bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of fallow management systems and frequency of cropping on weed growth and crop yield
Authors: Akobundu  , Ekeleme  , Chikoye
Published: March 2003

The influence of weeds on maize intercropped with cassava was evaluated in three fallow management systems and four cropping frequencies from 1989 to 1996 in Ibadan, Nigeria, West Africa. Fallow management systems consisted of natural bush, Leucaena leucocephala hedgerows and Pueraria phaseoloides fallow. Frequencies of cropping were continuous cropping, 1 cropping year alternating with 1, 2 and 3 years of uncropped fallow. Shrubs and climbers contributed 60–70% and herbs (predominantly weeds) 30–40% to the total dry matter produced in all treatments. Weed dry matter and seedbank increased with time in all treatments but was higher in natural bush fallow by the fifth and sixth years and in continuously cropped plots. Weed seed density increased with time in the continuously cropped plots and in plots cropped after 1 or 2 years of fallow but decreased with time when the fallow period was up to 3 years. Maize grain yield decreased over time in both unweeded and weeded plots irrespective of treatment with the exception of the weeded P. phaseoloides fallow treatment. Cassava tuber yield decreased over time in unweeded plots in all treatments while tuber yield increased in weeded P. phaseoloides fallow treatment and remained relatively constant in L. leucocephala and natural bush fallow plots. The results from this study suggest that planted fallow involving legume species is more effective in weed management in the long term than natural fallow. Fallow period was beneficial to crop yield and yield improvement increased with the length of the fallow cycle, particularly for cassava.
Weed‐suppressing rice cultivars – does allelopathy play a role?
Authors: Olofsdotter  , Navarez  , Rebulanan  , Streibig
Published: March 2003

A range of 111 rice cultivars was studied for weed‐suppressing ability in field experiments with a sown infestation of Echinochloa crus‐galli. Cultivars differed significantly in their ability to suppress the growth of E. crus‐galli, and the differences were reasonably reproducible over three seasons. The same rice cultivars were tested in a laboratory screening for allelopathic potential, which showed significant differences in the ability to reduce root growth of E. crus‐galli. Correlation between the laboratory screening and the field experiments showed that field performance could be described to some extent by E. crus‐galli root length reduction in the laboratory. Plant height in the field experiment was correlated with weed biomass 8 weeks after seeding. Even among the most weed‐suppressing rice cultivars, however, all heights were represented. None of the measured growth parameters from greenhouse studies could explain the distribution of weed‐suppressing rice cultivars. This indicates that allelopathy in combination with competitive ability determines the weed interference outcome of a given rice cultivar.
The relevance of morphological plasticity in the simulation of competition between maize and Datura stramonium
Authors: Cavero  , Zaragoza  , Bastiaans  , Suso  , Pardo
Published: March 2003

The INTERCOM model was calibrated for Datura stramonium and maize with data from monoculture plots, and used to simulate the competition between the weed and the crop. The model adequately simulated the growth (leaf area index, above‐ground biomass, plant height, yield) of both species in monoculture. In competition, the growth of D. stramonium and the competitive effect of D. stramonium on the growth of maize were clearly underestimated. Simulation of competition was improved when the observed morphological adaptations of D. stramonium under competitive light stress, as reflected in dry‐matter partitioning, height growth and specific leaf area (SLA) were considered. Model analysis demonstrated that the observed changes in SLA and height growth were more relevant for the increased competitive ability of D. stramonium. The modification of the model in order to simulate the effect of shading by an overtopping species in the SLA of the shaded species improved model simulation of competition.
Influence of climatic conditions and plant physiology on glufosinate‐ammonium efficacy
Authors: Petersen J , Hurle K
Published: March 2003

Under field conditions the efficacy of glufosinate‐ammonium on Galium aparine L. is quite often variable. Experiments under controlled conditions with G. aparine and the more susceptible species Brassica rapa L. showed that especially low relative humidity (r.h.) and low light intensity reduced the accumulation of ammonia in the plants and glufosinate‐ammonium performance. As the light intensity under field conditions always exceeds the intensities applied in the experiments this parameter may not be of practical importance. In contrast, low r.h. often occurs under field conditions and could explain the variable G. aparine control. A retention study showed that retention on G. aparine was significantly higher than on B. rapa but ammonia accumulation in the plants indicated that glufosinate‐ammonium uptake by G. aparine was lower than that by B. rapa. Glufosinate‐ammonium performance was improved on both species by adding ammonium sulphate to the spray solution; however, the increase in efficacy by ammonium sulphate was two times higher for G. aparine than for B. rapa. Ammonia accumulation in untreated plant parts after glufosinate‐ammonium application indicated some translocation of glufosinate‐ammonium in B. rapa but none in G. aparine.
Long‐term tillage and crop rotation effects on weed seedbank size and composition
Authors: Bàrberi P , Lo Cascio B
Published: March 2003

