bluuebunny/crossref_metadata_2025 huggingface dataset:
Topical 2% Minoxidil Solution in Male Pattern Alopecia. The Initial European Experience
Authors: Civatte J. ,   the European Topical Minoxidil Study Group
Published: May 2007

ABSTRACT: A double‐blind, 48‐week study was conducted to evaluate the safety and efficacy of topically applied 2% minoxidil solution in the treatment of male pattern baldness. Patients were randomly assigned to receive either 2% minoxidil solution or placebo for the first 24 weeks. After week 24, the placebo patients were crossed over to treatment with 2% minoxidil solution. Of the 428 patients enrolled in the study, 384 were evaluable at the end of the placebo‐controlled period, and 329 were evaluable at the end of the study. At the end of the placebo‐controlled period, the mean nonvellus hair count in the 2% minoxidil group was significantly higher than in the placebo group (p= 0.0187). The mean increase in nonvellus hair in the 2% minoxidil group from baseline to week 24 was also significantly higher than in the placebo group (p= 0.0385). From weeks 24 to 48, when both groups were on active drug, there was a statistically significant increase in the nonvellus hair count for both groups using within‐group analysis. The analysis of the patients'and investigators'assessment of hair growth showed significant differences in the distribution of responses between treatments at week 24. In both cases, it was believed that more hair growth
Book Reviews
Authors: BEERMAN HERMAN
Published: May 2007

Book review in this article:

DIAGNOSTIC ELECTRON MICROSCOPY IN PRACTICAL DERMATOLOGY. Judit Daróczy and I. Rácz.

DERMATOLOGY OF BLACK SKIN. Andre Basset, Bernard Liatund, Bassirou Ndiaye.

SKIN DISEASE IN OLD AGE. Ronald Marks.
IgA Dermatosis in an Adult Chinese Population
Authors: Ratnam K. V.
Published: May 2007

ABSTRACT: During a 10‐year period (1976–1985), eight Chinese patients from a population of 2.5 million fulfilled the criteria for dermatitis herpetiformis and linear IgA bullous dermatosis (LABD). These rare diseases among Asians presented during the third decade of life with homogenous linear IgA deposits along the dermoepidermal junction in four of the eight cases. Three had classic granular deposits in the papillary dermis, while one was negative. There has been a remission in two of the patients. Dermatitis herpetiformis among the Chinese differs from experience elsewhere in that there was no associated gluten‐sensitive enteropathy. The response to a very low‐dose dapsone was excellent in most cases.
Friction Amyloidosis
Authors: Wong Chu‐Kwan , Lin Chrang‐Shi
Published: May 2007

ABSTRACT: Three patients developed a peculiar pigmentation arising from prolonged mechanical friction with the skin due to the use of rough nylon towel or back scratcher for many years. Histochemical stains could not show the existence of amyloid in one of the cases, but amyloid deposition was identified in successive electron microscopic investigations in all three cases. Although “friction melanosis” was originally used by others to describe a close relationship between friction and skin pigmentation in a similar disorder, we consider the term “friction amyloidosis” more appropriate for specifying the important role of friction in causing the early stage of macular amyloidosis. Electron microscopic examination is of importance in establishing a firm diagnosis of this disorder.
Medically Important Solar Ultraviolet
Authors: Ilyas Mohammad , Aziz Damla Abdul , Tajuddin Mohammad Raisuddin
Published: May 2007

ABSTRACT: Results from a 6‐year study of solar ultraviolet A (UVA) radiation measurements at the equatorial location of Penang (5°N) are presented. On clear days, the diurnal flux reaches a very high dosage of about 3.0 × 10−2 KWHM−2 around midday. The average daily total flux is in the range of 7.6 × 10−1 KWHM−2 and does not change much seasonally. The high 83% cloud cover only reduces the incoming flux to about half. The radiation flux represents a lower limit of the incident UVA radiation applicable to much of the equatorial/ tropical region.
The Elastic Tissue of the Skin
Authors: Bouissou Hubert , Pieraggi Marie‐Thérèse , Julian Monique , Savait Thérèsa
Published: May 2007

ABSTRACT: In order to separate the changes of actinic damage from those of simple aging, we studied the elastic fibers in low and high sun‐exposed skins of normal subjects at different ages. Low sun‐exposed skin shows chronologic aging lesions only. These begin at age 30 with a disappearance of oxytalan fibers and with some abnormalities in the reticular and deep dermis; at age 40, aging changes are established: no oxytalan fibers, marked abnormalities, and lysis of elaunic and elastic fibers. In high sun‐exposed skin, age‐related lesions also occur but are associated with more or less precocious elastotic degeneration in reticular and deep dermis. Both types of aging fibers are revealed by the antielastin antibody HB 8, disappear with elastase, but resist collagenase. Actinic elastosis clearly originates from elastin. The two types of change differ in electron microscopic appearance: with spontaneous aging, elastic fibers are desintegrated (loose and porous fibers); in actinic damage, elastotic fibers are thicker and have accentuated microfiabril dense masses. The age‐associated lesions could be due to the activity of protease of fibroblastic origin whereas the elastotic degeneration is probably due to the actinic stimulation of fibroblasts.
Chancroid in El Salvador
Authors: Orellana‐Diáaz Orlando , Hernández‐Pérez Enrique
Published: May 2007

ABSTRACT: Ninety‐five cases of chancroid were studied during a 6‐month period in a dermatologic service in San Salvador; 88 (92.6%) were men and 7 (7.4%) were women, with a ratio of 12.5:1. The minimum age was 13 years and the maximum 46, with an average of 21 years. In most of the cases (81.05%), the incubation period varied from 1 to 7 days. Very painful adenopathies, enough to make walking difficult, were a striking feature in 69 cases (72.6%). Treatment was curative in all cases, except two, who received treatment with co‐trifamole (sulfatrifamole 400 mg/trimethoprim 80 mg). In two cases in which it was not possible to use co‐moxole (allergy, pregnancy), treatment was also curative using erythromycin.
Pyoderma Gangrenosum
Authors: Penmetcha Mohan , Navaratnam Anton E.
Published: May 2007

