bluuebunny/crossref_metadata_2025 huggingface dataset:
Paraneoplastic pemphigus in a dog
Authors: Lemmens  , De Bruin  , De Meulemeester  , Wyder  , Suter
Published: March 2003

This report presents a case of paraneoplastic pemphigus in a 7‐year‐old female Bouvier. The dog initially showed extensive oral ulcerations that exacerbated upon treatment with trimethoprim‐sulfadiazine. Subsequently, the dog developed vesiculobullous and ulcerative lesions on the ear margins, the nose, periocular, and at the nail beds. Due to complete therapy resistance and a deteriorating general condition, the dog was euthanized. During post‐mortem examination a thymic lymphoma was found. While an early biopsy of the oral cavity revealed features of erythema multiforme, skin lesions at necropsy were typical of pemphigus vulgaris. Indirect immunofluorescence of patient serum revealed an antikeratinocyte membrane pattern typical for pemphigus. The serum was also positive on bovine bladder epithelium. In a Western blot, autoantibodies to a 210 and a 190 kDa protein were detected.
Studies on the role of carbohydrates in the adherence of Malassezia pachydermatis to canine corneocytes in vitro
Authors: Bond  , Lloyd
Published: March 2003

A panel of four lectins was used to investigate the role of carbohydrates in the adherence of Malassezia pachydermatis to canine corneocytes in vitro. Pretreatment of canine corneocytes with concanavalin A (10 μg ml−1) inhibited (P < 0.01) the adherence of one out of six M. pachydermatis strains. This effect was abrogated by pre‐incubating concanavalin A with its hapten inhibitor (6% methyl α‐d‐mannopyranoside), suggesting that mannosyl‐bearing carbohydrate residues on the epithelial cells serve as ligands for adhesins expressed by this strain. However, treatment of corneocytes with soybean, wheat germ and gorse lectin, and pretreatment of the yeast cells with either of the four lectins had no reproducible effect on the adherence of two strains.
Induced and spontaneous IgE antibodies toDermatophagoides farinaein dogs and cats: evidence of functional heterogeneity of IgE
Authors: Halliwell  , Gilbert  , Mei Lian
Published: March 2003

Enzyme‐linked immunosorbent assays (ELISAs) were developed to measure IgE antibodies specific forDermatophagoides farinaein dogs and cats. Although higher levels were detected in atopic dogs and cats than in normal animals without skin disease, the differences were not statistically significant. On the other hand, levels in dogs and cats that were reared under laboratory conditions, and thus presumably not exposed to house dust mites, were either very low or undetectable. IgE antibodies were induced in 10 laboratory‐reared cats using low‐dose antigenic stimulation in aluminium hydroxide. All cats developed detectable IgE, but not all developed positive skin tests. However, serum from those cats with positive skin tests were able to give positive Prausnitz–Küstner (PK) tests. The canine data, together with previous work on basophil histamine release, suggests that the distinction between atopic and normal dogs may result from a heterogeneity of either IgE or of the high‐affinity mast cell receptor. The feline data can only be explained by the existence of a heterogeneity of IgE.
Monoclonal anti‐IgE antibodies in the diagnosis of dog allergy
Authors: Dérer  , Morrison‐Smith  , De Weck
Published: March 2003

The availability of anti‐dog IgE monoclonal antibodies has enabled development of highly specific ELISA assays for measuring antigen‐specific IgE in dog serum. In this article the authors propose criteria for evaluation of these monoclonals and demonstrate that some anti‐human IgE monoclonals recognize dog IgE. Combinations of two or more monoclonal antibodies can enhance assay sensitivity; for example, a mixture of DE38.HRPO and 4F4.HRPO conjugates detect total dog IgE in the range 10–10000 ng/mL. Results are reported from nine clinical studies conducted in Europe, Japan and Australia involving more than 400 dogs in which serologic IgE determinations performed using the CMG IMMUNODOT strip system for house dust mites, storage mites, flea, grass pollens and moulds were compared with immediate skin test findings. House dust mites were identified as the common major dog allergen throughout these areas although regional reactions to food allergens were observed. These results confirm that the CMG IMMUNODOT system is a valuable and reliable diagnostic test for dog allergy.
Comparison between IMMUNODOT tests and the intradermal skin test in atopic dogs
Authors: Zunic
Published: March 2003

This study evaluated a new perspective in the diagnosis of dermatitis in dogs with signs suggestive of allergic skin disease. The results obtained with CMG IMMUNODOT tests using the technique of allergen‐specific strip tests, as employed for human allergy diagnosis, were compared with those obtained by the intradermal skin test (IDST). Forty‐eight cases completed the diagnostic evaluation, which included IDST, flea‐control program, exclusion of sarcoptes and, for some cases, a 1‐ to 2‐month stabilization period on a restricted protein source diet and testing the serum in the presence of allergen‐specific IgE and total IgE. The most common disorders included house and storage dust mites, allergic dermatitis and flea‐allergic dermatitis together with atopy. This was confirmed serologically. In the case of positive IDST to pollens,Aspergillusspp. and cat epithelium, CMG IMMUNODOT strip tests were negative. A total of 25% of cases were considered to be primarily associated with food hypersensitivity, but only 4% were confirmed serologically. This study emphasizes the value of CMG IMMUNODOT tests as a support in the diagnosis of dog allergy.
Anti‐isthmus autoimmunity in a novel feline acquired alopecia resembling pseudopelade of humans*
Authors: Olivry T. , Power H.T. , Woo J.C. , Moore P.F. , Tobin D.J.
Published: March 2003

