bluuebunny/crossref_metadata_2025 huggingface dataset:
Metastatic Squamous Cell Carcinoma Resembling Angiosarcoma Complicating Dystrophic Epidermolysis bullosa
Authors: McGrath J.A. , Schofield O.M.V. , Mayou B.J. , McKee P.H. , Eady R.A.J.
Published: October 2009

We report a patient with generalized recessive dystrophic epidermolysis bullosa (RDEB) who developed 3 squamous cell carcinomas. The tumours appeared simultaneously at acral sites on both upper limbs and were poorly differentiated. Despite surgery and radiotherapy the patient died from metastatic disease within 6 months of presentation. This case highlights many of the typical features of this complication of RDEB including the overall poor prognosis. Of particular interest was the histology of one of the tumours which caused diagnostic difficulties: haematoxylin and eosin staining suggested an angiosarcomatous pathology, but the use of immunocytochemistry proved that the tumour was a squamous cell carcinoma in origin.
Eccrine Porocarcinoma
Authors: Akiyoshi E. , Nogita T. , Yamaguchi R. , Toyoda H. , Kawashima M. , Hidano A.
Published: October 2009

We describe a 78-year-old woman with eccrine porocarcinoma presenting a zosteriform appearance on the lateral upper part of the buttock. Erosion and bleeding were observed in the center of a 50 × 80 mm, erythematous indurated plaque with an elevated border. Posterior to the plaque, there was another erosive plaque, 50 × 20 mm in diameter with peripheral induration overlaid by two reddish papules. Based on the previous reports of 21 patients with eccrine porocarcinoma in Japan, we discuss the relationship between the clinical pattern and lymph node metastasis. The pedunculated eccrine porocarcinoma has less tendency to metastasize to the regional lymph nodes than the nonpedunculated form.
Is There a Link between Dendrocytes, Fibrosis and Sclerosis?
Authors: Piérard G.E. , Arrese-Estrada J. , Piérard-Franchimont C. , Deleixhe-Mauhin F.
Published: October 2009

In a series of fibrotic and sclerotic diseases including scars keloids fibromas scleroderma and lichen sclerosus et atrophicus, we found modifications in the dendrocyte population. Dendrocytes were numerous in fibrotic diseases associated with little deposits of collagen. Conversely, they were almost absent in sclerotic diseases when the lay-down of collagen was prominent. We hypothesize that dendrocytes, by their content in factor XIIIa, may limit the accumulation of collagen in the skin.
Kidney Biopsies in Methotrexate-Treated Psoriatics
Authors: Zachariae H. , Hansen H.E. , Søgaard H. , Olsen Steen
Published: October 2009

Kidney biopsies were studied in 19 psoriatics treated with methotrexate (MTX) from 1 month to 16 years. Only 3 of the patients had received the drug for less than 1 year. Four patients had been treaed for more than 10 years. The total doses of MTX ranged from 30 to 14,340 mg. In 17 of the 19 patients the cumulative MTX dose was 500 mg or more. In 9 patients the cumulative doses were over 2 g. With the exception of 1 patient, which presented sequelae of acute renal failure unassociated with MTX treatment, all other biopsies showed renal structures which, assessed by routine judgement, were found normal. Semiquantitative evaluation of interstitial fibrosis and arteriolar hyalinosis as well as interstitial volume estimated by morphometry showed no significant changes. No patient showed clinical or laboratory signs of renal impairment.
Seasonal Modulation of Sebum Excretion
Authors: Piérard-Franchimont C. , Piérard G.E. , Kligman A.
Published: October 2009

It is currently agreed that ambient temperature influences the sebum excretion rate. By using the Sebutape technique we have confirmed this concept, which is related to an increased delivery of sebum to the surface of the skin without an increment in the number of active sebaceous follicles.
Local Blanching after Epicutaneous Application of EMLA Cream
Authors: Villada G. , Zetlaoui J. , Revuz J.
Published: October 2009

EMLA cream is a topical formulation based upon the eutectic mixture of lidocaine and prilocaine and is used in clinical settings to produce local analgesia after application under occlusive dressing. A blanching reaction has been reported to occur locally after application, but it is not clear whether this reaction is caused by the anesthetic mixture, by the vehicle or the occlusion. We studied this blanching reaction in 50 healthy volunteers in a double-blind randomized assay: EMLA versus placebo, under occlusive dressing for 1 h, each subject being his own control. We found 33 cases (66%) of blanching after application of EMLA cream versus 3 cases (6%) after placebo, this difference being highly significant. Blanching was observed without delay, after removal of the dressing, and was very transient, disappearing in less than 3 h in all cases. We thus conclude that the blanching reaction is (1) frequent but very transient, and (2) determined by the anesthetic mixture included in EMLA cream and not by the vehicle alone, nor by the occlusion, since it is not found with the placebo. The precise mechanism of this reaction is unknown.
Psoriasis Related to Angiotensin-Converting Enzyme Inhibitors
Authors: Wolf Ronni , Tamir Anat , Brenner Sarah
Published: October 2009

Two mechanisms have been proposed for the pathogenesis of eruptions induced by angiotensin-converting enzyme (ACE) inhibitors: (1) an allergic, immune-mediated reaction and (2) a pharmacologic, dose-dependent response. Two cases of palmoplantar psoriasis are presented, which can be attributed to the induction (case 1) and exacerbation (case 2) of ACE inhibitors. The first patient developed his eruption 2 months after he had received captopril probably as a result of an allergic immunologic mechanism. This has been based mainly on circumstantial evidence and is further strengthened by the positive result of the mast cell degranulation test. The second patient developed an atenolol-induced, mild plantar psoriasis. She experienced a dramatic flare-up of her psoriatic lesions shortly after she had received an ACE inhibitor. It is suggested that her reaction occurred as a result of the enalapril-induced augmentation of kinin levels in the skin. These 2 patients represent deductive and unusual examples of the two different mechanisms that are responsible for the cutaneous complications of ACE inhibitors.
Demonstration of Quinolone Phototoxicity in vitro
Authors: Przybilla Bernhard , Georgii Aletta , Bergner Thomas , Ring Johannes
Published: October 2009