A 67‐year‐old man presented in April 1983 with three painful ulcers with bluish margins on the right shin and the lower back. The largest lesion was 6 cm in diameter. The lesions had started as painful nodules 8 months previously; these ulcerated within 2 weeks and fluctuated in size. There was no history of arthritis or bowel disease. Full blood count, erythrocyte sedimentation rate, serum electrolytes, urea, and liver enzymes were normal. Antinuclear antibody and rheumatoid factor were negative. The serum IgA level was elevated at 7.35 g/L (normal 0.8–4 g/L). Immunoelec‐trophoresis revealed IgA kappa paraproteinemia. Bence Jones protein was not found in the urine. Skeletal survey, bone marrow, sigmoidoscopy, and rectal biopsy were normal. No bacterial pathogens were grown. Histology of the edge of the ulcer showed dermal abscesses, dermal granulation tissue, and chronic inflammatory infiltrate extending to the subcutis.

During the next 2 years the patient developed active pyodermatous lesions on the trunk and left arm. Between April 1983 and March 1986, the patient received a combination of prednisolone 15–40 mgand azathioprine 50–100 mg daily, a 12‐week course of dapsone 200 mg daily, and repeated courses of oral and topical antibiotics. During this period, although the disease activity was lessened, the lesions never healed completely.

In April 1986, the pyoderma gangrenosum was more active; the ulcers enlarged and deyeloped active pustules at the margins. While the patient was still taking prednisolone 15 mg and azathioprine 50 mg, oral cyclosporin A 6 mg/kg daily (250 mg twice daily) was started; after 3 weeks, the dosage was increased to 10 mg/kg daily (400 mg twice daily) and the prednisolone was reduced to 5 mg daily over 2 months. At 3 weeks the ulcers started to heal, and at seven weeks all ulcers healed, leaving papery scars. Over a period of 4 weeks, the dosage of cyclosporin A was gradually reduced and the ulcers remained healed at a maintenance dosage of 250 mg daily. There was no change in the paraproteinemia. Weekly whole blood cyclosporin A levels were measured, and they fluctuated between 800 ng/ml and 910 ng/ml. On two occasions the levels were >1500 ng/ml.

During the course of the treatment, the patient developed nausea, hypertrichosis, transient thrombocytopenia, and hypertension (blood pressure of 190/110 mmHg); creatinine clearance fell from 87 to 46 ml/min. At a maintenance dosage of 250 mg daily, the blood pressure was 180/100 mmHg and creatinine clearance was 64 ml/min.
Occlusive Hydrocolloid Dressings Applied to Chronic Neuropathic Ulcers
Authors: Mumford J. W. , Mumford S. P.
Published: May 2007

ABSTRACT: The response of 47 chronic ulcers (41 neuropathic [leprosy], 3 stasis, 1 traumatic, and 2 of unknown etiology) to hydrocolloid occlusive dressings was evaluated at a rural south Indian hospital. The response to treatment was objectively evaluated by photographic estimation of the surface areas of the ulcers. Eight ulcers healed over the 2 months of the study, and all but one ulcer improved. This type of dressing may have a valuable role in the management of chronic ulcers in the tropics, particularly those due to leprosy.
Therapy of Tinea Nigra Plantaris
Authors: Sayegh‐CarreÑo Ricardo , Abramovits‐Ackerman William , PlanasGiréoan Guillermo
Published: May 2007

ABSTRACT: Four cases of tinea nigra plantaris are presented. The therapeutic approaches used by different dermatologists who treated these patients are analyzed in order to obtain a meaningful conclusion on how to best manage this infrequent entity. We conclude that the visible affected skin should be scraped off before using either ciclopiroxolamine or an imidazole topically; systemic therapy is not recommended.
Cutaneous Pathology in Toxic Shock Syndrome
Authors: Vuzevski V. D. , Joost Th. van , Wagenvoort J. H. T. , Dey J. J. Michiels
Published: May 2007

ABSTRACT: The pathologic findings in the skin in a new case of toxic shock syndrome (TSS) are detailed and are discussed in view of previously reported data on TSS in the literature. Necrolysis of keratinocytes at different levels of the epidermis In combination with a predominantly perivascular lymphocytic infiltrate were characteristic features in lesional skin biopsy specimens obtained 5 days after the onset of acute illness and during the development of erythroderma with purpura and diffuse intravasal coagulation. Prominent vascular changes in the skin, which have not been reported before in TSS, were excited endothelial cells in combination with the presence of thrombi in the superficial capillaries. Histopathologic investigations of the dermatitis in TSS can be helpful in differentiating this syndrome from other acute toxic skin eruptions.
Adult T‐Cell Leukemia/Lymphoma and Cutaneous T‐Cell Lymphoma Are They Related?
Authors: Yamada Mizuho , Takigawa M. , Iwatsuki K. , Inoue F.
Published: May 2007

ABSTRACT: Comparative studies were performed on clinical and laboratory features of four patients with different types of T‐cell lymphoma of the skin; adult T‐cell leukemia/lymphoma (ATLL), Sézary syndrome, mycosis fungoides, and Ki‐1‐positive lymphoma. All neoplastic cells studied showed a helper‐inducer T‐cell phenotype. A Ki‐1‐positive lymphoma is distinct from other types of cutaneous lymphomas because of unique morphologic and phenotypic features. Clonal proliferation of lymphocytes infected by human T‐cell lymphotrophic virus (HTLV)‐l distinguishes ATLL from other T‐cell lymphomas of the skin, especially in the endemic area of ATLL. From the pathogeneic point of view, ATLL should not be included in a group with mycosis fungoides and Sezary syndrome.
The Vulvo‐Vaginal‐Gingival Syndrome
Authors: Pelisse Monique
Published: May 2007

