bluuebunny/crossref_metadata_2025 huggingface dataset:
Explosive Eruption of Pyogenic Granuloma on the Scalp Due to Topical Combination Therapy of Minoxidil and Retinoic Acid
Authors: Baran Robert
Published: October 2009

A 55-year-old patient was treated with a combination of minoxidil and retinoic acid. After 1 month an explosive eruption of pyogenic granuloma appeared on the scalp. Despite redness and itchy reaction, caused only by the test containing both chemicals, histology did not give evidence of contact allergy.
Pyoderma gangraenosum of the Eyelids
Authors: Bruckner-Tuderman Leena , Schnyder Urs W.
Published: October 2009

We report a rare case of a 53-year-old female patient with pyoderma gangraenosum involving the upper and lower eyelid. The lesion began as a small rhagade and evolved within days to involve the eyelids as well as the cheek.The primary pustules grew to erosions and ulcers. Antibiotic treatment did not result in amelioration and laboratory tests did not reveal growth of any relevant microorganisms. After the clinical diagnosis of pyoderma gangraenosum a high-dose prednisone treatment was introduced to which the disease immediately responded. After 2 months, scarring of the involved skin was visible, but the eye itself had remained completely uninvolved with fully preserved visual acuity.
A Case of Familial Cylindromas and Trichoepitheliomas
Authors: Pfaltz Madeleine , Schnyder Urs W.
Published: October 2009

We report a case of multiple familial cylindromas and trichoepitheliomas of the hairy scalp and face.Therapy consisted in excision of the scalp, followed by autologous skin grafting. A cosmetically good result without tumour recurrence over a follow-up period of 14 years was achieved by this therapy.
Erythema multiforme Associated with Radiotherapy
Authors: Salomon D. , Saurat J.-.H.
Published: October 2009

Radiotherapy is widely considered as a possible triggering factor for erythema multiforme (EM). We report on 3 cases of an EM-like dermatosis following deep radiotherapy for a visceral neoplasia and review the relevant literature of the previously published cases. It appears that: (1) all the dermatoses occurring during radiotherapy do not fulfill the criteria for EM; (2) neither the type of neoplasia treated nor a particular type of radiotherapy appear to be associated with EM, and (3) the role of radiotherapy in inducing EM has never been demonstrated properly and in many instances drugs should have been considered as culprit.
Eosinophilic Pustular Folliculitis (Ofuji’s Disease): Efficacy of Isotretinoin
Authors: Berbis Philippe , Jancovici Eliane , Lebreuil Georges , Benderitter Thierry , Dubertret Louis , Privat Yvan
Published: October 2009

The case of a 30-year-old man with a 6-year history of eosinophilic pustular folliculitis (EPF) is reported. Isotretinoin (1 mg/kg/day) led to a dramatic improvement of all the lesions within 2 weeks. The withdrawal of the drug was followed by a recurrence after 10 days of the papulopustular f ollicular and pruritic lesions. Reintroduction of isotretinoin was successful. The benefits of isotretinoin in the treatment of EPF have to the best of our knowledge never been reported previously. The mechanisms underlying this efficacy may involve the inhibition of the eosinophilic chemotactic factors thought to be present in sebaceous lipids and in the stratum corneum of patients suffering from EPF.
Idiopathic Acquired Generalized Anhidrosis: Electron-Microscopic and Immunohistochemical Studies and Analysis of Lectin-Binding Pattern of the Cell Membrane
Authors: Terui Tadashi , Ohkawa Yohkon , Tagami Hachiro
Published: October 2009

Idiopathic acquired generalized anhidrosis with sudden onset is rare and its pathogenesis is not known. We report a patient with this condition, and the results of electron-microscopic and immunohistochemical studies as well as an analysis of the lectin-binding pattern of the cell membrane. Electron-microscopically, the cells of the eccrine sweat gland showed vacuolar changes. Besides their cytoplasmic changes, the results of a deficient lectin-binding pattern of the glandular cells suggest that there are disturbances in the formation of glycoproteins on their membrane.
Peroxidase Activity in Mast Cell Granules in Urticaria pigmentosa
Authors: Akiyama Masashi , Watanabe Yonosuke , Nishikawa Takeji
Published: October 2009

The morphology of mast cells in the skin lesion from a case of urticaria pigmentosa was observed using light and electron microscopy. Furthermore, the IgE deposition on mast cells in the lesion was studied with immunoelectron microscopy. Diaminobenzidine reaction and 4-chloro-naphthol reaction were used to detect endogenous peroxidase activity in mast cells in the lesion. Ultracytochemical techniques were applied to clarify the localization of peroxidase activity in the mast cells. Morphologically, neither blast-like cells nor intermediate cells between basophils and mast cells were found in the lesion. No mast cells in the lesion did exhibit IgE deposition on their plasma membrane. By light microscopy, granular stains of diaminobenzidine reaction and 4-chloro-naphthol reaction were observed in the cytoplasm of mast cells in the lesion. By electron microscopy, a finely stippled peroxidase staining was observed in some granules of the mast cells. Perinuclear cisterna and endoplasmic reticulum appeared devoid of enzymatic activity. These findings suggest that the infiltrating mast cells in this case were immature.
Stratum corneum Lipids in Skin Xerosis
Authors: Saint-Léger D. , François A.M. , Lévêque J.L. , Stoudemayer T.J. , Kligman A.M. , Grove G.
Published: October 2009

