bluuebunny/crossref_metadata_2025 huggingface dataset:
Cyclosporin A in the treatment of severe allergic contact dermatitis
Authors: Flori Laura , Perotti Roberto , Mazzatenta Carlo , Andreassi Lucio
Published: August 2010

Background Allergic contact dermatitis is sometimes difficult to treat because the patients are unable to effect prevention. Contact dermatitis can then become chronic and progressive, posing serious therapeutic problems.

Patients and Method Fifteen patients with severe allergic contact dermatitis were treated with cyclosporin A (CyA). All patients were polysensitized and unable to avoid with haptens for socioeconomic reasons. The drug was given orally at a dose of 5 mg/kg/day for 4 weeks followed by 3 mg/kg/day for a further 2 months. In three patients the treatment was continued for a further period of 60 days at 2 mg/kg/day.

Results All patients responded well to the therapy and no side effects were observed. The manifestations of acute inflammation improved rapidly, whereas the signs of chronic reaction took longer to regress. At the end of treatment some subjects remained without lesions for up 6 months while others relapsed with mild forms. The recurrent dermatitis responded to a further cycle of CyA. Patch test reactions were only slightly modified after 30 days of treatment.

Conclusion Our results qualify CyA as a new drug for the treatment of allergic contact dermatitis. It cannot be regarded as the elective treatment but it can be extremely useful in chronic and severe cases.
Combined retinoid plus surgical treatment of hypertrophic Darier's disease
Authors: Calderon M José , Landa Ncrea , Gardeazabal Jesús , Sueiro Fernando A. , Diaz‐Perez Jose L.
Published: August 2010

A 28‐year‐old male with severe hypertrophic Darier's disease was successfully treated with a combination of retinoids, dermabrasion and surgical excision. No recurrences have been noted after a follow up of 2 years.
B‐Scanning assessment of the anti‐inflammatory activity of methylprednisolone aceponate on experimentally induced allergic reactions
Authors: Seidenari Stefania , Di Nardo Anna , Giannetti Alberto
Published: August 2010

Background The inhibitory activity of methylprednisolone aceponate (MPA) on experimentally induced allergic reactions was assessed by an echographic method employing a B‐scanner and a dedicated software, and compared to the effects of corticosteroids of known potency.

Material and methods Experimental lesions, which were induced by patch testing 12 sensitized subjects with 5% nickel sulfate (pet.), were treated with two medications of different steroids (clobetasol propionate, fluocinolone acetonide, clobetasone butyrate, and methylprednisolone aceponate), performed 16 and 40 h after the application of the nickel patch tests. Clinical and echographic evaluations were carried out at the beginning of the experiment, and 64 hours after the induction of the reactions, Values of skin thickness and of extension of hypo‐reflecting dermal areas were determined by image processing on echographic recordings.

Results Rank order of the potency of the tested corticostcroids, as evaluated by echography, was the same as the one obtained by visual scoring. MPA proved to be less effective than clobetasol propionate, more effective than clobetasone butyrate. and equally as effective as fluocinolone acetonide.

Conclusion This experiment indicated MPA can be considered a potent steroid.
Cutaneous distribution of orally administered itraconazole in guinea pigs, studied by autoradiography
Authors: Stoppie Paul , Borghgraef Peter , Borgers Marcel
Published: August 2010

Background Itraconazole is an orally active antifungal lipophilic drug with high affinity for sebum and keratinocytes.

Aim The aim of the study was to investigate the routes of percutaneous egression and the sites of cutaneous action/storage of 3H‐labelled itraconazole in an experimental animal model.

Material and methods Hartley guinea pigs were dosed orally by gavage for 2 consecutive days at 10 mg/kg/day 3H‐itraconazole dissolved in polyethylene glycol 200. At various time points after the second gavage, small full‐thickness samples of dorsal skin were excised and processed using dry‐apposing autoradiography.

Results Our research revealed an accumulation of silver grains over the epidermis and its appendages (hair follicle and sebaceous gland), the dermal fat tissue and the hypodermal muscle tissue on tissue sections at 6, 24 and 48 h time intervals, whereas at the remaining time points (96, 168 and 336 h) the silver grain density was markedly decreased to background level.

Discussion The present histological distribution data support the current method of oral treatment with itraconazole as the treatment schedule of choice to eradicate infective organisms residing in the deeper skin layers.
Langerhans‐cell histiocytosis confined to the skin of an elderly patient
Authors: Pauluzzi Paolo , Trevisan Giusto , Sartori Paola
Published: August 2010

Langerhans‐cell histiocytosis is a proliferative disorder of histiocytic cells that usually affects children during the first years of life. An unusual case of skin limited Langerhans‐cell histiocytosis in a 81‐year‐old man is presented. Mono‐organic involvement seems to be a sign of good prognosis, as is old age in such cases.
Examination of the dermal lymphatics in psoriasis⋆
Authors: Pençe Buket , Atakan Nilgön , Akkaya Sevinç , Gököz Aytac
Published: August 2010

