologic examination (KOH). Individuals had to be 18 years or older and in good general health. Patients with a sensitivity to imidazole or the allylamine derivative were excluded, as were subjects participating in any other investigational drug study within 4 weeks prior to the start of the trial. Other exclusion criteria included women who were pregnant, lactating, or in whom there was a lack of adequate contraception. Patients with a history of chronic liver disease were also excluded, as were individuals with a tinea infection at another anatomic site. Patients receiving any agents known to have an interaction with either itraconazole or terbinafine, including rifampin, phenytoin, digoxin, warfarin, astemizole, terfenadine, cisapride, simvastatin, and lovastatin, were excluded from the study. The patients must not have received systemic antifungal or corticosteroid therapy for at least 30 days, or applied topical antifungals or corticosteroids for at least 14 days, prior to the onset of the study. Patients were withdrawn from the study if a serious adverse event occurred which, in the opinion of the investigator or participant, merited discontinuation from the trial, if the randomization code was broken, or if the subject withdrew consent.

Patients were evaluated at baseline, week 1, week 2 (end of double‐blind treatment phase), and week 6 from the start of treatment. The primary efficacy measure was the mycologic cure rate (negative light microscopic examination and culture, or one test negative and the other not positive). The secondary assessment included the clinical global evaluation: healed (absence of signs and symptoms), markedly improved (≥ 50% clinical improvement), considerable residual lesions (< 50% clinical improvement), no change, or worsening. The three symptoms that were evaluated were desquamation, erythema, and pruritus. The severity of the symptoms was graded as: absent, 0; mild, 1; moderate, 2; severe, 3. Clinical success was defined as occurring when patients were healed or markedly improved. Any adverse event that occurred was recorded. The study was approved by an ethical committee and informed consent was obtained from each patient.
Marginal acrokeratoderma and psoriasis: is there an association?
Authors: Rai Ranju , Saraswat Abir , Kaur Inderjeet , Kumar Bhushan
Published: March 2003

Case 1 A 70‐year‐old housewife presented to us with multiple, asymptomatic, depressed, crateriform plaque lesions over the radial margin of the index finger and thumb and thenar and hypothenar eminences of both hands of 25 years' duration (Fig. 1). There was no history of prolonged sun exposure or repeated trauma to the hands and there were no such lesions on the soles. None of her other family members were affected. We made a provisional diagnosis of keratoelastoidosis marginalis. Skin biopsy revealed an unremarkable epidermis, with minimal lymphocytic infiltration in the upper dermis and hyalinization in the reticular dermis, extending to the deeper dermis. Two years later she returned with well‐defined, erythematous, scaly, mildly itchy plaque lesions over the instep of both feet and the center of both palms. A clinical diagnosis of palmoplantar psoriasis was made.

Case 1. Crateriform plaque lesions on the hands. Note the palmoplantar psoriasis

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A careful search to discover any correlation between these two disorders revealed that plaque lesions with a central saucer‐like depression on the sides of the fingers and the palmar surface have been noted in patients with otherwise typical lesions of psoriasis (Caro MR, Senear FE. Psoriasis of the hands. Nonpustular type. AMA. Arch Dermatol Syphilol 1956; 74: 629‐633). We then began to look for these lesions in all patients attending our dermatology clinic. Screening of more than 500 patients suffering from cutaneous disorders other than psoriasis revealed no marginal keratodermas. A careful search of 500 consecutive patients attending our psoriasis clinic revealed two more cases.

Case 2 A 23‐year‐old laboratory technician with psoriasis over the center of the palms of 6 months' duration was found to have multiple depressed plaques of 3 × 3 mm along the outer margin of the index finger and inner margin of the thumb on examination (Fig. 2). These had been present before the appearance of classical psoriasis lesions, but the exact duration was not known.

Case 2. Depressed plaques along the outer margin of the index finger

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Case 3 A 62‐year‐old shopkeeper with generalized psoriasis of 2 years' duration was found to have pin‐head to pea‐sized asymptomatic depressed lesions over the margins of the index finger and thumb (Fig. 3). He was worried about them mainly due to their cosmetic appearance. None of the above patients had any gross evidence of actinic damage. All the lesions were crateriform, with no elevated or translucent lesions seen.

Case 3. Depressed lesions on the index finger. Note the lesions of psoriasis over the dorsa of the hands

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Morphology of glass fibers in electronics workers with fiberglass dermatitis – a scanning electron microscopy study
Authors: Hsieh Meng Ying , Guo Yueliang Leon , Shiao Judith Shu Chu , Sheu Hamm Ming
Published: March 2003

Abstract

Background  Fiberglass is used as a reinforcement filler material in printed circuit boards (PCBs) which are widely used in the electronics industry. In a recent survey, we demonstrated that fiberglass dermatitis is the most common occupational dermatosis among electronics industry workers in Taiwan. Little is known, however, about the morphologic structures of the glass fibers which induce dermatitis. The purpose of this study was to assess the morphology of fiber spicules and to determine the relationship of this structure to fiberglass dermatitis.