Lipids of the stratum corneum are implicated in cohesion and desquamation of the stratum corneum as well as in the maintenance of normal barrier function. Evidence linking the intercellular lipids to such processes has mainly been derived from studies on acquired or inherited diseases of lipid metabolism manifesting abnormalities in the structure and the function of the stratum corneum. We have studied the composition of stratum corneum lipids in clinically normal individuals with typical xerosis or ‘winter dry skin’ in order to establish if the lipid composition differs from that of normal individuals, showing no signs of xerosis. The amount of total stratum corneum lipids was not related to xerosis (22.0 ± 1.8 μg/cm2 for normal skin, and 26.3 ± 2.9 μg/cm2 for severe xerosis), and no correlation was evident between polar lipids, cholesterol sulfate (2.8 ± 0.5% for normal skin, and 1.6 ± 0.2% for severe xerosis), or ceramides types I-VI, and dry skin. It therefore appears that dramatic changes in stratum corneum lipids are not detectable in normal ‘winter dry’ skin. However, a decreased proportion of neutral lipids (sterol esters, triglycerides), coupled to increased amounts of free fatty acids were found associated to the severity of dry skin. Apart from a decline in the sebaceous function and in esterases activity, winter dry skin does not appear to be associated to dramatic changes in polar stratum corneum lipids.
Studies on Two Siblings with Recessive Dystrophic Epidermolysis bullosa (Hallopeau-Siemens) and the Piasminogen Activator and Its Inhibitor in the Lesion
Authors: Kaneko Fumio , Tsukinaga Ichiro , Ando Masaaki , Ohkawara Akira , Oguchi Haruhisa , Oikawa Kiyoshi , Nagai Morihito
Published: October 2009

Activities of piasminogen activators (PA) and their inhibitors were studied in the bullous lesions of 2 siblings with recessive dystrophic epidermolysis bullosa (RDEB). The hematological findings of the patients revealed hyperfibrinogenemia, hyper-γ-globulinemia and marked thrombocytosis. The immunofluorescent studies showed strong deposits of piasminogen, fibrin-degenerative products and α1-antitrypsin around the blister lesions. On the other hand, α1-macroglobulin (α2-M) was sparsely deposited.The levels of α2-M in the blister fluid of the patients were also decreased in comparison with those from patients with other bullous dermatoses.The topical application of antibiotic ointment with strong PA inhibitor was clinically effective when applied to the blister and eroded lesions of the patients. These findings suggest that the increased activity of PA may play an important role in the development of blister formation in patients with RDEB.
Plasminogen Activators: Possible Roles in Cell Proliferation
Authors: Takada Akikazu , Takada Yumiko
Published: October 2009

Plasminogen activators (PAs) convert plasminogen to plasmin by the cleavage of the Arg-Val bond. There are two distinct types of PA, tissue type (t-PA) released from the endothelial cells of the blood vessels and urinary type (u-PA) released from urinary tubules. u-PA was found to be released from activated macrophages and virally transformed cells. t-PA was also found to be released from breast cancer cells induced by carcinogens or melanoma cells. In structure, t-PA has a finger domain homologous to fibrin-binding domain of fibronectin and a growth factor domain homologous to the epidermal growth factor. u-PA has no finger domain but has a growth factor domain. It is proposed that PA may be important in tumor growth due to the stimulation of tumor cells through binding of growth factor domain to its receptor of tumor cells. Another hypothesis is that PA may activate procollagenase to collagenase, which digests collagen to facilitate tumor growth. We have measured the concentrations of t-PA and u-PA in plasma, urine and tumor tissues of patients with cancer of the digestive tract and patients with uterine or ovarian tumors. The results indicate that the concentrations of u-PA increased in urine, plasma and cancer tissues of patients with cancer of the digestive tracts whereas no increase was observed in t-PA levels. On the other hand, the concentration of t-PA increased mostly in plasma of patients with uterine and ovarian cancers, but t-PA levels in tissues did not increase in patients with uterine and ovarian cancer.
Lipid Peroxides and Superoxide Dismutase (SOD) Induction in Skin Inflammatory Diseases, and Treatment with SOD Preparations
Authors: Niwa Yukie
Published: October 2009

In the skin ulcer or severely inflamed and erosive lesions induced due to burn, wounds and other dermatitides, lipid peroxides were markedly increased, with resultant cytotoxic effects in situ. Generally, superoxide dismutase (SOD), which scavenges oxygen radicals or inhibits lipid peroxidation, is adapted to be induced (increased) under oxygen toxicity. For the treatment of not only systemic inflammatory diseases but also skin ulcer lesions, especially due to burn and wounds, liposomal-encapsulated SOD injection was effective. Topical application of free Mn-SOD or Cu, Zn-SOD extracted from bovine, bacterial and other species except for human was also dramatically effective in skin lesions; a burnt patient who was advised to undergo skin transplantation showed complete healing with free SOD cream. In addition, topical application of low molecular weight antioxidants, AOAor Bio-harmony, also showed remarkable effectiveness in these skin lesions. However, SOD dissolved in the vehicle containing greater amounts of vaselinum album (white petrolatum) rapidly lost its activity, and that dissolved in the vehicle with large quantities of water lost its activity within 3 months. In conclusion, SOD should be dissolved in the vehicle before use, however, low molecular weight antioxidant cream can be commercially sold because it does not lose its activity for long periods.
Hypoplasie dermique en aires
Authors: Frenk E. , Vust J.F.
Published: October 2009

A typical case of focal dermal hypoplasia is described. Despite its widely distributed cutaneous involvement, the only extracutaneous anomaly observed was a syndactyly of the 2nd and 3rd digits of the right foot.
Solitäre Tumorform als Erstmanifestation der Mycosis fungoides
Authors: Büchner S.A. , Koch B. , Rufli T.
Published: October 2009

A case of localized mycosis fungoides manifesting as a solitary tumor in a 77-year-old man is reported. Histological examination revealed an upper dermal and epidermotropic infiltrate of atypical lymphoid cells consistent with mycosis fungoides. With the use of the immunohistological technique, the majority of the cutaneous infiltrate expressed the immunologic phenotype of helper T cells confirming the diagnosis of a cutaneous helper T cell lymphoma. This supports the concept that localized mycosis fungoides is part of the spectrum of cutaneous T cell lymphoproliferative disorders.
Umbilikale Endometriose vom stummen Typ
Authors: Rufli T.
Published: October 2009