Pseudopelade is a primary scarring (cicatricial) alopecia of humans characterized by lymphocyte‐rich inflammation centred around the hair follicle isthmus. Lymphocyte folliculotropism is associated with isthmus apoptosis and, ultimately, follicular destruction and dermal fibrosis. In a cat, an acquired alopecia was diagnosed as pseudopelade based on the following criteria: (i) an adult‐onset, patchy to diffuse nonpruritic hair loss; (ii) an early folliculo‐destructive phase in which lymphocytes and dendritic cells accumulated in and around the follicular isthmus; and (iii) a late stage in which the lower segments of hair follicles underwent atrophy and were replaced by fibrosing tracts. Additionally, immunological investigations characterized the cytotoxic phenotype of isthmotropic lymphocytes and demonstrated the presence of circulating IgG autoantibodies specific for multiple follicular antigens. Altogether, the results of the present study suggest an immune‐mediated pathogenesis for this case of feline pseudopelade, similarly to that causing alopecia areata in humans and other mammalian species.
Evaluation of the clinical efficacy of marbofloxacin (Zeniquin) tablets for the treatment of canine pyoderma: an open clinical trial
Authors: Paradis Manon , Abbey L. , Baker B. , Coyne M. , Hannigan M. , Joffe D. , Pukay B. , Trettien A. , Waisglass S. , Wellington J.
Published: March 2003

The efficacy and field safety of marbofloxacin (Zeniquin) for the treatment of superficial and deep bacterial pyoderma were evaluated. Seventy‐two dogs were treated with 2.75 mg kg−1of marbofloxacin orally once daily for 21 or 28 days. Sixty‐two dogs (86%) had superficial pyoderma and 10 (14%) had deep pyoderma. A history of prior pyoderma was reported in 39/72 dogs. Pretreatment aerobic bacteriologic cultures of skin lesions were performed in 47 cases and the predominant pathogen isolated wasStaphylococcus intermedius. Treatment was successful in 62/72 (86.1%) dogs, improvement was noted in 6/72 (8.3%) dogs and treatment failed in 4/72 (5.6%) dogs. Adverse effects associated with treatment included listlessness, anorexia, vomiting, soft stool, flatulence and polydipsia; these adverse effects were seen in only 6/81 dogs. Marbofloxacin was safe and effective for the treatment of superficial and deep pyoderma in dogs at the dosage used in this study.
Effects of dietary flax seed and sunflower seed supplementation on normal canine serum polyunsaturated fatty acids and skin and hair coat condition scores
Authors: Rees C.A. , Bauer J.E. , Burkholder W.J. , Kennis R.A. , Dunbar B.L. , Bigley C.E.
Published: March 2003

This prospective study involved supplementing 18 normal dogs with flax seed (FLX) and sunflower seed (SUN) and evaluating their effects on skin and hair coat condition scores and serum polyunsaturated fatty acids (PUFA) concentrations. Skin and hair coat were evaluated in a double‐blinded fashion using a numeric scoring system and serum PUFA concentrations were determined. Our hypothesis was that changes in serum PUFA concentrations are associated with improvements in skin and hair coat and that serum PUFA would provide an objective method for making dietary fatty acid supplement recommendations. Although a numerical improvement was found in hair coat quality in both groups, this improvement was not sustained beyond 28 days. The relative per cent of 18:3n‐3 concentrations in serum phospholipids increased in the FLX treated dogs but these concentrations remained unchanged in the SUN treated dogs. Also, elevations in relative per cent of 18:2n‐6 concentrations in serum phospholipids were seen in the FLX group. The ratio of serum polyunsaturated to saturated fatty acids also showed a transient increase. These increases preceded the peak skin condition score peak value by approximately 14 days. It was concluded that a 1‐month supplementation with either flax seed or sunflower seed in dogs provides temporary improvement in skin and hair coat. These changes appeared to be associated with increased serum 18 carbon PUFA.
Follicular dysplasia in five Weimaraners
Authors: Laffort‐Dassot Catherine , Beco Luc , Carlotti Didier Noel
Published: March 2003

AbstractThis study evaluated the clinical and histopathological features and results of light and electron scanning microscopy assessments of follicular dysplasia in five Weimar Pointers. The data were compared with those obtained in three normal Weimaraners. In our study, this dermatosis affected young adults that showed progressive alopecia of the trunk (head and limbs were spared) associated with recurrent folliculitis/furunculosis. Exclusion of other dermatoses and the presence of histopathological lesions and hair shafts abnormalities seen in light and/or scanning electron microscopy similar to colour dilution alopecia led to the diagnosis of follicular dysplasia. The lesions we observed are the same as those described previously in colour dilution alopecia, but they were less pronounced in all our samples.
Degradation of chlorsulfuron and triasulfuron in alkaline soils under laboratory conditions
Authors: SARMAH  , KOOKANA  , ALSTON
Published: March 2003