The ‘first-generation’ quinolones cinoxacin, nalidixic acid, oxolinic acid, pipemidic acid and rosoxacin and the newly developed quinolones ciprofloxacin, enoxacin, fleroxacin, norfloxacin and ofloxacin were screened in vitro at 10––5,10––4 and 10––3M concentrations for ultraviolet (UV)-induced phototoxic effects in a photohemolysis test. At 10––3 M, photodependent effects of norfloxacin could not be evaluated, as hemolysis occurred without irradiation. All other compounds with the exception of ciprofloxacin were found to be phototoxic at 10-3 M and some also at 10-4M. Hemolysis was UV dose dependent and for all compounds most prominent after exposure to UVA-rich radiation except for fleroxacin which was most active in the UVB range. Besides fleroxacin, also oxolinic acid, pipemidic acid and rosoxacin induced hemolysis with irradiations rich in UVB. It is concluded that quinolones have to be regarded as potentially phototoxic substances. Therefore intense light exposure should be avoided during treatment with these agents.
Study on Cross-Reactivity to the Para Group
Authors: Picardo Mauro , Cannistraci Carlo , Cristaudo Antonio , De Luca Chiara , Santucci Baldassarre
Published: October 2009

In 80 patients, positive to at least one hapten of the para group (para-phenylenediamine, diaminodiphenylmethane, benzocaine, PPD mix), patch tests were carried out with freshly prepared solutions of para-phenylenediamine (PPD) and of 3 selected aromatic compounds related structurally to PPD (para-aminophenol, ortho-aminophenol, hydroquinone). The number of positive reactions correlated with the rate of decomposition of the substances as evaluated by high-pressure liquid chromatography. PPD, which was almost decomposed after 24 h, gave the highest number of positive reactions, followed by ortho-aminophenol and by para-aminophenol, while hydroquinone, which was oxidized to the extent of 35% did not give any reactions. To evaluate if a different rate of oxidation can modify the patch test response in the same patients and in 10 normal volunteers tests were carried out with PPD solutions containing the oxidizing agent silver oxide (0.1%). By this procedure a significant increase in the number of positive responses was observed. The results suggest that the rate of decomposition and therefore the amount of quinone(s) generated, might be the key to eliciting patch test responses to oxidizable aromatic haptens.
Guidelines for Histopathologic Diagnosis of Plantar Malignant Melanoma
Authors: Saida Toshiaki , Yoshida Nagako
Published: October 2009

Detection of early lesions of malignant melanoma is highly important for the improvement of the prognosis. However, diagnosis of early malignant melanoma is not easy and is often discordant even among expert dermatopathologists. In this study, we propose guidelines for the histopathologic diagnosis of plantar malignant melanoma and malignant melanoma in situ on the sole. They are formulated with two-dimensional coordination of maximum diameters of the lesions and degrees of intraepidermal proliferation of solitary-arranged melanocytes. The guidelines are simple and reproducible, and surely contribute to the accurate diagnosis of early plantar malignant melanoma.
Xeroderma pigmentosum Group D Patient Bearing Lentigo maligna without Neurological Symptoms
Authors: Fukuro Shuhei , Yamaguchi Jun , Mamada Akira , Kondo Seiji , Satoh Yoshiaki
Published: October 2009

A 35-year-old Japanese female patient with xeroderma pigmentosum (XP), registered as XP114TO, was assigned to complementation group D by the cell fusion complementation test. The patient had manifested moderate solar sensitivity and freckles by the age of 6 years. The skin phototest using 290- and 300-nm monochromatic ultraviolet (UV) light revealed slightly lowered minimal erythema doses at 24 h after irradiation. The XP114TO skin fibroblasts exhibited about the 6-fold higher sensitivity to the lethal effect of 254-nm UV as did normal cells. Unscheduled DNA synthesis (UDS) induced in XP114TO cells by 254-nm UV (10 J/m2) was 33% of normal, falling into the group D range of 25–50% UDS. The patient developed lentigo maligna on the right side of the nose. Unlike the typical XP group D cases in the West, she showed no neurological abnormalities.
Topical Alpha-Interferon in Recurrent Genital Herpes Simplex Infection
Authors: Shupack J. , Stiller M. , Knobler E. , Ackerman C. , Jondreau L. , Kenny C.
Published: October 2009

We conducted a double-blind placebo-controlled clinical trial on 98 subjects to assess the efficacy of two strengths of topical human leukocyte α-interferon, 104 and 106 IU/g in a 1% nonoxynol-9 base, in the treatment of recurrent genital herpes simplex virus (HSV). The study medication was applied during the prodromal phase or at the first sign of recurrence of the infection. The high-dose α-interferon was found to be significantly more effective than the low-dose interferon and placebo with respect to the duration of viral shedding as well as in reducing the time to the end of all subjective symptoms, including pain, burning and itching. No difference between the three groups was found in times to crusting or healing. Further studies of topical interferon in the treatment of HSV and other viral infections are merited.
Combination of Topical Calcipotriol (MC 903) and UVB Radiation for Psoriasis vulgaris
Authors: Kragballe Knud
Published: October 2009

