bluuebunny/crossref_metadata_2025 huggingface dataset:
Age-Associated Increase in Abdominal Obesity and Insulin Resistance, and Usefulness of AHA/NHLBI Definition of Metabolic Syndrome for Predicting Cardiovascular Disease in Japanese Elderly with Type 2 Diabetes Mellitus
Authors: Sakurai Takashi , Iimuro Satoshi , Araki Atsushi , Umegaki Hiroyuki , Ohashi Yasuo , Yokono Koichi , Ito Hideki
Published: October 2009

Background: Management of metabolic syndrome (MetS) seems to constitute an efficient strategy to attain successful ageing. Although the clinical entity of MetS in patients with diabetes mellitus has been discussed, there is very little information on MetS-type cardiometabolic risk factor clustering in diabetic elderly. Objective: To determine the relationship among age-associated changes in obesity, insulin resistance, and clustering of MetS-type risk factors, in association with vascular complications, in Japanese elderly with type 2 diabetes. Methods: A cross-sectional study was conducted of 812 diabetic elderly enrolled in the Japanese Elderly Diabetes Intervention Trial. Information on diabetes, blood examinations and complications was obtained. Abdominal obesity, insulin resistance and prevalence of MetS risk factor clustering, defined by three sets of criteria from the International Diabetes Federation (IDF), the Japanese Society of Internal Medicine (JSIM), and the American Heart Association and the National Heart, Lung, and Blood Institute (AHA/NHLBI), were analyzed. Results: Waist circumference and insulin resistance estimated by homeostasis model assessment insulin resistance (HOMA-IR) increased with age, followed by a partial decrease at age 80 and over. Prevalence of IDF-MetS and JSIM-MetS also increased with age at least until the age of 80, whereas the incidence of AHA/NHLBI-MetS did not show any apparent age changes. There was a significant crude linear association between waist circumference and HOMA-IR, which was highly elevated in IDF and AHA/NHLBI overlapping with MetS, and also elevated in AHA/NHLBI without abdominal obesity. Although IDF-MetS and JSIM-MetS, which specify abdominal obesity, did not always appear to be associated with cardiovascular diseases, AHA/NHLBI-MetS, comprising both abdominal obesity and non-abdominal obesity, independently correlated with coronary heart disease and stroke after adjustment for other risk factors of atherosclerotic diseases. Conclusion: There was an age-associated increase in the prevalence of abdominal obesity and insulin resistance in elderly diabetic Japanese subjects, with a clear relationship between waist circumference and insulin resistance. However, insulin resistance was elevated not only in cases with but also in those without abdominal obesity if accompanied by clustering of metabolic disorders. The AHA/NHLBI definition of MetS proved to be the most useful to predict cardiovascular disease in the diabetic elderly.
Nail Changes as the First Sign of Systemic Amyloidosis
Authors: Fanti P.A. , Tosti A. , Morelli R. , Galbiati G.
Published: October 2009

A 68-year-old man had had for 3 years a severe onychodystrophy involving all fingers and toes which clinically mimicked nail lichen planus. The nail biopsy showed amyloid deposits in the superficial dermis of the nail matrix. Physical, pathological and laboratory examinations confirmed the diagnosis of primary systemic amyloidosis. At the time of the diagnosis the patient did not present any other cutaneous sign of systemic amyloidosis.
Rapid Development of Multiple Squamous-Cell Carcinomas during Chronic Granulocytic Leukemia
Authors: Disdier P. , Harle J.R. , Grob J.J. , Weiller-Merli C. , Magalon G. , Weiller P.J.
Published: October 2009

We report a 65-year-old patient who presented a rapid eruption of keratoses on sun-exposed areas and an explosive transformation into several squamous-cell carcinomas, occurring during the accelerated phase of a chronic granulocytic leukemia. Clinical findings resembled those usually descibed in xeroderma pigmentosum. The role of immunosuppression, chemotherapy and possible genetic predisposition is discussed.
L-Tryptophan-Induced Eosinophilia-Myalgia Syndrome
Authors: Mainetti C. , Schmied E. , Masouyé I. , Chavaz P. , Saurat J.-H.
Published: October 2009

Two female patients who fulfilled the criteria for L-tryptophan-induced eosinophilia-myalgia syndrome (EMS) had, together with morphea-like and fasciitis-like sclerotic changes of the skin, lesions that clinically mimicked pseudoxanthoma elasticum (PXE). Histology was compatible with the diagnosis; electron microscopy did not reveal calcium deposits. PXE-like changes may represent an additional feature of the pleomorphic L-tryptophan-induced EMS.
Senile Erythroderma with Serum Hyper-IgE
Authors: Frenk E. , Gueissaz F. , Vion B.
Published: October 2009

A case of senile erythroderma with serum hyper-IgE is presented. It is comparable to 8 cases previously described by Japanese authors.
Nodular Cutaneous Mucinosis – An Unusual Multiple Type of Euthyreotic Focal Mucinosis
Authors: Schneider B.V. , Hohl D. , Schnyder U.W.
Published: October 2009

A 32-year-old Turkish man with a progressive appearance of indolent, skin-colored nodules on the trunk and proximal extremities is presented. Clinical and laboratory examinations did not reveal any other relevant abnormalities. Histological specimens showed focal, ill-defined depositions of acid mucopolysaccharides mainly in the reticular dermis. Collagen fibers were split up and separated. Ultrastructurally, activated fibroblasts and an increased synthesis of collagen fibrils and elastic microfibrils as well as numerous macrophages were noticed. Diagnostically, an unusual multiple type of cutaneous focal mucinosis is most likely.
Stratum corneum Lipid Function
Authors: Schürer N.Y. , Plewig G. , Elias P.M.
Published: October 2009