The degradation of chlorsulfuron and triasulfuron was investigated in alkaline soils (pH 7.1–9.4) spiked at 40 μg a.i. kg–1 under laboratory conditions at 25 °C and a moisture content corresponding to 70% field capacity (–33 kPa), using high‐performance liquid chromatography. Degradation data for the two herbicides did not follow first‐order kinetics, and observed DT50 values in surface soils ranged from 19 to 42 days and from 3 to 24 days for chlorsulfuron and triasulfuron respectively. Disappearance of both chlorsulfuron and triasulfuron was faster in non‐sterile than in sterile soil, demonstrating the importance of microbes in the breakdown process. The persistence of chlorsulfuron increased with increasing depth, which can be attributed to the decline in the microbial populations down the profile. The DT50 value for chlorsulfuron at 30–40 cm depth was nearly four times higher than that in the top‐soil. The results obtained show that persistence of these herbicides in alkaline surface soils at 25 °C and at a moisture content of 70% field capacity is similar to those reported in other European and North American soils. The study shows that if these herbicides are contained in surface soil layers, the risk of residue carry‐over under southern Australian conditions is small. However, the rate of their degradation in alkaline subsoils is very slow, and under conditions conducive to leaching their prolonged persistence in the soil profile is possible.
Natural products as sources of herbicides: current status and future trends
Authors: Duke  , Dayan  , Romagni  , Rimando
Published: March 2003

Although natural product‐based discovery strategies have not been as successful for herbicides as for other pesticides or pharmaceuticals, there have been some notable successes. Phosphinothricin, the biosynthetic version of glufosinate, and bialaphos are phytotoxic microbial products that have yielded commercial herbicides. Cinmethylin, a herbicidal analogue of cineole, has been sold in Europe and Asia. The triketone herbicides are derivatives of the plant‐produced phytotoxin leptospermone. These products represent only a small fraction of commercialized herbicides, but they have each introduced a novel molecular target site for herbicides. Analysis of the literature reveals that phytotoxic natural products act on a large number of unexploited herbicide target sites. The pesticide industry’s natural product discovery efforts have so far concentrated on microbially derived phytotoxins, primarily from non‐pathogenic soil microbes, involving the screening of large numbers of exotic isolates. Plant pathogens usually produce potent phytotoxins, yet they have received relatively little attention. Even less effort has been made to discover plant‐derived phytotoxins. Bioassay‐directed isolation has been the preferred method of discovery after a producing organism is selected. This laborious approach often leads to rediscovery of known compounds. Modern tandem separation/chemical characterization instrumentation can eliminate much of this problem by identification of compounds before they are bioassayed.
Influence of straw management, nitrogen fertilization and dosage rates on the dissipation of five sulfonylureas in soil
Authors: Menne H J , Berger B M
Published: March 2003

The dissipation behaviour of metsulfuron‐methyl, tribenuron‐methyl, thifensulfuron‐methyl, triasulfuron and amidosulfuron were studied in soil following post‐emergence spring applications to cereal crops. Incorporation or removal of straw and different fertilizer applications had no influence on the disappearance time (DT50) of the herbicides. However, in laboratory trials dissipation of metsulfuron‐methyl, triasulfuron and amidosulfuron at higher application rates was accelerated after incorporation of straw into the soil. The addition of straw decreases soil pH thereby causing faster hydrolysis of the compounds. Addition of nitrogen fertilizer increased the half‐lives (t1/2) of the herbicides. Combination of both straw and N fertilizer, however, had no effect. Neither straw nor N influenced the degradation of tribenuron‐methyl and thifensulfuron‐methyl.

The DT50of all herbicides investigated varied from 6 to 17 days in the field trials. Except for amidosulfuron, herbicides could not be detected 38–68 days after application. In the laboratory, t1/2values were higher than those in the field at 75 days (amidosulfuron), 63 days (metsulfuron‐methyl), 35 days (triasulfuron) and 13 days (tribenuron‐methyl). Only the t1/2of thifensulfuron‐methyl was at 29 h faster under laboratory conditions. T1/2values of all herbicides were influenced by their initial concentration. The t1/2values of amidosulfuron and tribenuron‐methyl at 1 mg a.i. kg−1soil were 2–2.5 times higher than at the recommended field application rate of 42 μg a.i. kg−1 soil.
Non‐chemical weed management in organic farming systems
Authors: Bond W , Grundy A C
Published: March 2003

Concern about potential increases in weed populations without the use of herbicides has limited the uptake of organic farming. However, as both public demands for organic produce and the profile of organic farming have increased in recent years, so too has the range of weed control options. Progress in cultural methods of weed control has included the use of novel weed‐suppressing cover crops, and the identification of specific crop traits for weed suppression. Direct weed control has also seen developments, with new implements appearing on the market that could benefit in the future from sophisticated machine guidance and weed detection technology. Advances in novel techniques such as steaming have also been made. Many weed control operations in organic systems present the grower with conflicts, and both these and many of the most recent developments in organic weed control are reviewed. An increase in our understanding of weed biology and population dynamics underpins long‐term improvements in sustainable weed control. The outcome of these studies will benefit conventional and organic growers alike. Emphasis is given to the need for flexibility and a combination of weed biology knowledge, cultural methods and direct weed control to maintain weed populations at manageable levels.
Effect of tillage, cover crop and crop rotation on the composition of weed flora in a sandy soil
Authors: SHRESTHA A , KNEZEVIC S Z , ROY R C , BALL‐COELHO B R , SWANTON C J
Published: March 2003