ABSTRACT: The vulvo‐vaginal‐gingival syndrome, a new form of erosive lichen planus, has recently been described. The clinical features of this condition are reviewed and summarized based on the personal examination of 19 affected patients. Each of these patients demonstrated erosive or des‐quamative disease on some combination of vulvar, vaginal, or gingival mucosal surfaces, but often, at a single point in time, only one or two of the three areas were involved. Clinical features supporting the diagnosis of lichen planus included the regular presence of a narrow white reticulated border at the periphery of the eroded vulvar lesions and the occasional presence of nonerosive lichen planus lesions elsewhere on the skin or mucous membranes. Biopsy specimens taken from the white reticulated border generally revealed the typical histology of lichen planus, whereas biopsy specimens taken from the central eroded surface more often showed only a nonspecific inflammatory reaction. Recognition of the vulvo‐vaginal–gingival syndrome as part of the lichen planus spectrum will likely reduce the frequency of otherwise unclassifiable cases of vulvo‐vaginal desquamative and erosive mucositis.
Risk Factors for Basal Cell Carcinoma
Authors: Hogan Daniel J. , To Teresa , Gran Linda , Wong David , Lane Peter R.
Published: May 2007

Completed questionnaires regarding suspected risk factors for basal cell carcinoma (BCC) were completed by 538 basal cell carcinoma patients and 738 age‐, sex‐, and location‐matched controls in Saskatchewan. Significant risk (actors were identified using chi2 analyses. Relative risks were subsequently computed. The following relative risks were identified: occupation of farming, 1.29; prominent freckles in childhood, 1.23; family history of skin cancer, 1.22; sunburn, 1.19; Irish, Scottish, Welsh mother, 1.19; light skin color, 1.18; red/blond hair color, 1.16; and working outdoors more than 3 hours/day in winter, 1.13: The average age of cases of BCC with a family history of skin cancer was significantly lower than cases of BCC with no family history of skin cancer (63.86 vs. 67.02 years, p = 0.018). No association was noted between BCC and psoriasis.
Bowen's Disease and Internal Malignancy A Meta‐analysis
Authors: Lycka Barry A. S.
Published: May 2007

ABSTRACT: Bowen's disease frequently has been reported to be associated with internal malignancy, although this association has been extremely controversial. The present study uses the technique of meta‐analysis to address this issue by pooling the results of the 12 studies published in the English‐language literature that previously have attempted to study this issue. The results indicated no significant association between the two conditions (chi square, 1 d.f., = 0.128, p> 0.05, 95% confidence interval = 0.105–0.1503). Clearly, no extensive investigation in patients having Bowen's disease is warranted.
Concomitant Unilateral Idiopathic Atrophoderma of Pasini and Pierini (IAPP) and Morphea
Authors: Murphy Phyllis K. , Hymes Sharon R. , Fenske Neil A.
Published: May 2007

ABSTRACT: A 17‐year‐old black man suddenly developed an unilateral eruption of clinically apparent lesions of Idiopathic atrophoderma of Pasini and Pierini (IAPP) and concomitant lesions of morphea. Histologially the lesions are indistinguishable. IAPP appears to be a variant of morphea.
Cutaneous Leishmaniasis In India
Authors: Dogra Jaideep , Aneja Neelam , Lal Bhupendra Behari , Mishra Shyam Nath
Published: May 2007

Abstract: Fifteen patients with cutaneous leishmaniasis were randomly selected for clinical trials with itraconazole. A single daily itraconazole dose of approximately 4 mg per 1 kg of body weight was administered to each patient with breakfast for 6 weeks. Five patients served as controls. On completion of therapy, ten cases in the study group (66.6%) were considered to be cured. No major adverse effects were reported. No significant changes were seen in the controls at the end of the study. The possibility of spontaneous recovery will be discussed in this report even though it is considered to be unlikely. Itraconazole has promising potential in cutaneous leishmaniasis therapy.
Erythromelalgia
Authors: Mehle Anthony L. , Nedorost Susan , Camisa Charles
Published: May 2007

ABSTRACT: Erythromelalgia, characterized by temperature‐dependent redness, pain, and warmth in one or more extremities, may be a primary disease or occur secondarily to underlying illnesses. Myeloproliferative disorders (eg, essential thrombocythemia) and a number of other associations have been reported. Two cases are described: one associated with essential thrombocythemia and the other the first reported case associated with pernicious anemia.
Determination of Different Populations of Blood Lymphocytes in Brazilian Patients with Hanseniasis
Authors: Azulay Rubem David
Published: May 2007

The number of B and T lymphocytes were determined in the blood of 35 Brazilian patients with leprosy: 19 lepromatous (L), 9 borderline (B), 4 tuberculoid (T), and 3 indeterminate (I) and also in a control group of 30 normal individuals. The results, were as follows. B lymphocytes, no differences between the patients with hanseniasis and the control group; T lymphocytes, there was an evident depletion in the patients with L compared to the control group and patients with T; and the average of T lymphocytes in B and I was lower than that seen in the control group and in patients with T. Despite this alteration they approach to what is found in the patients with T and the control group.
Cutaneous Leishmaniasis
Authors: El Darouti M. A. , Al Rubaie S. M.
Published: May 2007

A combination of both intralesional stibogluconate injection and superficial cryotherapy (not including the base of the lesion nor the 1–2 mm rim of the surrounding normal skin) was performed in an attempt to improve the therapeutic efficacy of either of the two modalities when used separately in the treatment of cutaneous leishmaniasis. This combined therapy resulted in a 100% cure rate in 75 patients with 23 lesions of cutaneous leishmaniasis. Two control groups, one treated with superficial cryo and the other treated with intralesional Stibogluconate injection alone were included in the study for evaluation. The results obtained by combined superficial freezing and intralesional Stibogluconate injection were much more impressive than those obtained by each of the two modalities when used alone.
Argon Laser Treatment of Small Keratoacanthomas in Difficult Locations
Authors: Neumann Reinhard A. , Knobler Robert M.
Published: May 2007