The stratum corneum contains a complex mixture of polar and nonpolar lipids in its intercellular spaces. These lipids, present in form of multiple lamellae, have been investigated for their role in providing the epidermal barrier to transcutaneous water loss, the selective barrier from the inside to the outside of the organism and partly the process of physiological desquamation. The composition of these lipids varies from species to species, with the body region and the degree of keratinocyte differentiation. The most undifferentiated layers of the epidermis contain typical membrane lipids, phospholipids, while more differentiated layers contain ceramides, cholesterol and free fatty acids. Essential fatty acids are essential for the maintenance of the lamellar structures and epidermal barrier function. Epidermal linoleic and arachidonic acids derive from exogenous sources. Only recently attempts have been made to elucidate the timing and regulation of epidermal fatty acid metabolism. Keratinocytes do not express a low molecular weight fatty acid binding protein like other cells active in lipid metabolism, but may employ alternative ways in fatty acid uptake and metabolism.
The Skin: An Immunoreactive Target Organ during Interleukin-2 Administration
Authors: Dummer R. , Miller K. , Eilles C. , Burg G.
Published: October 2009

Six patients with metastatic malignant melanoma were treated systemically with dacarbazine and interleu-kin-2 (IL-2). During IL-2 administration all patients developed a macular erythematousrash followed by scaling which began 24–48 h after IL-2 infusion. The dermatological changes were associated with elevated interferon-γ and tumor necrosis factor α serum levels (immunoradiometric assay). Histology revealed nonspecific spongiotic foci in the epidermis and a perivascular mononuclear infiltrate in the dermis. Immunohistochemistry characterized this infiltrate mainly as activated T helper lymphocytes and revealed the expression of intercellular adhesion molecule 1 by endothelial cells and keratinocytes that might have been induced by interferon-γ. The skin reactions associated with systemic IL-2 administration show that the skin actually participates as a target organ. They should be differentiated from drug eruptions.
Malignant Melanoma in Southern Germany: Different Predictive Value of Risk Factors for Melanoma Subtypes
Authors: Weiss J. , Bertz J. , Jung E.G.
Published: October 2009

The presented case-control study with 204 melanoma patients and 200 control persons assesses the significance of melanoma risk factors for an ethnically homogeneous population from a geographically small region. In a multivariate analysis of the data the total number of benign naevi proved to be the most predictive parameter with a relative risk (RR) of 14.9 (total number of naevi higher than 50). The constitutional factors red hair colour and skin type 1 were less predictive with an RR of 2.9 and 4.9, respectively. Occupational and recreational sun exposure were of ancillary importance (RR 1.8 and 2.1). The assessment of the risk for the subtypes of melanoma however showed a clear difference in the predictive value of the mentioned risk factors. The risk of developing superficial spreading melanoma is nearly exclusively defined by the number of benign naevi (RR 24.8), red hair colour was of subordinate importance (RR 4.2), whereas the risk of lentigo maligna melanoma is dependent on skin type 1 (RR 12.9) and sun exposure (RR3.4).
Comparison of the Kinetics of Sebum Secretion in Young Women with and without Acne
Authors: Piérard-Franchimont C. , Piérard G.E. , Saint-Léger D. , Lévêque J.L. , Kligman A.M.
Published: October 2009

We utilized a sebum-sensitive adhesive film, Sebutape®, to visualize the pore patterns of women with and without acne with computerized image analysis. In normal young women, we found a positive correlation between the number of active sebaceous follicles and total sebum excretion. When seborrhea was intense this correlation was however lost. The situation was more complex in acne. The severity of seborrhea was positively correlated with the mean sebum excretion of individual follicles but not with the number of active follicles.
Lack of Correlation between in vitro Immunological Alterations and the Development of Scleroderma-Like Skin Lesions in Toxic Oil Syndrome Patients
Authors: Gutiérrez C. , Aparicio M.J. , Sánchez M.J. , Cabrero E.
Published: October 2009

We examined whether immunological disturbances could influence the development of scleroderma-like skin lesions in patients affected by the Spanish toxic oil syndrome (TOS). To this end, peripheral blood mononuclear cells (PBMC) were collected from 13 chronic patients and 8 control subjects. All patients had suffered a toxic-induced severe neuromyopathy, and 6, in addition, had developed sclerodermoid skin manifestations. The phenotypic profile and the concentrations of interleukin-2 (IL-2) and of molecules with B cell differentiation factor IgG activity (BCDF-IgG) in supernatants of phytohemagglutinin-stimulated lymphocytes were analyzed both in patients and in normal controls. Molecules with BCDF-lgG activity were found increased in supernatants of mitogen-stimulated lymphocytes from TOS patients. Concentrations of IgG secreted by staphylococcus aureus-SAC-B blasts in the presence of TOS PBMC supernatant was 88 ± 32.62 ng/ml (mean ± 1 SD) versus 53 ± 5.34ng/ml in the presence of control supernatant (p < 0.01). Levels of BCDF-lgG activity in TOS PBMC supernatants positively correlated with IgG serum levels (r = 0.69, p < O.01). The phenotypic profile of lymphocyte populations and the production of IL-2 were not altered in TOS subjects. No statistically significant differences were observed in the lymphocyte distribution nor in the IL-2 and BCDF-lgG production when comparing patients with or without scleroderma-like skin lesions. The results indicate that there was a dysfunction of the immune response in TOS subjects, which, however, was not sufficient for the development of the sclerodermoid lesions.
Intravenous Single-Dose Ceftriaxone Treatment of Chancroid
Authors: Hartmann A.A. , Elsner P. , Burg G.
Published: October 2009