A 43-year-old woman presented an umbilical tumor which had been growing for 3 months. There were no subjective symptoms, no periodically appearing pain. The differential diagnosis to Sister Josef’s nodule is of major importance.
Epidermolytic Palmoplantar Keratoderma of Vörner: Is It the Most Frequent Type of Hereditary Palmoplantar Keratoderma?
Authors: Hamm H. , Happle R. , Butterfass T. , Traupe H.
Published: October 2009

In a retrospective study, we reevaluated the biopsies that had been obtained, during the past 11 years, from 26 patients presenting with hereditary palmoplantar keratoderma (PPK). Twelve out of 26 biopsies disclosed the histological features of epidermolytic hyperkeratosis, consistent with the diagnosis of epidermolytic PPK of Vörner. A review of the histologically examined cases of the literature revealed a comparable predominance of this hereditary PPK. We conclude that, in contrast to the current opinion, epidermolytic PPK of Vörner represents the most frequent type of hereditary PPK.
Vitiligo as a Reaction to Topical Treatment with Diphencyprone
Authors: Hatzis J. , Gourgiotou K. , Tosca A. , Varelzidis A. , Stratigos J.
Published: October 2009

During the topical treatment of 45 patients, who had extensive forms of alopecia areata, with the allergen diphencyprone, 3 of them (6.7%) developed vitiligo. Two were females and 1 male aged 53, 19 and 28 years respectively. None of these patients had a personal or family history of vitiligo. Vitiligo appeared 3–5 months after the onset of treatment and was localized only to the areas of topical application in the younger woman and the man. In the older woman, vitiligo extended to several areas apart from those where the medicament was applied. After the end of diphencyprone treatment, vitiligo had a spontaneous significant improvement only in the man. Mitochondrial autoantibodies were found in the older woman only. To our knowledge, vitiligo due to diphencyprone has not been previously reported.
Nuchal Nevus flammeus as a Skin Marker of Prognosis in Alopecia areata
Authors: Hatzis J. , Kostakis P. , Tosca A. , Parissis N. , Nicolis G. , Varelzidis A. , Stratigos J.
Published: October 2009

In this work, the incidence of nuchal nevus flammeus was studied in 205 patients suffering from various forms of alopecia areata, as well as in a group of 555 volunteers without alopecia areata xamined in our outpatient clinic. The incidence of nuchal nevus flammeus in the totalis-universalis form of alopecia areata was 58.2% (examined patients, n = 79), in ophiasis-extensive forms 22.8% (examined patients, n = 70) and in simple forms of alopecia areata 3.6% (examined patients, n = 56). In the group of 555 volunteers without alopecia areata the incidence of nuchal nevus flammeus was 4.5%. Our results show that nuchal nevus flammeus could be a valuable skin marker indicating a more severe course of alopecia areata.
Lesional Keratinocytes Express OKM5, Leu-8 and Leu-11b Antigens in Lichen planus
Authors: Simon Miklós
Published: October 2009

Biopsy specimens of involved and uninvolved skin were studied in 16 patients with lichen planus using murine monoclonal antibodies against several cell surface markers of effector and/or accessory cells of the immune system. In contrast to uninvolved skin, keratinocytes were found to express HLA-DR, OKM5, Leu-8 and Leu-11b antigens in all biopsies from involved skin. We demonstrate here for the first time the in vivo expression of several effector and/or accessory cell markers on keratinocytes in lichen planus.
Age-Associated Changes in Stratum corneum Lipids and Their Relation to Dryness
Authors: Léger Saint , François A.M. , Lévêque J.L. , Stoudemayer T.J. , Grove G.L. , Kligman A.M.
Published: October 2009

Stratum corneum lipids (SCL) were collected on the right and left legs of 50 subjects of varying ages and skin dryness. The level of dryness and composition of the lipid was the same on both sides. While skin dryness continuously increased with age, the composition of SCL showed a constant profile from the 50s. Aging was mostly associated with a decrease in sterol esters and tryglycerides. On the legs, the SCL do not seem to primarily govern the increased desquamative process which features xerosis.
Recombinant Interferon Alpha-2A (Roferon-A) in a Case of Buschke-Löwenstein Giant Condyloma
Authors: Zachariae Hugh , Larsen Mose , Søgaard H.
Published: October 2009

A case is presented of a 63-year-old female suffering from Buschke-Löwenstein giant condyloma acuminatum of more than 12 years’ duration. The lesions had spread from portio and vagina to the bladder and the right ureter resulting in hydronephrosis of the right kidney leading to subsequent surgical procedures including the establishment of an ilealbladder and exstirpation of the right ureter and nephrectomy of the right kidney. Treatment with recombinant interferon alpha-2A 1.8 mU for 5 days a week resulted in steady regression of all tumor masses. After 6 months of treatment the tumors which had covered the whole of vagina and portio and filled out the whole vagina cavity were reduced to 5 small pin-size lesions at the introitus. Initial side effects of flu-like symptoms disappeared spontaneously without discontinuation of treatment.
Treatment of Multiple Relapsing Warts with Diphenciprone
Authors: Orecchia G. , Douville H. , Santagostino L. , Rabbiosi G.
Published: October 2009

44 patients with multiple recalcitrant warts were treated with weekly applications of diphencyprone. 20 patients were cured completely and 17 improved with reduction in the number or dimension of warts. Plantar warts responded less satisfactorily. Sensitization is not always tolerated by patients and the risk of eczema spreading to other sites must be considered. However, topical immunotherapy has to be considered as an alternative means of treatment in selected patients. The mode of action is discussed.
Residual Plasma Concentrations of Acitretin (Ro 101670) and Its Metabolite (Ro 13–7652) after Chronic Administration
Authors: Berbis P. , Bun H. , Al Mallah N.R. , Durand A. , Rognin C. , Geiger J.M. , Privat Y.
Published: October 2009