Seventeen patients (mean age, 64.7 years) with solitary keratoacanthomas (KA) located on the face and auricles were treated with the argon laser. All lesions were less than 10 mm in diameter and had been present for 2–10 weeks (mean, 3.8 weeks). The diagnosis was made clinically and was confirmed by histology. The lesions were treated with the argon laser using the continuous exposure technique with a power setting of 4.5 watts (W) and a beam diameter of 1 mm. Complete re‐epithelialization occurred within 14–21 days. Excellent treatment results were achieved in 65% of the patients. Thirty‐five percent healed with mild scarring. During a follow‐up period of 2 years no recurrences were noted. The use of the argon laser for removal of small KAs in difficult locations, which would often require invasive surgery, appears to be an effective additional treatment modality.
Cutaneous Phaeohyphomycosis Caused by Exophiala jeanselmei After Renal Transplantation
Authors: Hachisuka Hiroshi , Matsumoto Tadahiko , Kusuhara Masahiro , Nomura Hirofumi , Nakano Shunji , Sasai Yoichiro
Published: May 2007

A 60‐year‐old man who had had a renal transplantation developed a nodule on the dorsum of his right middle finger, which was subsequently diagnosed as cutaneous phaeohyphomycosis caused by Exophiala jeanselmei. The patient was successfully treated with 5–fluorocytosine. To our knowledge, this case is the third reported case in the world caused by this species in a postrenal transplant patient that manifested as phaeohyphomycosis.
Cronkhite‐Canada Syndrome
Authors: Herzberg Arlene J. , Kaplan David L.
Published: May 2007

This article describes the light and electron microscopic studies from a macule and the surrounding lightly hyperpigmented skin of a patient with the Cronkhite‐Canada syndrome. Increased numbers of melanin granules in keratinocytes, increased numbers of melanosomes in melanocytes, and areas with increased numbers of melanocytes were found in the macular lesion. Skin from both the macule and surrounding area were also characterized by compact hyperkeratosis as well as perivascular inflammation and exocytosis not previously reported in these patients.
Acrodermatitis Enteropathica in Saudi Arabia
Authors: Mostafa Wedad Z. , Al‐Zayer A. A.
Published: May 2007

Four patients with acrodermatitis enteropathica (AF) are presented from three Saudi families. The clinical picture in these patients is basically similar to that described elsewhere. These patients, however, showed different degrees of involvement of various body systems. In all cases, low serum zinc levels were documented, and they responded well to zinc supplementation. In the follow‐up evaluation, angular cheilitis was observed as a feature that appears to herald the relapse of disease. Interestingly, when patients are treated, it was the last sign to disappear. Current information on zinc is summarized.
Botryomycosis
Authors: Findlay G. H. , Vismer H. F.
Published: May 2007

ABSTRACT: Botryomycosis is a rare and chronic but readily treatable form of mycetoma. It is caused by a persistent bacterial infection and is distinguished by the formation of grains and multiple sinuses in the skin. The most usual cause is caused by Staphylococcus aureus. The authors'experience with four Transvaal cases is reported. In one case there was destruction of the skull and penetration of the cranial cavity by the botryomycotic process. Treatment with a range of common antistaphylococcal antibiotics led to astonishingly rapid recovery. Among the drugs used, cotrimoxazole was, perhaps, the most practical.
Treatment of Sickle Cell Leg Ulcers with Pentoxifylline
Authors: Frost Marc L. , Treadwell Patricia
Published: May 2007

ABSTRACT: A 58–year‐old black man with leg ulcers of 43 years duration responded to pentoxifylline 400 mg tid in 8 months. The ability of pentoxifylline to increase erythrocyte flexibility and decrease blood viscosity was the basis for our use of this agent. Oral pentoxifylline may be a useful adjunct in healing sickle cell leg ulcers and preventing their recurrence.
Postherpetic Neuralgia and Systemic Corticosteroid Therapy
Authors: Lycka Barry A. S.
Published: May 2007

ABSTRACT: Corticosteroids are frequently advocated for use in prevention of postherpetic neuralgia (PHN), although their use is replete with controversy. The present study is a meta‐analysis of the four well‐controlled clinical studies conducted on this issue. The results indicated there is a statistically significant decrease in proportions affected at 6 and 12 weeks. Standard difference scores were −2.0559 and −4.1442, respectively, and 95% confidence intervals were −3.98% to −31.80% and −14.16% to −43.84%, respectively. At 24 weeks, no differences were detectable between placebo‐ and corticosteroid‐treated groups (SD = 0.6603, p > 0.05, 95% confidence intervals of −6.78% to 24.67%). Side effects of treatment were rare and mild, affecting only 2.5% of patients treated with corticosteroids. No patients had dissemination of disease. Systemic corticosteroid treatment decreases the proportion of patients affected by PHN, especially when it is defined as pain occurring at 6 or 12 weeks after the acute event.
Cutis Verticis Gyrata
Authors: Diven Dayna G. , Tanus Tonny , Raimer Sharon S.
Published: May 2007

Abstract: When the scalp exhibits folds and furrows resembling gyri, it is termed cutis verticis gyrata. The possible etiologies may be categorized as primary essential, primary nonessential, and secondary cutis verticis gyrata. This is based on history, physical examination, and histologic criteria with or without laboratory examinations.
Topical Metronidazole Gel
Authors: Witkowski Joseph A. , Parish Lawrence Charles
Published: May 2007