The antimicrobial susceptibility of Haemophilus ducreyi varies according to the geographic region. Increased resistance to trimethoprim and/or sulfamethoxazole led the Centers for Disease Control to recommend 250 mg ceftriaxone as a single intramuscular dose for chancroid. Intravenous or muscular routes of administration result in equivalent bioavailability. To avoid side effects such as syringe abscess and lidocaine intolerance, we prefer intravenous ceftriaxone therapy. The efficacy of this regimen is reported in 3 cases of chancroid. The intravenous administration of 1 g of ceftriaxone in chancroid seems to be as effective as administration by the intramuscular route, but it may lower the risk of syringe abscess, lidocaine intolerance and the emergence of resistant strains.
Recurrent Mucocutaneous Lymphocytic Infiltration Possibly Associated with Epstein-Barr Virus Infection
Authors: Okada N. , Tei H. , Yamamura T. , Sato K. , Negoro S. , Yoshikawa K.
Published: October 2009

A 32-year-old man had a history of recurrent but self-healing necrotizing nodules on the face and oral mucosa. Histologically the lesion was composed of necrotizing foci surrounded with dense CD8+ T lymphocytic infiltration in the dermis. Laboratory examination showed marked blood CD8+ T lymphocytosis with a reversed ratio of CD4+/CD8+ of 0.11. Except for a very high titer of antibodies against Epstein-Barr-virus-associated antigens, no signs of infection were observed.
Erythroderma as the Initial Presentation of the Acquired Immunodeficiency Syndrome
Authors: Janniger C.K. , Gascon P. , Schwartz R.A. , Hennessey N.P. , Lambert W.C.
Published: October 2009

A 32-year-old black homosexual man, seronegative for human immunodeficiency virus antibody, presented with erythroderma. His peripheral blood was significant for circulating Sézary-like cells bearing the CD8(+) phenotype. Eighty-eight percent of his lymphocytes were CD8(+) as well. He seroconverted 3 months after the initial presentation. We conclude that erythroderma was the presenting sign of the acquired immunodeficiency syndrome.
Multiple Hereditary Trichoepithelioma and Cylindroma (Brooke-Spiegler Syndrome)
Authors: Delfino M. , D’Anna F. , Ianniello S. , Donofrio V.
Published: October 2009

Three cases of trichoepithelioma associated with cylindroma (Brooke-Spiegler syndrome) in the same family are reported. Three generations were affected. The syndrome usually beginning at puberty is inherited as an irregular autosomal dominant trait.
Incontinentia pigmenti with Hyperkeratotic Lesions in Adulthood and Possible Squamous Cell Carcinoma
Authors: Korstanje M.J. , Bessems P.J.M.J.
Published: October 2009

A case of incontinentia pigmenti with extensive and progressive hyperkeratotic lesions at the age of 25 years is reported. The histology showed a keratoacanthoma-like picture and signs compatible with squamous cell carcinoma. To our knowledge this has not been previously reported.
Vitiligo and Cutaneous Melanoma
Authors: Schallreuter K.U. , Levenig C. , Berger J.
Published: October 2009

The examination of 623 melanoma patients in North Germany yielded the depigmentation disorder vitiligo in 23 cases (i.e. 3.7%). In 11 patients, the disease preceded their tumor, whereas in 11 patients, vitiligo developed after diagnosis of primary and/or metastatic melanoma into the regional lymph nodes. In 1 case the onset of melanoma in relation to the tumor remained undefined. The prevalence of vitiligo increased with tumor risk factors based on tumor thickness and anatomical site of tumor location (i.e. for low risk 1.75% intermediate risk 5.2% and high risk 5.8%). A comparison of the prevalence of vitiligo to the normal population of Northwestern Europe (i. e. 0.38–0.57%) showed a 7- to 10-fold increase for the patients with melanoma. A reverse analysis of the data yielded a 180-fold higher prevalence of melanoma in the group of patients with vitiligo. These results strongly support a more thorough examination of patients with vitiligo for primary melanoma.
Intermittent Corticosteroid Maintenance Treatment of Psoriasis: A Double-Blind Multicenter Trial of Augmented Betamethasone Dipropionate Ointment in a Pulse Dose Treatment Regimen
Authors: Katz H.I. , Prawer S.E. , Medansky R.S. , Krueger G.G. , Mooneye J.J. , Jones M.L. , Samson C.R.
Published: October 2009

Ninety psoriasis patients, who were either completely cleared of or manifested only a minimal presence of disease signs following 3–4 weeks of twice daily treatment with augmented betamethasone dipropionate (ABD) ointment 0.05%, were enrolled in this multicenter, double-blind, placebo-controlled study. The study was designed to determine if an intermittent pulse dose regimen of ABD ointment could safely and effectively maintain a remission disease status when treatment was applied in three consecutive applications 12 h apart, once a week for a maximum treatment period of 6 months. The disease of 60% of the patients in the active treatment group was successfully controlled for 6 months, while 80% of the placebo-treated patients experienced exacerbation of disease signs. No serious local or systemic treatment-related adverse experiences were reported. ABD ointment 0.05% when applied using the intermittent treatment regimen described here, was shown to be a clinically beneficial and well-tolerated method of long-term (up to 6 months) maintenance therapy for psoriasis patients.
Ammoniated Mercury Ointment as a Cause of Peripheral Neuropathy
Authors: Kern F. , Roberts N. , Ostlere L. , Langtry J. , Staughton R.C.D.
Published: October 2009