The synthetic compound MC 903 (calcipotriol) is a structural analogue of the naturally occurring, biologically active 1,25-dihydroxyvitaminD3 [1,25-(OH)2-D3]. MC 903 and 1,25-(OH)2-D3 show similar receptor binding and comparable effects on cell differentiation. However, MC 903 appears to be at least 100 times less potent in its effects on calcium metabolism. In previous double-blind placebo-controlled studies, topical MC 903 has been shown to have a therapeutic effect in psoriasis. The present open study involving 20 patients with psoriasis vulgaris was a right/left comparison of the efficacy and tolerability of MC 903 ointment (50 μg/g) alone or with UVB radiation. After treatment for 8 weeks, topical MC 903 alone resulted in marked improvement in 66% of the patients and in clearance in 17%. Combination of topical MC 903 with UVB resulted in marked improvement in 50% of the patients and in clearance in 39%. These differences were not statistically significant. No significant change in serum calcium levels was detected. Two patients developed a facial dermatitis which disappeared spontaneously during continued treatment. These results show that the combination of topical MC 903 and UVB radiation is well tolerated. Larger-scale studies are warranted to answer the question whether UVB radiation induces a significant improvement of the antipsoriatic effect of topical MC 903.
Ciclosporin in Localized and Systemic Scleroderma – A Clinical Study
Authors: Wörle B. , Hein R. , Krieg T. , Meurer M.
Published: October 2009

Four patients with systemic scleroderma and 1 patient with localized scleroderma were treated with ciclosporin (CS) given in daily doses between 2.2 and 5.6 mg/kg body weight for 3–26 months. Under this medication clinical improvement was observed in 4 patients with partial regression of cutaneous sclerosis and inflammation, healing of fingertip ulcerations or leg ulcers and improvement of articular mobility. However, in 1 patient with rapidly advancing systemic scleroderma a short-term therapy with CS in low doses (2–3 mg/kg body weight) resulted in arterial hypertension and renal dysfunction. Therefore careful selection of patients and close-meshed controls are indicated when CS is considered as anti-inflammatory treatment in scleroderma.
Esophageal Involvement in Pemphigus vulgaris: Report of Two Cases and Review of the Literature
Authors: Lurie R. , Trattner A. , David M. , Sandbank M.
Published: October 2009

Two patients with esophageal involvement of pemphigus vulgaris are presented, who were diagnosed histopathologically and by direct immunofluorescence. In most dermatological textbooks the possibility of esophageal involvement is not mentioned. In the English medical literature 11 cases have been reported. It seems that if upper gastrointestinal endoscopy had been done on a routine basis it might have shown that esophageal involvement is more widespread than present findings indicate.
Squamous Cell Carcinoma and Basal Cell Carcinoma within the Clinical Picture of a Chronic Venous Insufficiency in the Third Stage
Authors: Blank Armin A. , Schnyder U.W.
Published: October 2009

Two cases of neoplastic ulcers of the leg will be described, which presented themselves within the clinical picture of a chronic venous insufficiency in its third stage. Both cases had a phlebological anamnesis. The transformation of chronic ulcers of the leg into spinal cell carcinomas is well known. With the presence of an ulcus cruris, however, basal cell carcinomas are rarely considered in a differentiated diagnosis. Yet both of these (by and large common) skin tumors can occur in the clinical picture of an ulcus cruris. The role of the dermatologist in the early diagnosis and treatment such neoplastic ulcers is therefore an important one.
Successful Immunotherapy by Dinitrochlorobenzene in a Case of Recurrent Acrolentiginous Melanoma
Authors: Sigg C. , Schnyder U.W.
Published: October 2009

The successful immunotherapy by dinitrochlorobenzene in a 71-year-old woman suffering for 2 years from an exulcerated acrolentiginous melanoma is reported.
Erythema multiforme-Like Eruptions: a Rare Side Effect of Topical Immunotherapy with Diphenylcyclopropenone
Authors: Perret C.M. , Steijlen P.M. , Zaun H. , Happle R.
Published: October 2009

We report 3 cases of erythema multiforme following topical application of diphenylcyclopropenone (DCP) for the treatment of alopecia areata. This eruption represents a rare side effect which could be controlled with corticosteroids given both systemically and topically. When this unusual reaction occurred, treatment with DCP was stopped. In one of the patients, subsequent topical immunotherapy with squaric acid dibutylester was not complicated by this side effect and resulted in complete hair regrowth.
Human Cutaneous Response to a Mixed Surfactant System: Role of Solution Phenomena in Controlling Surfactant Irritation
Authors: Rhein Linda D. , Simion Anthony , Hill Robert L. , Cagan Robert H. , Mattai Jairajh , Maibach Howard I.
Published: October 2009

Exposure of the skin to surfactant-based products can result in irritation. To control this effect researchers are probing mechanisms of surfactant action. In vitro studies show that mixing surfactants often results in less denaturation (swelling) of stratum corneum. We have explored the in vivo human irritation response (using a 21-day cumulative irritation test) to two of these surfactants – sodium lauryl sulfate (SLS) and (C12–C14) alkyl, 7-ethoxy sulfate (AEOS-7EO). Results demonstrate that addition of AEOS-7EO to a constant dose of SLS results in a significant reduction in erythema, hence producing a milder system. The reason for the synergism is unclear, but may relate to experimentally determined alterations in the micellar solution properties of the SLS upon addition of AEOS-7EO.
Properties of Acid Phosphatase in Human Stratum corneum
Authors: Meyer J.C. , Grundmann H.P. , Knabenhans Susi
Published: October 2009