Size and composition of the weed seedbank was assessed after 12 years of application of four tillage systems in two crop rotations. Mouldboard and chisel ploughing at 45 cm, minimum tillage at 15 cm and no tillage were compared in continuous winter wheat and a pigeon bean/winter wheat 2‐year rotation. Weed control was based upon post‐emergence herbicide application. Weed seedling emergence from soil samples taken at 0–15, 15–30 and 30–45 cm depths was assessed in a non‐heated glasshouse for 12 months. The tillage system influenced weed seedbank size and composition to a much greater extent than crop rotation. Total weed seedling density was higher in no tillage, minimum tillage and chisel ploughing plots in the 0–15, 15–30 and 30–45 cm layers respectively. Density in the whole (0–45 cm) layer did not differ significantly among tillage systems. With no tillage, more than 60% of the total seedlings emerged from the surface layer, compared with an average 43% in the other tillage systems. Crop rotation did not influence either weed seedbank size or seedling distribution among soil layers, and only had a small influence on major species abundance. The weed seedbank was dominated (>66%) by Conyza canadensis (L.) Cronq. and Amaranthus retroflexus (L.), which thrived in chisel ploughing and no tillage respectively. Results suggested that crop rotation and substitution of mouldboard ploughing by non‐inversion tillage (especially by minimum tillage) would not result in increased weed problems, whereas use of no tillage might increase weed infestations because of higher seedling recruitment from the topsoil.
Sugarbeet yield response to competition from Sinapis arvensis or Lolium perenne growing at three different distances from the beet and removed at various times during early growth
Authors: Heisel T , Andreasen C , Christensen S
Published: March 2003

A sugarbeet field experiment was conducted in 1999 and 2000 to measure beet yield where Sinapis arvensis or Lolium perenne were growing in the crop row at 2, 4 or 8 cm from the beet plants. The weeds were removed by cutting once in the growing season in either late May, mid‐June or early July. The number of neighbouring beet plants to every target beet plant was recorded. Projected leaf cover of a subset of the data with non‐cut weeds was analysed by using image analysis to investigate whether this could be used to predict beet yield loss early in the growing season. Increasing the distance between beet and weed from 2 to 8 cm increased the beet yield significantly by an average of 20%, regardless of weed species. The dry weight of non‐cut and re‐growing weeds at harvest time decreased when cutting was postponed to the period between mid‐June and early July. The number of neighbours described a sigmoidal yield decline of the single beet plants. Results from image analysis showed that approximately 33 g of beet yield was lost in October/November for each per cent relative projected leaf cover of the weeds in May, despite variation in growing conditions. The results are discussed in relation to potentials for robotic in‐row weed control.
Epidemiology and in vitro activity of antimycotics against candidal vaginal/skin/nail infections in Singapore
Authors: Kwok Yew‐Kai‐Colin , Tay Yong‐Kwang , Goh Chee‐Leok , Kamarudin Ali , Koh Mong‐Teck , Seow Chew‐Swee
Published: March 2003

BackgroundCandidal infections of the skin/nails and vagina are very common worldwide. Various in vitro test systems are available to help to determine the antifungal activity of drugs. The minimum inhibitory concentration (MIC) is a standard measure of the in vitro potency of drugs against yeasts.

MethodsVaginal smears and skin/nail scrapings of 50 consecutive patients with candidal vaginitis and 46 consecutive patients (28 women, 18 men) with cutaneous/nail candidosis were used in the study. Direct microscopy and culture from vaginal smears and skin scrapings were performed on all patients. The MICs were determined using the broth dilution method.

ResultsFor vaginal candidosis, the mean age of the patients was 28.2 years (range,

9–49 years). Candida albicans accounted for 58% of the isolates, C. glabrata for 32%, C. tropicalis for 6%, and C. parasilosis for 4%. At the MIC of 4 mg/L, 65–95% of C. albicans, 66–94% of C. glabrata, 33–100% of C. tropicalis, and 0–50% of C. parasilosis were susceptible to the drugs tested (ketoconazole, itraconazole, nystatin, amorolfine, clotrimazole, and miconazole).

For cutaneous/nail candidosis, the mean age of the patients was 45 years (range,

19–82 years). C. albicans made up 59% of the isolates, C. parasilosis 20%, C. krusei 13%, C. glabrata 4%, and C. tropicalis 4%. At the MIC of 4 mg/L, 59–96% of C. albicans, 100% of C. glabrata, 83–100% of C. krusei, 89–100% of C. parasilosis, and 100% of C. tropicalis were susceptible to the drugs tested (ketoconazole, itraconazole, nystatin, amorolfine, clotrimazole, and miconazole).

Conclusions
C. albicans is the most common Candida species causing cutaneous/nail and vaginal candidosis in Singapore. The in vitro antifungal activities of ketoconazole, itraconazole, nystatin, amorolfine, clotrimazole, and miconazole are similar against the various Candida species. C. parasilosis in vaginal candidosis appears to be less susceptible. Here, itraconazole and amorolfine may be more effective.
Immunoregulatory mechanisms and stress hormones in psoriasis (part 1)
Authors: Weigl MD Bea A.
Published: March 2003

Background In an earlier paper, the author noted that psoriatic eruptions may be produced in phases of humoral and cellular immunodeficiency and in the presence of streptococcal antigen‐releasing inflammatory foci. In this study it was investigated as to whether stress hormones glucocorticoids, catecholamines) are substantially involved in the activity phases (eruptions) of psoriasis.

Methods During a series of investigations over two years, the following were determined for 70 chronic psoriasis patients and 50 controls: cortisol‐adrenaline serum levels, polyclonal serum immunoglobulins IgM, IgG, IgA, total serum IgE, complements C3, C4, T‐cells and subpopulations, streptococcal antibody titres ASO/ADNase B.

Results Phases of clinical inactivity are associated with a mechanism called immunologic regulation: elevated antibacterial titres and unremarkable findings for all other parameters. Phases of clinical activity (in 25/70 patient) showed absolutely elevated serum cortisol levels, absolutely decreased serum epinephrine levels, deficient serum IgM or IgG and IgE levels, increased C3, decreased C4 and T4:T8 ratio, and significantly elevated streptococcal titres.