A 72-year-old Caucasian man with widespread psoriasis presented with a sensory-motor peripheral neuropathy following 40 years’ use of an ammoniated mercury ointment. No clinical involvement of his central nervous system was noted and no other possible causative factors for his peripheral nerve disease were found. D-Penicillamine treatment induced mercuriuresis and blood levels of mercury fell to normal. His peripheral neuropathy improved slowly after normalisation of the serum mercury. It is believed that his condition was caused by percutaneous absorption of mercury. Ammoniated mercury ointments should have no role in the current management of skin disorders.
Postlymphography Linear Dermatitis
Authors: Hasson A. , Zamora E. , Gutierrez M.C. , Arias D. , Martín L. , Barat A. , Requena L. , de Castro A.
Published: October 2009

Cutaneous effects secondary to lymphograpy are rare events. We herein report a patient with Hodgkin’s disease who developed a linear dermatitis in both lower limbs 6 days after a pedal lymphograpy. Histopathologic examination of the lesions demonstrated a subacute dermatitis. Patch tests with the substances used in the lymphography yielded negative results. We dicuss the possible pathogenic mechanisms of this striking linear dermatitis.
Plexiform Fibrohistiocytic Tumor
Authors: Giard F. , Bonneau R. , Raymond G.P.
Published: October 2009

Two groups of cells, one rounded or oval and the other spindle-shaped, were found in a case of plexiform fibrohistiocytic tumor. Immunohistochemistry was strongly positive for alpha smooth muscle actin in most cells of both types but stronger in the spindle-shaped cells, suggesting a myofibroblastic origin. This was in correlation with electron microscopic findings which revealed fibroblasts, myofibroblasts and some undifferentiated mesenchymal cells. However, factor XlIIa was negative suggesting that this tumor does not originate from dermal dendrocytes.
CO2 Laser Therapy for Steatocystoma multiplex
Authors: Krähenbühl A. , Eichmann A. , Pfaltz M.
Published: October 2009

The case of a 22-year-old Philippine woman with a nonhereditary, classical syndrome of steatocystoma multiplex with histological and ultrastructural findings is reported. The good results of CO2 laser therapy are shown and the literature is reviewed.
Cell Cycle Kinetics of Human Anagen Scalp Hair Bulbs in Thyroid Disorders Determined by DNA Flow Cytometry
Authors: Schell H. , Kiesewetter F. , Seidel C. , Hintzenstern J.v.
Published: October 2009

In both, 6 hyperthyroid and 6 hypothyroid patients as well as 10 healthy volunteers, cell cycle kinetics of dissected anagen scalp hair bulbs were determined by means of DNA flow cytometry (DNA-FCM). Compared with the healthy control group in patients with thyroid disorders striking differences of cell kinetic data were evaluated. In hyperthyroidism a significant increase (30%) and in hypothyroidism a significant decrease (15%) of S and G2 + M phase cell percentages was found. The proliferation index (S + G2 + M%) calculated revealed similar results. A correlation between the height of S phase percentages and plasma T3 levels was recognizable but could not be proved statistically. By means of DNA-FCM the study demonstrates for the first time the influence of thyroid hormones on in vivo cell cycle kinetics of human scalp hair bulbs.
Liver Iron Overload and Desferrioxamine Treatment of Porphyria cutanea tarda
Authors: Rocchi E. , Cassanelli M. , Borghi A. , Paolillo F. , Pradelli M. , Pellizzardi S. , Vezzosi A. , Gallo E. , Baccarani Contri M. , Ventura E.
Published: October 2009

The aim of this paper is to evaluate invasive and non-invasive indices of iron store and compare the effectiveness of different ferrodepletive protocols in 150 patients with porphyria cutanea tarda (PCT). Iron removal was performed either by intensive phlebotomy (22 cases) or slow subcutaneous and high intravenous doses of desferrioxamine (18 and 5 cases, respectively), and several laboratory parameters were studied; among these, oligo-elements and urinary porphyrins (detected by HPLC) were taken into account before and after the treatments. Serum iron, transferrin saturation, ferritin (RIA) and nuclear magnetic resonance results were compared with invasive findings in order to detect the metal deposition in liver tissue (atomic absorption concentration, optic or electron-microscopic detection). Liver iron overload was observed in 95% of cases. Full normalization of the disease took place by all the treatments, even if it required slightly more time in the phlebotomy group. We may conclude that ferrodepletive treatments are highly effective in PCT and, considering the fact that siderosis and liver damage always accompany the disease, these treatments are proposed as first choice in such cases.
Plasmapheresis in Solar Urticaria
Authors: Leenutaphong V. , Hölzle E. , Plewig G. , Kutkuhn B. , Grabensee B.
Published: October 2009

Three patients with solar urticaria were treated with plasmapheresis. By intradermal injection of in vitro irradiated serum the existence of a circulating photoallergen was demonstrated in cases 1 and 2 but not in case 3. Plasmapheresis induced complete remission of solar urticaria in case 1 and transient improvement in case 2. In case 3, however, no beneficial effect was observed. It is suggested that some patients with solar urticaria, probably those with a circulating photoallergen, may benefit from plasmapheresis.
In vivo Biophysical Characterization of Skin Physiological Differences in Races
Authors: Berardesca E. , de Rigal J. , Leveque J.L. , Maibach H.I.
Published: October 2009

The role of race in modulating skin responses has been investigated. Several parameters (skin thickness, transepidermal water loss, water content of the stratum corneum and skin biomechanics) have been measured using noninvasive tools in whites, Hispanics and blacks to assess whether the melanin content could induce changes in skin biophysical properties. Marked differences between races appear in stratum corneum water content and in skin extensibility, recovery and elastic modulus. Measurements done in different sun-exposed sites highlight the effects of solar irradiation on the skin and the role of melanin in preventing skin damage. The study shows that racial differences in skin physiology exist and are mainly related to the protective role of melanin present in races with darker skin. Moreover, differences in skin hydration are not fully explained according to the site and presence of hair.
Pseudohomozygous Type II Hyperlipoproteinemia
Authors: Fujita M. , Okamoto S. , Shirai K. , Saito Y. , Yoshida S.
Published: October 2009