In recent years, research on the aetiology of psoriasis has focused on immune aetiopathogenesis. However, in the last few years, research on the immunoloogical changes in psoriasis has failed to mention the lymphatics. Also, studies emphasizing the importance of the dermal lymphatics have neglected the lymphatic changes seen in psoriasis. Therefore, we decided to put this matter back on the agenda. Skin biopsies from 20 patients with psoriasis vulgaris were examined lymphatically by light microscopy using the orcein stain. We found a considerable increase in both number and dilatation in the lymphatics of psoriatic plaques, compared with both the clinically uninvolved skin of the psoriatic patients and also the skin of the control group.
Immediate hypersensitivity parameters in bullous pemphigoid
Authors: Katsantonis J.C. , Vlachonicolis I.G. , Papavasiliou E. , Tosca A.D.
Published: August 2010

Elevated serum IgE levels gave rise to the hypothesis that type 1 immune reaction is implicated in the pathology of Bullous Pemphigoid. IgE serum levels were estimated in 91 patients with Bullous Pemphigoid (BP) and in 26 healthy individuals. In 30 of the patients, the dermal mast cell infiltrate and peripheral blood eosinophils (%) were studied. Patients were subdivided in four groups according in diagnostic criteria or treatment. It was found that all patients, including those receiving treatment, had considerably elevated serum IgE compared to controls. Patients fulfilling all criteria had markedly increased IgE compared to those with negative indirect immunofluorescence. A significant correlation was found between serum IgE and dermal mast cell infiltrate but not between serum IgE and peripheral blood eosinophils, or between peripheral eosinophilia and dermal mast cells. Immediate hypersensitivity parameters, systemic or local, are apparently involved in BP lesion formation although to date it remains unknown at which particular step such parameters might be crucial. The possible biological significance of IgE overproduction and its interrelationship with local inflammatory cellular events is discussed.
Demonstration of fusobacteria in eruptions of perioral dermatitis using the tape stripping toluidine blue (TSTB) method
Authors: Berardi Paride , Benvenuti Silvano , Genga Antonio , Cecchini Fabio
Published: August 2010

Background and design To dale the pathogenesis of perioral dermatitis has not been completely‐understood. The role of fusobacteria was postulated by some investigators during the 1970s and subsequently disputed by others, who failed to confirm the presence of these bacteria. In a 6‐year period we investigated 341 patients with various facial eruptions, using the tape stripping toluidine blue (TSTB) method. According 1.0 the first clinical diagnosis 70 patients presented perioral dermatitis and 271 other facial conditions, including seborrheic dermatitis, rosacea, acne, contact dermatitis and bacterial infections.

Results Fusobacteria were found in 57 (81%) of the 70 patients with perioral dermatitis, and in 14 (5%) of the 271 with other conditions. When only the clinically typical, unquestionable cases were considered, the percentages were 95% and 0%, respectively.

Conclusions Our data support the view that fusobacteria are possibly involved in the pathogenesis of perioral dermatitis.
Can segmental neurofibromatosis be considered a rare disease?
Authors: Calzavara‐Pinton Pier G. , Carlino Anna , Gavazzoni Remo , Zane. Cristina , Panfilis Giuseppe De
Published: August 2010

‘True’ segmental neurofibromatosis (SNF) is characterized by the unilateral, segmental appearance of neurofibromas and/or ‘cafe au lait’ spots in the absence of genetic transmission. SNF is apparently rare: only 41 cases have been described since the first report by Crowe in 1956. However, the incidence of SNF is probably higher because more and more patients have been described in the last few years and several cases have been observed by single trained authors in a short time. In 1988 and 1989 we had described two patients affected by ‘true’ SNF. Now we report three additional patients observed in the last two years. ‘True’ SNF is considered to be a consequence of a post‐zygotic (hence non‐transmissible) mutational event but this hypothesis is not suitable for cases with segmental lesions matching deep systemic involvement, bilateral distribution of cutaneous lesions or genetic transmission. Additional reports, with careful investigations of both systemic involvement in SNF patients and apparently unaffected relatives and with long follow‐ups, will help clarify the genetics and the pathogenests of the disease.
Italian multicenter study⋆ on Epiquick®, Rapid Patch Test® and TRUE TestTM
Authors: Ayala F. , Balato N. , Lembo G. , Patruno C. , Angelini G. , Valsecchi R. , Tosti A. , Rivara G. , Pigatto P. , Seidenari S. , Lisi P. , Rafanelli A. , Saccabusi S. , Schena D. , Kokelj F.
Published: August 2010

Using 3 different ready‐to‐apply patch test systems (Epiquick®= EPI; Rapid Patch Test®= RPT; TRUE TestTM= TT), 316 patients sensitive to at least one allergen were studied in order to investigate the reproducibility of these tests in comparison with the Finn Chamber ®(FC) technique. Each patient was tested with a different ready‐to‐use system. Each test was compared to the same allergen applied with FC to either side of the upper back. Comparisons were made using EPI, RPT, and TT in 93 (183 tests), 119 (262 tests), and 104 (242 tests) patients respectively. When a positive test result occurred on only one side of the back, the concordance was defined as negative. Similarly, doubtful reactions on either side corresponding to positive or negative results were considered as non concordant. The concordance of positive reactions was 80.9% between the EPI and the FC technique, 77.5% between the RPT and the FC technique, and 72.3% between the TT and the FC technique. The frequency of questionable (+?) and irritant reactions (IR) was about the same for the different tests. Nevertheless, when comparing the positive reactions vs +?, IR, or negative reactions in paired tests, positive results were more frequently obtained with the FC technique. Our data suggest that the standard method with FC allows a better detection of contact allergy than the new ready‐to‐use systems tested in this study.
Cyclosporin A in chronic actinic dermatitis
Authors: Parodi A. , Gallo R. , Guarrera M. , Rebora A.
Published: August 2010