Conclusions The greatly elevated serum cortisol levels indicate that glucocorticoids are produced in excess via the pituitary adrenal axis and are significantly involved in the triggering of immunosuppressive phases (eruptions) in psoriasis.
Erythroderma: a clinico‐etiologic study of 90 cases
Authors: Pal, MCPS, FCPS Sabrina , Haroon, FRCP, FCPS Tahir Saeed
Published: March 2003

Background The difficulty with erythroderma lies in finding the underlying cause. Almost all the published original clinical series of erythroderma originate from western countries. Our aim was to evaluate various causes of exfoliative dermatitis in our community and compare the findings with previous studies.

Methods Ninety patients with erythroderma of either sex and any age, were studied at the Dermatology Department, Mayo Hospital, Lahore, Pakistan, between April 1992 and May 1995. A thorough clinical examination and relevant laboratory investigations, including skin biopsies, were performed.

Results The mean age of onset was 41.6 years with a male : female ratio of 2.8 : 1. The onset was acute in 69% of patients. The salient features included nail changes (80%), mucosal involvement (36.6%), alopecia (30%), islands of normal skin (14.4%), and the “deck chair sign” (5.5%). The most frequent cause of erythroderma was pre‐existing dermatoses (74.4%), including psoriasis (37.8%), dermatitis (12.2%), ichthyoses (7.8%), and pemphigus foliaceus (5.6%). Drugs and malignancy each induced erythroderma in 5.5% of cases. No cause could be found in 14.6% of cases.

Conclusions Etiologically, pre‐existing dermatoses showed the highest incidence and drugs the lowest compared with previous studies. Dermatitis was less common. There was a greater variety of causes of erythroderma in our series. Hair and nails were more frequently involved. Mucosal involvement, not mentioned in other studies, was present in 36.6% of our cases. The “deck chair sign” and islands of normal skin were seen in dermatoses not reported previously.
Jaipur block in postherpetic neuralgia
Authors: Bhargava Rishi , Bhargava Sudha , Haldia Kailash N. , Bhargava Puneet
Published: March 2003

Background Postherpetic neuralgia, a common sequele to herpes zoster infection, is a chronic debilitating problem. The available therapeutic modalities are usually ineffective.

Methods A total of 3960 patients (1326 women and 2634 men; age group, 21–84 years), with postherpetic neuralgia as the presenting complaint and with pain lasting from 2 months to 5 years, were treated with Jaipur block, consisting of local subcutaneous infiltration of 2% xylocaine, 0.5% bupivacaine, and 4 mg/mL dexamethasone solution. Patients were followed up at six‐weekly intervals with subsequent injections given in non‐responders.

Results Twenty eight per cent of patients obtained complete relief from pain after a single injection, another 57% after a second injection, and 11% after a third injection; 4% of patients did not respond to treatment. The non‐responders were either old (over 60 years) or had pain lasting for more than 2 years. The response to therapy was similar in both sexes. There were 31 left‐handed patients in this study. Pain was less severe in left‐handed patients and they obtained complete relief after a single injection. Side‐effects including giddiness and sweating were seen, occasionally, in a few patients.

Conclusions Ninety six per cent of patients obtained complete relief after the block with a follow‐up of up to 19 years.
Eosinophilic ulcer of oral mucosa
Authors: Chung Hae‐Shin , Kim Nam Soo , Kim Young Bae , Kang Won Hyoung
Published: March 2003

A 41‐year‐old woman was seen for the examination of a painless lesion on the posterior hard palate of 2 weeks’ duration. She had no systemic symptoms. Examination of the hard palate showed a single 1 × 1 cm, round, punched out ulcer with an erythematous base; the margins of the ulcer were slightly raised and indurated ( Fig. 1). Other clinical findings were normal and laboratory study of a cutaneous biopsy showed necrotic ulceration with dense inflammatory cell infiltration. An extensive inflammatory cell infiltration with predominantly eosinophilic cells was present throughout the submucosa. A single application of liquid nitrogen decreased the lesion.

Ulcer found on the posterior hard palate at the time of initial visit

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Pustular eruption in a malaria patient treated with chloroquine
Authors: Goihman‐Yahr Mauricio
Published: March 2003

A 42‐year‐old Thai woman with Plasmodium vivax malaria was treated with a total dose of 1800 mg of chloroquine phosphate over 6 h. Acetaminophen was administered to reduce fever. The patient awoke the next morning with diffuse macular erythema, studded with 1–2 mm vesicles and pustules, predominantly on the face and the extremities (
Fig. 1). Some pustules were follicular. The mucous membranes, palms, and soles were unaffected. A gram stain of the pustule contents showed only scattered neutrophils. A skin biopsy from a lesion on the upper leg showed the features of a drug‐induced pustular eruption: cell‐poor subepidermal blisters with scattered subcorneal pustules (
Fig. 2), mild spongiosis, and a sparse infiltrate of neutrophils and eosinophils in the papillary dermis.
1 A urine screen (Lignin test) for sulfonamides was negative, and high pressure liquid chromatography analysis of the serum showed no sulfadoxine. Hematolgy and biochemistry values, erythrocyte sedimentation rate, and glucose 6‐phosphate dehydrogenase levels were normal. Serologies for mycoplasma antibody, Herpes simplex immunoglobulin M (IgM) and IgG, cytomegalovirus IgM, anti‐human immunodeficiency virus, venereal disease research laboratory test, antinuclear antibody, alpha‐fetoprotein, and carcino‐embryonic antigen were negative. A hepatitis B panel, serum pregnancy test, and three sets of blood cultures were negative. A chest X‐ray was normal. The patient was in otherwise good health and had no history of skin diseases. Chloroquine was discontinued and the eruption quickly resolved with mild desquamation.