In order to study the elimination of Ro 10-1670 (acitretin) and Ro 13-7652, its 13-cis-isomeric metabolite after chronic administration, determination of the residual plasma concentrations of these two compounds were assayed in 9 patients in a range of 22–30 days following cessation of a 2- to 7.5-month course with daily oral doses of 10–50 mg of acitretin. A highly sensitive HPLC method was used (2 ng/ml). Residual plasma concentrations of Ro 10-1670 were below the quantification limit in all cases. Residual plasma concentrations of Ro 13-7652 were below the quantification limit in 7 cases and respectively of 3 and 4 ng/ml in the other 2 cases. These data appear to confirm the absence of storage of acitretin even after an extended course of therapy.
Clinical, Histological and Immunological Studies in 50 Patients with Bullous Pemphigoid
Authors: Hadi S.M. , Barnetson R.StC. , Gawkrodger D.J. , Saxena U. , Bird P. , Merret T.G.
Published: October 2009

Fifty patients with bullous pemphigoid were investigated over periods of up to 7 years. Sequential studies of circulating basement membrane zone (BMZ) antibody titres revealed two groups of patients: 44% had a high initial titre (> 1:160) and 56% had a low initial titre (< 1:160). Subjects with titres > 1:160 continued to have high titres, whereas in those with lower titres the BMZ antibodies usually became undetectable after 4 months. The BMZ antibody titres were of no prognostic value. High titres remained high even in patients who were in remission and off treatment, and in these subjects, there was no evidence of a change in the IgG subclass. The initial BMZ IgG antibody titres showed a highly significant correlation with total serum IgE concentrations. A significant correlation also existed between total serum IgE and IgG4 concentrations, although not between the serum IgE and the peripheral blood eosinophil count. No anti-BMZ antibody of IgE class was found, nor specific IgE against inhalants and foods identified, and the significance of the high total serum IgE remains unexplained. The majority of those followed for more than 2 years were able to stop their steroid therapy without further blistering: this confirms that pemphigoid tends to be a self-limiting disease. Nine patients had a recent history of malignant disease, and this is no more than would be expected for this age group of patients: however, 3 patients presented with pemphigoid and figurate erythema and all died of neoplastic disease, suggesting that such patients should be investigated thoroughly for neoplasia.
Neutrophil Chemotaxis in Patients with Pustulotic Arthro-Osteitis
Authors: Jurik A.G. , Ternowitz T. , Graudal H.
Published: October 2009

The chemotactic response of peripheral blood polymorphonuclear leukocytes (PMNs) to N-formyl-methionyl-leucyl-phenylalanine was determined in four groups of persons (I) 19 patients with pustulosis palmoplantaris (PPP) and skeletal disorder (pustulotic arthro-osteitis); (II) 15 patients with a similar anterior chest wall involvement, but no PPP; (III) 9 patients with PPP, but without skeletal involvement, and (IV) 69 healthy adults (controls). The chemotactic activity of PMNs was found to be significantly increased in groups I–III, and patients with a similar osteoarthropathy, but no PPP compared with the controls. Furthermore the patients with pustulotic arthrosteitis had enhanced chemotactic activity compared with the patients with PPP only. This indicates that both skeletal involvement and PPP are somehow related to the function of PMNs. Colchicine was found of benefit in 2 of 3 group I, and in 6 group II patients, and it normalized their PMN chemotaxis.
Eosinophilic Pustulosis: A Case Report
Authors: Barnadas Maria A. , Moreno Abelardo , de Moragas José M.
Published: October 2009

A 16-year-old female had a chronic cutaneous eruption clinically characterized by papules, pustules and large exudating plaques of 2 years duration. Multiple biopsies showed infiltration of the follicular epithelium by eosinophils and intraepidermal pustules with neutrophils and eosinophils that were accompanied either by acantholysis or spongiosis. Eosinophilia and hypoproteinemia were detected. A definite infectious etiology or autoimmune mechanism could not be established. Differential diagnosis with other entities that share some clinico-pathological and immunological features are discussed.
Pityriasis lichenoides et varioliformis acuta and Acquired Toxoplasmosis
Authors: Rongioletti Franco , Rivara Gianpiero , Rebora Alfredo
Published: October 2009

A patient presented with a typical pityriasis lichenoides et varioliformis acuta (PLEVA) and disclosed serological evidence of an active and recent toxoplasmosis. Specific treatment of toxoplasmosis promptly and definitively resolved PLEVA lesions. Serological tests for Toxoplasma gondii should be performed in all PLEVA patients.
Cutaneous Reactions to Nifedipine
Authors: Alcalay J. , David M. , Sandbank M.
Published: October 2009

Nifedipine, a calcium-channel-blocking agent, is widely used as an antianginal and antihypertensive drug. Cutaneous reactions to nifedipine are extremely rare. A review of the literature revealed only three additional cutaneous eruptions which include vasculitis, erythematous edema of the legs and erythromelalgia. We present the first case of fixed drug eruption due to nifedipine.
Rapid Response of Transient Acantholytic Dermatosis to Selenium Sulfide Treatment for Pityriasis Versicolor
Authors: Segal Rina , Alteras I. , Sandbank Miriam
Published: October 2009

The observation of a 51-year-old male patient with transient acantholytic dermatosis (TAD) is briefly reported. The discrete eruption, composed of erythematous escoriated papules and papulovesicles, moderately itching, was located on the back and chest, more permanent during the summer season. The biopsy revealed suprabasal acantholysis and Darier-like elements. Lesions of pityriasis versicolor, confirmed by microscopic examination and fluorescence in Wood’s light, were intermingled with TAD in the same patient. A topical treatment with selenium sulfide brought TAD lesions to the disappearance in 1 week. Comments are made in relation with the possibility of Malassezia furfur to induce acantholytic phenomena.
Retinoid Effects on the Epidermis
Authors: Elias Peter M.
Published: October 2009

