bluuebunny/crossref_metadata_2025 huggingface dataset:
Corticosteroid‐Unresponsive Pemphigus Vulgaris Following Antiepileptic Therapy
Authors: Sehgal Virendra N. , Srivastava Govind
Published: May 2007

A 40‐year‐old man, an established pemphigus vulgaris patient in remission, reported with recurrence of extensive blisters over the skin and the mucous membranes. In addition, he had grand mal epilepsy for which he was being given 200 mg diphenylhydantoin and 60 mg phenobarbitone. In view of the severity of the condition, he was admitted and was administered 100 mg (20 tablets) of prednisolone daily in addition to antiepileptic treatment. Despite this, there was hardly any perceptible amelioration of his clinical picture. Instead, fresh lesions continued to add to its severity, resulting in extensive erosions of the skin and mucous membranes. We were impelled to increase the dose to 30 mg dexamethasone (=300 mg prednisolone), a dose so far never given to any other pemphigus patient in our institution. This too had no effect. At this point, interaction of antiepileptic drugs and steroids was believed to be responsible. Accordingly, antiepileptic drugs were gradually tapered over 7 days. Following their discontinuation, a dramatic improvement was noticed in the next 72 hours, which was characterized by the absence of new lesion and regression of old lesions. The further course of the disease was uneventful, and the lesions cleared completely in 15 days. Corticosteroids were gradually tapered off under the cover of cyclophosphamide 100 mg daily.
Pediculosis Capitis in Benghazi, Libya
Authors: Bharija S. C. , Kanwar A. J. , Singh Gurmohan , Belhaj M. S.
Published: May 2007

ABSTRACT: A school survey of pediculosis capitis in Benghazi, Libya, revealed an alarmingly high prevelence of 78.6%. The percentage of infestation was 67.2% for boys and 88.1 % for girls. It was more frequent in schools located in rural areas (85.55%) as compared with those in urban areas (44.28%). There was no significant difference in infestation in younger and older children of either sex. Besides other factors for such a high prevalence, the lack of health education of family members may play a crucial role in transference and louse infestation.
Widespread Bullous Fixed Drug Eruption Mimicking Toxic Epidermal Necrolysis
Authors: Baird Bonnie J. , De Villez Richard L.
Published: May 2007

ABSTRACT: This paper is written to heighten awareness of the presence of the most severe form of fixed drug eruption. Two patients with a widespread bullous form of fixed drug eruption (FDE) were initially given the diagnosis of toxic epidermal necrolysis (TEN). Both gave a history of a previous widespread eruption from the responsible drug, each had biopsies consistent with fixed drug eruption, and most importantly, both had an uncomplicated course, with complete cutaneous reepithelialization within 10 days. These observations suggest that widespread bullous fixed drug eruption may portend a more favorable prognosis than TEN, thus stressing the potential importance of distinguishing the two diseases. A review of fixed drug eruption and possible means of differentiating the widespread bullous form from TEN are discussed.
Cutaneous Sarcoidosis and Tribal Scarifications in West Africa
Authors: Alabi G. O. , George A. O.
Published: May 2007

ABSTRACT: Sarcoidosis is quite common in American and West Indian blacks. In America, the incidence in blacks could be up to 10 times higher than in whites. Sarcoidosis is generally believed to be rarer in African blacks and especially along the West African coast from which the American blacks trace their ancestry. The difference in incidence may be due to environmental influences, poor reporting system from inadequate local awareness of the presentation, confusion with tuberculosis, and lack of the Kveim antigen. Diagnosis of sarcoidosis is most commonly made from the pulmonary and skin manifestations. Since the skin manifestation presents readily for observation without the need for costly devices like x‐ray machines, the present study focused on and analyzed the seven cases seen in the skin clinic within a period of 2 years (an incidence of 0.85%), showing that the commonest Presentation was as scar‐sarcoid on longstanding tribal marks. Tribal scarification is common in West Africa, and one should investigate any change in a longstanding scar. This heightened awareness in areas where scarification is or was practiced could endthe belief of the rarity of Sarcoidosis in the West African subregion.
Hyperpigmentation of the Clavicular Zone: A Variant of Friction Melanosis
Authors: Magaña‐García Mario , Carrasco Eugeimio , Herrera‐Goepfert Roberto , Pueblitz‐Peredo Siegfried
Published: May 2007