Nodular xanthomas on both elbows and a streak-like xanthoma on the intergluteal area developed in a 4-year-old girl with type IIa hyperlipoproteinemia. She had no disease associated with secondary hypercholesterolemia and no family history of hypercholesterolemia. Her xanthomas regressed under fat restriction diet and cholestyramine therapy. She was diagnosed as having pseudohomozygous type II hyperlipoproteinemia. The low-density lipoprotein (LDL) receptor activities of her cultured fibroblasts in terms of binding, internalization and degradation rate of LDL were normal. These results are consistent with a new syndrome of pseudohomozygous type II hyperlipoproteinemia and suggest that the mechanism of hypercholesterolemia, which induced xanthoma, differs from familial hypercholesterolemia.
Injection of Allergen-Antibody Complexes Is an Effective Treatment of Atopic Dermatitis
Authors: Leroy B.P. , Lachapelle J.M. , Somville M.M. , Jacquemin M.G. , Saint-Remy J.M.R.
Published: October 2009

Atopic dermatitis (AD) can be exacerbated by contact with airborne allergens, amongst which Dermatophagoides pteronyssinus (Dpt) appears to be potentially important. Specific IgE antibodies towards Dpt are often found in AD and it can therefore be speculated that suppression of the production of anti-Dpt IgE might result in a significant clinical improvement. Complexes of antigen and specific antibodies have been shown to suppress the production of antibody in other systems; we report here the evaluation in an open trial of the capacity of such complexes to improve symptoms of AD. Ten adult patients were enrolled in this study. In addition to satisfying the criteria of AD, they all suffered from a severe disease (more than 20% of the body surface involved) that had been stable for at least the last 2 years. The patients had high titers of total IgE antibodies and specific anti-Dpt antibodies. Allergen-antibody complexes were prepared from Dpt allergens and an excess of autologous specific anti-Dpt antibodies obtained by immunoadsorption. The patients received regular injections of these complexes throughout 1 year, during which clinical parameters of disease intensity, percentage of body surface affected and intensity of pruritus were regularly monitored. A significant clinical improvement was obtained after 3–4 months of therapy and was maintained through the 9th month. After 1 year of treatment 2 patients were completely free of disease 4 had residual lesions which continued to improve and 4 patients had a partial recurrence of dermatitis. In addition to the demonstration that injection of antigen-antibody complexes results in a clinical benefit, these results suggest that the immune response towards Dpt is a relevant factor in AD.
A Case of Hepatitis Related to Etretinate Therapy and Hepatitis B Vaccine
Authors: Green C. , Lakshmipathi T.
Published: October 2009

The case of a 41-year-old male patient is described who developed acute reversible hepatitis related to etretinate therapy. During the course of etretinate he received 2 doses of hepatitis B vaccine; this and his HLA typing A1, A2, Bw57, Cw6 may have predisposed him to develop this reaction.
Eosinophilic Cellulitis: Histologic Features in a Cutaneous Mastocytoma
Authors: Hunt S.J. , Santa Cruz D.J.
Published: October 2009

A cutaneous mastocytoma with associated histologic features of eosinophilic cellulitis is reported. The tumor occurred as a small, asymptomatic lesion on the left thigh of a 4-year-old boy. Microscopically, an accumulation of mast cells, microgranulomas, eosinophils and ‘flame figures’ was present. A pathogenesis involving mast cell degranulation, eosinophil chemotactic factors and eosinophil major basic protein is discussed.
Borrelia burgdorferi and Different Types of Morphea
Authors: Aberer E. , Klade H. , Stanek G. , Gebhart W.
Published: October 2009

Thirty patients with different clinical manifestations of morphea (circumscribed scleroderma) were investigated for serum antibodies against Borrelia burgdorferi determined by ELISA and Western blot analysis. Forty-six percent of the patients were seropositive. Western blots confirmed the ELISA results in 10 of 25 patients (40%), showing a reactivity pattern which can be seen in the course of Lyme borreliosis. In some cases the outcome after antibiotic treatment suggests a direct correlation between the further development of skin lesions and Borrelia infection. Because of these findings we suggest some morphea types to be possibly due to a B. burgdorferi infection.
Porphyria cutanea tarda Associated with Human Immunodeficiency Virus Infection
Authors: Boisseau A.-M. , Couzigou P. , Forestier J.-F. , Legrain V. , Aubertin J. , Doutre M.-S. , Maleville J. , Geniaux M. , Beylot C.
Published: October 2009

We report the cases of 4 male subjects, 29, 32, 41 and 44 years old, presenting isolated seropositivities for the human immunodeficiency virus (HIV), or full-blown acquired immunodeficiency syndrome, associated with a typical porphyria cutanea tarda (PCT). The 4 patients are in the usual risk groups for HIV infection. Viral hepatitis was observed in 3 of the 4 cases. Over the past 3 years, 15 cases associating HIV infection and PCT have been reported; almost all had the usual risk factors for HIV infection and hepatopathy. We speculate that HIV infection may have favored the occurrence of early PCT in these cases by altering the metabolism of the porphyrins, either directly or by means of the associated hepatopathy.
Prevalence of Atopy in Vitiligo
Authors: Perfetti L. , Cespa M. , Nume A. , Orecchia G.
Published: October 2009