Since metaplasia and gap junction stimulation are prominent features of retinoid activity in embryonic and neoplastic epidermis, it is ironic that the mechnism(s) of retinoid action in postnatal tissues, where these drugs are employed clinically, appears to be different. Histologic studies in both animals and man with both topical and systemic retinoids demonstrate acanthosis, hypergranulosis, and changes in the thickness and organization of the stratum corneum, due to a boost in cell turnover. On an ultrastructural level, desmosomes are actively shed at the level of the spinous layer, leading to many new attachment points along the cell membranes of the outer epidermis. This change coupled with decreased tonofilaments, enhanced keratinocyte autolysis, and intercellular deposition of glycoconjugates (not mucin by standard histochemistry and lectin binding) lead to loosening and fragility of the stratum corneum. The biochemical basis of retinoid activity (in addition to increased cell turnover) appears to be global enhancement of glycoconjugate synthesis and the generation of less mature keratins. These epidermal effects of retinoids can be exploited therapeutically: (1) to cause loosening of thickened stratum corneum, e.g., in psoriasis or ichthyosis; (2) to enhance penetration of pharmacologic agents, e.g., 5-FU, across hyper-trophic actinic keratoses; and finally (3) in neoplastic epidermis, where mucous metaplasia and gap junction proliferation occur, retinoids can normalize differentiation.
Characterization of Apoprotein Metabolism and Atherogenic Lipoproteins during Oral Isotretinoin Treatment
Authors: Melnik B. , Bros U. , Plewig G.
Published: October 2009

Apoprotein, lipoprotein and lipid parameters of 36 normolipidemic subjects (23 males, mean age 22.7 ± 7.6 years; 13 females, mean age 26.2 ± 9.8 years) receiving oral isotretinoin (mean daily dose 0.73 ± 0.26 mg/kg body weight) for nodulocystic acne (n = 18), severe acne papulopustulosa (n = 15), gram-negative folliculitis (n = 2) and papulopustular rosacea (n = l) were monitored before and during isotretinoin therapy at biweekly intervals over a period of 14.6 ± 5.6 weeks. Pretreatment values of mean plasma triglycerides increased significantly (p < 0.001) from 81.8 ± 31.9 mg/dl to 112.4 ± 38.7 mg/dl (47.4%) during isotretinoin treatment. With respect to the mean percent increase of plasma triglycerides from pretreatment levels, patients were classified as nonresponders ( < 10% triglyceride increase), responders ( > 10% < 50% triglyceride increase) and hyperresponders ( > 50% triglyceride increase), revealing a distribution of 25.0, 36.1 and 38.9%, respectively. Isotretinoin treatment had no influence on the isoelectric focusing pattern of apoprotein E isoforms and C apoproteins. In particular, apoprotein C-II, the cofactor of lipoprotein lipase, was not affected. No correlation between apoprotein E phenotypes (2/3, 3/3, 3/4) and the mean plasma triglyceride increase could be demonstrated. Apoprotein B-48, a marker of chylomicrons and atherogenic chylomicron remnants, could not be detected by SDS-PAGE. On the other hand in 21.0% of patients with preexisting mean lipoprotein Lp(a) levels of 18.1 ± 12.9 mg/dl a moderate increase of atherogenic Lp(a) to mean levels of 37.0 ± 22.0 mg/dl was observed. Pretreatment values of very-low-density lipoprotein (VLDL) apoprotein (apo) B (7.5 ± 2.0 mg/dl), low-density lipoprotein apo B (67.3 ± 17.5 mg/dl) and total plasma apo B (76.6 ± 19.0 mg/dl) increased significantly to levels of 10.3 ± 2.4 mg/dl (p < 0.001), 75.7 ± 15.8 mg/dl (p < 0.10) and 85.9 ± 17.7 mg/dl (p < 0.05), respectively. As lipoprotein lipase and hepatic lipase activities have been shown to be unaffected by isotretinoin treatment, our data support the hypothesis that isotretinoin induces hepatic oversecretion of VLDL, a condition resembling type IV hyperlipidemia in diabetics, familial hypertriglyceridemia or familial combined hyperlipidemia.
Skeletal Changes Associated with Chronic Isotretinoin and Etretinate Administration
Authors: McGuire Joseph , Lawson Jack P.
Published: October 2009

The skeletal changes associated with systemic retinoid therapy reflect the influence of retinoids on differentiating systems. Although skin is usually the intended target, treatment with retinoids often results in abnormalities of ossification and calcification. The effects of retinoids on bone may be profound and include progressive calcification of ligaments and tendon insertions, premature fusion of epiphyses, modeling abnormalities of long bones, and perhaps osteoporosis. Although it has been known since 1933 that vitamin A cause bone abnormalities, the mechanism of this effect has been elusive. Recent work suggests a possible relationship of the retinoids with several cytokines, which results in enhanced maturation of the preosteoclast. The increasing number of significant bone changes, including posterior lumbar vertebral osteophytosis, make skeletal toxicity the principle risk factor of chronic systemic retinoid therapy.
Treatment of Subcorneal Pustulosis by Etretinate
Authors: Iandoli Raffaele , Monfrecola Giuseppe
Published: October 2009

A 69-year-old man with sulfone-resistant subcorneal pustular dermatosis was successfully treated by etretinate, 1 mg/kg body weight for 5 days, followed by 0.75 mg/kg body weight for 2 months. This confirms the possible usefulness of systemic retinoids in nonpsoriatic pustulosis.
Autoimmune Thyroiditis and Generalized Granuloma annulare: Remission of the Skin Lesions after Thyroxine Therapy
Authors: Willemsen Maria J. , de Coninck Arlette L. , Jonckheer Marc H. , Roseeuw Diane I.
Published: October 2009