Sheets of stratum corneum were prepared by a trypsinization procedure from human skin samples, homogenized with a freeze press and then fractionated into a soluble fraction and a sediment by centrifugation at 50,000 g. Acid phosphatase (AcP) activity was found in both fractions but the bulk of the activity was detected in the supernatant. Highest activities were observed after treatment with Triton X-100. The bulk of the AcP activity remained bound to the pellet if suspension and fractionation of the homogenized stratum corneum were performed in acetate buffer in the range between pH 4.0–5.0, probably due to ionic or hydrophobic interactions. AcP activity was totally lost if homogenates or fractions were stored frozen at –20°C in buffers with pH values lower than 4.0. Triton X-100 extracts from whole skin, epidermis, stratum corneum, cultured skin fibroblasts and leukocytes were compared by isoelectric focusing. Extracts from whole skin, epidermis and stratum corneum yielded almost identical patterns with one main AcP activity band at pi of 5.65 whereas a second pronounced band from whole skin behaved similarly to one band from cultured skin fibroblasts and leukocytes (pI 6.1). The prominent band from extracts of stratum corneum and epidermis was not observed in extracts of skin fibroblasts and leukocytes. Hence we conclude that stratum corneum and epidermis contain a tissue-specific AcP.
The Relevance of the Mouse Papilloma Test as a Predictor of Retinoid Activity in Human Psoriasis
Authors: Teelmann Kampe , Bollag Werner
Published: October 2009

The combination of the results of mouse antipapilloma tests with those from hypervitaminosis A tests in mice as the basis for calculating a therapeutic index has been used for more than 20 years in the search for retinoids as useful drugs in human dermatology. A number of retinoids identified as active or inactive when administered systemically in these mouse systems have gone into clinical trials; clinical results on 11 retinoids were available for a retrospective analysis on the predictive relevance of the mouse models for retinoid activity in human psoriasis. This analysis revealed that the therapeutic index in mice correctly identified eleven compounds and differentiated them into markedly active moderately active or inactive retinoids when subsequently used clinically in the treatment of various forms of psoriasis. Acidic retinoids were more difficult to assess than nonacidic ones and the therapeutic index appeared to underestimate their potency in humans. One retinoid, motretinide, showed a favorable therapeutic index but failed to demonstrate antipsoriatic activity in the clinic. The reason for this discrepancy is that humans and mice metabolize this compound differently. Thus, although chemically induced skin papillomas in mice reflect only certain analogies to human psoriasis and other keratinizing dermatoses, they may be considered a useful tool in the search for retinoids for the treatment of keratinization disorders.
Alopecia areata: More on Topical Sensitizers
Authors: Orecchia G. , Marelli M.A. , Perfetti L. , Rabbiosi G.
Published: October 2009

Our experience on treating alopecia areata with topical sensitizers (diphencyprone, squaric acid dibutylester) is reported: staging, prognosis, side effects, follow-up, and psychological attitude of the patients towards this therapy and wigs are the focused aspects. The possible mechanisms of action of these allergens are discussed, reporting the case of a female patient with concomitant appearance of hair regrowth and psoriatic plaques in the same area after SADBE therapy.
Age-Related Rather than Ulcer-Related Impairment of Venous Function Tests in Patients with Venous Ulceration
Authors: Höhn L. , Chiarenza S. , Schmied E. , Bounameaux H.
Published: October 2009

Various noninvasive tests of venous function and skin oxygenation were studied in 12 patients with unilateral venous ulcer and in 24 control subjects. In the ulcer patients, there was no difference between the leg with and the leg without ulcer regarding all the tests studied. Except for the maximal venous outflow, the patients and their age- and sex-matched controls did not differ with regard to all parameters studied. In contrast to these findings ageing was associated with a reduction in maximum venous outflow, a shortening in venous filling time, an increase in venous pressure in the posterior tibial vein and a diminution of transcutaneous partial oxygen pressure.
Cutaneous Metastatic Lymphangitis from Squamous Cell Carcinoma of the Cervix
Authors: Bachaud J.M. , Mazabrey D. , Berrebi A. , Maisongrosse V.
Published: October 2009

A case of cutaneous metastatic lymphangitis which appeared during the unusual evolution of a cervix carcinoma is reported. DNA sequences of No. 18 human papilloma virus (HPV) were isolated in both vaginal and cutaneous specimens. The hypothesis that a particular evolution of invasive cervix carcinomas might be related to the type of associated HPV is suggested.
Nevoid Basal Cell Carcinoma Syndrome and Acrokeratosis verruciformis
Authors: Humbert Philippe , Laurent René , Faivre Brigitte , Agache Pierre
Published: October 2009

An exceptional case of nevoid basal cell carcinoma (NBCC) syndrome occurring with acrokeratosis verruciformis (AKV) in the same patient is presented. The occurrence of two rare autosomal dominant diseases in a patient suggests that AKV might be one of the different dyskeratoses of the NBCC syndrome. The clinical aspect of the flesh-colored papules of AKV, indistinguishable from flat warts, might nevertheless prompt performance of a biopsy.
Squamous Cell Carcinoma Arising on a Congenital Fissure of the Lower Lip
Authors: Serrano S. , Aneiros J. , O’Valle F. , Martinez C.
Published: October 2009

In this study we document a case of squamous cell carcinoma in a young man arising on a fissure of the lower lip. The fissure, which existed since birth, could be considered congenital. We report here the clinical and pathological aspects; the pathogenesis is discussed.
Cornified Cell Envelope
Authors: Hohl Daniel
Published: October 2009