The development of integrated weed management strategies requires knowledge of mechanisms that influence compositional changes in weed flora. A 9‐year study was initiated in 1988 at Delhi, Canada, on a loamy sand soil to evaluate the effect of tillage systems [conventional (CT) and no‐till (NT)] and cover crops (only in NT) on weed density, species composition and associations, and crop yield in a winter wheat (Triticum aestivum L.)/bean/winter wheat rotation. Three bean types: soyabean (Glycine max L. Merr.), white bean (Phaseolus vulgaris L.) and kidney bean (P. vulgaris L.) were included. The NT system included variations: rye (Secale cereale L.) or maize (Zea mays L.) cover crop, volunteer wheat disked after harvest and wheat stubble. Data were collected in 1994, 1995 and 1996. Tillage systems, cover crops and crop type had differential effects on weed densities, species composition and associations. Weed densities were not affected by tillage or cover crops in wheat but, in the beans, densities were greater in the CT than in the NT systems. Various associations of weed species with tillage system, cover crop and crop type were observed. Crop yields were not affected by tillage type or cover crop, except that soyabean yields were highest in plots with cover crops.
A questionnaire study of road pavers’ and roofers’ work‐related skin symptoms and bitumen exposure
Authors: Riala Riitta , Heikkilä Pirjo , Kanerva Lasse
Published: March 2003

BackgroundSkin contact with the components in asphalt and bitumen can lead to irritant and allergic contact dermatitis, but few data are available in the dermatologic literature on the skin symptoms caused by work with bitumen. In addition, working methods have changed markedly during recent decades.

MethodsA questionnaire was delivered to 50 roofers and 101 road pavers. The questionnaire dealt with skin symptoms, symptoms caused by solvent products, the use of personal protection, smoking, eating habits, work conditions, changing and cleaning of overalls, etc.

ResultsForty‐eight per cent of the road pavers and 58% of the roofers responded to the questionnaire. Relatively high percentages of work‐induced skin irritation were reported by both the roofers (44%) and the road pavers (31%); 22% of the road pavers had dermatitis often or sometimes compared with 15% of the roofers. The hands, arms, face, and lower extremities were the most common sites affected. In addition to bitumen products, the road pavers considered amine adhesion‐improving agents for paving and naphtha and solvents used in machine repairs, to be the main causes of their skin symptoms. The skin problems of the roofers were caused by man‐made mineral fibers, cutback bitumen, and hot bitumen burns.

ConclusionsRoofers endure greater exposure to chemicals than road pavers. Certain components, e.g. polycyclic aromatic hydrocarbons in bitumen, can be absorbed through the skin. Skin exposure should be lowered by keeping the tools, working clothes, shoes, and gloves clean. Overalls and gloves are recommended to be changed at least once a week. Water laundering is not sufficient in dissolving bitumen from overalls and underwear. Cleaning the skin with solvents or naphtha is not recommended, as they are skin irritants.
Atypical molluscum contagiosum infection in an HIV‐infected patient
Authors: Mastrolorenzo MD Antonio , Urbano MD Francesco G. , Salimbeni MD Luca , Paoli MD Simone , Comin Camilla E. , Zuccati MD Giuliano
Published: March 2003

A 43‐year‐old man, who was an intravenous drug abuser from 1978 to 1988, was referred to our STD & AIDS Center in October 1995 with flesh‐colored nodules of the foreskin. He was confirmed to be seronegative in February 1989, and the first positive human immunodeficiency virus (HIV) serology was documented in October 1989. At that time, the CD4+ count was 114/mm3 and anti‐retroviral therapy was therefore initiated and prolonged until October 1995. Within the last 4 months, the patient progressively lost weight (13 kg) and suffered from recurrent oral candidiasis, cytomegalovirus (CMV) retinitis, and severe oral herpes simplex virus (HSV) infection. Shortly afterwards the dermatologic lesions appeared. At this time, the CD4+ count had decreased to 8/mm3. Examination revealed nodules distributed over the external and internal linings of the foreskin, some isolated and some grouped, but individually well defined. These lesions, of the same color as the surrounding skin or slightly erythematous, were of varying sizes ranging from 0.5 to 1 cm in diameter, sessile, globous, coated with a keratotic epidermal layer, not shiny, hard‐elastic, non‐tender at compression, and without evident central umbilication, mimicking condylomata acuminata (Fig. 1). Upon squeezing, no discharge could be seen. The source of this infection was not identified as the patient denied sexual contact for the previous year.

A three‐lesions biopsy showed the characteristic histologic features of molluscum contagiosum (MC). The dermis appeared indented by multiple, closely packed, lobules of proliferating epithelium (Figs 2 and 3). The infected keratinocytes contained intracytoplasmatic inclusions, the so‐called molluscum bodies displacing the nucleus and enlarging the infected cells.
Erythema nodosum and associated diseases. A study of 129 cases
Authors: Cribier Bernard , Caille Anne , Heid Ernest , Grosshans Edouard
Published: March 2003

Background Erythema nodosum (EN) is associated with many infectious diseases. The purpose of this study was to evaluate the relative prevalence of associated diseases in a large series of EN, and to review the previously described causes of EN.

Materials and methods A total of 157 inpatients with a diagnosis of EN made in Strasbourg, France between 1960 and 1995 were studied retrospectively, but only 129 patients with confirmed EN were evaluated. A biopsy was taken in 30 patients with atypical clinical symptoms. Chest radiography, blood cell count, throat swab, and anti‐streptolysin dosage were performed systematically. Viral investigations and serodiagnoses for various bacterial infections were carried out in approximately half of the patients. All investigations were analyzed retrospectively and compared with the world literature.