Two patients with chronic actinic dermatitis received considerable benefit from the administration of cyclosporin A. The drug was initially given at 5 mg/kg/day and then reduced to about 4 mg/kg/day. No side effects have been registered so far. The scanty literature is reviewed. Cyclosporin A may be a useful adjunct to the armamentarium in this difficult‐to‐manage disorder.
Acrokeratosis paraneoplastica (Bazex syndrome) and inappropriate antidiuretic hormone secretion associated with epidermoid and anaplastic bronchial cancer
Authors: Bazex J. , ElSayed F. , Cadilhac H. , Gorguet B. , Soulier M. , Durand D.
Published: August 2010

A 54‐year‐old patient received medical consultation for an acrokeratosis paraneoplastica in association with antidiuretic syndrome that revealed a small cell epidermoid and anaplastic bronchial cancer. Treatment of the neoplasm by polychemotherapy with Adriblastine, Carboplastine and Vepeside rapidly cured the acrokeratosis. Similarly, the syndrome of inappropriate antidiuretic hormone secretion was also completely controlled by hydrous restriction and treatment with demeclocyeline. Our observation illustrates quite well the paraneoplastic aspect of acrokeratosis whose association with antidiuretic syndrome has been rarely reported.
Massive gastrointestinal strongyloidiasis following corticosteroid therapy presenting with erythroderma and generalised lymphadenopathy
Authors: Pec Juraj , Straka Stefan , Palencarova Mariana , Adamkov Marian , Michal Ladislav , Vestenieka Gabriela , Minarikova Eva
Published: August 2010

A case of Strongyloides stercoralis hyperinfection is described in a retired miner with erythroderma and diabetes mellitus, in a prelymphoma stage, treated with corticosteroids. On admission the patient was excreting massive quantities of rhabditiform and filariform larvae of Strongyloides stercoralis and also parasite ova were detected in his stool. The authors assume the Strongyloidex Stercoratis was a case of hyperinfection despite the negative results of histological examination of biopsies taken from lesions on perianal and gluteal regions. In the patient's biochemical profile the shift of immunologic parameters to levels of immunodeficiency, high values of total IgE without eosinophilia, and high values of proteins were indicative of acute inflammation. The patient's condition included extensive loss of body mass (14 kg) and repeated attacks of bacterial infection of the skin associated with fever. The patient did not report any symptoms indicating disturbances of the gastrointestinal tract cither before or during treatment. After antiparasitic treatment the stool became parasitologically negative, and it remained negative also in follow‐up examinations, and the general condition of the patient improved. However, 6 months later the skin biopsy revealed a malignant lymphoma, mycosis fungoides.
Steatocystoma multiplex and eruptive vellus hair cyst
Authors: Ríos‐Buceta L. , Caballero M. Jones , Montañés M. Aragüés , Fernández J. Fraga , Díez A. Gareía
Published: August 2010

Background of study Steatocystoma multiplex (SM) and eruptive vellus hair cyst (EVHC). are both entities with similar clinical features, hut with important histological differences. In the last few years, several authors have reported examples of both cysts with mixed historical features, and have proposed the idea that the two conditions are related.

Subjects We report here 3 cases, histological features of SM. EVHC, and the other presenting cysts with mixed histological findings.

Conclusions The different histological findings in the cases reported support the idea that SM and EVHC are extremes of a spectrum
Cryotherapy in cases with leishmaniasis cutis
Authors: Memişoǧlu Hamdi Rifal , Kotogyan Agop , Acar Mehmet Alpaslan , Özpoyraz Metin , Uzun Soner
Published: August 2010

Aim/Objective To prove the effectiveness of cryotherapy in the treatment of leishmaniasis cutis in a large group of patients.

Subjects Two hundred and sixty‐six lesions of 227 patients with leishmaniasis cutis.

Methods Cryotherapy with a double freeze‐thaw cycle by a CS‐76 apparatus and liquid nitrogen.

Results All lesions responded well with cosmetically acceptable scars. The recurrance rate was only 4%.

Conclusion Cryotherapy is an effective method of treatment of leishmaniasis cutis.
Long‐term systemic therapy with dimethylfumarate and monoethylfumarate (Fumaderm®) in psoriasis
Authors: Thio H.B. , van der Schroeff J.G. , Nugteren‐Huying W.M. , Vermeer B.J.
Published: August 2010

Objective The aim of this study was to assess the clinical efficacy of long‐term (> 6 months) oral fumarate maintenance treatment regimen and to determine its adverse effect profile.

Background We previously showed the efficacy of oral fumarate treatment in psoriasis. However, little is known about long‐term maintenance therapy with oral fumarates. Because of concern about renal toxicity and/or other potentially hazardous adverse effects, their role in the long‐term management of psoriasis is still controversial and limited.

Methods Clinical data and laboratory parameters of 83 psoriasis patients who were treated with oral fumarates during an uninterrupted period of 6 or more months, were collected and subsequently analysed.