Methods  Fourteen female patients with a diagnosis of fiberglass dermatitis were selected for study. The diagnosis was confirmed in all patients by positive skin stripping for glass fibers and matching with glass fibers from dust collected in work areas and from samples collected by scraping the edge of PCBs. Samples of collected glass fibers were analyzed by scanning electron microscopy (SEM).

Results  SEM of the fiberglass samples revealed that fibers were approximately 10 μm in diameter. In samples from both the edge of PCBs and from dust collected in work areas, SEM revealed that most of the fibers were in bundles of various sizes and lengths. All fibers collected from patients' skin by tape stripping showed a singular spicule, most had a sharp free end, and the lengths were in the range 50–150 μm.

Conclusions  Singular glass fibers with a sharp free end and a length of 50–150 μm are most likely to induce fiberglass dermatitis.
Intralesional cryosurgery using lumbar puncture and/or hypodermic needles for large, bulky, recalcitrant keloids
Authors: Gupta Somesh , Kumar Bhushan
Published: March 2003

Abstract

Background  Keloids are notoriously difficult to treat. A variety of treatment modalities are currently in use, indicating that none is totally satisfactory. Surface cryosurgery is effective for smaller keloids, but not for larger ones. It often results in widespread depigmentation over the surface of the keloids, which may not be desirable, especially in patients with dark skin.

Objectives  To determine the efficacy of intralesional (IL) cryosurgery in large, bulky keloids unresponsive to IL steroids, and to observe the extent of depigmentation and other complications produced by the technique.

Methods  Twelve patients with large, bulky, symptomatic keloids unresponsive to at least five injections of IL triamcinolone acetonide were included in the study. The age of the patients and the duration of the keloids were in the range 19–50 years and 1–12 years, respectively. The IL cryosurgery device was assembled using a small liquid nitrogen Dewar cylinder, a rubber and a plastic tube taken from a drip‐set, adhesive tape, and hypodermic and lumbar puncture needles. The lumbar puncture or injection needle was introduced through the lesion until it appeared at the other side. Liquid nitrogen was then passed through the needle. The freezing time was between 20 and 30 s. The procedure was repeated for a second freeze–thaw cycle in the same session.

Results  The patients underwent a minimum of five up to a maximum of 10 sessions of IL cryosurgery. Seven out of 12 patients showed > 75% flattening. Depigmentation was observed along the tracks of the needles in all the patients, which improved during follow‐up due to pigment spread from the normally pigmented areas in between. At the end of follow‐up, 1–25% of the area remained hypo‐ or depigmented in four patients, 26–50% in six patients, and 51–75% in the remaining two patients.

Conclusions  IL cryosurgery should be the preferred mode of therapy for large, bulky keloids, which are unresponsive to IL steroids.
Risk factors for cutaneous melanoma: a case–control study in Argentina
Authors: Loria Dora , Matos Elena
Published: March 2003

Abstract

Background  Although cutaneous malignant melanoma (CMM) is still a relatively rare neoplasm, incidence rates are increasing in many white populations worldwide. A case–control study was performed in Argentina to estimate the risk factors for CMM.

Methods  The study group comprised 101 hospital cases with histologically verified melanoma and 246 controls, frequency matched by age, sex, and hospital. Individuals were interviewed about demographic and constitutional factors and sun exposure history.

Results  The following risk factors were significant in the logistic analysis: nevi on arms (odds ratio (OR) = 6.3 for 20 or more), skin phototype (OR = 4.1 for type l or ll), holidays spent at the beach (OR = 4 for more than 6 weeks lifelong), fair skin tone (OR = 3.4), light eye color (OR = 2.8), sunburn before the age of 15 years (OR = 2.4), and participation in outdoor sports (OR = 3.2 for more than 5790 h accumulated in a lifetime). Occupational sun exposure was not related to CMM risk. Educational level, hair color, and the presence of freckles were not independent risk factors for CMM.

Conclusions  The risk factors found for the studied population, with nearly 90% of the individuals born in Argentina and with nearly 50% with four southern European grandparents, were consistent with those described for other countries. This investigation has resulted in findings that may be of use in preparing actions to prevent CMM in Argentina; these should be directed at those individuals who present the abovementioned risk factors. These actions should include instructions to avoid excessive sun exposure, with the aim to reduce melanoma incidence.
Atopic dermatitis: immunophenotyping of inflammatory cells in skin lesions
Authors: Lugović Liborija , Lipozenočić Jasna , Jakić‐Razumović Jasminka
Published: March 2003

Abstract

Background  The ever increasing incidence of atopic dermatitis (AD) has stimulated many researchers to use various diagnostic procedures to obtain new data to help elucidate the pathogenesis of the disease.