Results The female : male ratio was 5 : 1 and the mean age was 31 years. We found 28% confirmed streptococcal infections, 11% sarcoidosis, 1.5% enteropathies, 1.5% Chlamydia infections, 0.8% Mycoplasma infections, 0.8% Yersinia infections, 0.8% hepatitis B, and 0.8% tuberculosis (one case). The causative factor could not be determined in 55% of patients.

Conclusions Our data confirm the predominance of streptococcal infections and sarcoidosis among patients with EN. Tuberculosis has virtually disappeared, since the last case was observed in 1962. Various viral or bacterial diseases are rarely associated with EN, but all patients were not thoroughly investigated. A large and prospective study should be performed in order to determine the true prevalence of associated diseases in EN. In the absence of specific symptoms, exhaustive investigations are not cost‐effective.
Frequency of pre‐existing actinic keratosis in cutaneous squamous cell carcinoma
Authors: Mittelbronn Michele A. , Mullins Diane L. , Ramos‐Caro Francisco A. , Flowers Franklin P.
Published: March 2003

Background Controversy over the rate of malignant transformation of actinic keratosis (AK) into cutaneous squamous cell carcinoma (SCC) has generated considerable debate regarding the importance of treating all such precancers to preclude their transofrmation. Current changes in US healthcare policy will deny many individuals access to certain simple and effective treatment modalities for precancerous lesions.

Objective Our purpose was to determine whether there is a significant association between the presence of cutaneous SCC and pre‐existing AK.

Methods One hundred and sixty five consecutive cases of cutaneous SCC, retrieved from the files of a university‐affiliated dermatopathology laboratory serving north‐central Florida, were selected for review by a single dermatopathologist (D.M.). Hematoxylin and eosin stained skin tissue slides were examined under light microscopy for the presence of AK in close proximity to, or giving rise to, cutaneous SCC.

Results Of the 165 cutaneous SCC cases reviewed, 82.4% (136 out of 165) were found to have concomitant AK giving rise to and/or in close proximity to SCC. Of the 136 AK‐positive SCC cases, 26.7% (44) were identified as superficial SCC arising within an AK (AKSSCC) and 55.7% (92) had AK in close proximity to SCC (AK + SCC). Close proximity is defined to include AK changes located directly adjacent to (on the shoulder of) SCC, to a maximum distance of 8 mm away.

Conclusions The 82.4% prevalence of concomitant AK and cutaneous SCC in our biopsy population suggests a strong correlation between these two lesions. The fact that 26.7% of these lesions had SCC arising from AK highlights the importance of early recognition and effective treatment for AK.
The histopathology of pathergy: a chronologic study of skin hyperreactivity in Behçet's disease
Authors: Ergun Tülin , Gürbüz Oya , Harvell Jeff , Jorizzo Joseph , White Wain
Published: March 2003

Background many patients with Behçet's disease (BD) demonstrate hyperreactivity (pathergy), and the induced skin lesions may serve as a model for the disease.

Objective This study examined the sequence of histopathologic changes after needle prick trauma.

Methods Eight patients fulfilling the International Study Group Criteria for Behçet's Disease, two patients with recurrent aphthous stomatitis, and two healthy controls each underwent intradermal injections with subsequent biopsies at 0, 4, 24, and 48 h. Hematoxylin and eosin sections were evaluated in a blinded fashion according to 11 histopathologic criteria.

Results At time zero, normal skin was seen. By 4 h, neutrophils were present usually admixed with lymphocytes (8 out of 10). The inflammatory cell density peaked by 24 h in 8 out of 10 patients and at 48 h in 2 out of 10 patients. Sparse leukocytoclasis was identifiable from 4 to 48 h, but was not associated with fibrin. True vasculitis (as evidenced by fibrin within vessel walls and/or intraluminal thrombi) was not seen. Intraepidermal pustules (IEPs) and polymorphonuclear (PMN) aggregates within the needle tract were seen as early as 4 h. The control patients and three out of eight of the BD patients failed to develop clinical lesions. Among this group histopathologic IEPs were lacking in all but two BD patients.

Conclusions These data suggest that early pathergy is mediated by PMNs and lymphocytes without vasculitis. Hyperchemotaxis may explain the rapid accumulation of PMNs along the injection site.
Lupus miliaris disseminatus faciei evoked during pregnancy in a patient with cutaneous lupus erythematosus
Authors: Walchner Monika , Plewig Gerd , Messer Gerald
Published: March 2003

A 30‐year‐old woman with a history of cutaneous lupus erythematosus (LE) developed lupus miliaris disseminatus faciei (LMDF) during her 32nd gestational week ( Fig. 1). After the birth of a healthy daughter, the skin lesions improved without treatment. A worsening of LMDF 6 months later was treated with 20 mg isotretinoin (0.3 mg/kg body weight) in combination with an oral contraceptive. The skin lesions improved significantly after 1 month of systemic treatment; however, 4 months later, new lesions occurred on both cheeks, and were diagnosed as cutaneous LE (
Fig. 2). Systemic isotretinoin therapy was discontinued and local application of a prednicarbate‐containing ointment was initiated, leading to an improvement of the skin manifestations.