The cornified cell envelope (CE) is a highly insoluble structure on the inside of the plasma membrane of terminally differentiated keratinocytes. The cellular and molecular biology of the CE is outlined and new areas of research involving the CE are reviewed focussing on morphological and biochemical connections, the sequential gene expression during terminal differentiation, the interaction of lipids and proteins forming the epidermal barrier, the cysteine-rich pool of proteins in the epidermis as well as the molecular cloning and/or characterization of major components of the CE.
Longitudinal Melanonychia Induced by 3′-Azidodeoxythymidine
Authors: Tosti Antonella , Gaddoni Giuseppe , Fanti Pier Alessandro , D’Antuono Antonietta , Albertini Francesco
Published: October 2009

9 Caucasian patients who developed longitudinal melanonychia during 3′-azidodeoxythymidine (AZT) treatment for HIV infection are reported. The occurrence of nail pigmentation was not related to drug dosage or to the severity of the HIV infection. AZT as well as other drugs acting on DNA synthesis or transcription seem to be a quite frequent cause of longitudinal melanonychia.
Papular and Nodular Mucinosis as a Sign of Lupus erythematosus
Authors: Rongioletti Franco , Parodi Aurora , Rebora Alfredo
Published: October 2009

We describe 3 cases of papular and nodular mucinosis (PNM), a clinically distinctive cutaneous mucinosis associated with lupus erythematosus (LE), which has received little attention in the dermatologic literature. Histopathology shows deposits of mucin in the dermis without microscopic features of LE while immunofluorescent studies disclose linear or granular deposits of IgG, IgM and C3 at the dermoepidermal junction. In about 80% of the 14 cases described in the literature PMN has been associated with systemic LE with prevalent joint and kidney involvement. The possible prognostic significance of this singular dermatosis is discussed.
High Level of Serum Squamous Cell Carcinoma-Related Antigen in a Case of Bowen’s Disease
Authors: Yamamoto T. , Mamada A. , Kondo S. , Yamaguchi J. , Ohara K.
Published: October 2009

A case of Bowen’s disease on the lower abdomen is described. It was characterized by the unusually large size of the lesion and the high level of serum squamous cell carcinoma-related antigen which however decreased rapidly after surgical removal of the tumor.
Treatment of Cutaneous T Cell Lymphoma with Intermediate Doses of Interferon Alpha 2a
Authors: Nicolas J.F. , Balblanc J.C. , Frappaz A. , Chouvet B. , Delcombel M. , Thivolet J.
Published: October 2009

In this study we treated 6 patients with epidermotropic cutaneous T cell lymphoma (CTCL) with intermediate doses of recombinant alpha 2a interferon (18–100 × 106 IU/week) for 2–6 months. One patient experienced complete clinical remission in spite of a persistent dense lymphocytic skin infiltrate. One patient was markedly improved and 2 patients were moderately improved. The clinical condition of the 2 remaining patients was unchanged by interferon treatment. In all cases lesions relapsed a few weeks after treatment was discontinued. This study shows that interferon can be used to treat epidermotropic CTCL. However, a 2- to 6-month treatment using moderate doses did not lead to the high percentage of remission previously reported by others with high doses of recombinant alpha 2a interferon, for longer periods. This result suggests that interferon should be used at high doses and/or for long time periods for clinical improvement of CTCL patients.
Carcinoma Cuniculatum of the Buttock
Authors: Melo Carlos R. , Melo Ivanir S.
Published: October 2009

A rare case of carcinoma cuniculatum involving the buttock in a 56-year-old male is presented. This case is uncommon in that the tumor was largely subcutaneous, while the usual carcinoma cuniculatum is an exophytic growth. Although carcinoma cuniculatum has a wide clinical and histological spectrum, to our knowledge there has been only 1 case with similar histological features, located in a pilonidal sinus, and another case located on the buttock.
Paget’s Disease of the Nipple Resembling an Acantholytic Disease on Microscopic Examination
Authors: Wolf Ronni , Bernstein-Lipschitz Liora , Rothem Arye
Published: October 2009

Two biopsies of an erosive lesion of the nipple had an appearance of an acantholytic disease without showing malignant cells. Only a third biopsy through the nipple with removal of a larger portion revealed some nests of atypical, large cells with clear cytoplasm, typical of Paget’s disease. Immunohistochemical findings with carcinoem-bryonic antigen confirmed the diagnosis of Paget’s disease of the nipple. This is the first case of Paget’s disease which shows extensive acantholysis on microscopic examination and which resembles pemphigus vulgaris histologically. Acantholytic diseases are easily distinguished from Paget’s disease and have never been mentioned in the differential diagnosis of this disease. A large biopsy through the nipple with the removal of a liberal portion of the nipple is suggested in every case of a suspected unilateral lesion of the nipple in order to avoid the overlooking of small nests of Paget’s cells, as in our first biopsies, showing a histological picture of an acantholytic disease.
Successive Legionellosis in the Course of Lymphomatoid Granulomatosis
Authors: Humbert Philippe G. , Dalphin Jean C. , Zultak Maurice , Breton Jean L. , Fellman Dominique , Laurent René
Published: October 2009

A 75-year-old male presented with typical cutaneous lesions and pulmonary involvement due to lymphomatoid granulomatosis. A legionellosis was associated with this condition. Though the radiological findings in lymphomatoid granulomatosis are suggestive, they are not specific, and set a difficult problem in distinguishing the two conditions. Monoclonal antibody studies indicated the predominance of CD8 T lymphocytes in the infiltrate of the skin, as well as in the bronchoalveolar fluid.
Melanoacanthoma of the Penis Shaft
Authors: Vion B. , Mérot Y.
Published: October 2009

We report an additional case of melanoacanthoma, a rare benign mixed tumor of both keratinocytes and melanocytes occurring in a 66-year-old man on the penis shaft a localization not previously described. Clinical and histological features are briefly discussed.
Histiocytome fibreux malin de la jambe consécutif à un traumatisme
Authors: Mérot Yves , Carrel Claude-France , Vion Brigitte , Frenk Edgar
Published: October 2009