Abstract: Ten putrid‐smelling decubitus ulcers were successfully treated with metronidazole gel. Anaerobes were cultured from five ulcers and Wood's light examination was positive in four ulcers before treatment. The odor was eliminated after 36 hours of therapy. All results of post‐treatment cultures of anaerobes and Wood's light examinations were negative.
Topical Metronidazole Gel
Authors: Nielsen P. Gamborg
Published: May 2007

Abstract: Two percent metronidazole and 5% benzoyl peroxide cream was evaluated in four clinical trials. It could be shown that this test cream was significantly better than 5% benzoyl peroxide jelly alone, and significantly better than a placebo cream, it was also shown that 2% metronidazole and 5% benzoyl peroxide cream was equal to systemic oxytetracycline therapy. The advisability of the combination of metronidazole and benzoyl peroxide was simultaneously discussed.
Oral Pemphigus Vuigaris in Young Adults
Authors: Firth Norman , Rich Alison , Varigos George , Reade Peter C
Published: May 2007

Abstract: Three patients, aged 31, 26, and 22 years, had pemphigus vulgaris. A delay in diagnosis and appropriate treatment occurred because the initial presentation was confined to the oral mucosa.
Book Reviews
Authors: Beerman Herman
Published: May 2007

Book reviewed in this article:

Differential Diagnosis in Dermatology. Richard Ashton and Barbara Leppard.

Manuale Di Dermatologia E Venereologia. Maurizio Binazzi.

Neoplasms with Eccrine Differentiation. P. Abenoza and A. Bernard Ackerman.
Treatment of Pemphigus
Authors: Piamphongsant Thada , Ophaswongse Suwirakorn
Published: May 2007

ABSTRACT: Ninety‐eight cases of various types of pemphigus were treated between 1978–1987. Sixty‐one cases were pemphigus vulgaris (PV), 22 cases were pemphigus foliaceus, generalized type (PFG) in which one case developed pemphigus vegetans, 11 cases were pemphigus foliaceus localized type (PFL), and four cases were pemphigus erythematosus (PE). Fifteen mild cases of PV and three mild PFG were treated with corticosteroid (prednisolone or prednisone) alone, and dapsone or cyclophosphamide (CP) were added as treatment failed in two cases of each. Dapsone alone was used effectively in three cases of mild PV. Eight cases of moderate and three cases of severe PV, as well as five cases of moderate PFG, failed to respond to corticosteroid alone but were cleared by the addition of CP. Thirty‐two moderate cases of PV and PFG treated with a combination of corticosteroid 60 mg/day plus initial CP and 14 severe cases of PV and PFG treated with corticosteroid 120 mg/day plus initial CP, resulted in clearing skin lesions in 2 months. Azathioprine or chlorambucil were substituted in three cases who developed CP toxicity. Addition of gold sodiumthiomalate in six refractory cases when the above regimens failed, caused a complete remission in two and partial control in four. Higher dosage of prednisolone or prednisone more than 120 mg/day has never been used. Eleven cases of PFL and four cases of PE were treated with uneventfully good results. Intercellular antibody titers became negative within 4.67 months except in refractory cases, however, the treatment was continued for at least 3 years. Herpes simplex superimposed infection was more common than herpes zoster infection. Remission rate at present is 32.76%. The causes of death in four cases were assumed to be due to the complications of treatment.
Tissue Level Lymphocyte Subpopulations in Donovanosis
Authors: Sehgal Virendra N. , Gupta Madan M. , Jain Vinod K.
Published: May 2007

Abstract: Total T‐, B‐, T4‐, and T8‐lymphocyte populations were estimated in tissue sections of ulcers from 22 donovanosis patients, comprising 17 ulcerogranulomatous, four hypertrophic, and one sclerotic variants, using monoclonal antibodies and immunohistochemical technique (PAP). T‐ and B‐lymphocytic infiltrations in the tissues were almost identical, without any significant difference in ulcerogranulomatous and hypertrophic variants. The T4:T8 ratio in ulcerogranulomatous variants, however, was 1.41, which was significantly higher than that of hypertrophic variants (1.28), indicating a greater cell‐mediated immune response in the former than in the latter. This is substantiated by the documentation of a paucity of Donovan bodies, both in the tissue smear and slow (overnight) Giemsa‐stained tissue sections, in the ulcerogranulomatous variant.
The Role of Cyclosporine A in the Treatment of Pemphigus Erythematosus
Authors: Campolmi P. , Bonan P. , Lotti T. , Palleschi G. M. , Fabbri P. , Panconesi E.
Published: May 2007

Abstract: Steroids are effective in the autoimmune bullous disease pemphigus; however, treatment may be difficult to sustain because of severe side effects. Cyclosporine A acts mainly on helper/inducer T lymphocytes and has few side effects at few doses. We report three patients with pemphigus erythematosus who had a relapse while receiving the maintenance dose of steroid therapy. All patients who were treated with both cyclosporine A (5 mg/kg/d) and prednisone (1 mg/ kg/d) responded remarkably well to combined therapy. After clearing, prednisone was discontinued and cyclosporine A was reduced to 2 to 3 mg/kg/d. With this treatment, all patients have been virtually free of symptoms, have remained well, and have had normal laboratory values.
Melanoma
Authors: Williams Hywel C. , Smith David , du Vivier Anthony
Published: May 2007

A retrospective review of 182 cutaneous melanomas seen at King's College Hospital from 1970 to 1987 showed that surgeons saw much thicker melanomas (median 3.64 mm) when compared to dermatologists (median 1.14 mm). Surgeons saw a greater proportion of nodular melanomas, less superficial spreading melanomas, were less likely to make the correct clinical diagnosis, and were more likely to perform wide excisions for thin melanomas (less than 2 mm) when compared to dermatologists. General surgeons see a different group of melanoma patients compared to dermatologists and manage them differently from dermatologists working with plastic surgeons. There is a need for a combined approach for the diagnosis and management of cutaneous melanoma between specialists.
8‐Methoxypsoralen Serum Levels in Poor Responders to Photochemotherapy
Authors: Walther Thomas , Haustein Uwe‐Frithjof
Published: May 2007