Results In 31 of the 83 patients the oral fumarate therapy was discontinued preliminarily (<6 months) because of intolerable adverse effects (9 patients), lack of clinical efficacy (16 patients), insurance refunding problems (4 patients) and lost to follow‐up (2 patients), A major improvement of the psoriasis was present in 41 of the 83 patients. Long‐term oral fumarate maintenance therapy was accompanied by subjective adverse effects, mainly flushing (28 patients) and gastrointestinal upset (15 patients) and by a relative lymphocytopenia (35 patients).

Conclusion Oral fumarates are effective well tolerated drugs suitable for long‐term management of psoriasis. However, this systemic therapy still has to be considered experimental and should only be performed under strictly controlled conditions. The cause and the clinical relevance of the relative lymphocytopenia, which occurs in a high percentage of patients during long‐term oral fumarate maintenance treatment regimen are unknown and still have to be determined.
Drug‐induced pemphigus in a predisposed girl⋆
Authors: Ruocco Vincenzo , Satriano Rocco A. , Lombardi Maria Luisa
Published: August 2010

A 10‐year‐oId‐girl, with an atopic background and with certain pemphigus‐prone antigens in her HLA haplotype (DR4, w6; DQwl. w3), developed pemphigus foliaceus while on treatment with feprazone for an acute bout of pharyngitis. The diagnosis of pemphigus was confirmed by cyto‐histologic and immunofluorescence studies. The inducing role of feprazone was supported by a positive MFF test to the drug. The conventional steroid treatment cleared up all lesions in lour weeks. One year later, in absence of any therapy, the patient is well, but pemphigus antibodies are still present in her serum. Interestingly, a second‐degree aunt of the patient, genetically unrelated to her, suffered from pemphigus vulgaris triggered by feprazone.
Ultrasonic therapy for psoriasis
Authors: Clark Adele R. , Feldman Steven R. , Jorizzo Joseph L.
Published: August 2010

Ultrasound waves are routinely used in various fields of medicine. Ultrasonic cleaning involves the therapeutic application of ultrasound via an aqueous medium. Low frequency ultrasonic debridement and cleaning may be beneficial in the treatment of chronic plaque psoriasis. The mechanism of action is unclear, but may be related to the stable cavitational effects induced by ultrasonic energy.
Cholinergic urticaria simulating aquagenic urticaria: A case report with lesions only occurring after contact with hot water
Authors: Zouboulis Christos C. , Blume Ulrike , Gollnick Harald , Orfanos Constantin E.
Published: August 2010

A 20‐year‐otd female presented with a 3‐month history of urticaria induced by water. During evaluation she repeatedly developed disseminated, severely itching. 2 to 5 mm large, anemic wheals at the center of indistinctly marginated patches of erythema on the upper part of the body after hot showers, which disappeared within 30 min. This rush was maximally reproducible twice daily. Serum histamine increased from 100 ng/ml to 140 ng/ml 30 min after provocation of the eruption. No lesions occurred after vigorous exertion or cold showers. A cholinergic and not an aquagenic urticaria was diagnosed because (i) the eruption only occurred after hot showers and not after cold showers or exertion to sweating, and (ii) a refractory period was observed. Provocation tests for other types of urticaria were negative. Cetirizine, in an initial dosis of 10 mg/d. followed 1 h later by a hot shower as a hardening regimen, suppressed the urticarial eruption, however, recurrences occurred twice, immediately after discontinuation of the drug.
Prostate cancer metastatic to skin
Authors: Bellman Betty , Grossman Marc , Spitz Joel
Published: August 2010

Cutaneous metastases from adenocarcinoma of the prostate are uncommon despite prostate cancer being the second most common malignancy in the American male population. We report bright red “berry‐like” cutaneous metastases in a dermatomal distribution from adenocarcinoma of the prostate. The prostate origin of the adenocarcinoma was confirmed by immunohistochemical staining for prostate‐specific antigen.
A case of hemophagocytic syndrome associated with B‐cell lymphoma
Authors: Ando Iwao , Okitsu Hiroshi , Kukita Atsushi , Kishino Satoshi , Mizuguchi Kunio
Published: August 2010

A rare case of hemophagocytic syndrome (HPS) associated with B‐cell lymphoma is reported. A 38‐year old female with dyspnea and fever developed a subcutaneous nodule with purpuric erythema on her right thigh and consulted our department on September 2, 1991. The histologic picture of this nodule revealed a dense infiltration of atypical lymphocytes into the dermis and subcutaneous tissue. A surface marker study of these atypical cells were CD22, CD74, and HLA‐DR positive, indicating a B‐cell origin for these cells. Normal histiocytes phagocyting erythrocytes were mixed with the infiltrating cells. The patient also had pericardial effusion, liver dysfunction, hepatosplenomegaly, and bleeding tendencies. The diagnosis was HPS associated with B‐cell lymphoma. She died of DIC on November 8, 1991.
Bleomycin‐induced flagellate dermatitis in AIDS patients with Kaposi's sarcoma
Authors: Nandwania R. , Money‐Kyrle J. , Hawkins D.A. , Staughton R.C.D. , Phillips R.H.
Published: August 2010

Objective To describe and illustrate bleomycin‐induced cutaneous toxicity, which may present atypically in AIDS patients with Kaposi's sarcoma.

Design and subjects Case note review of all AIDS patients receiving systemic chemotherapy in the preceding year.