ABSTRACT: This paper reports on clinical, laboratory, and pathologic findings of 10 cases of an idiopathic form of hyperpigmentation of the clavicular zone, a peculiar entity of circumscribed, glistening, pigmented lesions affecting young Latin women. Pathologic findings consisted of focal to extensive necrosis of the epidermis, focal areas of junctional cleavage, and melanin deposition within the epidermis, dermis, and melanophages, which places this lesion within the group of brown hypermelanoses. The authors feel that friction with clothing or with scrub pads made of sedge (a very common practice amongst mexicans in the bath room) against clavicular protuberances is fundamental in its pathogenesis.
Percutaneous Transluminal Angioplasty
Authors: Lewis John E.
Published: May 2007

ABSTRACT: Percutaneous transluminal angioplasty in the lower extremities is often an efficacious and safe adjunct to medical or surgical treatment, or both, of recalcitrant ischemic ulcers.
Vibrio vulnificus Infection in Hawaii
Authors: Nip‐Sakamoto Carla J. , Pien Francis D.
Published: May 2007

ABSTRACT: A life‐threatening Vibrio vulnificus infection occurred in a 52‐year‐old Korean woman with hepatic cirrhosis. Four days after ingesting raw crab, the patient presented to the hospital with nausea, vomiting, fever, hypotension, and hemorrhagic blistering of the left foot. Vibrio vulnificus was recovered from both her blood and a foot wound.
Bullous Systemic Lupus Erythematosus
Authors: Fleming Matthew G. , Bergfeld Wilma F. , Tomecki Kenneth J. , Tuthill Ralph J. , Morris Molly , Benedetto Ernest A. , Weber L. Arthur
Published: May 2007

ABSTRACT: Two patients with bullous systemic lupus erythematosus are reported. In one, the disease appears to have been caused by hydralazine. The cutaneous lesions of bullous SLE have not been previously reported in drug‐induced lupus.
Incidence of Chancroid in Vienna From 1980 to 1988
Authors: Neumann R. A. , Knobler R. M. , Aberer E. , Kopp W.
Published: May 2007

ABSTRACT: The authors report on a retrospective study of the occurrence of chancroid in the city of Vienna during the past 10 years. After identifying two patients at the authors' department with chancroid in March 1988, the authors investigated the frequency with which this disease presented during the last 10 years. Of 32 patients, six presented between 1977 and 1980, and one patient in 1987. The remaining 25 patients were diagnosed within a 4‐month period in 1981, suggesting a limited outbreak. The source of this infection could be traced to Turkey; infected prostitutes contributed to further spread in Vienna. All patients were treated successfully with sulfamethoxazole/trimethoprim. Efficient control of this outbreak can be attributed to inpatient treatment of the prostitutes. Appropriate and timely treatment must be proceeded by careful and exact diagnosis of this disease whose clinical picture is constantly diverging from its classical form.
Book Reviews
Authors: BEERMAN HERMAN
Published: May 2007

Book review in this article:

COMMON PROBLEMS IN DERMATOLOGY. Kenneth E. Greer.

DERMATOLOGICAL SIGNS OF INTERNAL DISEASE. J. P. Callen, J. Jorizzo, K. E. Greer, N. Penneys, W. Piette, J. J. Zone.

SURGICAL ANATOMY OF THE SKIN. Stuart J. Salache, Gerald Bernstein, Mickey Senkarik.

ESSAYS ON LEPROSY. Terence J. Ryan, A. Colin McDougall, Editors.
A Preliminary Study on the Link Between PUVA and Skin Cancer
Authors: Chuang Tsu‐Yi , Tse Jimson , Cripps Derek J.
Published: May 2007

One hundred four psoriatic patients who had 8‐methoxypsoralen‐ultraviolet light A (PUVA) treatment between 1975–1987 were investigated to determine if skin cancer had ever occurred during or after the therapeutic period. Incidence data of skin cancer was applied to this group of patients to measure the expected number of patients with skin cancer. The significance of observed number versus expected of PUVA‐treated patients with skin cancer was analyzed. The authors did not observe a significant increase of patients with skin cancer.
Drug‐Induced Toxic Epidermal Necrolysis Treated with Cyclosporin
Authors: Renfro Lisa , Grant‐Kels Jane M. , Daman Lauren A.
Published: May 2007

A 35‐year‐old woman developed toxic epidermal necrolysis secondary to phenytoin. Because the life‐threatening eruption was resistant to prednisone and high‐dose methylprednisolone therapy, cyclosporine therapy was initiated. Within 24–48 hours, the eruption stabilized and the patient improved.
Clinical Evaluation of an After‐Pediculicide Nit Removal System
Authors: Defelice Janet , Rumsfield Jean , Bernstein Joel E. , Roshal Jay Y.
Published: May 2007