Abstract: 8‐Methoxypsoralen (8‐MOP) serum levels of psoriatic patients poorly responsive to photochemotherapy (PUVA) treatment (problem cases) were determined by the HPLC method with 11 single blood probes over 8 hours. Abnormally low or deviated serum levels were found in 7 of 11 PUVA problem patients. There was a great interindividually different first‐pass effect for 8‐MOP in dependence on the galenic formulation of the 8‐MOP brand; therefore, the change to another 8‐MOP brand with a modern galenic formulation led only to a slight increase of serum levels, and consequently an increase in the 8‐MOP dosage was necessary. It is important to be cautious at this point because patients may show an unproportional increase of 8‐MOP serum levels due to the individually limited capacity of biotransformation. The studies of the authors reaffirm the necessity of the determination of 8‐MOP serum levels in problem cases of PUVA therapy.
Reticulate Nonmelanocytic Hyperpigmentation Anomaly
Authors: Oriba Howard A. , Lo Jacob S. , Dijkstra Jacob W. E. , Bergfeld Wilma F.
Published: May 2007

ABSTRACT: A 26‐year‐old white woman had reticulate nonmelanocytic hyperpigmentation anomaly characterized by partially blanching red‐brown papules and macules and a histologic picture of digitate epithelial budding proliferation with lightly pigmented rete ridges. Except for the classically described hyperpigmentation at the rete ridge tips, the patient has Dowling‐Degos disease. This case of a reticulate nonmelanocytic hyperpigmentation anomaly is probably a variant of Dowling‐Degos disease.
PILOMATRICOMA: A RETROSPECTIVE STUDY
Authors: AHMAD MANZOOR , KHAN INAM ULLAH , KHAN AMIR HUSSAIN , REHMAN SIMEEN BER , ZUBAIRI ADNAN MANSOOR
Published: May 2007

A study of 53 Pakistani patients with pilomatricoma diagnosed at AFIP during 1985–1989 is presented. It constituted 37.2% of all benign adnexal tumors, during the same period. 56.2% of patients were more than 30 years of age. Differences in site, sex, and age distribution from Western reports were observed. Unusual clinical presentations were also noted. This study outlines the clinicopathologic features of pilomatricoma in Pakistan.
MELASMA‐LIKE (PIGMENTED) ACTINIC LICHEN PLANUS
Authors: AL‐FOUZAN ABDULWAHAB S. , HASSAB‐EL‐NABY HUSSEIN M.M.
Published: May 2007

Four patients suffering from pigmented actinic lichen planus were studied. Clinically, the lesions are melasma‐like, affecting mainly the face and exacerbating in summer and spring time. The histopathologic and immunofluorescence studies showed typical changes of actinic lichen planus. The possibility of pigmented actinic lichen planus should be considered in every patient with facial melanosis.
ALOPECIA UNIVERSALIS TREATED WITH ORAL CYCLOSPORINE A AND PREDNISOLONE: IMMUNOLOGIC STUDIES
Authors: TESHIMA HIDEKI , URABE ATSUMICHI , IRIE MASAHIRO , NAKAGAWA TETSUYA , NAKAYAMA JUICHIRO , HORI YOSHIAKI
Published: May 2007

Alopecia universalis is a refractory condition. Although the cause of this disease is unknown, immunologic abnormalities have recently been suspected. Thus, we treated six cases of refractory alopecia universalis with immunotherapy. Oral administration of cyclosporine A (2.5 mg/kg) and prednisolone (5 mg/day) resulted in marked symptomatic improvement. Cyclosporine A did not produce any side effects because the administered dosage was relatively low. At present, more than 6 months after the cessation of treatment, recurrence of alopecia has not been seen. Oral administration of low‐dose cyclosporine A and prednisolone is considered to be an effective treatment for this disease. Immunologic examination of peripheral blood demonstrated improvement of immunologic function. In particular, cos‐positive T cells, NK cells, and C3, which had been reduced, were increased. A reduction in active CD4 cells, eosinophils, and circulating immune complexes was observed. Histology with fluorescent antibodies showed T‐cell infiltration around the hair matrixes. This phenomenon was no longer observed after treatment. These improvements in immunologic function were seen in parallel with the resolution of the clinical symptoms, indicating that immunologic abnormalities are related to this disease.
INCIDENCE OF SKIN DISEASE IN CUZCO, PERU
Authors: FAILMEZGER CHARLES
Published: May 2007

In the nations of the developing world, the incidence of skin disease is especially affected by geography. While most studies focus on the tropics, this report records the pattern of skin diseases encountered in a South American mountain city. Among 1277 patients examined, the noninfectious dermatoses predominated.
BEHÇET'S DISEASE AND SURGICAL INTERVENTION
Authors: BOZKURT MERAL , TORIN GAMZE , AKSAKAL BURHAN , ATAOGTLU ÖMÜR
Published: May 2007

Behçet's Disease (BD) is a systemic disorder with an unknown etiopathogenesis. The need for clinical criteria in the establishment of diagnosis is of great importance. We present the case of a 27‐year‐old man with BD, who had a surgical operation during the active period of his disease and experienced subsequent complications. Cutaneous hyper‐reactivity response to minor cutaneous trauma—the pathergy phenomenon— is found in most patients with BD. Theoretically, major traumas may lead to major reactions in the skin or any of the organs. In practice, we observed that while there was a severe inflammatory reaction — histopathologically a superficial perivascular dermatitis—which developed at the incision site, the systemic symptoms of the disease increased in spite of intensive treatment of the condition.
DETECTION OF AUTOIMMUNITY PARAMETERS IN THE ACQUIRED IMMUNODEFICIENCY SYNDROME (aids)
Authors: KYRIAKIS KYRIAKOS , TOSCA ANDRONIKI , KATSANTONIS JOHN , HATZIVASILIOU MARIA , ELIOPOULOS GEORGE , STRATIGOS JOHN
Published: May 2007