Aims  To perform cell immunophenotyping and to analyze the presence of inflammatory cell‐surface markers in the biopsies of skin lesions from 15 AD patients and five healthy subjects.

Methods  Immunohistochemical analysis was performed in a group of AD patients and compared with that in a control group of healthy subjects. Avidin–biotin immunoperoxidase staining of paraffin‐embedded, 4 μm skin sections, with semiquantitative counting of cells labeled with anti‐CD3, anti‐CD8, anti‐CD20, anti‐HLA‐DR (HLA, human leukocyte antigen), and anti‐immunoglobulin E (anti‐IgE) primary antibodies, was used.

Results  The results of AD skin analysis showed a greater infiltration of CD3+ lymphocytes, especially of CD4+ subtype, compared with CD8+ lymphocytes. AD skin biopsy specimens also showed a higher intraepidermal HLA‐DR+ Langerhans' cell count, the presence of HLA‐DR on lymphocytes in the dermis, and higher intraepidermal expression of IgE+ cells compared with healthy controls.

Conclusions  A statistically significant difference (P < 0.05) was found between the two groups for intradermal and intraepidermal CD3, CD4, and HLA‐DR, intradermal CD8, and intraepidermal IgE+ cells. Immunophenotyping was found to be a useful diagnostic method in AD patients.
Psoriasis vulgaris and acute guttate psoriasis in a family
Authors: Banno Tomohiro , Fujisawa Hiroshi , Satomi Hisae , Imakado Sumihisa , Otsuka Fujio
Published: March 2003

A 33‐year‐old man (Case 1) developed scaling and erythema on the extensor side of his extremities, head, and back, 3 years before his first visit to our hospital. The lesions spread out to form several plaques and became persistent (Fig. 1a). Serum antistreptolysin O (ASO) was within the normal range and a pharyngeal culture showed normal flora. Histologic findings were compatible with psoriasis vulgaris (Fig. 1b). Topical steroid therapy was effective; however, scaling and erythema persisted.

(a) Well‐demarcated scaling and erythema on the leg of Case 1. (b) Skin biopsy specimen from scaling and erythema showing hyperkeratosis, parakeratosis, elongated rete ridges, and inflammatory cell infiltration into the epidermis

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The 8‐year‐old daughter (Case 2) of Case 1 had suffered severe tonsillitis 2 months prior to the skin eruptions. Numerous rain drop‐like scaly papules appeared on her legs and generalized rapidly (Fig. 2a). Her tonsils were swollen and reddish. Streptococcus pyogenes was detected by pharyngeal smear. The ASO value was at a high level. Histologic examination showed slightly elongated rete ridges, focal lack of the granular layer, parakeratosis, mild spongiosis, and exostosis of neutrophils (Fig. 2b). She was diagnosed with acute guttate psoriasis. Administration of oral antimicrobials reduced the ASO value and led to remission of the disease. After 1 month of antimicrobial treatment, the erythematous papules disappeared.

(a) Numerous rain drop‐like scaly papules on the arm of Case 2. (b) Skin biopsy specimen from scaling and erythema showing elongated rete ridges, focal lack of granular layer, parakeratosis, mild spongiosis, and exostosis of neutrophils

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The human leukocyte antigen (HLA) typing of the father was HLA‐A24, A31, B7, B39, and Cw7, and that of the daughter was HLA‐A24, A31, B39, and Cw7. Both possessed HLA‐A24, B39, and Cw7. The HLA typing of other family members was also studied. The mother had HLA‐A11, A24, B39, B62, Cw4, and Cw7, and her son had HLA‐A11, A24, B7, B62, Cw4, and Cw7. The result of HLA typing is shown in Table 1.

Human leukocyte antigen (HLA) typing in family members

Father (Case 1)

A24
A31
B7
B39

Mother
A11
A24

B39
B62
Cw4
Cw7

Daughter (Case 2)

A24
A31

B39

Cw7

Son
A11
A24

B7

B62
Cw4
Cw7

Lymphocyte stimulating test was performed using heat‐killed S. pyogenes which were boiled at 70 °C for 10 min and sonicated. The stimulation index was twofold higher in the daughter than in the father (Fig. 3).

The result of the lymphocyte stimulating test (LST) using heat‐killed S. pyogenes (S.I., stimulation index)

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Pigmented vulvar macules as a presenting feature of the Carney complex
Authors: Pandolfino Tomi L. , Cotell Stephanie , Katta Rajani
Published: March 2003

A 27‐year‐old woman was referred by her gynecologist for asymptomatic pigmented vulvar lesions first noted 2 years previously. Medical history was significant for a personal history of atrial myxoma, diagnosed due to a systolic murmur, along with a family (maternal) history of atrial myxoma. The patient also reported irregular menses, increasing and darkening of body and facial hair, and an increase in shoe size.