Following a skin injury to the left leg, a 62-year-old lady developed a progressively enlarging multinodular mass of the pretibial area of the left leg. Histologic examination revealed a grade II malignant fibrous histiocytoma. An extensive work-up did not show any evidence of disseminated disease. A lower leg amputation was performed. The patient is alive and well 10 months following surgery.
The Poikiloderma of Rothmund-Thomson Syndrome: Changes in Langerhans Cell Morphology and Distribution
Authors: Smitt Henk Sillevis , Gons Margreet H. , Oorthuys Johanna W.E. , Krieg Suze R. , Bos Jan D.
Published: October 2009

A black girl with the Rothmund-Thomson syndrome is presented. Immunophenotyping of subpopulations of immunocompetent cells in a biopsy of an atrophic hyperpigmented skin lesion revealed sparsity and unusual distribution of epidermal Langerhans cells. These cells were mainly located in the basal layer of the epidermis and did not show the usual dendritic pattern. Impressive immunoreactivity of the dermal infiltrate was observed by anti-HLA-DR staining. The changes in Langerhans cell morphology and distribution may indicate functional impairment of the up-regulating arm of skin immunity.
Decrease of Ultraviolet-Induced DNA Injury in Human Skin by p-Aminobenzoic Acid Esters
Authors: De Rijcke S. , Heenen M.
Published: October 2009

The effect of a sunscreen containing a p-aminobenzoic acid (PABA) ester on ultraviolet-induced DNA injury was assessed on human epidermal cells by the measure of unscheduled DNA synthesis intensity. Our results show that DNA repair was reduced by approximately 50%. Therefore sunscreens based on PABA esters might be expected to reduce photocarcinogenesis.
Serum Levels of Apolipoproteins AI, All and B in Psoriasis
Authors: Aguilar Martinez A. , Guerra Rodriguez P. , Ambrojo Antunez P. , Cristóbal Gil M.C. , Urbina Gonzalez F.U. , García Párez A.
Published: October 2009

Since an increased incidence of occlusive vascular disease has been reported in psoriasis, serum levels of apolipoproteins AI AII and B were determined in 61 patients with the disease and compared with that of 34 healthy controls. No significant differences were found between the two groups. These findings suggest that the ocurrence of thromboembolic disorders in psoriasis is not related to altered levels of apolipoproteins AI, All, B in these patients.
Multiple Subcutaneous Abscesses due to Mycobacterium Tuberculosis in an Immunocompetent Host
Authors: Petit A. , Maslo C. , Herschkovitch D. , Perrin P. , Janier M. , Civatte J.
Published: October 2009

A 58-year-old immunocompetent man presented with a 9-month history of several disseminated subcutaneus ulcerative nodules, fever and weight loss. Histopathological changes were not specific. X-ray of the chest disclosed a large right hilar density highly suggestive of a lung carcinoma. All these manifestations eventually proved to be caused by Mycobacterium tuberculosis, which grew from sputum and skin. We report this case because of its striking clinical features.
Increased Mast Cell Numbers in the Sclerotic Skin of Porphyria cutanea tarda
Authors: Torinuki Wakio , Kudoh Kazuhiro , Tagami Hachiro
Published: October 2009

We quantitated numbers of mast cells in the sclerotic skin noted on the dorsa of the hands of 10 patients with porphyria cutanea tarda (PCT) and compared them with those of diffuse scleroderma and healthy controls. Mast cell counts in sclerodermoid skin of PCT patients were significantly greater than those in involved skin of 9 patients with diffuse scleroderma in its late stage and also greater than those in normal skin of 8 controls. When mast cell density was analyzed according to the depth of the dermis, an 84% increase was noted in the uppermost layer (0–0.2 mm in depth) and a 150% increase in the second uppermost layer (0.2–0.4 mm in depth) in the patients with PCT when compared with those in the corresponding sites of the controls. These results suggest a possible role of mast cells in the pathogenesis of sclerodermoid skin of PCT.
Overview of Recent Clinical Pharmacokinetic Studies with Acitretin (Ro 10-1670, Etretin)
Authors: Brindley C.J.
Published: October 2009

Following oral administration of acitretin with food, peak plasma concentrations of unchanged drug (Ro 10-1670) are reached within 4 h. The mean absolute bioavailabihty of acitretin is 59% with high interpatient variability consistent with that of etretinate. Taking acitretin with food results in an increased and more consistent bioavailabihty. The drug appears to be extensively distributed throughout the body without unexpected accumulation and the elimination half-life is approximately 50 h. Acitretin has a profound pharmacokinetic advantage over etretinate because it is eliminated more rapidly from the body; etretinate is sequestered into fatty tissue due to its greater lipophilicity creating a deep compartment from which it is only slowly released. Acitretin is eliminated entirely by the metabolism and the resultant metabolites are excreted via the kidney and bile.
Benefit of Progressively Increasing Doses during the Initial Treatment with Acitretin in Psoriasis
Authors: Berbis P. , Geiger J.-M. , Vaisse C. , Rognin C. , Privat Y.
Published: October 2009