We have examined various autoimmunity parameters in AIDS with special emphasis on the expression of pemphigus and bullous pemphigoid antibodies. Sera from healthy seropositive individuals without syphilis (cs−, n = 17), seropositive individuals with syphilis (cs+, n = 11), and patients with AIDS (n = 6) were studied and compared with normal controls (n = 30); autoimmunity parameters related to dermatology were evaluated. Indirect immunofluorescence (IIF) for pemphigus and pemphigoid antibodies, antinuclear antibodies (ANA), anti‐DNA antibodies, antismooth muscle antibodies (ASMA) antimitochondrial antibodies (AMA), and antithyroid antibodies (ATA) was carried out and findings were graded with a cumulative index (ci) for each patient group. Pemphigus and bullous pemphigoid‐like antibodies (IgG, PV+BP) were detected in 33% of the AIDS patients. Statistically increased ci (P<0.01) was found in the cs− group compared with the cs+ group and in the AIDS group compared with cs− (P<0.01).
SPECIFIC CUTANEOUS LESIONS IN A CD8+ PERIPHERAL T‐CELL LYMPHOMA
Authors: MARTI ROSA M. , ESTRACH TERESA , PALOU JOSÉ , URBANO‐ISPIZUA ALVARO , GRATACOS JORDI , CERVERA RICARDO , PELIU EVARISTO , GRAU JOSÉ M. , MASCARO JOSÉ M.
Published: May 2007

Histopathologic, immunohistochemical, and ultrastructural studies were carried out on cutaneous lesions of a 43‐year‐old man with an aggressive peripheral T‐cell lymphoma involving the lung, central nervous system, bone marrow, and skin. Some results are distinctive and not previously reported, such as extremely strong epidermotropism, aberrant CDS+ immunophenotype with lack of one pan T antigen (CDS), and giant cytoplasmic granules. We discuss these features comparing them with other hematologic malignancies usually involving the skin, such as cutaneous T‐cell lymphoma, adult T‐cell leukemia/lymphoma, angiocentric lymphomas, and malignant histiocytosis.
ISSUES IN MEASURING PERCUTANEOUS ABSORPTION OF TOPICAL CORTICOSTEROIDS
Authors: MAIBACH HOWARD I. , WESTER RONALD C.
Published: May 2007

Studies that examine the pharmacokinetics of topical drugs at their site of action in the skin have been difficult to perform and, therefore, limited in number. In the early years of topical drug pharmacokinetic research, investigators had to rely on the measurement of less direct indicators of drug throughput such as blood levels and urinary excretion. Today, advances in theory are impelling pharmacokinetic research in new directions, including the measurement of drug availability in tissue compartments within the skin. This research will lead to greater precision in pharmacokinetic measurement and greater relevance of these measurements to the therapeutic efficacy of topical cortico‐steroids in cutaneous disease states.
POROKERATOSIS IN IMMUNOSUPPRESSED AND NONIMMUNOSUPPRESSED PATIENTS
Authors: RAYCHAUDHURI SIBA P. , SMOLLER BRUCE R.
Published: May 2007

Porokeratosis is an uncommon, inherited, autosomally dominant disorder. In the last decade association of porokeratosis and immunosuppression has been observed. In this study we carried out a comparative study between immunosup‐pressed and nonimmunosuppressed porokeratosis cases. We found that 9 out of 20 cases of porokeratosis were associated with organ transplantation/immunosuppression. Clinicopathologic study revealed that the pattern of disease is alike both in immunosuppressed and nonimmunosuppress‐ed patients. Our observations indicate that immune modulation could be a factor in the genesis of porokeratosis.
CANDIDA ALBICANS ‐ SAPROPHYTE OR PATHOGEN?
Authors: JAAFAR RADZI , PETTIT JOHN H.S.
Published: May 2007

Skin scrapings taken from toe spaces of 200 healthy volunteers and from toe webs and groins of 150 pediatric patients were cultured for Candida albicans using the serum germ‐tube test. The results showed that Candida albicans can be isolated in about 15% of normal toe spaces and 14% of children with normal groins. Although Candida albicans can be found in various grades of athlete's foot and also in some abnormal groins, we believe that it is not necessarily responsible for these conditions and is often present at these sites only as a saprophyte.
TREATMENT OF BENIGN PIGMENTED EPIDERMAL LESIONS BY Q‐SWITCHED RUBY LASER
Authors: TAYLOR CHARLES R. , ANDERSON R. ROX
Published: May 2007

Background. Disorders of cutaneous pigmentation are a common problem, which can cause substantial cosmetic morbidity. Traditional treatments are often ineffective and sometimes associated with further hyperpigmentation, hypo‐pigmentation, or scarring. Because the Q‐switched ruby laser has proven useful for the treatment of tattoos and, in a small number of cases, benign disorders of the epidermal melanin, we decided to apply this modality systematically to additional benign pigmented lesions.

Methods. Thirty‐four benign pigmented epidermal lesions including lentigines, café‐au‐lait macules, and nevi spili in nine white patients were exposed to single pulses of a Q‐switched ruby laser (694 nm, 40 ns pulse duration) at 4.5 and/or 7.5 J/cm2.

Results. After one treatment, substantial clearing occurred at each fluence in all lentigines and café‐au‐lait macules. Initial improvement was achieved in a small nevus spilus after two treatments at 4.5 J/cm2, and a larger nevus spilus after one treatment at 7.5 J/cm2 with complete removal of the junctional or compound nevi portion but no improvement in the cafe‐au‐lait portion. Complete return of the background pigment was observed by 1 year. There was no scarring. Immediately after treatment, histology revealed vacuolizaton of keratinocytes and melanocytes, and occasional subepidermal blisters.