Erythematous macules studded with small pustules (arrows) on the upper legs

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Biopsy specimen from a lesion on the leg contains cell‐poor subepidermal blisters and subcorneal pustules (arrows) (hematoxylin and eosin, original magnification, ×400)

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A clinico‐etiologic correlation in tinea capitis
Authors: Jahangir Mohammad , Hussain I. , Khurshid K. , Haroon T. S.
Published: March 2003

Background Tinea capitis is a dermatophytosis with diverse clinical manifestations. The causative fungi of tinea capitis vary with geography and time. This study aimed to identify the etiologic agents and to determine the clinico‐etiologic correlation of tinea capitis in Lahore, Pakistan.

Methods From clinically suspected cases of tinea capitis, skin scrapings and hair samples were taken and subjected to microscopy and culture.

Results Of 100 evaluable patients, 95% were children below 12 years of age with almost equal sex incidence. Noninflammatory and inflammatory lesions were seen in 56.4% and 43.6%, respectively. Trichophyton violaceum was the most common etiologic agent, responsible for 82% of infection, followed by T. tonsurans (8%), T. verrucosum (5%), and T. mentagrophytes (5%).

Conclusions
T. violaceum is the predominant pathogen causing tinea capitis in this part of the world, and gives rise to a varied clinical picture.
Occupational allergic contact dermatitis from unsaturated polyester resin in a car repair putty
Authors: Kanerva Lasse , Estlander Tuula , Alanko Kristiina , Pfäffli Pirkko , Jolanki Riitta
Published: March 2003

Background Unsaturated polyester (UP) resins are widely used as cements in car repair painting to produce a smooth surface before the final painting. We report two car painters with hand and face dermatitis who were sensitized to a UP resin used for car repair cements.

Methods Patch testing with commercial substances and ingredients and extracts from UP resins was used to verify the sensitivity.

Results Both patients showed an allergic patch test reaction to a UP resin. They also had an allergic patch test reaction to diethyleneglycol maleate (DEGM), an extract of a UP resin.

Conclusions Both patients had been patch tested elsewhere with negative results because UP resins had not been used for patch testing. Accordingly, patients with dermatitis who have been exposed to UP resins need to be patch tested with UP resins. The specific chemical causing allergic contact dermatitis in our patients was DEGM.
Xeroderma pigmentosum in black South Africans
Authors: Jacyk Witold K.
Published: March 2003

Background Xeroderma pigmentosum occurs in all races. There is little information on its clinical picture, frequency, and types of malignant lesions in individuals of African negroid extraction.

Methods Fifteen black South African patients, aged from 10 months to 21 years, with xeroderma pigmentosum were prospectively studied. Detailed dermatologic, ophthalmologic, and neurologic examinations were carried out in all patients. Cutaneous, conjunctival, and lingual malignant lesions were histologically assessed. Complementation studies were not performed.

Results Twelve patients had cutaneous malignancies, predominantly squamous carcinomas, usually several at one time. Carcinomas of the tip of the tongue occurred in five patients and conjunctival carcinomas in four. Cutaneous and mucosal carcinomas developed at an earlier age than in the series from other parts of the world. Three patients had extensive skin involvement characteristic of xeroderma pigmentosum, but did not develop malignancies. They most likely belong to a complementation group(s) with higher rates of unscheduled deoxyribonucleic acid (DNA) synthesis.

Conclusions Xeroderma pigmentosum in South African black people is characterized by the very early development of cutaneous, ocular, and tongue squamous cell carcinomas and usually has a rapid and devastating course.
Bockhart’s impetigo: complication of waterbed use
Authors: Hsu Sylvia , Halmi Bill H.
Published: March 2003

A 30‐year‐old black man with no relevant past medical history presented with a 2‐day history of a mildly pruritic eruption that began on his legs and spread to his trunk. He stated that he awoke with the eruption on his legs after he had slept on a waterbed. He had experienced profuse sweating because of the plastic bedcover. He denied any medical problems. Specifically, he had no fever or chills. He also denied taking any medications or applying any topical agents to his skin.

On physical examination, the patient appeared to be a healthy black man who had hundreds of 1‐mm, white‐to‐yellow pustules on his back ( Fig. 1) and proximal, posterior extremities
(
Fig. 2). His face, scalp, mucous membranes, palms, and soles were spared. The pustules had no surrounding erythema
(
Fig. 3).

Multiple 1–2‐mm pustules on the back

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Multiple 1–2‐mm pustules on the proximal, posterior arm

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Close‐up of pustules on the back

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A skin biopsy revealed a subcorneal pustule at the follicular orifice with neutrophils and scattered clumps of bacteria consistent with a superficial bacterial folliculitis.