Setting Combined oncology and HIV out‐patient clinic at the Chelsea and Westminster Hospital in London.

Outcome measured Cutaneous toxicity associated with intravenous bleomycin therapy.

Results We report three cases of bleomycin‐induced flagellate dermatitis with atypical presentation of pruritic skin lesions after relatively low doses of bleomycin.

Conclusions Bleomycin usage is increasing as an effective agent in the treatment of AIDS‐related Kaposi's sarcoma. Awareness that cytotoxic drugs may produce a range of unusual cutaneous adverse effects in this patient population is important for doctors of all specialities who treat HIV‐infected patients. The pathomechanism of flagellate dermatitis is discussed.
Syphilis incidence in West Saxony (Germany) between 1983 and 1992
Authors: Haustein Uwe‐F.
Published: August 2010

Background Classical sexually transmitted diseases, such as syphilis and gonorrhoea, have shown a marked reduction in incidence over the past decade in industrialised countries. A contrary trend was observed for syphilis in West Saxony.

Methods Data compiled on the incidence of syphilis in West Saxony (1.4 Mill, population) from 1983 to 1992.

Results The total number of patients notified with syphilis was 1509. The incidence increased between 1984 and 1984 by a factor of 7.7. Seventy one percent were clinically active, whereas 29% were in the latent stages.

Conclusion Despite a relatively high level of the health care and strict reporting system, syphilis incidence increased. Reasons are discussed.
Increased prevalence of herpes viruses in high grade CIN and carcinoma of the cervix: the potential for synergistic effect⋆
Authors: Baldauf J‐J. , Dreyfus M. , Monlun E. , Ritter J. , Obert G.
Published: August 2010

Objective To assess the prevalence of human papillomavirus (HPV) type 16 and 18, herpes simplex virus (HSV) and human cytomegalovirus (HCMV) in cervical biopsies in order to evaluate their relationship in cervical intraepithelial neoplasia (CIN) and cancer.

Setting Colposcopy clinic; Service de Gynécologic‐Obstétrique I, Hôpital de Hautepierre. Hôpitaux Universities de Strasbourg and Laboratoire Commun ULP/Synthélabo et U74 INSERM. Institut de Virologie dc la Faculté de Medecine de Strasbourg, France.

Subjects Forty‐two women with low grade and high grade CIN, twenty women with cervical squamous cancer and twenty‐two women with normal cervix assessed by cytological, colposcopical and histological analysis.

Methods Viral DNA was detected by PCR technique in colposcopically directed biopsies.

Results The prevalence of HPV16 and/or HPV18 with HSV and/or HCMV was significantly higher in cancers (25%) or high grade CIN (29%) than in normal cervices (0%). On the contrary, when only HPV DNA was found, there was no significant difference between cancers (3O%). high grade CIN (29%) and normal cervices (9%).

Conclusions The results support the hypothesis of a role of herpes viruses (HSV and HCMV) as cofactors in cervical carcinogenesis.
A mild form of captopril‐induced pemphigus
Authors: Schettino A. , Giordano C. , Parisi A. , Calabrò G.
Published: August 2010

We describe a mild form of drug‐induced pemphigus in a woman with essential arterial hypertension treated with captopril. Complete recovery was observed three weeks after the therapy had been discontinued.
Concurrent oral and genital infection with HPV DNA types 6 and 11 in a heterosexual male
Authors: Ward Kathleen A. , McKernan Sinead A. , Durnien Natalina N. , Dinsmore Wallace W.
Published: August 2010

Objective Detection of HPV DNA in oral and genital lesions of a heterosexual male. 4 months after oral and vaginal intercourse with a woman with vulvar warts. Passible modes of acquisition of oral HPV infection in the male sexual partner are discussed.

Setting Genitourinary Medicine clinic.

Methods Polymerase chain reaction amplification of genomic DNA from oral and genital lesions. HPV DNA typing by dot blot hybridization.

Results HPV DNA types 6 and 11 were identified in a polypoid tongue lesion and in a penile wart from the male sexual partner.

Conclusions The acquisition of oral HPV infection in the male sexual partner may have resulted from genital‐oral HPV transfer, either by direct contact with vulvar warts or by digital self‐inoculation.
Treatment of 208 extensive basal cell carcinomas with Mohs micrographic surgery
Authors: Neumann H.A.M. , Krekels G.A.M. , Verhaegh M.E.J.M.
Published: August 2010

Aim With the rapidly increasing number of basal cell carcinomas in Europe, a close look at Mohs Micrographic Surgery (MMS) is timely.

Subject We report the results of MMS in the Netherlands, as treatment for extensive basal cell carcinomas.

Methods Patients (n= 198) with extensive basal cell carcinoma (n= 208) were treated with MMS. The mean follow up period was 6.4 years.

Results Four of 208 BCCs recurred.

Conclusions Considering a recurrence rate of only 2% for the treatment of extensive and mainly recurrent basal cell carcinomas, we suggest that MMS provides the best prospect for total tumour removal.
Anti‐HCV‐core specific IgM in porphyria cutanea tarda
Authors: Gandolfo Luciana D'Alessandro , Ameglio Franco , Biolcati Gianfranco , Pimpinelli Fulvia , Trento Elisabetta , Galante Marisa , Nardi Armando , Topi Giancarlo
Published: August 2010

Aim Analysis of the prevalence of scrum IgM antibodies directed against the HCV‐core antigen (HCV‐IgM) in patients with Porphyria cutanea tarda (PCT), taking into account the hepatic histological picture, liver biochemical markers and the PCI biochemical indices.