Conclusions. These findings show that while the Q‐switched ruby laser may not be entirely useful for treating nevi spili, it does provide an effective treatment for lentigines and café‐au‐lait macules.
ULTRASTRUCTURE OF TRICHOPHYTON VIOLACEUM
Authors: AMER MOHAMED A. , TAHA MOHAMED , DIAB NAGWA A. , EL MOUGHITH A. , EL HARRAS MONA
Published: May 2007

Background. The ultrastructure of different fungi have been described in recent literature; however, few reports have concerned dermatophytes.

Methods. Fine structure of Trichophyton violaceum was observed using electron microscopy.

Results. Hyphae appeared as branched segmented filaments with a cell wall consisting of two layers. Thin electron dense plasma membrane was evident continuous with the inner surface of the cell wall. Septal walls with central pores and a uniform electron opacity plugs were seen. The hyphae were multinucleated and the cytoplasm contained endoplasmic reticulum, mitochondria, and vacuoles.

Conclusions. Although these findings showed ultrastructural similarities of the cell wall with Microsporum canis, Microsporum gypseum and Microsporum audouinii, there were some points of difference in the ultrastructure of the hyphae in Epidermophyton floccosum, and in the mitochondria of Trichophyton mentagrophytes as described by other investigators.
PSORIASIS‐LIKE LESIONS IN GUINEA PIGS RECEIVING PROPRANOLOL
Authors: TÜZÜN BINNUR , TÜZÜN YALÇIN , GÜREL NURAY , TÜZÜNER NÜKHET , ALTUG TUNCAY , BÜYÜKDEVRIM SEVIM
Published: May 2007

Background. β‐Blockers cause a psoriasiform eruption. We investigated the skin effects of systemic propranolol in a formal protocol.

Methods. Propranolol, 0.1 mg/day, was used systemically by gavage in eight albino guinea pigs. Normal saline was given to another group of seven guinea pigs.

Results. Propranolol produced psoriasiform lesions in five of seven guinea pigs on the 30th day. Biopsies showed acanthosis, parakeratosis, microabscesses, and cellular infiltration of upper dermis. Topical application of propranolol did not produce clinical psoriasiform changes, while acanthosis and papillomatosis was observed in six of the six guinea pigs.

Conclusions. Systemically given propranolol can lead to psoriasis‐like lesions, which might be due to a serum factor.
TREATMENT OF PAUCIBACILLARY LEPROSY
Authors: SAXENA UMA , MISRA R.S. , RAMESH V.
Published: May 2007

Background. When multidrug therapy was introduced a decade ago to shorten the duration of treatment, paucibacillary leprosy was advocated 6 months of treatment. The diagnosis is based mainly on clinical and histopathologic examination, negative slit‐skin smear examination, and positive lepromin test.

Methods. The case records of 508 paucibacillary leprosy patients attending our urban leprosy center have been analyzed with reference to regularity of therapy, response to multidrug regimen, follow‐up, and relapse.

Results. The incidence of paucibacillary leprosy was found to be 37%. Defaulter rate was 45%. Nine percent of the cases attended the center with deformities emphasizing the need for corrective surgery and early case detection to prevent them.

Conclusions. The main problem that we faced was the optimum duration of treatment, which is as yet an unsettled question. The opinions of other workers have been given, and a slight modification in current WHO regimen has been suggested without significantly affecting the cost of therapy.
MESOGLYCAN TREATMENT RESTORES DEFECTIVE FIBRINOLYTIC POTENTIAL IN CUTANEOUS NECROTIZING VENULITIS
Authors: LOTTI TORELLO , CELASCO GIUSEPPE , TSAMPAU DIONIGI , TEOFOLI PATRIZIA , BENCI MAUKIZIO , DAHM MICHAEL , COMACCHI CLAUDIO , GHERSETICH ILARIA , MATUCCI‐CEIUNIC MARCO
Published: May 2007

Background. Cutaneous necrotizing venulitis (CNV) is a clinical disorder associated with segmental inflammation and fibrinoid necrosis of the dermal venules. It usually presents clinically as palpable purpura, even sometimes as nodules, bullae, ulcers, and urticarial lesions. This form, when showing as leukocytoclastic vasculitis is apparently characterized by the tissue deposition of circulating immune complexes and by reduced cutaneous (cfa) and plasma (pfa) fibrinolytic activity due to reduced release of plasminogen activator (PA) from the venular endotheliocytes. Reduced cfa and pfa cause large amounts of fibrin deposits in both intra‐ and perivascular areas, which are able to magnify and self perpetuate the inflammatory processes following immune complex deposition.

Methods. We have studied both the pfa and cfa potential (the maximum amount of PA released in the skin after certain stimuli) and the deposits of immunoglobulins, C3, and fibrin related antigen, before and after intradermal injection of histamine (a substance able to provoke endothelial release of PA), in three subjects affected by CNV before and 20 days after 10 mg/kg/day I.M. treatment with the fibrinolytic agent mesoglycan.

Results. Cutaneous fibrinolytic activity and cfa potential, reduced prior to treatment, was normal after treatment, while the deposits of immunoglobulins (IgA, IgG and IgM), C3, and fibrin related antigen, detected with direct immune fluorescence (dif) showed similar findings before and after treatment.

Conclusions. These data suggest that reduced cfa may play a major role in the pathogenesis of the immunologically mediated injury in cnv. The intraperivascular deposition of fibrin is favored. The fibrinolytic agent mesoglycan seems effective in restoring defective fibrinolysis in patients affected by cutaneous necrotizing venulitis, suggesting that in cases with reduced cutaneous fibrinolitic activity (or potential) the use of a fibrinolytic agent should be considered.