The patient was treated with topical clindamycin gel twice a day. He returned 7 days later with a total clearance of his pustules. He had only diffuse, fine scale on the affected areas with no postinflammatory hyperpigmentation.
Ultrastructure of pitted keratolysis
Authors: De Almeida Hiram L. , De Castro Luis A. S. , Rocha Nara E. M. , Abrantes Valter L.
Published: March 2003

A 20‐year‐old man presented with pitted keratolysis (PK), demonstrating the typical crateriform pits on the hallux ( Fig. 1), ball of the foot, and on the interdigital surface. The involved keratin specimen was obtained by a shaving technique and processed for transmission (TEM) and scanning (SEM) electron microscopy. The patient, who wore only sports shoes, had hyperhidrosis plantaris. He was treated with topical erythromycin with good results. Bacterial cultures from the lesions showed Corynebacterium sp.

Crateriform pits on the hallux

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TEM demonstrated filamentous coccoid bacteria in the keratin ( Fig. 2), showing transversal septations. Tunnel‐like spaces were built inside the horny layer, where the bacteria showed a hairy surface (

Fig. 3).

Bacteria inside the stratum corneum (TEM, × 25,000)

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Hairy surface from the causative agent (TEM, × 106,000)

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Crateriform pits ( Fig. 4) and small incipient lesions (

Fig. 5) were easily identified on the plantar surface by SEM. On examination of the floor of these lesions, tunnel openings were found (

Fig. 6) in which bacteria could be observed. With higher magnification, the transversal septation, seen by TEM, was also shown with SEM (

Fig. 7). The normal appearing plantar skin was also examined, showing incipient bacterial colonies with tunnels without keratin loss (

Fig. 8).

Pitted keratolysis with two incipient lesions on the right side (SEM, × 77.5)

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Higher magnification of the incipient lesion from the right upper corner of Fig. 4 (SEM, × 310)

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Tunnel openings in the floor of the pits (SEM, × 15,500)

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Details of the bacteria; note the transversal septation (SEM, × 31,000)

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The causative agent in tunnels in normal appearing skin (SEM, × 4650)

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Survey on the epidemiology of Microsporum canis infections in Crete, Greece over a 5‐year period
Authors: Maraki Sofia , Tselentis Yiannis
Published: March 2003

Background
Microsporum canis is a frequent cause of tinea capitis and tinea corporis in Europe and especially in the Mediterranean area.

Objective This study was undertaken to examine the epidemiologic features of all cases of M. canis infections recorded in Crete, Greece, during a 5‐year period (1994–1998).

Methods The epidemiology of 111 cases of dermatophytoses due to M. canis was analyzed according to the sex, age, origin of the infection, place of residence, body site affected, and seasonal progression.

Results
M. canis constituted 24.5% of all dermatophytes isolated during the study period. Women were more frequently affected than men (54%), and infections were most prevalent in patients up to the age of 9 years (46.8%). Cats were identified as the commonest source of the infection (82%). As regarding the place of residence, most of the infected patients came from rural areas (64.9%). The commonest sites of M. canis infection (in decreasing order of frequency) were: the head, the lower extremities, the trunk, and the upper extremities. The greatest number of cases were seen in September and December.

Conclusions The findings of the present study indicate that M. canis infections have gradually decreased in recent years in this geographic area. Eradication requires elimination of the natural source of the infection, represented mainly by stray animals.
Anxiety, depression, and nature of acne vulgaris in adolescents
Authors: Aktan Sebnem ,   md, Özmen Erol ,   md, S Berna ,   cedil,   anli,   md
Published: March 2003

Background The reported prevalence of acne in adolescence is variable; improved treatment may have modified its prevalence and severity; acne has been related to psychiatric morbidity for many years.

Methods Two thousand six hundred and fifty‐seven high school students were examined, and adolescents with acne were interviewed about the subject of acne vulgaris. The severity of acne was graded using the Global Acne Grading System (GAGS). The Hospital Anxiety and Depression (HAD) scale was evaluated for one of every two subjects with acne (n = 308) and for the same number of sex‐matched control subjects (n = 308) to determine the prevalence of depression and anxiety.

Results Six hundred and fifteen of the subjects (23.1%) were determined to have acne. Acne prevalence in girls and boys was 16.1% and 29.2%, respectively (P < 0.001). Two hundred and twenty‐five (15.8%) of 1424 boys and only 109 (8.8%) of 1233 girls had moderate or severe/very severe acne (P < 0.001), but the GAGS scores in the groups of boys and girls with acne were not significantly different. The acne and control groups showed no significant differences in the HAD anxiety and depression subscale scores. The HAD anxiety subscale scores of girls were significantly higher than those of boys in the acne group. The severity of acne was not correlated with the HAD anxiety or depression subscale scores.

Conclusions Acne results in higher anxiety in adolescent girls. Although acne and moderate/severe acne are more common in adolescent boys, the severity of acne was found to be similar in boys and girls with acne. Adolescent girls are more vulnerable than boys to the negative psychological effects of acne.
Oral penicilliosis in a patient with human immunodeficiency virus in northern Thailand
Authors: Kantipong Pacharee , Walsh Douglas S.
Published: March 2003

A 25‐year‐old Thai woman with human immunodeficiency virus (HIV) infection diagnosed by serology 4 months previously presented to the outpatient clinic with a chief complaint of a sore throat. Three months prior to presentation, she was diagnosed with oral and vaginal candidiasis and bronchitis. The patient was afebrile and other vital signs were normal. Examination of the oral cavity showed patchy erythema and leukoplakia on the buccal mucosa, suggestive of candidiasis. In addition, there were multiple, shiny, translucent papules, 2–4 mm in diameter, especially prominent on the upper palate, suggestive of penicilliosis (Fig. 1). Indeed, a Wright‐stained scraping from a papule revealed numerous inflammatory cells, many containing abundant yeast‐like organisms undergoing binary fission characteristic of penicilliosis (Fig. 2). A slant agar fungal culture of material from an upper palate papule grew Penicillium marneffei, consisting of white, gritty hyphae with underlying deep red coloring as depicted in Fig. 3, as well as Candida albicans. The oral lesions resolved after 2 weeks of treatment with ketoconazole 200 mg twice daily.