The purpose of this double-blind study was to compare the therapeutic effects of a low initial dosage of acitretin, increased at 2-week intervals (group 1:10, 30, 50 mg/day) with a high initial dosage decreased at similar intervals (group 3: 50, 30, 10 mg/day) and with a constant dosage (group 2: 30 mg/day) in 66 patients (47 men and 19 women) with severe psoriasis. At the end of the double-blind phase the mean percent improvement calculated by the Psoriasis Area and Severity Index score, was as follows: 62.7% in group 1, 55.9% in group 2 and 67.1% in group 3.The double-blind phase of 6 weeks was followed by an open phase of 6 weeks, during which the patients were treated either with 10, 30 or 50 mg/day, according to the therapeutic response. At the end of treatment (12 weeks), a mean improvement of more than 80% was obtained in all three groups. Hypervitaminosis A signs and symptoms were observed in all patients. The frequency and severity of these adverse reactions were shown to be dose-dependent. This study shows that a low dose progressively increased is advisable because of similar activity and better acceptability.
Double-Blind Placebo-Controlled Study with Topical 2% Ketanserin Ointment in the Treatment of Venous Ulcers
Authors: Roelens P.
Published: October 2009

Previous animal and human data have shown that ketanserin, the first specific serotonin2 antagonist, may have beneficial effects on peripheral vascular diseases and on the healing of ulcers. In this double-blind study a 2% ketanserin ointment in a polyethylene glycol base was used to treat 23 patients with venous ulcers (13 ketanserin, 10 placebo). Classical wound care measures were maintained in both groups; therefore, conventional ulcer therapy (with placebo in a polyethylene glycol base) was in reality compared with conventional ulcer treatment plus ketanserin. The most important parameter for evaluation in this study was the development of granulation tissue (first sign of successful wound healing). The evolution of granulation was significantly better with ketanserin than with placebo (p < 0.05, Mann-Whitney U test). According to the investigator’s evaluation, ketanserin showed a response in 10 out of 11 patients as opposed to 5 out of 10 placebo patients at the end of the study. This first double-blind placebo-controlled study suggests that topically applied ketanserin promotes the healing of venous ulcers.
Allergic Contact Dermatitis to Naftifine
Authors: Senff H. , Tholen S. , Stieler W. , Reinel D. , Hausen B.M.
Published: October 2009

We report on two cases of allergic contact dermatitis due to naftifine, an antimycotic substance. Epicutaneous tests were positive with the reagent itself but not with other compounds of the ointment. Additionally, one of the patients reacted to an ointment containing clotrimazole. Until now, only few cases of contact allergy to naftifine have been described, but an increasing number is expected.
Maculopapular Rash due to Coumarin Derivatives
Authors: Kruis-de Vries M.H. , Stricker B.H.C. , Coenraads P.J. , Nater J.P.
Published: October 2009

The case history is presented of a patient who developed a maculopapular rash following treatment with 3 different coumarin derivatives. Apparently cross-sensitivity between coumarin derivatives may occur.
Werner’s Syndrome and Astrocytoma
Authors: Laso F.J. , Vasquez G. , Pastor I. , Procel C. , Santos-Briz A.
Published: October 2009

Werner’s syndrome, a relatively rare and autosomal recessive disorder, is well known to be characterized by a high frequency of malignant neoplasms. Werner’s syndrome has not infrequently been associated with meningiomas. We report a case of Werner’s syndrome and temporal astrocytoma in a 49-year-old male. As far as we are aware, this is the first report of the association of Werner’s syndrome and astrocytoma.
Vesicular Pemphigoid – Ultrastructural and Immunoelectron Microscopic Study
Authors: Hayakawa Kazuhito , Shimizu Hiroshi , Amagai Masayuki , Harada Takashi , Nishikawa Takeji , Yamasaki Yuichiro
Published: October 2009

We report a patient with vesicular pemphigoid who showed clinically numerous small vesicles and figurate erythema over the trunk and extremities. Although large blisters were absent, immunofluorescent study revealed IgG and C3 deposition at the basement membrane zone of the lesional skin. The patient responded well to the combined use of corticosteroid and dapsone. Immunoelectron microscopy showed IgG and C3 deposition at the undersurface membrane of the basal cells and the lamina lucida. Electron microscopy of the nonvesiculated early erythematous skin showed small vacuoles and lacunae along the uppermost portion of the dermis. Although the clinical features of this patient and the good therapeutic response to dapsone were atypical, the results of immunopathology and immunoelectron microscopy were consistent with typical pemphigoid.
Normalization of Skin Appearance in a Patient with Scleromyxoedema after Intensive Chemotherapy for Hodgkin’s Disease
Authors: Alberts A.S. , Schulz E.J. , Falkson Geoffrey , Simson I.W. , Coccia-Portugal M.A.
Published: October 2009

A patient with scleromyxoedema was treated for 6 years with cytostatic drugs. During this time the skin lesions followed a fluctuating but progressive course. After 6 years she developed Hodgkin’s lymphoma of the mixed cellularity type. Intensive cytostatic treatment given for Hodkin’s disease resulted in virtually complete disappearance of the scleromyxoedema lesions. The development of Hodgkin’s disease is considered fortuitous and not due to the previous cytostatic drugs.
Primary Anaplastic Large Cell Lymphoma of the Skin
Authors: Berti Emilio , Gianotti Raffaele , Alessi Elvio
Published: October 2009

Anaplastic large cell lymphoma is a subtype of nodal and extranodal lymphoproliferative disorder characterized by peculiar histopathological features and the positivity of lymphoid proliferating cells for Ki-1/Ber-H2 monoclonal antibody. A case, misdiagnosed as cutaneous metastasis and treated by surgery, in a woman with a history of previous neoplasms, is reported. In spite of the high histopathological malignancy of the tumor, the patient is alive and free from recurrent or metastatic disease after 3 years of follow-up.
Sporotrichoid Pyogenic Bacterial Infection
Authors: Tanaka S. , Mochizuki T. , Watanabe S.
Published: October 2009