A significant problem in the management of pediculosis is the removal of nits from the hair after pediculicide treatment. This study describes use of a nit removal system incorporating a creme rinse containing formic acid that loosens' the bond between the nit and hair. Twenty‐four children with pediculosis capitis, age 4 to 12 years, were evaluated. Sections of hair with equivalent numbers of nits were identified as control or test sites. Combing for 5 minutes after use of the formic acid rinse removed 93.5% of nits compared with a 27.6% reduction in the control section (p < 0.0001). These results demonstrate that use of this nit removal system greatly facilitates nit removal.
Giant Cell Tumor of Tendon Sheath
Authors: Sapra Sheetal , Prokopetz Robert , Murray A. H.
Published: May 2007

The giant cell tumor of tendon sheath (localized nodular tenosynovitis) is the second most common tumor involving the hand but is only rarely reported in the dermatologic literature. A case of giant cell tumor and a review of the clinical and pathologic records of 111 patients are discussed.
Dermal Leishmaniasis and Rifampicin
Authors: Joshi Ravi Kumar , Nambiar P. M. K.
Published: May 2007

In an uncontrolled study, the effectiveness of rifampicin was assessed in cutaneous leishmaniasis. Twelve of 15 patients (80%) showed good response. The treatment ranged from 2 to 12 weeks. Tolerance of the drug was excellent and apart from red discolouration of the urine, no other side effects were encountered. Rifampicin appears to have a place in the management of cutaneous leishmaniasis.
Markers and Relative Risk in a German Population for Developing Malignant Melanoma
Authors: Garbe Claus , Krüger Sabine , Stadler Rudolf , Guggenmoos‐Holzmann Irene , Orfanos Constantin E.
Published: May 2007

ABSTRACT: The relationship between cutaneous malignant melanoma (MM) and possible risk factors was assessed in a case‐controlled study. Two hundred patients and 200 non‐melanoma controls of German origin matched for age and sex were interviewed and examined for pigmented moles and pigmentation characteristics. In patients with MM significantly more melanocytic nevi ≥ 2 mm (MCN) were found (mean, 53 MCN) compared to control cases (mean, 18 MCN). For persons with >60 MCN the relative risk (RR) for developing MM increased 15 times compared to ≤ MCN. Additional independent markers for an increased risk were presence of atypical MCN (RR = 7 vs. none) found in 45% of patients and in 5% of the control group, moderate to large numbers of actinic lentigines (RR = 6.2 vs. none), and lack of tanning as well as a tendency to sunburn (skin type I; RR = 2.2 vs. skin type IV) No significant correlation was found between the relative risk for MM and hair color, eye color, duration of free time sun exposure and number of sunburns. Individuals with permanent outdoor profession and sun exposure, however, showed a clearly increased relative risk for developing MM.
Changing Pattern of Cutaneous Tuberculosis
Authors: Sehgal Virendra N. , Jain Manoj K. , Srivastava Govind
Published: May 2007

ABSTRACT: During the past 3 years, we have seen a changing pattern of cutaneous tuberculosis, in which its incidence was recorded to show an upward trend affecting predominantly the adult men. The latter was true in reinfection‐lupus vulgaris and tuberculosis verrucosa cutis, whereas a substantial number of children were victims of reactivation‐scrofuloderma. The duration of the disease was usually short in reactivation tuberculosis. Its clinical expression, however, conformed largely to the ritual text except that apple‐jelly nodules were infrequently demonstrated. Similarly, the morbidity was low. The affliction of the extremities in lupus vulgaris, in particular, was a contrasting feature. The histopathology invariably either confirmed or supplemented the clinical impression. The ultimate confirmation of cutaneous tuberculosis was done only by the demonstration of Mycobacterium tuberculosis in smears, or its recovery in vitro. In view of the limitations of the preceding parameters, the diagnosis may reasonably be made based on the history and evolution of the disease, cardinal morphologic features of reinfection and reactivation tuberculosis, and histopathologic characteristics. A response to antitubercular drugs may be of assistance.
Ichthyosis
Authors: Bousema Mente , Van Diggelen Otto , Van Joost Theodoor , Stolz Ernst , Naafs Ben
Published: May 2007

ABSTRACT: The reliability of clinical signs to differentiate between autosomal dominant ichthyosis (ADI) or sex‐linked ichthyosis (SLI) were assessed. SLI was defined as ichthyosis in combination with steroid sulphatase deficiency. Age of onset and format of the scales were found to be reliable signs to ascertain the diagnosis of ADI or SLI. The ADI‐like appearance in histopathology seems to be of little diagnostic value.
Regional Dermatoses in the African Race
Authors: Olumide Yetunde Mercy , Odunowo Bolanle David , Odiase Abimbola Olajuwon
Published: May 2007