Oral cavity with shiny, flesh‐colored papules on the upper palate. Arrow shows area from where material for Wright's stain and culture was obtained

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Smear of papule material from hard palate showing a cluster of intracellular yeast forms (arrow), many undergoing binary fission, consistent with P. marneffei (Wright's stain, × 1000)

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Representative slant agar culture of P. marneffei depicting white gritty colonies with underlying red coloring

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Clinical, histopathologic, and therapeutic aspects of subepidermal autoimmune bullous diseases with IgG on the floor of salt‐split skin
Authors: Barnadas Maria A. , González Ma José , Planagumà Mercè , Romaní Jordi , Curell Román , De Moragas José Ma , Alomar Agustí
Published: March 2003

Abstract

Background  About 12% of patients with subepidermal autoimmune bullous disease and immunoglobulin G (IgG) at the dermal–epidermal junction present diseases other than bullous pemphigoid.

Materials and methods  We report the clinical, histopathologic, and therapeutic aspects of eight cases of subepidermal bullous disorder with IgG on the floor of salt‐split skin.

Results  A predominant neutrophilic infiltrate was detected in six of the eight patients. In one patient, the inflammatory infiltrate was neutrophilic and eosinophilic in the same proportion. A good response to dapsone alone or combined with prednisone was observed in six patients.

Conclusions  The salt‐split skin direct immunofluorescence test is useful for its diagnostic and therapeutic implications.
Levamisole: a safe and economical weapon against pediculosis
Authors: Namazi Mohammad Reza
Published: March 2003

Twenty‐eight patients with pediculosis capitis, defined as the presence of pruritus, living eggs, and/or lice in the hair, were enrolled in an uncontrolled open pilot study. The subjects were school‐age girls (7–12 years old), apparently free of other diseases, and not treated for pediculosis for 4 weeks prior to this study. Family contacts were not treated for pediculosis. The mothers of the patients, who had given informed consent, were asked not to use any topical pediculocide on the girls during the drug trial. Other than the drug administered in the study, the subjects did not take any oral medicine, including cotrimoxazole and ivermectin, during the trial. Treatment consisted of 3.5 mg/kg once daily oral administration of levamisole for 10 successive days, which was given to the subjects in their school by health personnel. A 10‐day course was chosen because the subjects lived in unhygienic and overcrowded conditions in a poor village where head lice infestation was hyperendemic. Therefore, two treatment courses spaced 10 days apart could not preclude new infestations from other affected persons and fomites and might have led to a false deduction of drug ineffectiveness. Substituting ‘‘N’' for the grade of living nits and ‘‘L’' for adult lice, three forms of response based on the meticulous examination of the entire scalp with the use of a lens with high magnification and a powerful light source were considered: (i) total responsiveness, defined as N2 = 0 and L2 = 0; (ii) partial responsiveness, defined as 0 ≠ N2 < N1 and 0 ≠ L2 < L1; and (iii) complete unresponsiveness, defined as N2 ≥ N1 or L2 ≥ L1. The detection of unhatched nits which were operculated and generally located within one‐quarter of an inch of the scalp was used to indicate the presence of lice infestation and also to judge the clinical response. For those small nits whose opercula were difficult to see with a hand lens, a low power microscopic study was performed to determine whether the nits were unhatched or not.

Of the 28 girls enrolled in the study, one patient refused to take the drug after 2 days of treatment. No adverse reactions were noted in any of the 28 subjects. On the 11th day, meticulous hair examination showed that 23 patients had responded to treatment (85%; 95% confidence interval (CI): 66–94%). Of these, 18 showed complete responsiveness (67%; 95% CI: 48–82%). More complete information is given in Table 1. Confidence intervals were calculated using the likelihood method.

The results of the trial of levamisole 3.5 mg/kg once daily for 10 days in the treatment of 27 patients with head lice

Type of response
Number of cases
Percentage
95% confidence interval

Complete responsiveness
18
67%
48–82%

 (N2 = 0; L2 = 0)

Partial responsiveness
5
19%
–

 (0 ≠ N2 < N1 OR 0 ≠ L2 < L1)

Responsiveness (total + partial)
23
85%
66–94%

Unresponsiveness
4
15%
–

 (N2 >= N1; L2 >= L1)

This study suggests that levamisole is effective against pediculosis with a dose of 3.5 mg/kg administered for 10 days.
Lactate dehydrogenase isozymes in and intralesional steroid injection therapy for pseudocyst of the auricle
Authors: Miyamoto Hideaki , Okajima Mitsuya , Takahashi Ikuyo
Published: March 2003

Background  Various treatments for pseudocyst of the auricle have been reported. Recently, several patients have been treated successfully with steroid injections. The lactate dehydrogenase (LDH) levels of cystic fluid have been reported to be high, and the LDH‐4 and LDH‐5 isozymes were found to predominate, although the serum LDH levels and LDH isozyme patterns were normal.

Objective  To find a way of preventing auricular pseudocyst recurrences after steroid injection therapy and to examine the relationships between recurrences and the LDH level and isozyme pattern of the cystic fluid.