Physical examination revealed multiple 2‐5 mm dark brown to black macules on the labia majora and minora. (Fig. 1) Faint scattered light brown macules were noted on the chest and face. A 2‐mm brown scleral macule was present adjacent to the iris, and scattered small pigmented macules were present on the vermilion border of the lips. A 4‐mm blue‐black papule was found on the upper back, and several firm, 2 mm flesh‐colored papules were found on the abdomen and thigh. Hypertrichosis of both forearms was present, and enlargement of the jaw and hands was noted.

Multiple dark brown to black macules on the labia majora and minora

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Histopathologic evaluation of the blue‐black papule was consistent with a blue nevus, with elongated pigmented spindle cells. Although polygonal cells were noted in the main part of the lesion, these did not meet the criteria for the epithelioid variant of blue nevus, as they were smaller. Histopathologic evaluation of the abdominal lesion (Fig. 2) revealed spindle‐shaped fibroblasts and a mucinous stroma within the upper dermis consistent with a cutaneous myxoma.

Hematoxylin‐eosin stain at 112× magnification reveals spindle‐shaped fibroblasts and a mucinous stroma

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Endocrinologic evaluation revealed normal serum levels of prolactin, free and total testosterone, DHEA‐S, and AM cortisol as well as normal thyroid function tests. A 24‐ h urine collection for 17‐ketosteroids and cortrosyn stimulation tests were also within normal limits. Both somatomedin C and growth hormone levels, however, were elevated, at 970 ng/mL (114‐942 ng/mL) and 41.3 ng/mL (0‐10 ng/mL), respectively, consistent with acromegaly. MRI revealed a focal pituitary mass, compatible with a primary pituitary neoplasm. The patient underwent surgical resection of the tumor, which was found to be a growth hormone‐producing pituitary adenoma.

The diagnosis of Carney complex was made, due to cutaneous and mucosal lentigines, cutaneous myxomas, blue nevus, atrial myxoma, pituitary neoplasm with acromegaly, and a positive family history.
Evaluation of inflammatory parameters in physical urticarias and effects of an anti‐inflammatory/antiallergic treatment
Authors: Frezzolini Alessandra , De Pità Ornella , Cassano Nicoletta , D’Argento Vito , Ferranti Giulio , Filotico Raffaele , Vena Gino A.
Published: March 2003

Background  Physical urticaria (PU) includes a heterogeneous group of urticarias whose etiopathogenic aspects are still obscure and whose therapeutical management is often difficult. We have previously demonstrated the efficacy of a sequential treatment with nimesulide, a unique nonsteroidal anti‐inflammatory drug, and ketotifen in various forms of PU.

Methods  The expression of some inflammatory parameters was evaluated in 10 patients affected with some forms of PU. In particular, serum levels of interleukin (IL)‐4, IL‐1β, tumor necrosis factor (TNF)‐α, adhesion molecules (sELAM, sICAM‐1 and sVCAM), soluble receptors (sIL‐2R, sCD30, sCD23) and IgE were assessed. Moreover, the cutaneous expression of IL‐1β, TNF‐α and ICAM‐1 was studied on biopsy specimens taken from nonlesional skin of patients. The same parameters were further evaluated in both skin and serum following treatment with nimesulide and ketotifen, in order to better understand the possible effects of these agents on the inflammatory network of PU.

Results  Before therapy we could detect significantly higher serum levels of IL‐1β and TNF‐α (P < 0.001) and of circulating adhesion molecules in comparison with controls (sELAM, sICAM: P < 0.001; sVCAM: P < 0.02); after treatment, a significant reduction of each was observed (P < 0.05). Simultaneously, a high expression of IL‐1β, TNF‐α and ICAM‐1 was detected in all skin specimens at the baseline, with a relevant decrease following therapy.

Conclusions  These results confirm the therapeutical value of treatment with nimesulide and ketotifen in PU and suggest that these agents are able to reduce the release and the expression of some inflammatory molecules that are up‐regulated in PU.
A novel sustained‐release matrix based on biodegradable poly(ester amide)s and impregnated with bacteriophages and an antibiotic shows promise in management of infected venous stasis ulcers and other poorly healing wounds
Authors: Markoishvili Kalistrat , Tsitlanadze George , Katsarava Ramaz , Glenn J. , Morris Jr. MD  , Sulakvelidze Alexander
Published: March 2003

Healing of poorly vascularized and venous stasis ulcers is often refractory to therapy, particularly when they are infected. Systemic antibiotic therapy may be of little benefit in this setting because of poor penetration of the antibiotic into the wound and the frequent associated emergence of bacterial strains resistant to common antimicrobial agents. Given the clinical significance of these problems, there is a need to explore alternative management approaches for these difficult‐to‐treat wounds.