Lupus miliaris disseminatus faciei (LMDF)

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Cutaneous lupus erythematosus; flare‐up after healing of LMDF

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Histopathologic examination of an erythematous papule of the cheek revealed necrotic areas in the dermis surrounded by giant and epithelioid cells, as well as an inflammatory infiltrate around the hair follicles with lymphocytes, granulocytes, and histiocytes ( Fig. 3). A skin biopsy taken from an erythematous plaque of the face revealed a thin epidermis with vacuolization of the dermo–epidermal junction, as well as necrotic keratinocytes, lymphocytic infiltrates, and the deposition of mucin, consistent with the diagnosis of LE (
Fig. 4). Antinuclear antibodies (ANA) were positive (titer, 1 : 320), all routine laboratory parameters were within normal limits, and no anti‐cardiolipin, ‐Ro/SSA, or ‐La/SSB antibodies were detectable.

Caseation necrosis in the dermis surrounded by giant and epithelioid cells, and inflammatory infiltrates around the hair follicles with lymphocytes, granulocytes, and histiocytes, consistent with the diagnosis of LMDF

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Lymphocytic infiltrates, vacuolar degeneration, and deposition of mucin, consistent with the diagnosis of lupus erythematosus

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The clinical course of this patient suggests that possible common pathogenetic pathways of LMDF and LE may involve a localized autoimmune‐like process initially restricted to the site of the sebaceous glands, and in both diseases antigen expression may be provoked by UV radiation, hormonal, or viral factors.
Terbinafine 1% cream vs. bifonazole 1% cream in the treatment of tinea cruris
Authors: Budimulja Unandar
Published: March 2003

A total of 185 patients with a clinical diagnosis of tinea cruris and a positive mycologic examination were recruited into this double‐blind randomized multicenter study comparing 1% terbinafine cream once daily for 1 week and 2 weeks placebo with 1% bifonazole cream applied once daily for 3 weeks.

At the first visit and 1, 2, 3, and 8 weeks after the start of the study, signs and symptoms were assessed clinically and scores were taken for mycologic assessments (microscopy and culture). Assessments of clinical signs and symptoms were scored as follows. Pruritus: 0 = absent; 1 = mild, occasionally disturbing daily activities; 2 = severe, frequently disturbing daily activities and sleep. Erythema: 0 = absent; 1 = redness;

2 = bright redness, easily visualized. Scales: 0 = absent; 1 = scarcely visible and only in some areas; 2 = thick, covering a large area. Papule: 0 = absent; 1 = scarcely distributed; 2 = densely distributed and/or in the presence of plaques. At weeks 1, 2, 3, and 8, the effectiveness of therapy was clinically evaluated globally and given a rating of cured = 0, mild = <4, or severe = 4–8. The primary efficacy parameter was the mycologic cure rate at the follow‐up weeks during treatment and 5 weeks after the end of

treatment. The tolerability of the study medication was assessed at weeks 1, 2, and 3 of follow‐up. Adverse events were also recorded at the same time. Routine hematologic and biochemical tests were performed at the start of the study and at the end of treatment.
Class II major histocompatibility complex typing across the ethnic barrier in pemphigoid gestationis. A study in Mexicans
Authors: García‐González Edith , Castro‐Llamas Javier , Sci Bch , Karchmer Samuel , Zúñiga Joaquín , De Oca Darío Montes , Ambaz Miguel , Bolaños Rubén , Granados Julio
Published: March 2003

Background Pemphigoid gestationis (PG), also called herpes gestationis, is a rare autoimmune disease of pregnancy or puerperium (estimated 1 out of 50,000 pregnancies among Caucasians). A previous series has demonstrated an association of PG with human leukocyte antigen (HLA)‐DR3 or HLA‐DR4 haplotypes. While these haplotypes are most commonly found in individuals of European ancestry, they have also been found in African–American patients affected with PG. PG has rarely been reported in other ethnic groups, and the HLA association in non‐Europeans has not been examined.

Methods We have characterized eight patients of Mexican ancestry who have PG by clinical, histologic, and immunofluorescence criteria. Class I and class II major histocompatibility complex (MHC) antigens were studied by standard microlymphocytotoxicity assays. Class II MHC antigens were further studied by polymerase chain reaction (PCR) amplification of HLA‐DRB1, DQA, and DQB genes and allele‐specific oligonucleotide hybridization. For comparison purposes, we used results obtained from a group of 100 ethnically matched healthy individuals.

Results We found that all eight patients had the HLA‐DR3/DR4 phenotype; all HLA‐DR3 haplotypes were HLA‐DRB1*0301, DQA1*0501, and DQB1*0201, whereas half of the HLA‐DR4 haplotypes were from the DRB1*0401 subtype and the other half were DRB1*0407.

Conclusions These results suggest that, in Mexicans, the genetic susceptibility for the development of PG is strongly influenced by the genetic admixture of Caucasian origin, and the role of class II MHC antigens in the pathophysiology of this disease is confirmed.
Sensitivity of indirect immunofluorescence and immunoblotting for the detection of intercellular antibodies in endemic pemphigus foliaceus (fogo selvagem)
Authors: Rowilson‐Cunha Paulo , Bystryn Jean‐Claude
Published: March 2003

Background Two assays are available to detect anti‐skin antibodies in patients with fogo selvagem (FS): indirect immunofluorescence (IIF) and immunoblotting (IB). This study was conducted to compare the sensitivity of these assays in detecting FS antibodies.

Design Eighty‐nine serum samples of 48 patients with FS and control serum from 15 normal individuals were tested concurrently for the presence of FS antibodies by IIF and IB. IIF studies were conducted using four different substrates: human skin, monkey and guinea pig esophagus, and bovine tongue.