Methods  Steroid injection therapy was given to nine Japanese patients with pseudocyst of the auricle at our clinic between 1994 and 1999. We determined the LDH level and isozyme pattern of the cystic fluid and sera of seven patients.

Results  All nine patients in this series were treated successfully with steroid injections, although three suffered recurrences. Although the serum LDH levels of seven patients were almost normal, their cystic fluid LDH levels were very high. LDH‐4 and LDH‐5 predominated in the cystic fluid of all seven, although their serum LDH isozyme patterns were virtually normal.

Conclusions  Auricular pseudocyst recurrences show no relationship with either the LDH levels or isozyme pattern. An undiluted solution of steroid fluid should be used in order to prevent recurrences.
Eccrine syringosquamous metaplasia
Authors: Darouti Mohammad A. El , Marzouk Salonas A. , Hadidi Heba A. Ei , Sobhi Rehab M.
Published: March 2003

A 7 year‐old male child presented with erythematous erosive plaques affecting the upper and lower eyelids of the left eye and extending to the cheek. Crustations over the right nostril were also evident. His general health status was normal. His medical history revealed that he was suffering from chronic myeloid leukemia for which he was receiving cyclic pulse therapy of cytarabine, doxorubicin and prednisone.

It was noticed that the skin eruption was activated after each cycle and faded in 2–3 weeks to reappear after the next cycle but it never really cleared completely. The clinical differential diagnosis included herpes simplex, contact dermatitis, neutrophilic eccrine hidradenitis (NEH) and atypical fungal infection.

The investigations included a complete blood count which showed a picture of improving leukemia with a total leucocytic count of 60 000/cc, RBCs count 3.7 × 106/cc, and platelet count of 110 000/cc. His hemoglobin was 9% The differential leucocytic count was as follows: basophils 0; eosinophils 4; blast cells 0; promyelocytes 0; myelocytes 10; juvenile cells 7; staff cells 14; segmented 45; lymphocytes 18 and monocytes 2.

Cultures for fungi were negative, and serological examination for HIV, herpes simplex (IgG and IgM) cytomegalovirus and Epstein‐Barr virus antibodies were within normal ranges.

Examination of a skin biopsy taken from the periorbital lesions revealed the presence of numerous islands of squamous cells extending from the epidermis into the upper‐ and mid‐dermis. Some of the islands were typically present around sweat ducts. On higher magnification, the cells forming the islands and lining the ducts were found to have abundant eosinophilic cytoplasm and large pale nuclei with prominent nucleoli. Some of the cells were dyskeratotic and there were occasional mitotic figures. Sparse lymphoid cell infiltrate was found surrounding some of the squamous cell islands.

Based on the findings of squamous metaplasia of the cells lining the sweat ducts as well as the resemblance of some islands to squamous cell carcinoma, the diagnosis of eccrine syringosquamous metaplasia was made.

Apart from the use of topical antibiotic creams, the patient received no therapy for his condition. Spontaneous improvement occured within 18 days after initial presentation but it recurred after the next cycle of chemotherapy.
Immunochemotherapy for cutaneous leishmaniasis: a controlled trial using killed Leishmania (Leishmania) amazonensis vaccine plus antimonial
Authors: Machado‐Pinto Jackson , Pinto Jorge , Da Costa Carlos Alberto , Genaro Odair , Marques Marcos José , Modabber Farrokh , Mayrink Wilson
Published: March 2003

Background Leishmaniasis is endemic in 88 countries in the world, and 350 million individuals are at risk of acquiring the disease. Treatment for American cutaneous leishmaniasis (ACL) is long, expensive, and associated with important side‐effects.

Methods In this double‐blind, placebo‐controlled study, we treated 102 patients with ACL using either a combination of a single‐strain Leishmania amazonensis killed promastigote vaccine plus a half dose of meglumine antimoniate, or placebo plus the same half dose regimen of meglumine antimoniate, in 10‐day series followed by 10‐day intervals.

Results Of the 47 patients in the experimental arm, 47 (100%) were cured after four series of treatment, compared to four of 49 (8.2%) in the control group (P < 0.0001). Six patients were lost to follow‐up.

Conclusions The combination of a single‐strain Leishmania (Leishmania) amazonensis killed promastigote vaccine with a half dose regimen of antimonial is highly effective for the treatment of ACL.
Treatment of cutaneous T‐cell lymphoma with alitretinoin gel
Authors: Bassiri‐Tehrani Shirley , B.A.  , Cohen David E.
Published: March 2003

A 62‐year‐old man with a 5‐year history of tumor stage cutaneous T‐cell lymphoma (CTCL) used alitretinoin gel, 0.1% twice daily on a right sole tumor. The treatment at the time of topical therapy included acitretin, 35 mg daily, and psoralen with ultraviolet A radiation (PUVA) twice weekly. Previous therapy included topical mechlorethamine, etretinate, and topical glucocorticoids. After 6 weeks, he discontinued alitretinoin gel upon noting that the treated tumor site had turned black. Two weeks later (2 months after the initiation of therapy) he presented with a 6‐cm keratotic plaque on the treated area with a 1‐cm eschar. No lymphadenopathy, peripheral erythema, or tenderness was noted. He started amoxicillin/clavulanate, 875 mg twice daily, and 2% mupirocin ointment. One month later, the foot lesion had completely eroded into a 6‐cm plaque (Fig. 1). There were no changes in the tumors on his trunk, face, and extremities.