PhagoBioDerm is a novel wound‐healing preparation consisting of a biodegradable polymer impregnated with an antibiotic and lytic bacteriophages, which was recently licensed for sale in the Republic of Georgia (one of the former Soviet Union republics). In 1999–2000, in Tbilisi, Georgia, 107 patients who had ulcers that had failed to respond to conventional therapy were treated with PhagoBioDerm alone or in combination with other interventions.

The wounds/ulcers healed completely in 67 (70%) of 96 patients for whom follow‐up data were available. In 22 cases in which microbiologic data were available, healing was associated with the concomitant elimination of, or a reduction in, specific pathogenic bacteria in the ulcers.

Our findings suggest that this slow‐release biopolymer is safe and of possible benefit in the management of refractory wounds, and they support the apparent utility of bacteriophages in this setting. Further studies, including carefully designed clinical trials, will be required to rigorously evaluate the efficacy of this novel wound dressing preparation.
The seroprevalence of Helicobacter pylori and nitric oxide in acne rosacea
Authors: Gürer Mehmet Ali , Erel Arzu , Erbaş Deniz , Çağlar Kayhan , Atahan Çiğdem
Published: March 2003

Background Acne rosacea is a dermatosis with unknown etiology. Some studies have reported a high prevalence of Helicobacter pylori infection in acne rosacea. Other studies have reported a decrease in the severity of the lesions of acne rosacea after eradication of H. pylori. H. pylori is a Gram‐negative bacterium which colonizes the gastric mucosa and increases the synthesis of oxygen radicals, such as superoxide and proinflammatory cytokines. These cytokines have been demonstrated to stimulate the synthesis of the inflammatory species nitric oxide (NO). In this study, we examined the role of NO in the possible effect of H. pylori in acne rosacea.

Methods Thirty‐three acne rosacea patients were included in the study and the control group comprised 20 healthy individuals. The levels of immunoglobulin G antibodies against H. pylori in the serum samples were measured using the enzyme‐linked immunoabsorbent assay method. Measurement of nitrate was performed using chemiluminescence in accordance with the method described by Braman and Hendrix (Braman RS, Hendrix SA. Nanogram nitrite and nitrate determination in environmental and biological materials by vanadium(iii) reduction with chemiluminescence detection. Anal Chem 1989; 61: 2715–2718). For statistical analysis, the t‐test was used.

Results The seropositivity of H. pylori in acne rosacea patients was found to be high; however, the serum nitrate levels were found to be normal.

Conclusions The results of the study indicate that the inflammatory species NO, which has been hypothesized to be associated with H. pylori, has no role in the inflammatory mechanism of acne rosacea.
Nargile (Hubble‐Bubble) smoking‐induced hand eczema
Authors: Onder Meltem , Oztas Murat , Arnavut Onder
Published: March 2003

A 65‐year‐old retired man with hand eczema presented to the Dermatology clinic in October of 2001. He complained of scaly, fissured plaque‐type lesions over the radial margin of his right index finger and thumb (Fig. 1). He first noticed these changes 2 years ago.There was no history of irritation from his occupation. None of the other family members were affected. There was no history of atopy or psoriasis.

Hyperkeratotic scaly plaques along the outer margin of the right index finger and thumb related with habit of nargile smoking

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The physical examination was remarkable for scaly, fissured, hyperkeratotic patches on the palms and palmar surfaces of the finger tips of the right hand. No nail changes were noted. The other fingers were free from lesions.There were no changes on the feet or soles. A diagnosis of eczema was suspected. Hobbies and repeated trauma to the hands were investigated. He had a habit of “nargile” smoking,starting at 35 years of age and he was using this apparatus more than 2 h a day.

We performed patch tests with European standart test serial and they were negative. Yeast examination using KOH was negative. The diagnosis of Nargile (Hubble‐bubble) eczema was made. It was advised that he stop smoking. Mild topical corticosteroids and emollient with urea were started. Clinical evaluation demonstrated resolution of the lesions after 2 weeks of therapy.
Mees’ lines in a patient following acute arsenic intoxication
Authors: Seavolt Maralyn B. , Sarro Robert A. , Levin Kerry , Camisa Charles
Published: March 2003

A 62‐year‐old Turkish man developed nausea and vomiting 1 h following a dinner with friends and business associates. In the following few days, he developed dark urine, anemia, and thrombocytopenia. Five of his dinner companions developed similar symptoms of varying degrees, and one died. It is unknown how their food and beverage consumption differed during the meal. During the subsequent month, the patient developed gait ataxia, leg weakness, and burning pain and numbness in a glove‐and‐stocking distribution. Six weeks later, he traveled to the USA and was evaluated by our Department of Neurology. An electromyogram demonstrated generalized peripheral polyneuropathy, with motor and sensory axon loss. The patient was referred to the Department of Dermatology for evaluation of possible arsenic poisoning.