59 patients suffering from vitiligo were investigated anamnestically and clinically with intradermal (prick tests) and laboratory tests (RAST and total IgE count) for the presence of atopy. Clinical manifestations (allergic rhinitis, asthma) and intense positive prick tests and RAST with an increase in total IgE count were found in 13 patients (22%). This frequency was significantly higher than that found in the normal population in our area (11.9%; p = 0.0212). These patients had a significantly higher incidence of vitiligo in their families (76.9 vs. 29.7% of the non-atopic; p < 0.025), an earlier onset (14.1 vs. 24 years of the nonatopic) and a rapid worsening of the disease.
Loose Anagen Hair in a Child with Noonan’s Syndrome
Authors: Tosti A. , Misciali C. , Borrello P. , Fanti P.A. , Bardazzi F. , Patrizi A.
Published: October 2009

We report on a 4½-year-old girl affected by loose anagen hair and Noonan’s syndrome. The girl had short, blond, easily pluckable hair that had never been cut. The trichogram showed an absolute prevalence of abnormally shaped anagen bulbs lacking inner and outer root sheaths. A scalp biopsy evidenced a marked cleft formation between fragmented inner root sheaths and irregularly shaped hair shafts.
Prospective Randomized Study Comparing the Debriding Effect of Krill Enzymes and a Non-Enzymatic Treatment in Venous Leg Ulcers
Authors: Westerhof W. , van Ginkel C.J.W. , Cohen E.B. , Mekkes J.R.
Published: October 2009

The debriding potential of a recently discovered potent enzyme preparation derived from Antarctic krill (Euphausia superba) was compared to a routine non-enzymatic treatment in 31 patients with venous leg ulcers. To assure a reliable interpretation of the cleaning effect, computer image analysis was used to measure wound size and the amount of debris day by day. Krill enzyme treatment was significantly (p < 0.01) better than the non-enzymatic treatment. The necrotic area diminished by 53% while in the control group no reduction of the necrotic area was observed in 7 days. The median time required to clean the ulcer was 7 days in the krill group and 10 days in the control group. Afterwards the ulcers were grafted with autologous skin biopsies, which yielded similar results in both groups. No side effects were observed. It was concluded that krill enzymes fulfil criteria for effective debridement of venous leg ulcers.
Acantholytic Pilomatricoma
Authors: Nakayama H. , Mihara M. , Shimao S.
Published: October 2009

An 11-year-old girl had a slowly enlarging, painful, pink-red tumor on her scalp of 1 month’s duration. The lesion was composed of several, round tumor cell nests in the dermis. Each nest was made up of peripheral basophilic cells and central shadow cells or eosinophilic materials. Occasionally the nests, having central eosinophilic degeneration, became epithelial cysts, some of which showed acantholytic changes in their cyst wall. This seems to be the first case of an acantholytic variant of pilomatricoma.
Idiopathic Recalcitrant Facial Flushing Syndrome
Authors: Tur E. , Ryatt K.S. , Maibach H.I.
Published: October 2009

This report neologizes a new syndrome name, idiopathic recalcitrant facial flushing syndrome, to describe all cases of persistent facial flushing with unknown etiology. Three cases of recalcitrant flushing are described. Therapy with a variety of modalities, monitored objectively with laser Doppler velocimetry, proved unsuccessful. Some investigational and management aspects of difficult cases of idiopathic flushing are reviewed.
Malignant Melanoma at Sites of Therapeutic X-Irradiation
Authors: McDonagh A.J.G. , Wright A.L.
Published: October 2009

Two patients are reported in whom malignant melanoma developed at sites of low-dose superficial X-ray therapy given for treatment of benign dermatoses. No causal link has been established between melanoma and X-irradiation, but previous reports of a possible association are reviewed. The probable importance of ultraviolet exposure after X-irradiation in such patients is emphasised.
Papillomavirus Common Antigen in Bowen’s Disease
Authors: Grussendorf-Conen Elke-Ingrid , Giesen Matthias
Published: October 2009

We studied 173 biopsies of histologically determined Bowen’s disease and looked for the presence of papillomavirus antigen using immunoperoxidase staining. Fifty-nine of the lesions were located at the head, 49 at the extremities, 36 at the trunk and 29 originated from the genital region. Papillomavirus capsid antigen could be clearly identified in 39 (22.5%) cases. Eleven (38%) of the 29 lesions located on genital skin were positive for papillomavirus capsid antigen while 28 (19.4%) of the 144 biopsies from other skin regions contained viral antigen. Our findings are suggestive of an etiologic relationship between the virus and this dermatosis which represents a special variant of squamous cell carcinoma. They indicate that human papillomaviruses may play an important role in the development of cutaneous malignancies.
Water Vapour Loss Threshold and Induction of Cholinergic Urticaria
Authors: Tupker R.A. , Doeglas H.M.G.
Published: October 2009

A patient is described with cholinergic urticaria (CU) in whom the symptoms could be provoked by gustatory stimuli. The aim of this study was to investigate whether there is a threshold of sweating (monitored by skin water vapour loss (SVL) measurements) at which CU can be provoked. Provocations with lemon and sal-ammoniac liquorice induced transient sweating differing both in degree and duration. Only ‘doubly salted’ liquorice, which caused the most intense sweat response, resulted in urticarial lesions. This finding suggests a threshold dependency for the induction of CU. SVL measurement may be a useful method for the evaluation of sweating tests in CU patients.
Topical Ketoconazole for Infantile Seborrhoeic Dermatitis
Authors: Taieb A. , Legrain V. , Palmier C. , Lejean S. , Six M. , Maleville J.
Published: October 2009