Results FS antibodies were detected much more commonly by IIF than by IB, i.e. in 71% vs. 28% of serum samples respectively. By IIF, the antibodies reacted most strongly against human skin.

Conclusions IIF is a more sensitive assay than IB for detecting antibodies associated with FS. The sensitivity of the test is maximized by using human skin as a substrate.
Epidemiology and control of scabies in an Egyptian village
Authors: Hegazy Aly A. , Darwish Nora M. , Abdel‐Hamid Ibrahim A. , Hammad Sabry M.
Published: March 2003

Background Some studies have addressed the epidemiology of scabies among rural populations in developing countries; however, the epidemiology of scabies among the rural population in Egypt is unknown. We sought to determine the magnitude of scabies infestation in an Egyptian village and to evaluate the control measures after 1 year.

Methods This study was carried out on 3147 residents of Mit‐Moaned village in Dakahlia governorate, Egypt. It was a cross‐sectional follow‐up study where the same individuals examined in round I were re‐examined in round III. The two rounds were separated by a period of 1 year, during which infested patients were followed up and new cases were discovered (round II). Patients and their household contacts received treatment with topical permethrin. Patients showing resistance to permethrin received a single oral dose of ivermectin.

Results In round III, the overall prevalence rate of scabies was reduced from 5.4% in round I to 1.1%. The incidence of new cases among susceptible persons during round II was 1.1%. Scabies was significantly (P < 0.05) more prevalent among families of large size, high crowding index at night, low socioeconomic standards, and those receiving their water supply from a hand pump. Children younger than 10 years showed the highest prevalence.

Conclusions Our data provide the first complete picture of the epidemiology of scabies in rural Egypt. The epidemiologic characteristics of the disease should be considered in the design of disease control programs for other villages with scabies epidemics. Our findings revealed that good control was achieved with the following: increased awareness and better case finding, education of the staff at the rural health unit, improved hygiene measures, and massive treatment campaigns using effective drugs such as topical permethrin and oral ivermectin.
Dermatology in the new millennium
Authors: Ryan Terence J.
Published: March 2003

With this issue, the Journal introduces a new series of essays devoted to the forthcoming millennium. Colleagues from around the World will be discussing their views about dermatology, reflecting upon the past accomplishments, or projecting what the twenty‐first century might hold for our speciality. (We’ll have to wait until the twenty‐fifth century to find out about Buck Roger's acne!) LCP
Treatment outcome of acne vulgaris with oral isotretinoin in 89 patients
Authors: Ng Patricia Pei‐Lin , Goh Chee‐Leok
Published: March 2003

This is a retrospective study of 114 patients who received oral isotretinoin for acne vulgaris for a minimum of 6 weeks between January 1994 and March 1995. Relapse was defined as deterioration in acne sufficient to merit systemic therapy, either with antibiotics or with another course of isotretinoin. Patients were considered nonrelapsers after a minimum period of 1 year post‐treatment with isotretinoin.

Case notes were traced and the following data were retrieved: age, sex, duration of acne, site of acne, previous treatment with either antibiotics or isotretinoin, indications for treatment, total cumulative dose of oral isotretinoin, average daily dose of isotretinoin,

response, relapse, time taken to relapse, and subsequent treatment. Those with either complete or partial (>80%) clearance were considered as responders because of the difficulty in categorizing them accurately due to the retrospective nature of the study. A telephone interview was conducted as far as possible with all patients who had an inadequate follow‐up period to ascertain if they had relapsed, i.e. if they had been prescribed systemic therapy for further flares of acne. Analyses of laboratory abnormalities were performed only in patients who had serial alanine aminotransferase (ALT), total cholesterol, and triglyceride readings.

Data were analyzed using the chi‐squared test, Student’s t‐test, Mann–Whitney U‐test, and Fisher’s exact test.

Of the 114 cases studied, 21 were excluded because of the following reasons: no weight was documented, 12; antibiotics were started immediately after completion of treatment making it impossible to document relapse, 2; patients were not seen at all after completing treatment and were uncontactable, 7. A further four cases with a break of 4 weeks or more during treatment were excluded as the accuracy of the calculated total cumulative dose of isotretinoin may be affected, given the half‐life of 10–20 h.
Terbinafine vs. placebo for onychomycosis in black patients
Authors: Billstein Stephan , Mph . , Kianifard Farid , Justice Angela
Published: March 2003

Eight US centers enrolled in a multicenter, randomized, double‐blind, placebo‐controlled, parallel‐group trial comparing the efficacy of 12, 16, and 24 weeks of oral therapy with terbinafine, 250 mg/day, and placebo in patients aged 18 to 75 years with both a positive KOH wet mount and mycologic culture of one or more dermatophytes from the large toenail, designated as the target toenail, or another infected toenail if no large toenail was infected. Primary exclusion criteria included: systemic antifungal therapy during the previous 3 months; topical antifungal therapy for the infected toenail(s) during the previous month; white superficial toenail onychomycosis; immunosuppression or immunodeficiency, including known human immunodeficiency virus (HIV) infection; hepatic enzymes >1.5 times the upper limit of normal at screening; and any marked laboratory abnormalities.