A patient suffering from generalized granuloma annulare associated with mild hypothyroidism due to an atrophic autoimmune thyroiditis is presented. Treatment with thyroxine resulted in the restauration of a euthyroid state. Subsequently disappearance of the antithyroid antibodies along with a progressive decrease in the number of the skin lesions was noticed. The association between generalized granuloma annulare and autoimmune thyroiditis has been reported once previously in the literature, but it might be of more frequent occurrence.
Eosinophilic Fasciitis (Shulman Syndrome) in Association with Morphea, Immunological Disturbance and Profuse Achromia
Authors: Viraben R. , Dupré A.
Published: October 2009

A case of localized eosinophilic fasciitis (EF) is reported. Profuse hypopigmentation, guttate morphea and immunological disturbances accompanied the subcutaneous changes. The case links Shulman’s syndrome with classical localized cutaneous scleroderma.
X-Ray Microanalysis of the Fingernails in Cirrhotic Patients
Authors: Djaldetti M. , Fishman P. , Harpaz D. , Lurie B.
Published: October 2009

The element content of clipped nails of 13 patients with liver cirrhosis was examined by X-ray microanalysis, and compared with that of 50 healthy subjects. The results showed a statistically significant increase in the percentage of Na, Mg and P and a slight, but statistically significant decrease in S and Cl. The percentage of K, Ca, Fe, Cu and Zn did not show any difference from that of the controls. The findings indicate that X-ray microanalysis may be a valuable tool for the simultaneous examination of a large number of elements in the fingernails.
Therapeutic Concentrations of Griseofulvin Do Not Affect Yeast Cell Phagocytosis by Monocytes
Authors: Athlin Leif , Domellöf Lennart , Norberg Bo
Published: October 2009

The effect of griseofulvin on monocyte phagocytosis was assessed by studying the uptake of fluorescent yeast cells by glass-adherent monocytes (a fluorescence-quenching technique). In contrast to other microtubule antagonists, grisofulvin did not inhibit monocyte phagocytosis. It is suggested that the lack of griseofulvin interference with essential leukocyte functions is a possible explanation for the fact that the microtubule antagonist griseofulvin serves as a comparatively safe and harmless drug.
Remission of Psoriasis with Etidronate Treatment of Underlying Paget’s Disease of Bone
Authors: Monk B.E. , Cundy T.F.
Published: October 2009

The case is reported of a 64-year-old man in whom psoriasis developed in relation to Paget’s disease of the underlying bone. Treatment of Paget’s disease was associated with remission of psoriasis. We suggest that local hyperaemia is the common link in this association and that this lends support to the theory that vascular factors are important in the pathogenesis of psoriasis.
Sarcoidosis with Extensive Cutaneous Ulceration
Authors: Gupta Aditya K. , Haberman Herbert F. , From George L.A. , Lipa Michael
Published: October 2009

A 70-year-old white woman with sarcoidosis and insulin-resistant diabetes mellitus presented with extensive cutaneous ulcerations. Both the cutaneous lesions and the systemic features of sarcoidosis showed a dramatic improvement during oral corticosteroid therapy. When extensive cutaneous ulcerations are present, it is important to consider sarcoidosis, as these may be the only presenting sign of the disease. Unlike ulcerated necrobiosis lipoidica diabeticorum, sarcoidal ulcerations may respond well to treatment with oral corticosteroids.
Erythema chronicum migrans: Evidence for Cellular Immune Reaction in the Skin Lesion
Authors: Büchner Stanislaw A. , Rufli Theo
Published: October 2009

Skin biopsy specimens from 9 patients with erythema chronicum migrans (ECM) were studied immunohistochemically using a series of monoclonal antibodies. In biopsy specimens taken from the erythematous peripheral portion of ECM the perivascular infiltrates were composed predominantly of LEU-4+ T cells. LEU-3a + helper/inducer T cells were more numerous than LEU-2a+ cytotoxic/suppressor T cells. Of particular interest was the high number of LEU-6+ Langerhans cells in the epidermis and dermis of specimens taken from the erythematous portion of ECM as well as from the noninflammatory skin outside the erythema. The presence of LEU-6 + Langerhans cells and T cells in the ECM lesions suggests that, apart from humoral factors, a cell-mediated immune response directed against Borrelia burgdorferi antigen is important as well in the pathogenesis of this disease.
Extracutaneous Spreading with Fatal Outcome of Mycosis fungoides in a Patient Treated with Ciclosporin A: A Word of Caution
Authors: Thomsen Kristian , Lange Wantzin Gunhild
Published: October 2009

A patient with mycosis fungoides in the tumor stage was treated with ciclosporin A orally in daily doses of 5 mg/kg body weight for 5 weeks. Three weeks after cessation of treatment the patient died with dissemination of the cutaneous lymphoma to the lungs, myocardium, liver, pancreas, kidneys, adrenals, and stomach. Treatment with ciclosporin A may have contributed to the death of this patient.
Hexyl-Nicotinate-Induced Vasodilation in Normal Human Skin
Authors: Dowd Pauline M. , Whitefield M. , Greaves M.W.
Published: October 2009

Hexyl nicotinate in a lotion formulation was applied topically to the skin of 10 healthy volunteers with clinically normal skin. Erythematous responses were assessed visually and skin blood flow determined by means of a laser Doppler flow meter which measures the blood cell flux (Pf2 Perimed, Sweden). Mean erythematous responses and increased blood cell flux were dose-related but in several subjects increases in blood flow occurred in the presence of barely detectable erythematous responses. In some subjects, hexyl nicotinate may be an effective cutaneous vasodilator even in the presence of minimal erythema.
Severe Erosive Lichen planus and Polycythemia vera in an Adolescent
Authors: Berbis P. , Devaux J. , Benveniste M.J. , Perrimond H. , Privat Y.
Published: October 2009