Background Hepatic damage, especially that due to HCV infection, has been previously reported as a PCT trigger. HCV‐IgM reactivity, a marker of chronic HCV hepatitis, suggested to be related to active virus replication could also be related to the PCT clinical course.

Methods Blood samples of 97 patients, previously analyzed for a panel of clinical, histological and laboratory variables, followed in our Centre for Porphyria. stored at ‐ 80°C, were available to be retrospectively assayed for anti‐HCV‐core IgM (HCV‐IgM. ELISA).

Results 61% HCV‐IgM positivity was found, with no apparent significant relationship with the respective histological hepatitis classification. PCT remission phase, and PCT familiarity, when evaluated on overall patients. The levels of HCV‐IgM presented u peculiar behaviour when correlated to the serum AST values. In fact, there was a significant positive correlation in those with HCV‐IgM < 4 and a not significant, inverse correlation in the remaining group. These two groups showed other differences: the HCV‐IgM levels were correlated to histology, PCT remission and to the markers of liver disease (such as AST and ALT) only in the first group.

Conclusion a relationship between IgM response, PCT activity and the underlying liver disease is suggested.
Specific IgE and skin tests to house dust and storage mites and eosinophil cationic protein in scabies
Authors: Haustein U.‐F. , Maus C. , Zschiesche A. , Münzberger Chr.
Published: August 2010

Background In addition to the infestation with scabies mites also allergic IgE mediated mechanisms play a role in the pathogenesis of scabies.

Aim The aim of this study was to answer the question whether specific IgE mediated reactions to house dust and storage mites can be found and whether eosinophils are involved in the pathogenesis of scabies.

Material 44 scabies patients (12 children. 32 adults) were classified according to the extent of skin involvement as mild, moderate and severe. Age‐ and sex‐matched healthy controls and patients with atopic dermatitis were studied for comparative purposes.

Methods Total and specific IgE to Dermatophagoides pteronyssinus, D. farinae, Acartis siro and Pityrosporon ovale were tested by CAP‐FEIA (Pharmacia. Sweden) before and 6 weeks after treatment and prick tests were performed with the same allergens. The number of eosinophils in the peripheral blood and tissue specimens was counted and the eosinophil cationic protein (ECP) was determined by CAP‐FEIA in serum before and 6 weeks after therapy.

Results The total IgE was increased in 86% of patients. It was correlated with the extent of skin involvement (p < 0.05) and was significantly less increased 6 weeks after treatment (p < 0.115). Specific IgE to house dust and storage mites was increased up to 48% in the CAP‐EEIA and up to 61% in the prick test, all together significantly higher than in controls and in comparable frequencies with atopic dermatitis. Pityrosporon ovate IgE was within normal ranges. Die ECP levels were increased in 89% of patients and correlated only in mild versus moderate or severe extent of the disease. 6 weeks after treatment, however, they were significantly less increased (p < 1.01). In addition. ECP levels were correlated with the IgE levels in scabies (C = 0.88). The number of eosinophils in the peripheral blood was increased in 64% of cases and in tissue specimens in 84% of cases studied. In principle, the extent of skin lesions was milder and the frequencies of specific IgE in the CAP‐ and prick test as well as the levels of total IgE (p < 0.01) and ECP (only in the tendency) were lower in children than in adults.

Discussion The frequencies in the total and specific IgE to house dust and storage mites are comparable with those in atopic dermatitis. The question remains open, whether this is due to cross reactivity with scabies mites or whether this suggests an enhanced susceptibility to generalized scabies eruption. The increase in the ECP and its correlation to IgE, its decline after treatment (p < 0.05) and the occurrence of eosinophils in the peripheral blood and in inflammatory infiltrates of the skin suggest the involvement of eosinophils in the pathogenesis of scabies as an ectoparasitic IgE mediated disease.
A symmetrical pustular auricular eruption due to recurrent HSV infection
Authors: Papadavid E. , Munn S. , Chu A.C.
Published: August 2010

We report a patient with a symmetrical presentation of HSV infection on both pinna, recurrent since his childhood. Our patient used to play rugby as a student and we feel that the symmetrical and unusual distribution for his viral infection may be related to direct inoculation due to trauma sustained in contact sports and subsequent autoinoculation. To our knowledge, no similar symmetrical presentation of HSV infection has been reported in the literature.
Hypereosinophilic syndrome as prodrome of bullous pemphigoid:report of a case
Authors: Palleschi G. M. , Caproni M. , Falcos D. , Giacomelli A. , Fabbri P.
Published: August 2010

Persistent hypereosinophilia, cardiac involvement and a recurrent erythematous‐papular pruritic eruption histologically characterized by eosinophilic spongiosis are described in a 77‐year‐old man. This condition, suggestive of “idiopathic” hypereosinophilic syndrome, represented the prodromic phase of atypical bullous pemphigoid, which manifested 7 months later.
Cutaneous manifestations in an autistic population
Authors: Srebrnik Avigdor , Brenner Sarah , Holan Agatha , Stein Daniel , Elizur Avner
Published: August 2010

Background The observation of combinations of cutaneous signs that appear to be specific to autistic patients indicates a possible genetic association between autism and certain cutaneous manifestations.