Cutaneous examination revealed one transverse white band on several fingernails approximately 3–4 mm distal to the proximal nail fold, consistent with Mees’ lines (Fig. 1). A plaque of confluent 3‐mm hypopigmented macules was evident on the extensor aspect of the left forearm (Fig. 2). Hair, nail, and urine samples were obtained to rule out heavy metal poisoning; the arsenic levels obtained were 27.6 µg/g (normal, 0.03–3 µg/g), 2.98 µg/g (normal, 0.03–3 µg/g), and 82 µg/L (normal, < 81 µg/L), respectively.

Mees' lines present on the fingernails

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Hypopigmented macules on the forearm characteristic of “raindrops on a dusty road,” which developed after the arsenic intoxication

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These laboratory findings were consistent with acute arsenic poisoning. The patient was treated with oral succimer (water‐soluble analog of dimercaprol), 10 mg/kg every 8 h, for 14 days with improvement of his neurologic symptoms. It is unknown exactly how the arsenic poisoning occurred, or the motivation behind it; however, criminal intent was suspected and is under investigation by the Turkish authorities.
Pentamidine, the drug of choice for the treatment of cutaneous leishmaniasis in Surinam
Authors: Lai A Fat Esther J. S. K. , Vrede Martinus A. , Soetosenojo Ramon M. , Lai A Fat Rudy F. M.
Published: March 2003

Background Cutaneous leishmaniasis is an endemic disease in Surinam. The disease was treated until the early 1970s with pentavalent antimony. Pentamidine mesylate was introduced by Niemel in 1973 for the treatment of cutaneous leishmaniasis in Surinam.

Materials and methods In this retrospective study, we evaluate the results of treatment with pentamidine mesylate in 235 patients and with pentamidine isethionate in 80 patients.

Results In the pentamidine mesylate‐ and pentamidine isethionate‐treated groups, a cure rate (healing without relapse) of nearly 90% was found. Relapses were seen in approximately 10% of patients in both groups. Minor side‐effects, such as pain at the injection site, bitter taste, and nausea, were seen with both drugs in about 65% of patients. Complaints of the respiratory tract were seen in less than 10% of patients in the pentamidine isethionate‐treated group, but were uncommon in the pentamidine mesylate‐treated group.

Conclusions Pentamidine mesylate and isethionate have similar safety, efficacy, and side‐effect profiles in the treatment of cutaneous leishmaniasis in Surinam.
Prolidase deficiency
Authors: Kokturk Aysin , Kaya Tamer Irfan , Ikizoglu Guliz , Koca Aynur
Published: March 2003

A 32‐year‐old mentally retarded woman was admitted to hospital with recurrent ulcers on her legs, which appeared for the first time at 8 years of age. Apart from recurrent lower respiratory tract infections and chronic otitis media, her personal history was unremarkable. Her parents were second‐degree relatives. The family history showed no similar disease or mental retardation. Physical examination revealed that the patient had an unusual facial appearance, with a high‐arched palate; she had multiple tooth caries (Fig. 1).

Facial appearance of the patient

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There was edema and induration on both legs; extensive polygonal ulcers with elevated borders were noted. All lesions were 2–4 mm deep with vertical margins and a necrotic base. The surrounding skin was atrophic, and depigmented cicatricial lesions were detected (Fig. 2). She had crops of erythematous lesions and telangiectasias over the face, shoulders, arms, and extremities. She also showed photosensitivity, palmar hyperkeratosis, verrucous papules and plaques on the dorsal aspects of both feet consistent with lymphedematous changes, pes planus deformity, and hyperextensible joints. There was a scleroatrophic appearance and flexion contracture of the little fingers on both hands. Her abdomen was relatively protuberant and she had splenomegaly. Laboratory analysis revealed an elevated erythrocyte sedimentation rate, hypergammaglobulinemia, and iron deficiency anemia. A large amount of hydroxyproline was detected after hydrolysis of a 24‐h urine specimen (205 mg/day). Her plasma manganese level was 1.94 mg/dL (normal) and her vitamin C level was 1.4 mg/dL (below normal). Skin biopsies showed nonspecific inflammatory changes. Topical silver sulfadiazine and oral vitamin C (3 g/day) treatment was started.