In an open study, 19 infants with a bipolar seborrhoeic rash were treated with ketoconazole 2% in cream once a day and evaluated over 10 days of treatment. At day 10, 78.9% of patients were almost cleared. Percutaneous absorption peaked 1–3 h after topical treatment, and was minimal. No plasma ketoconazole accumulation over the 10-day treatment was detected. Treatment failures corresponded to histologically psoriasiform eruptions and probable atopic dermatitis.
Urticaria with Macroglobulinaemia
Authors: Bonnetblanc J.M. , Drouet M. , Laplaud P. , Bedane C. , Bernard P.
Published: October 2009

A case of chronic urticaria-like lesions with macroglobulinaemia (Schnitzler syndrome) is described. This case is unique by its double IgM monocomponents and by the follow-up study which shows immunoglobulins modifications between cutaneous flare-up and remission. As 1 case had a lymphoma, we studied the mononuclear cells of the bone marrow of Schnitzler syndrome to raise a possible malignant evolution of that disorder, and we discovered a hypodiploid population, which we compared with similar studies of myeloma and monoclonal ‘benign’ gammopathies.
Water-Induced Itching
Authors: Bircher Andreas J.
Published: October 2009

In this paper the current knowledge on water-induced pruritus is reviewed. To the present, three forms, namely aquagenic pruritus (AP), aquagenic pruritus of the elderly (APE) and water-related itching in polycythemia rubra vera (PRV) have been recognized. Despite clinical similarities it appears that the pathophysiology is different in the three forms. The currently most effective treatment for AP is addition of sodium bicarbonate to the water, control of xerosis with emollients for APE and aspirin for water-induced itching in PRV.
Levels of Soluble Interleukin-2 Receptors Correlate with the Severity of Atopic Dermatitis
Authors: Wüthrich B. , Joller-Jemelka H. , Helfenstein U. , Grob P.J.
Published: October 2009

Levels of soluble interleukin-2 receptors (sIL-2R) were measured as a marker of lymphocyte activation in serum of 37 patients with atopic dermatitis (AD) and of 16 patients with psoriasis vulgaris (PV), all individuals being hospitalized in the Zurich High Mountain Clinic of Davos-Clavadel (altitude 1,600 m above sea level). Measurements were performed at admission and at discharge. The PV patients served as a control group. As a further control, 20 AD patients from the Department of Dermatology in Zurich (altitude 400 m) were also evaluated. The serum sIL-2R concentration in AD patients at admission was significantly elevated in comparison with PV patients and was highly correlated with the severity of the cutaneous involvement. Comparing the ‘extrinsic’ and ‘intrinsic’ types of AD, no significant differences of sIL-2R levels were found. The sIL-2R concentrations dropped at discharge. These results suggest that the measurement of the sIL-2R level could be a marker of disease activity.
Incidence of Polycystic Ovaries in Patients with Late-Onset or Persistent Acne: Hormonal Reports
Authors: Betti R. , Bencini P.L. , Lodi A. , Urbani C.E. , Chiarelli G. , Crosti C.
Published: October 2009

Forty-six women affected by late-onset or persistent acne were studied in order to investigate the frequency of hormonal abnormalities and polycystic ovaries. Hirsutism, perioral distribution of acne lesions and irregular menses were recorded. Hormonal measurements and ovarian echographies were performed. Twenty-four patients were affected with polycystic ovaries, detected by ultrasound scanning. Among the acne patients, the women with ovarian anormalities had higher values of androstenedione, dehydroepiandrosterone, dehydroepiandrosterone sulfate and luteinizing hormone (LH) and a higher LHT/follicle-stimulating hormone ratio than those with acne and without ovarian abnormalities. This study indicates the prevalence of polycystic ovaries in women with late-onset or persistent acne. Moreover, hormonal abnormalities indicate a subgroup of acne patients defined by the presence of ovarian disorders.
Hair Growth in Human Split-Thickness Skin Grafts Transplanted onto Nude Rats: The Role of Ciclosporin
Authors: Gilhar A. , Etzioni A. , Krueger G.G.
Published: October 2009

To date there have been no descriptions of hair growth following transplantation of human split-thickness skin grafts (HSTSG) to congenitally athymic (nude) mice or rats. Recently, we noted hair growth in HSTSG from scalp skin (HSTSG-SS) transplanted onto rats treated with ciclosporin (CS). By definition HSTSG-SS of 0.4 mm had all the anagen hairs cut from the papillae. Two months after engraftment, there was histological evidence of the formation of new papillae. Density of hair correlated with thickness of HSTSG, i.e. there were more hairs/square centimeter in HSTSG-SS of 1 mm thickness than in those of 0.4 mm thickness. New hairs appeared on an average of 1 cm2/week in HSTSG-SS that were 1 mm thick; by 10 weeks, the mean density was 7.9 hairs/cm2. In the thinner grafts, the density was 3.5 hairs/cm2 (p < 0.025). The rate of growth in the thicker grafts ranged from 0 to 0.25 mm/day, with an average of 0.1 mm/day. At 10 weeks after grafting, the hairs had a mean length of 4.4 mm in the thicker and 1.7 mm in the thinner grafts (p < 0.001). The average diameter of the hair shafts was 0.05 mm at the various times tested. These observations identify a previously unrecognized process of hair growth and present an in vivo model to study human hair growth process, including the role of CS in hair growth.
Delusional Parasitosis as ‘Folie à trois’
Authors: Gieler Uwe , Knoll Michael
Published: October 2009

Delusional parasitosis can apparently run in families. Three out of 9 members of a German family were fully convinced that their skin had been invaded by ‘tiny running animals’ even though there was no physical evidence of any infestation. Although the family was reluctant to be injected with neuroleptic drugs as this would have been an acknowledgement that their symptoms were in fact of psychological origin, they eventually agreed to be treated. When last contacted 3 years after diagnosis they still believed in the existence of the parasites but admitted that some of their symptoms had improved.
Nail Biting and Picking as a Possible Cause of Longitudinal Melanonychia
Authors: Baran Robert
Published: October 2009