Objective To examine the possibility of a genetic association between autism and cutaneous manifestations in an autistic population compared to a control group of psychiatric patients.

Subjects and methods Seventy‐four autistic and 67 psychiatric hospitalized patients underwent routine skin examination by it physician who was unaware of the patient individual diagnosis, medical history and family background. Data on concomitant diseases, family medical history, drug therapy and dermatologic findings were compared in the two populations.

Results The autistic population had a significantly higher frequency of seborrhea, atypical nevi, pigmentation, baldness and seizures, which may have a genetic background.

Conclusions The findings point to the possible genetic nature of autism, a speculation that requires further study.
PURPLE (atrophie blanche): clinical, histological and immunological study of twelve patients
Authors: Papi Massimo , Didona Biagio , De Pità Ornella , Silvestri Lorena , Ferranti Giulio , Gantcheva Mary , Chinni Luca Massimo
Published: August 2010

Objectives To investigate clinical, serologic, histopathologic and immunopathologic markers of PURPLE (painful purpuric ulcers with reticular pattern of lower extremities) or atrophie blanche.

Design Twelve consecutive patients affected with idiopathic PURPLE were studied in the period 1992–1996. Patients with systemic diseases correlated to PURPLE were excluded from the study.

Subjects All twelve patients were hospitalized at the Istituto Dermopatico Immacolata in Rome.

Results Various and dishomogeneous immunological alterations were detected. Circulating immune complexes, increased serum levels of anticardiolipin and antinuclear antibodies, reduced serum complement levels, and deposition of immunoreactants in dermal vessels, were found in a limited number of patients. The results were not statistically significant. All the patients showed very similar histopathological aspects, characterized by microvascular thromboses, endothelial swelling and segmental hyalinization of small dermal vessels.

Conclusion PURPLE is a thrombogenic vasculopathy in which unspecified immunological and laboratory changes are present. The recently suggested pathogenetic role of anticardiolipin and protein C deficiency in the disorder is not confirmed by this study.
Non‐bullous, erythema annulare‐like pemphigus
Authors: Mastrolonardo Mario , Conte Adele , Rantuccio Franco
Published: August 2010

A 25‐year‐old woman presented with a 1‐month duration, mildly pruritic, erythema annulare‐like rash involving the trunk and proximal aspects of the limbs, in the absence of any clinically obvious blister formation. Only discrete scaling and very sparse vesiculation were detected mainly at the periphery of the lesions. Biopsy specimens for histopathologic examination and direct immunofluorescence study showed typical pemphigus findings. Circulating anti‐epidermal cell surface antibodies were also detected with indirect immunofluorescence tests. The erythema annulare‐like pattern of presentation of pemphigus is exceedingly rare; nevertheless, this possibility should be considered in the differential diagnosis of persistent, annular and figurate erythematous eruptions.
Drug‐induced pemphigus. Does a relationship exist between inducing drug and lesion topography?
Authors: Brenner Sarah , Bialy‐Golan Anat , Ophir Joseph , Ruocco Vincenzo
Published: August 2010

Pemphigus subclasses differ both in target epidermal antigen of the autoantibodies and in predilection sites of lesions. The patterns of lesions are well documented and often lead to diagnosis of the subtype of the disease: but the causative factors have never been studied. We present a case of pemphigus exacerbated by two unrelated drugs, with distinct exacerbation‐specific patterns following each drug consumption. The patient is regarded as exemplifying a fixed drug eruption‐like phenomenon, with specificity of drug to anatomic distribution of lesions.
Erythrodermic bullous pemphigoid
Authors: Grunwald Marcelo H. , Amichai Boaz , Giryes Hani , Halevy Sima
Published: August 2010

We report a case of erythrodermic type of bullous pemphigoid which is a rare variant of bullous pemphigoid. Our patient had a peculiar clinical presentation with bullae, erosions and extensive erythrodermic areas, and distinct direct immunofluorescent findings which included linear IgG and C3 deposits in the basement membrane and also IgG in the intercellular spaces. Very high levels of serum IgE were also detected in our patient.
The transferential chimera II: some theoretical considerations
Authors: Martin‐Vallas François
Published: August 2010

Abstract:  The author develops here a theoretical model to account for the different levels of organization and functioning of the transference chimera of which he gave a clinical presentation in an earlier article. From his reading of Jung's ‘Psychology of the transference’ he derives a dynamic model of the chimera and links it to quantum mechanics and chaos theory not so much to describe the reality of the phenomenon, but to offer a model of representation as a conceptual and meditative tool for analysts to use in their practice. The main hypothesis of this work is that the chimera arises from the intimate interplay of the respective de‐integrates of the analyst and of the patient, thus constituting a genuine self in the transference. The author concludes with some implications for the analyst's own internal position.
ANZSJA's Songlines and Haerenga model of training
Authors: Caulfield Margaret , Norton Joy
Published: August 2010

Abstract:  Part One and Part Two of this article present the Australian and New Zealand Society of Jungian Analysts' 2006 model of training. The authors describe the process and thinking behind ANZSJA's recent revision of training.