Foot lesion eroded into a 6‐cm plaque.

image

A biopsy of the eroded lesion revealed a diffuse dermal, predominantly lymphocytic, infiltrate with histiocytes, eosinophils, and plasma cells. The morphologic features were suspicious for CTCL; however, immunophenotyping and immunogenotyping failed to detect a T‐cell receptor gene rearrangement, precluding a diagnosis of CTCL. Over the next 6 months, the ulcer re‐epithelialized and completely resolved. Eight months later, acitretin and PUVA were discontinued because of new tumor formation. Oral bexarotene and intravenous methotrexate with leucovorin rescue were initiated with stabilization of tumor growth. The right sole lesion has not recurred up to 20 months after treatment.
Two Japanese cases of localized involutional lipoatrophy
Authors: Hisamichi Katsuya , Suga Yasushi , Hashimoto Yukiko , Matsuba Shouichi , Mizoguchi Masayuki , Ogawa Hideoki
Published: March 2003

We present two Japanese cases of involutional lipoatrophy. The first case is that of a 30‐year‐old woman, who first appeared at our hospital complaining of a localized, well‐demarcated depression, approximately 3 × 4 cm in size, normal to slightly erythematous in coloration, on the lateral side of the left upper arm (Fig. 1a). The condition was asymptomatic, and she had noticed this anomaly a month prior to consultation. She received intramuscular injections of corticosteroids of unknown dosage at the affected site for the treatment of allergic rhinitis 4 months prior to her present consultation.

Clinical, histological and immunohistological findings in two cases of localized involutional lipoatrophy. Loss of subcutaneous tissue in the left upper arm is seen both in the first (a) and second (b) cases. Arrowheads indicate the depressed region. (c) The involved regions showed a decrease in the size of individual lipocytes in the first case (bar = 10 µm). (d) Immunoperoxidase staining for CD68 in the first case. Scattered macrophages (arrowheads) were identified within the affected adipose tissue and surrounding connective tissue (bar = 10 µm)

image

The second patient, a 23‐year‐old woman, appeared at our hospital complaining of a similar macule 4 × 4 cm in size, which she noticed several weeks prior to her most recent consultation. She had no history of injury or injection at the site before the development of the condition (Fig. 1b). She had been under treatment for atopic dermatitis since early childhood and was treated only with topical applications of white petrolatum containing 2% salicylic acid for the past several years.

In order to rule out the possibility of acquired partial lipodystrophy associated with localized scleroderma, lupus profundus and the other connective tissue diseases, a histological examination was performed for both patients. Histopathological analysis of the region exhibited a well‐defined fat lobule composed of numerous small adipocytes (Fig. 1c) embedded in hyaline connective tissue. Edema and dilated capillaries were noticeable in the subcutaneous tissue surrounding the area. Inflammatory cells were not prominent, although mononuclear cells were observed in both patients. No epidermal change was seen in either patient.

Direct and indirect immunofluorescence studies revealed no deposits of immunoreactants in the skin of either patient. Immunohistochemical studies with the antibody against macrophage (anti‐CD68 antigen; DAKO.) showed that positive cells were scattered around blood vessels and shrunken lipocytes in the subcutaneous tissues (Fig. 1d). Most of these cells in the fat lobules were also positive for mucin stains such as Alcian blue.

No abnormal findings came to light in the ordinary hematological and blood chemistry examinations of both patients. The autoantibody screening tests using antinuclear, anti‐DNA, anticentromere, and anti‐Scl‐70 antibodies were negative in both patients.
Exercise‐induced anaphylaxis in a marathon runner
Authors: Adams Brian B.
Published: March 2003

After completion of a marathon (26.2 mile running race), a 41‐year‐old woman presented to the medical tent complaining of hand swelling. She denied any hand pain or numbness, diarrhea, nausea, vomiting, or abdominal pain, but admitted to slight hoarseness. Whilst she denied shortness of breath at that moment, she had noted dyspnea out of proportion to her athletic activity during the first 3 miles of the marathon. Thereafter, she ran without respiratory discomfort.

She also recalled hand swelling and dyspnea out of proportion to her activity during her marathon training, especially on warm and humid days. Similar lesions, but to a much milder degree, had developed during brisk walks. These lesions began within the first 15 min of exercise and were associated with pruritus. She admitted to eating, only occasionally, a banana before her runs. She denied developing lesions whilst experiencing sudden powerful emotions, taking hot showers, or eating hot foods. She had no other medical problems, except for depression, for which she took venlafaxine. The symptoms related to her running were unrelated to her venlafaxine intake. She began having the swelling many years before starting the medication and continued having the swelling after discontinuation of venlafaxine. She had no history of atopic dermatitis, but 2 years subsequent to this most recent episode, she had been diagnosed with atopic dermatitis by her primary medical physician. There was no family history of similar eruptions.

Physical examination revealed diffuse swelling of both hands, including all digits, with mild, ill‐defined overlying erythema (Fig. 1). She had similar lesions on her feet and also had mild diffuse facial swelling, but did not have pronounced lip, tongue, or eyelid swelling. The swelling largely resolved within 4 h.

Diffuse swelling involving the hand and all digits with mild overlying erythema. Notice the constriction of the digit caused by the runner's wedding ring

image

Exercise‐induced anaphylaxis was diagnosed. The patient continues to have similar eruptions with exercise, but has refused treatment with antihistamines or epinephrine.