Ulcers and depigmented cicatricial lesions on the legs

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The effects of seeing on Sèrsic profiles
Authors: Trujillo I. , Aguerri J. A. L. , Cepa J. , Gutiérrez C. M.
Published: March 2003

The effects of seeing on the parameters of the Sèrsic profile are studied in an analytical form using a Gaussian point spread function. The surface brightness of Sèrsic profiles is proportional (in magnitudes) to r1/n. The parameter n serves to classify the type of profile and is related to the central luminosity concentration. It is the parameter most affected by seeing; furthermore, the value of n that can be measured is always smaller than the real one. It is shown that the luminosity density of the Sèrsic profile with n less than 0.5 has a central depression, which is physically unlikely. Also, the intrinsic ellipticity of the sources has been taken into account and we show that the parameters are dependent when the effects of seeing are non-negligible. Finally, a prescription for correcting raw effective radii, central intensities and n parameters is given.
`I'd rather go and know': women's understanding and experience of DEXA scanning for osteoporosis
Authors: Richardson Jane C. , Hassell Andrew B. , Hay Elaine M. , Thomas Elaine
Published: March 2003

Objective  To explore women's knowledge and understanding of osteoporosis and of dual energy x‐ray absorptiometer (DEXA) scans; the factors influencing their decision to have a scan and their experience of undergoing a DEXA scan.

Design  In‐depth interviews (using a topic guide) were carried out with 12 women [before a DEXA scan and after they had discussed the results with their general practitioner (GP)] and with three women who chose not to have a scan.

Setting  Stoke‐on‐Trent, Staffordshire, UK.

Participants  Women who responded to a primary‐care based questionnaire were purposively selected for interview.

Results  The women interviewed had varied levels of understanding of osteoporosis. For the majority of participants the scan was an overwhelmingly positive experience, despite some women's negative expectations. Findings are also explored in terms of the influences on women's decision‐making about whether to have a scan and the concept of `knowing' one's risk status.

Conclusions  The main implication for primary care is how to improve women's understanding of osteoporosis and DEXA scans in order to promote the strategy of scanning high‐risk women.
The relative fitness of Drosophila melanogaster (Diptera, Drosophilidae) that have successfully defended themselves against the parasitoid Asobara tabida (Hymenoptera, Braconidae)
Authors: Fellowes  , Kraaijeveld  , Godfray
Published: March 2003

Drosophila melanogaster larvae defend themselves against parasitoid attack via the process of encapsulation. However, flies that successfully defend themselves have reduced fitness as adults. Adults which carry an encapsulated parasitoid egg are smaller and females produce significantly fewer eggs than controls. Capsule-bearing males allowed repeated copulations with females do not show a reduction in their number of offspring, but those allowed to copulate only once did. No differences were found in time to first oviposition in females, or in time to first copulation in males. We interpret the results as arising from a trade-off between investing resources in factors promoting fecundity and mating success, and in defence against parasitism. The outcome of this investment decision influences the strength of selection for defence against parasitism.
Below-threshold mortality: implications for studies in evolution, ecology and demography
Authors: Promislow  , Tatar  , Pletcher  , Carey
Published: March 2003

Evolutionary biologists, ecologists and experimental gerontologists have increasingly used estimates of age-specific mortality as a critical component in studies of a range of important biological processes. However, the analysis of age-specific mortality rates is plagued by specific statistical challenges caused by sampling error. Here we discuss the nature of this ‘demographic sampling error’, and the way in which it can bias our estimates of (1) rates of ageing, (2) age at onset of senescence, (3) costs of reproduction and (4) demographic tests of evolutionary models of ageing. We conducted simulations which suggest that using standard statistical techniques, we would need sample sizes on the order of tens of thousands in most experiments to effectively remove any bias due to sampling error. We argue that biologists should use much larger sample sizes than have previously been used. However, we also present simple maximum likelihood models that effectively remove biases due to demographic sampling error even at relatively small sample sizes.
Evolution of phenotypic plasticity a comparative approach in the phylogenetic neighbourhood of Arabidopsis thaliana
Authors: Pigliucci  , Cammell  , Schmitt
Published: March 2003

The evolution of phenotypic plasticity has rarely been examined within an explicitly phylogenetic framework, making use of modern comparative techniques. Therefore, the purpose of this study was to determine phylogenetic patterns in the evolution of phenotypic plasticity in response to vegetation shade (the ‘shade avoidance’ syndrome) in the annual plant Arabidopsis thaliana and its close relatives. Specifically, we asked the following questions: (i) Do A. thaliana and related species differ within or among clades in the magnitude and/or pattern of plasticity to shade? (ii) Are the phenotypic variance–covariance matrices (phenotypic integration) of these taxa plastic to the changes in light quality induced by the presence of a canopy? (iii) To what extent does the variation in uni- and multivariate plasticity match the phylogeny of Arabidopsis? In order to address these questions we grew individuals from six taxa of known phylogenetic relationship in a greenhouse under full sun and under a grass canopy. Taxa differed in the magnitude, but not in the pattern, of plasticities for all traits. At the univariate level, the late flowering species, A. pumila and A. griffithiana, as well as the late flowering Moscow ecotype of A. thaliana, showed greater plasticity for allocation to vegetative and reproductive meristems. At the multivariate level, several taxa displayed a very low stability of their variance–covariance structures to environmental change, with only one taxon sharing as many as three principal components across environments. We conclude that both univariate and multivariate plasticities to vegetation shade can evolve rapidly within a genus of flowering plants, with little evidence of historical constraints (phylogenetic inertia).
Plant domestication: a model for studying the selection of linkage
Authors: D’Ennequin M. Le Thierry , Toupance  , Robert  , Godelle  , Gouyon
Published: March 2003