The influences on the development of analytical psychology and analytic training in ANZSJA are traced in the first paper. The training review undertaken indicated the desire for ANZSJA to continue to train Jungian analysts by exploring new ways of conceptualizing training. The images, metaphors and thinking, which underlie this innovative training model, are explored. The challenge involved in providing and developing training across a large geographic region with widely distributed and slender resources was embraced. ANZSJA have acknowledged the traditional practices of Australian and New Zealand indigenous peoples. The motif of journey and movement is at the core of the ANZJSA model. The ANZJSA training is not held or contained in a building or buildings but rather held at ‘meeting sites’ across the landscape of these two countries.

Accountability and transparency are central to this training model. In Part Two of the article the structure and documentation developed for this model are contextualized, outlined and linked to the ethos underpinning the current thrust of analytical training in Australia and New Zealand. The focus is the practical mechanisms and processes, which we have evolved to deliver our new training model. The process of engaging analysts in the new model is discussed.
Teaching ‘origins of depth psychology’: overview and candidate‐members' experience
Authors: Hinton Ladson
Published: August 2010

Abstract:  In 2002 the North Pacific Institute inaugurated a new seminar series on the ‘origins of depth psychology’ for incoming candidate‐members.1 This approach emphasized the historical and cultural embeddedness of analytic theory, practice and institutions. The seminar was experienced as enlightening and freeing, as well as sometimes painfully disillusioning. The overall feedback indicated that it fostered an opening of creative space for their education as analysts. This paper2 describes the structure, and some of the rationale and process of the seminar. It includes firsthand expressions of the candidate‐members' experiences.
Supervision and imagination
Authors: Bravesmith Anna
Published: August 2010

Abstract:  This paper explores the role of imagination for the supervisor and examines the differences between the supervisor's use of creative and defensive imagination. It is suggested that reverie and imagining play a central role in supervision but that these need to be harnessed in the service of the reality principle. It is argued that the Jungian emphasis on the ego‐self relationship provides a context for this process. A clinical example of work with a supervisee is described in which hidden aspects of a strong erotic transference/countertransference were revealed in the supervisor's imagining and became available for reflection.
Report from borderland: an addendum to ‘What works?’
Authors: ‘K’
Published: August 2010

Abstract:  Based on personal experience the following paper briefly argues that forming a supportive relationship prior to analysis is important for certain ‘borderline’ patients. Should such a relationship not be established analysis may prove destructive, despite the best of intentions. Direct expression of feeling is important here but, it is suggested, has been undervalued in the history of analysis because of fear of spontaneity. This also affects current day writing about analysis.
Leverage, Debt Maturity and Firm Investment: An Empirical Analysis
Authors: Dang Viet A.
Published: August 2010

Abstract:  In this paper, we examine the potential interactions of corporate financing and investment decisions in the presence of incentive problems. We develop a system‐based approach to investigate the effects of growth opportunities on leverage and debt maturity as well as the effects of these financing decisions on firm investment. Using a panel of UK firms between 1996 and 2003, we find that high‐growth firms control underinvestment incentives by reducing leverage but not by shortening debt maturity. There is a positive relation between leverage and debt maturity as predicted by the liquidity risk hypothesis. Leverage has a negative effect on firm investment levels, which is consistent with the overinvestment hypothesis regarding the disciplining role of leverage for firms with limited growth opportunities.
When Do Accounting Earnings Matter More than Economic Earnings? Evidence from Hedge Accounting Restatements
Authors: Hughen Linda
Published: August 2010

Abstract:  This study examines behavior following a change in accounting treatment for derivative hedges due to the misapplication of hedge accounting. I examine firms faced with the following choice; one, maintain stability in economic earnings but increase the volatility of accounting earnings or two, maintain stability in accounting earnings but increase the volatility in economic earnings. I find that firms’ historic abilities to meet earnings targets are positively associated with the likelihood that firms will focus on accounting earnings rather than economic earnings. Results provide evidence of a change in management behavior following a change in accounting method.
A valuable non‐invasive diagnostic investigation for paediatric idiopathic brachial neuritis
Authors: VASSALLO GRACE , MARTLAND TIM , FORBES WELLESLEY , MCCULLAGH GARY
Published: August 2010

Idiopathic brachial neuritis (idiopathic neuralgic amyotrophy) in children is a well‐recognized but rare condition. Although the precise aetiology is unknown, its usual occurrence after an infection suggests an immunological process. There is no specific test for brachial neuritis, and the diagnosis is one of exclusion with supportive evidence from nerve conduction studies, electromyography (EMG), and, in adults, changes in affected muscles on magnetic resonance imaging. Young children are often unable to tolerate EMG.
Developing and implementing quality inclusive education in Hong Kong: implications for teacher education
Authors: Forlin Chris
Published: August 2010

The government in Hong Kong has mandated that all schools should start to accept children with special educational needs by employing a whole school approach. This is not a simple move for teachers as inclusive education is complex, involving a range of issues including developing appropriate government and school policy; providing relevant support; enabling academic and social inclusion; changes to curriculum, pedagogy and assessment; preparing new teachers and improving existing teachers' skills in adapting instruction; modifying curriculum and classroom management; and developing functional multi‐agency collaboration to support all students. This paper provides an historical perspective to the development of special education and the transition towards inclusion in Hong Kong, and explores how this move has been both supported and hindered by education reform. A number of issues that have emerged as challenging for the movement towards inclusion and the type of teacher education that is necessary to support this transition are discussed.