Patients were randomized into four treatment groups: (i) 12 weeks of terbinafine (250 mg/day) followed by 12 weeks of placebo; (ii) 16 weeks of terbinafine followed by 8 weeks of placebo; (iii) 24 weeks of terbinafine; and (iv) 24 weeks of placebo. Both patient and physician were blinded to the treatment for the 24‐week treatment period. Blinding was maintained through the end of the study. Assessments were done at week −6 (screening visit) and at weeks 4, 8, 12, 16, 20, and 24 during the treatment period. Follow‐up assessments were scheduled for weeks 30, 36, 42, 48, 60, and 72. The mycologic efficacy variables included the percentage of patients with negative mycologic cultures, with negative KOH wet mounts, and with mycologic cure (both negative culture and negative KOH). The evaluations at week 48 and week 72 are reported here. The primary clinical variable was clinical cure, defined as 0% involvement of the target toenail.

The efficacy analysis included all patient who were randomized to therapy, fulfilled the mycologic criteria at screening, took at least one dose of study drug, and had at least one post‐baseline assessment. For each variable, the percentage in each treatment group showing efficacy was compared with the percentage in the corresponding placebo group.
Calcipotriol ointment vs. betamethasone 17‐valerate ointment in the treatment of lichen amyloidosis
Authors: Khoo Boo‐Peng , Tay Yong‐Kwang , Goh Chee‐Leok , Centre From the National Skin , Singapore .
Published: March 2003

Sixteen Asian patients (6 men and 10 women), in the age range 41–74 years, presenting clinically with symmetrically distributed lichen amyloidosis (LA) on the extremities, were enrolled in this double‐blind, right–left comparison pilot study to evaluate the efficacy of calcipotriol ointment (50 μg/g) vs. betamethasone 17‐valerate ointment (0.1%).

This trial was conducted in a tertiary skin referral center in Singapore and consecutive patients with LA were recruited over a 3‐month period. Excluded were patients who were pregnant or lactating, patients with known contact allergy to either calcipotriol or topical steroid, patients with hypercalcemia, and those with significant hepatic or renal disease.

After a washout period of 2 weeks, the ointments were applied separately to either the right or left extremities twice daily for a period of 12 weeks. Assessments were made at weeks 0, 4, 8, and 12 by both the physician and the patient. Treatment responses were assessed as follows: roughness (visual analog scale of 1–10, 1 being the least rough and 10 being the most rough), hyperpigmentation (visual analog scale of 1–10, 1 being the least hyperpigmented and 10 being the most hyperpigmented), and any adverse events. An additional parameter assessed by the patient was pruritus (visual analog scale of 1–10, 1 being the least pruritic and 10 being the most pruritic). Clinical photographs were taken during each review.

For analyses of the responses, the mean roughness score is defined as the average sum of the roughness score of all patients for each treated side. Likewise the mean hyperpigmentation score and the mean pruritus score are defined as the average sum of hyperpigmentation and the average sum of pruritus, respectively. Any score differences observed between week 0 and week 12 within the two treatment groups were analyzed by Wilcoxon signed ranked test for statistical significance; differences in scores between the two treatment groups were analyzed by Mann–Whitney U‐test.
Skin pathology findings in a cohort of 1500 adult and elderly subjects
Authors: Siragusa Maddalena , Schepis Carmelo , Palazzo Rosaria , Fabrizi Giuseppe , Guarneri Biagio , Del Gracco Stefano , Spada Rosario S. , Ferri Raffaele
Published: March 2003

Background No extensive studies are available in the literature on the eventual skin pathology induced by neurologic or systemic diseases in elderly individuals. Other factors, such as health and hygiene, socioeconomic status, and climate can also play an important role.

Methods Fifteen‐hundred subjects (886 women and 614 men; mean age, 67.8 years; range, 39–90 years) were admitted to the Department of Geriatrics at the Oasi Institute between 1992 and 1997; all these subjects were carefully evaluated from a dermatologic point of view. Each subject underwent specialist examinations, routine blood analyses, thoracic X‐rays, cerebral computerized tomography (CT) scan, and magnetic resonance imaging (MRI) when appropriate. A group of subjects without significant neurologic or systemic disease, comprising 116 women and 60 men (mean age, 64.5 years; range, range, 40–90 years), was selected and used as a normal control group. Subsequently, our attention was focused on the eventual presence of the following neurologic diseases: Alzheimer‐type dementia, vascular dementia, mixed‐type dementia, subcortical dementia, Parkinson’s disease, vascular brain disease, hemiplegia, etc. Thus, different subgroups were formed on the basis of such diagnostic categories and the frequency of skin pathology in each subgroup was evaluated.

Results Of the 1500 subjects, 1439 stated that they had never been affected by dermatologic disease. No statistically significant difference in frequency of skin pathology was found between normal controls and the different patient subgroups. Unsuspected and singular dermatoses were found, however, such as paraneoplastic syndromes, idiopathic tripe palms, white fibrous papulosis of the neck as an expression of photoaging, conditions induced by former popular traditions of Sicilian culture (anetoderma secondary to the application of Hirudo medicinalis and erythema ab igne), pigmented dermatoses never described before in Italy (prurigo pigmentosa and friction amyloidosis), and nail abnormalities (atypical half‐and‐half nail, and dyschromic nail changes in multiple system atrophy and in hemiplegia).

Conclusions The dermatologic screening performed in 1500 patients revealed several unexpected diagnoses and some original observations. Some rare dermatoses were described and certain hypotheses were suggested to explain the peculiar dyschromic changes of the fingernails in multiple system atrophy, the atypical cases of half‐and‐half nail, and the so‐called idiopathic tripe palms associated with psoriasis.