Erosive lichen planus developed in a 12-year-old adolescent also presenting polycythemia vera (Vaquez’ disease). Though a casual association cannot be exluded, the rarity of the two diseases in children suggests a pathogenetic link, possibly involving an abnormal hematologic stem cell line.
Multifocal Contact Dermatitis to Nitroderm TTS 5 with Extensive Postinflammatory Hypermelanosis
Authors: Harari Zvi , Sommer Ilan , Knobel Boleslaw
Published: October 2009

Allergic contact dermatitis to nitroglycerin has been previously reported. A localized cutaneous burn-like reaction due to the transdermal device was recently described. We are presenting a case of recurrent allergic contact dermatitis due to nitroglycerin as well as to its delivery device, resulting in numerous patches of postinflammatory hypermelanosis at the sites of application.
Regressing Atypical Histiocytosis (of Flynn)
Authors: Moayed M.J. , Kanitakis J. , Nabai H. , Mauduit G.
Published: October 2009

Regressing atypical histiocytosis (of Flynn) is a recently described disease that, in spite of histological features of malignancy, seems to run an indolent clinical course. A new case of this rare condition is reported herein.
Seasonal Variation of UV Radiation at the Dead Sea
Authors: Leibovici V. , Sagi E. , Siladji S. , Greiter J.C. , Greiter F. , Holubar K.
Published: October 2009

Pilot measurements were made of natural UV radiation (UVA and UVB, broad-band and erythemogenic) on the Dead Sea (400 m below sea level) and in Spain at sea level, both at approximately the same geographical latitude. Measurements were made at different times of single days during the 1985/1986 season. The preponderance of UVA over UVB was more pronounced in winter.
Terfenadine and Brompheniramine Maleate in Urticaria and Dermographism
Authors: Ormerod Anthony D. , Baker Roger , Watt Jane , White Marion I.
Published: October 2009

The effects of brompheniramine maleate (12 mg twice daily in sustained release form) and terfenadine (60 mg twice daily) on the symptoms and well-being of 16 adults with urticaria with or without dermographism were assessed by symptom questionnaire. Following an initial 2-week period without therapy, each drug was taken for 2 weeks in a randomised double-blind cross-over study. Both drugs produced significant relief of itch and rash but only brompheniramine produced significant drowsiness. Brompheniramine maleate was more effective than terfenadine in the patients with dermographism.
Evaluation of Cefotetan in Uncomplicated Gonorrhea
Authors: Korting H.C. , Abeck D. , Neubert U.
Published: October 2009

Cefotetan is a newly developed cephamycin especially resistant to bacterial beta-lactamase. Therefore both its in vitro activity against Neisseria gonorrhoeae and its clinical efficacy in uncomplicated gonorrhea are investigated. The minimal inhibitory concentrations (MIC) lie in the range of 0.016–2 μg/ml, 90% of the strains being inhibited by 0.5 μg/ml. Of 52 finally evaluable patients who were treated by a single intramuscular injection of 1 g, 48 (92.3%) were cured bacteriologically. Thus the present treatment protocol may prove useful in individual cases. It should, however, not be advocated for gonorrhea treatment in general.
Treatment of Psoriasis with Dithranol Cream Compared with Dithranol Paste
Authors: Young E.
Published: October 2009

In a paired-comparison study in 15 hospitalized patients suffering from psoriasis, Dithrocream® was compared with dithranol in Lassar’s paste. The therapeutic effectiveness of the two preparations was about the same, but Dithrocream gave fewer side effects in the form of staining and irritation.
Dysplastic Nevus Syndrome: Ultraviolet Hypermutability Confirmed in vitro by Elevated Sister Chromatid Exchanges
Authors: Jung Ernst G. , Bohnert Elisabeth , Boonen Hugo
Published: October 2009

The dysplastic nevus syndrome (DNS) is a clinical and genetic entity in which affected individuals have increased numbers of dysplastic nevi and a markedly increased risk of developing one or more cutaneous melanomas. Sister chromatid exchanges (SCE) are one of the cytogenetic end points that are positively correlated with the mutation rate and may therefore be used to estimate the spontaneous and the UV-induced mutagenesis in cultured and stored fibroblasts. SCE were presented and stained according to the Hoechst-Giemsa method. The normal control fibroblasts showed 9.48 ± 1.74 SCE per metaphase (n = 23) with an UV-C-induced increase (Δ SCE) of 1.61 ± 0.53 SCE per mJ/cm2 in the range of 0–5 mJ/cm2. Fibroblasts from DNS patients with melanoma (n = 12) showed normal values of spontaneous SCE but a significant increase (p = 0.01) of 2.43 ± 0.68 SCE per mJ/cm2. As in xeroderma pigmentosum, UV-C-induced Δ SCE appears as a valuable tool for measuring the individual hypermutability in DNS. Δ SCE indicates the increased susceptibility to UV-induced somatic mutations and may be etiologically relatd to the increased melanoma incidence in DNS.
Distribution of 2,4-Dinitrophenyl Groups on the Epidermal Langerhans Cells of Guinea Pigs following Skin Painting with 2,4-Dinitrochlorobenzene
Authors: Oka D. , Nakagawa S. , Oota T. , Ueki H.
Published: October 2009