The process of domestication leads to acquisition of traits that are often similar between plant species that belong to the same family but have different breeding systems. Hence domestication is a useful model for studying evolutionary responses to selection in plants with contrasting breeding systems. We consider a stochastic model simulating gene flow between a natural population and an initial population containing mutants with domesticated phenotypes at low frequency. We assume that a large number of loci contribute equally to the cultivated phenotype. Our results indicate that the number of loci for which the mutant (‘domestication’) allele is maintained is larger in autogamous plants than in allogamous ones and that domestication can lead to the selection of tightly linked combinations of genes in allogamous plants. This work provides a general model for the selection of gene clusters through a sieve effect and it is discussed in comparison with models proposed to explain the evolution of linkage of genes determining wing patterns in butterflies exhibiting Batesian mimicry.
A pluralist approach to sex and recombination
Authors: West  , Lively  , Read
Published: March 2003

One of the greatest challenges for evolutionary biology is explaining the widespread occurrence of sexual reproduction and the associated process of genetic recombination. A large number of theories have been developed that provide a sufficient short-term advantage for sex to offset its two-fold cost. These theories can be broadly classified into environmental (or ecological) and mutation-based models. Traditionally, the different theories have been viewed as competing, and empirical work has attempted to distinguish between them. Here we highlight the advantages that may be gained from considering that multiple mechanisms (environmental and mutational) may be at work, and that interactions between the theories may be very important.
A quantitative genetic analysis of leaf beetle larval performance on two natural hosts: including a mixed diet
Authors: Ballabeni  , Rahier
Published: March 2003

Published quantitative genetic studies of larval performance on different host plants have always compared performance on one host species or genotype vs. performance on another species or genotype. The fact that some insects may feed on more than one plant species during their development has been neglected. We executed a quantitative genetic analysis of performance with larvae of the leaf beetle Oreinaelongata, raised on each of two sympatric host plants or on a mixture of them. Growth rate was higher for larvae feeding on Adenostylesalliariae, intermediate on the mixed diet and lowest on Cirsium spinosissimum. Development time was shortest on A. alliariae, intermediate on mixed diet and longest on C. spinosissimum. Survival was higher on the mixed diet than on both pure hosts. Genetic variation was present for all three performance traits but a genotype by host interaction was found only for growth rate. However, the reaction norms for growth rate are unlikely to evolve towards an optimal shape because of a lack of heritability of growth rate in each single environment. We found no negative genetic correlations for performance traits among hosts. Therefore, our results do not support a hypothesis predicting the existence of between-host trade-offs in performance when both hosts are sympatric with an insect population. We conclude that the evolution of host specialized genotypes is unlikely in the study population.
Transitions in the evolution of meiosis
Authors: Hurst  , Randerson
Published: March 2003

Meiosis may have evolved gradually within the eukaryotes with the earliest forms having a one-step meiosis. It has been speculated that the putative transition from a one-step meiosis without recombination to one with recombination may have been stimulated by the invasion of Killer alleles. These imaginary selfish elements are considered to act prior to recombination. They prime for destruction (which occurs after cell division) the half of the cell on the opposite side of the meiotic spindle. Likewise the transition from one-step to two-step meiosis might have been stimulated by a subtly different sort of imaginary distorter allele, a SisterKiller. These are proposed to act after recombination. It has yet to be established that the presence of such distorter alleles could induce the transitions in question. To investigate these issues we have analysed the dynamics of a modifier (1) of recombination and (2) of the number of steps of meiosis, as they enter a population with one-step meiosis. For the modifier of recombination, we find that invasion conditions are very broad and that persistence of Killer and modifier is likely through most parameter space, even when the recombination rate is low. However, if we allow a Killer element to mutate into one that is self-tolerant, the modifier and the nonself-tolerant alleles are typically both lost from the population. The modifier of the number of steps can invade if the SisterKiller acts at meiosis II. However, a SisterKiller acting at meiosis I, far from promoting the modifier’s spread, actually impedes it. In the former case the invasion is easiest if there is no recombination. The SisterKiller hypothesis therefore fails to provide a reasonable account of the evolution of two-step meiosis with recombination. As before, the evolution of self-tolerance on the part of the selfish element destroys the process. We conclude that the conditions under which SisterKillers promote the evolution of two-step meiosis are very much more limited than originally considered. We also conclude that there is no universal agreement between ESS and modifier analyses of the same transitions.