Two cases of pyogenic bacterial infection, which initially resembled lymphocutaneous sporotrichosis, are reported. In case 1, Staphylococcus aureus and Streptococcus group A were cultured from the lesion and in case 2, S. aureus alone. Histologically, botryomycotic grains were identified in case 2; this patient had diffuse normolipidemic plane xanthoma. With oral administration of cefaclor, the cutaneous lesions dramatically improved in both cases.
Plasma Concentrations of Complement-Modulating Proteins (C1 Inhibitor, C4 Binding Protein, Factor H and Factor I) in Inflammatory Dermatoses with Special Reference to Psoriasis
Authors: Ohkohchi K. , Torinuki W. , Tagami H.
Published: October 2009

By using single radial immunodiffusion, plasma levels of four complement-modulating proteins, i.e. C1 inhibitor (C1INH), C4-binding protein (C4bp), factor H and factor I were measured in 42 psoriatic patients and in 60 patients with other inflammatory skin diseases in comparison with 27 normal controls. In psoriatic patients and those with related pustular dermatoses the levels of C4bp factor H and factor I were significantly increased. They correlated well with both extent of skin changes and disease activity. In contrast, in nonpsoriatic inflammatory dermatoses only factor H values were significantly increased in toxic erythema and factor I in atopic dermatitis. These results offer additional support for the hypothesis that the complement system is involved in psoriasis and related sterile pustular dermatoses.
Characterization of Receptors to the Anaphylatoxins on Isolated Cells
Authors: Fukuoka Y. , Nielsen L.P. , Hugli T.E.
Published: October 2009

The anaphylatoxins exhibit three primary functions in vivo, i.e. they induce granulocyte sequestration and adherence, promote spasmogenesis or smooth muscle contraction and exert immunoregulatory influences. C5a receptors have been demonstrated on human neutrophils, human monocytes, rodent macrophages from both the lungs and peritoneal cavity, two mouse macrophage cell lines (RAW 264 and J774.A1) and guinea pig platelets. To date, only guinea pig platelet has been shown to possess C3a receptors. In depth studies with the rat mast cell have demonstrated that both direct and indirect activation mechanisms may be operative in the mast cell; however, neither mechanism appears to depend on receptor-mediated stimulation of these cells.
Biological and Cellular Responses to Grass Pollen in Sensitive Patients
Authors: Dubertret Louis , Michel Laurence , Jean-Louis Francette , Denizot Yves
Published: October 2009

Using a noninvasive skin chamber technique, we studied the in vivo development of anaphylactic reactions in 8 pollen-sensitive patients suffering from seasonal allergic rhinitis/conjunctivitis/asthma and showing positive cutaneous reactions after intradermal allergen challenge. As agonists, histamine and pollen were introduced into the skin chambers and left in contact with superficial dermis during 6 h. The release of mediators (histamine and prostaglandin [PG] D2) and the modifications in protein diffusion occurring during the immediate (30 min) and the late (6 and 24 h) cutaneous reaction phases were quantitatively analyzed. 24 h after agonist introduction, the recruitment of inflammatory cells on the superficial dermis was studied by use of Rebuck’s windows. Histamine release in pollen-containing skin chambers was immediate and persisted until the 24th h despite replacement of the agonists by control medium at the 6th h. An intense PGD2 release occurred as soon as the first 30 min in chambers containing either exogenous histamine or pollen and was maintained until the 24th h. Protein diffusion induced by histamine and pollen was similar to the control one at 30 min but was intensely enhanced at the 6th h. At the 24th h, pollen-induced protein diffusion was still intense whereas that induced by histamine was analogous to the control one. 24 h after pollen challenge numerous eosinophils were recruited on the superficial dermis but almost none were observed after control medium or histamine. In conclusion, when applied on the dermis of pollen-sensitive individuals, pollen induced a typical and long-lasting anaphylactic skin reaction which differs from that induced by histamine alone since, beside the release of histamine, which persists at least during 24 h, it induces an immediate and long-lasting production of PGD2, a later-appearing and persisting increase in protein diffusion as well as a specific eosinophil recruitment.
Release and Synthesis of Histamine in Rat Basophilic Leukemia (2H3) Cells
Authors: Watanabe Takehiko , Maeyama Kazutaka , Taguchi Yoshitaka
Published: October 2009

On the stimulation of rat basophilic leukemia (2H3) cells with an IgE oligomer, the intracellular Ca2+ concentration, which was measured with fura-2 as a fluorescent probe, began to increase after 1 min lag period, reached its maximum at 4 min, and gradually decreased to the original level. The histamine release occurred slightly more slowly than the increase in the intracellular Ca2+. It started 2–3 min after the stimulation, reaching a peak at 6 min and thereafter decreasing slowly. To supplement the released histamine, the activity of histidine decarboxylase, a histamine-forming enzyme, increased 5-fold several hours after the stimulation by an IgE oligomer, and this increase may be mediated by protein kinase C system.
Modulation of Plasma Exudation by PGE2 and That of Leukocyte Migration by LTB4 in Inflammatory Models
Authors: Katori Makoto , Harada Yoshiteru , Ueno Akinori , Majima Masataka , Oda Takaharu , Kawamura Michiko
Published: October 2009

Des-Phe8-Arg9-BK could be detected in the entire course of rat carrageenin pleurisy up to 24 h, together with a reduction of the residual levels of high molecular weight kininogen and prekallikrein. On the basis of this continuous release of bradikinin, prostaglandin E2 was released up to 5 h in the pleural exudate and enhanced the plasma leakage. In rat cardiac infarction, the initial increase in the number of polymorphonuclear leukocytes in the cardiac tissue was accompanied by leukotriene B4 in the tissue and this was followed by the second increase and activation of the complement system.