It has been postulated that epidermal Langerhans cells (LC) are essential for induction and elicitation of contact sensitivity (CS) to simple chemical allergens. Although the precise role of LC in CS has not been determined, recent reports have focused on a function for LC in the presentation of antigen to T lymphocytes. To investigate this possibility, the distribution of allergen on the epidermal LC of inbred strain 13 guinea pigs was observed by the immunofluorescent method using antibodies against la antigen and hapten. 2,4-Dinitrophenyl groups were found to be localized on/in Ia-positive epidermal LC of the animals following skin painting with 2,4-dinitrochlorobenzene. This finding is discussed in relation to the role of LC as antigen presenting cells in CS.
Colchicine Treatment of Urticarial Vasculitis
Authors: Werni R. , Schwarz T. , Gschnait F.
Published: October 2009

A patient with clinically and histologically typical urticarial vasculitis has been treated with 0.5 mg of colchicine three times per day. This treatment resulted in both disappearance of urticarial skin lesions and amelioration of severe systemic symptoms such as abdominal pain, fever and arthralgia. Colchicine is proposed as an effective therapeutic agent for urticarial vasculitis if other drugs are ineffective, poorly tolerated or contraindicated.
The Relapses of Cystic Acne after Isotretinoin Treatment Are Age-Related: A Long-Term Follow-Up Study
Authors: Harms M. , Masouyé I. , Radeff B.
Published: October 2009

89 patients (66 males and 23 females) with severe acne were treated with isotretinoin and were followed up for a period of 6–47 months (mean 14 months) after the end of the therapy. Relapses occurred in 14.6% of the patients. They were not found to be related to the total amount of isotretinoin administered (up to 233 mg/kg); a possible, although not significant, link to sex was observed since relapses occurred in 16.6% males and 8.6% of females. But the age of the patients had a significant bearing on the likelihood of relapses: younger patients relapsed more frequently than older patients.
Dapsone in the Treatment of Cutaneous Lupus erythematosus
Authors: Lindskov Rune , Reymann Flemming
Published: October 2009

Thirty-three patients with chronic discoid lupus erythematosus (DLE) who had received dapsone for 1–27 months were reviewed. The dapsone treatment gave excellent results in 8 patients (24%), some effect in 8 patients (24%), while no response was seen in 17 patients (52%). Of the patients who had earlier been treated with hydroxychloroquine (HCQ), 76% responded excellently to the treatment. Of 6 patients who received a combined dapsone and HCQ therapy, 2 responded well. Six patients (18%) terminated the dapsone treatment because of side effects, none of which were serious. It is concluded that dapsone might be an alternative or a supplement to HCQ in the treatment of DLE, when the latter causes adverse reactions or fails to be effective. However, we find that HCQ remains the drug of choice when systemic treatment is needed.
Interleukin-1-Like Activity in Horny Layer Extracts: Decreased Activity in Scale Extracts of Psoriasis and Sterile Pustular Dermatoses
Authors: Takematsu Hideaki , Suzuki Ryuji , Tagami Hachiro , Kumagai Katsuo
Published: October 2009

Interleukin-1 (IL-1)-like activity was assessed in scale extracts prepared from skin specimens from 36 cases of psoriasis and other dermatoses characterized by the formation of sterile subcorneal pustules. IL-1 activity was detected in only 2 samples. In contrast, much higher IL-1 activity was demonstrated in horny tissue extracts prepared either from normal skin or from noninflammatory skin such as plantar callus, scar or ichthyosis. No correlation was found between neutrophil chemotactic activity and IL-1 activity demonstrable in horny tissue extracts.
Decreased Collagen and Hyaluronic Acid Content in Lesional Skin of Acrogeria
Authors: Konohana Akira , Miyakawa Shunichi , Tajima Shingo , Nishikawa Takeji
Published: October 2009

Biochemical analysis of involved and uninvolved skin of a 16-year-old female with acrogeria showed that hyaluronic acid and collagen contents were decreased only in involved skin. Explant cultures from both involved and uninvolved skin synthesized mainly hyaluronic acid in similar amounts. Since the glycosaminoglycans and hydroxyproline excreted in the urine were not increased, we speculate that a localized rather than a systemic abnormality may be present in acrogeria. Decreased collagen and hyaluronic acid contents in the patient are discussed in relation to Werner’s syndrome and type IV Ehlers-Danlos syndrome.
Water-Based versus Alcohol-Based Benzoyl Peroxide Preparations in the Treatment of Acne vulgaris
Authors: Fyrand Ole , Bang Jakobsen Henny
Published: October 2009

Forty-eight patients with acne vulgaris in the face were treated with a water-based (Basiron®) and an alcohol-based (Panoxyl®) 5% benzoyl peroxide preparation. A randomized double-blind, contralateral study was used. No difference in clinical effect was found. Treatment for 8 weeks resulted in at least 50% reduction in the number of closed comedones, papules and pustules in over 80% of the patients. In more than 70% of the patients, the reduction exceeded 75%. The water-based Basiron caused significantly less skin irritation than the alcohol-based preparation of Panoxyl.
Aleukemic Leukemia cutis
Authors: De Coninck A. , De Hou M.F. , Peters O. , Van Camp B. , Roseeuw D.I.
Published: October 2009

A patient with acute myelomonocytic leukemia is reported. He had presented erythroderma and atypical cellular infiltration of the skin 4 months prior to the detection of leukemia in the peripheral blood and bone marrow. Aleukemic leukemia cutis is a rare condition which is characterized by leukemic cells invading the skin prior to the observation of leukemic cells in the peripheral blood [1–3]. The cases of aleukemic leukemia cutis reported in the literature show little or no conformity in their clinical appearance [3–9]. Enzyme cytochemistry, immunocytological and electron-microscopic studies are of considerable help in differentiating the cutaneous infiltrates and in establishing early diagnosis [7, 9, 10]. We report herein a patient with erythroderma which regressed spontaneously, whereas microscopic examination of a cutaneous biopsy showed atypical cells infiltrating the dermis. After a period of 3 months, during which the patient remained free of lesions, he showed recurrence of the erythroderma while developing acute myelomonocytic leukemia.