Examination of individuals affected by onychotillomania led us to describe a new cause of longitudinal melanonychia (LM) of the finger-nails. Damage of the finger-nails was caused both manually and by chewing. The nail cuticles were usually pushed back, and biting caused pressure damage of the base of the nail. It is likely that finger-nails respond similarly to toe-nails and the matrix melanocytes can be stimulated by trauma. Such stimulation can apparently persist long after cessation of the trauma. Histological examination of the nail plates demonstrated that the pigment was melanin. In the matrix an increase in melanin content of melanocytes was found without melanocytic proliferation. LM due to onychotillomania should not be overlooked.
Relapsing Eruptive Psoriasis and Immunological Changes Triggered by Growth Hormone Therapy in a Growth Hormone-Deficient Girl
Authors: Maghnie M. , Borroni G. , Larizza D. , Lorini R. , Girani M.A. , Rabbiosi G. , Severi F.
Published: October 2009

A 9.8-year-old girl with growth hormone (GH) deficiency and concomitant chronic and localized psoriasis of the groins and axillae showed repeated and sudden relapse of eruptive psoriasis after GH treatment. The aggravating effect of GH and the improvement of the skin condition after withdrawal suggests, at least in this case, that GH plays a significant role in the pathogenesis of psoriasis.
Papules in the Auricular Concha: Lichen amyloidosus in a Case of Biphasic Amyloidosis
Authors: Barnadas Maria A. , Pérez Mercedes , Esquius Jordi , Curell Román , de Moragas José M.
Published: October 2009

We present a patient with lichen amyloidosus on the ears and macular amyloidosis on the back. These diagnoses were supported by histological, histochemical and immunohistochemical studies. This is to the best of our knowledge the first reported case of a biphasic form of amyloidosis whose Hchenoid counterpart consists of papules on the ears. This suggests that primary cutaneous localized amyloidosis may have peculiar clinical manifestations depending on the location of the lesion.
Hereditary Benign Telangiectasia: A Congenital Type
Authors: Watanabe Mariko , Tomita Yasushi , Tagami Hachiro
Published: October 2009

Hereditary benign telangiectasia (HBT) is inherited in an autosomal dominant fashion, and in all the cases reported in the past it developed after birth. We describe 3 congenital cases of HBT in the same Japanese family: a 29-year-old father and his 5-month- and 2-year-old daughters have had scattered erythematous patches of various sizes in diameter since birth.
Laugier’s Disease
Authors: Dupré A. , Viraben R.
Published: October 2009

Pigmented macules of the malpighian mucous membranes have been described under numerous names since the first description by P. Laugier in 1970 of the ‘pigmentation mélanique lenticulaire essentielle de la muqueuse jugale et des lèvres’. In this paper, we show that (1) the lesions may occur in all malpighian mucous membranes, (2) are easily distinguished from melanoma both clinically and if necessary by histology, and we suggest (3) that, whichever the localization is, the condition should be called Laugier’s disease.
Mineralization of Collagen and Elastic Fibers in Superficial Dystrophic Cutaneous Calcification: An Ultrastructural Study
Authors: Fartasch M. , Haneke E. , Hornstein O.P.
Published: October 2009

The ultrastructural morphology of localized skin calcifications without associated diseases and with normal serum calcium and phosphate ion values is still unknown. In a case of superficial dystrophic calcinosis cutis (DCC) the role of collagen elastin and ground substance in the process of calcification and the organization of the apatite crystals could be studied by light and electron microscopy despite technical difficulties in sectioning the hard tissue. Ultrastructural investigation revealed the nucleation of calcification being related to collagen and elastic fibers. No intracellular calcification was found. A flower-like arrangement of pleomorphic crystals was found around single collagen fibrils resembling the calcification of collagen seen in bone tissue. The elastic fibers showed a different pattern of calcification compared with other diseases (e.g. pseudoxanthoma elasticum) with known calcification of the elastic fibers. The process of mineralization was initially linked to the microfibrils of the elastic fiber.
T Cell Receptor Gene Rearrangement Analysis in Mycosis Fungoides and Disseminated Lymphocytoma Cutis
Authors: Amagai M. , Hayakawa K. , Amagai N. , Kobayashi K. , Onodera Y. , Shimizu N. , Nishikawa T.
Published: October 2009

A cDNA from the Cτβ2 region of the T cell receptor gene was used as a probe to investigate the clonal composition of T cells in the skin lesions of 3 patients with mycosis fungoides (MF) and 1 patient with disseminated lymphocytoma cutis (DLC). All of these skin lesions showed helper/inducer T cell dominant infiltration. Clonal T cell populations, as evidenced by rearranged DNA bands, were demonstrated in all the skin lesions of the 3 patients with MF, but not in the lesion of the patient with DLC. The patients with MF appeared to have the same gene rearrangement pattern in DNA obtained from separate lesions, providing evidence that the T cells in both sites were derived from the same clone. Our results show that this gene rearrangement analysis helps to diagnose difficult cases of lymphoproliferative disorders.
Linear Sebaceous Nevus Syndrome
Authors: Nuno K. , Mihara M. , Shimao S.
Published: October 2009

A boy with linear sebaceous nevus syndrome was followed up to 3 years of age, at which time he died of pneumonia. The lesions of nevus sebaceus were located in the midline and on both sides of the face and there were partial colobomata of the right outer canthus continuous with pseudopterygium and of the left upper eyelid. At 2 months of age, the patient developed infantile spasms. At 1 year, electroencephalography revealed hypsarrhythmia, and left carotid angiography showed an arteriovenous malformation. At 2 years, the mental retardation and delayed motor development were detected.