Abstract: Many diseases are peculiar to the black race and most practicing physicians in Africa have limited access to histopathologists, therefore, diagnosis is largely clinical. A retrospective study of 10,000 consecutive patients seen at the skin clinic of the Lagos University Teaching Hospital, Nigeria, was conducted with the objective of identifying the notable dermatoses affecting various parts of the body. The face and the shins were observed to have a very broad spectrum of dermatoses. Useful clinical descriptions of these dermatoses are highlighted in a three part paper to help practicing physicians.
Psoriasis Patient Support Group and Self‐Care Efficacy as an Adjunct to Day Care Center Treatment
Authors: Abel Elizabeth A. , Moore Ursula S. , Glathe John P.
Published: May 2007

Abstract: Patients treated with chronic disabling psoriasis often have psychosocial concerns that need to be addressed. The weekly patient support group at Stanford, led by a psychiatrist, is an integral part of the Psoriasis Day Care program. Although not considered group therapy in the traditional sense due to its self‐selective nature, the support group aims to reduce feelings of isolation and to enhance coping skills and self‐efficacy. In this setting, patients explore their feelings about psoriasis enabling them to better adapt to a visible disease. Common topics for discussion include lifestyle changes, stressful relationships, associated emotional reactions, occupational limitations, and treatment concerns. Components of the Psoriasis Day Care Center that enhance treatment response and responsibility for self‐care include: health education, psychosocial support systems, stress reduction, and enhanced coping skills acquired through shared experiences with other patients and medical personnel.
Cutaneous and Plasma Fibrinolytic Activity in Systemic Sclerosis
Authors: Matucci‐Cerinic M. , Lotti T. , Lombardi A. , Pignone A. , Iannone F. , Beneforti E. , Cinotti S. , Morfini M. , Caignoni M.
Published: May 2007

Abstract: Eleven patients with systemic sclerosis (SSc) were studied for plasma and cutaneous fibrinolytic activity, residual (potential fibrinolysis) fibrinolytic activity (FA) of the dermal vessels that is related to the endothelial storage of plasminogen activators that become available due to particular stimuli such as intradermic injection of histamine, and the serum levels of circulating von Willebrand antigen, antithrombin III, plasminogen, (β‐thromboglobulin, and platelet aggregate ratio (PAR). Cutaneous FA (autohistographic fibrin film method) appeared normal or increased in non‐affected skin, normal in lesional skin, and increased after intradermal (i.d.) injection of 0.1 ml of 0.01% histamine. Monoclonal antibodies directed against the catalytic site of tissue type plasminogen activator completely blocked the fibrinolytic activity, while anti‐urokinase antibodies did not abolish the lysis areas. Plasmatic FA, euglobulin lysis time test, (ELT) and the levels of β‐thromboglobulin resulted similar to the controls. A significant increase in von Willebrand Factor VIII antigen (but not of Factor VIII coagulant) was observed in the patients (p < 0.01). Platelet aggregate ratio, levels of plasma plasminogen and Antithrombin III showed a significant difference (p < 0.01) when compared with the control subjects. Data suggest that primary injured microvessels in SSc are likely to be arteriolae while venulae could be affected by secondary hypoxia due to the arteriolar damage with consequent release of tissue type plasminogen activator. Therefore, the authors suggest that the fibrinolytic potential is maintained in SSc and that the fibrinolytic therapy should not be used in all patients with SSc but only in those cases with documented exhaustion of plasmatic and/or cutaneous FA.
The Use of Sulfasalazine in Atrophie Blanche
Authors: Gupta Aditya K. , Goldfarb Michael T. , Voorhees John J.
Published: May 2007

Abstract: Atrophie blanche can be a chronic condition for which there is no satisfactory treatment. Two patients with atrophie blanche who had not responded to various therapeutic modalities were given a trial of sulfasalazine 1 g three times daily. The ulcers healed within 3 months in both cases. In view of these positive results, patients should be treated with sulfasalazine to determine the efficacy of this drug in atrophie blanche.
Clinicopathologic Study of Cutaneous Plasmacytoma
Authors: Torne Ramon , Su Daniel , Winkelmann R. K. , Smolle Josef , Kerl Helmut
Published: May 2007

ABSTRACT: Eight patients with skin tumor lesions composed of dense, predominantly plasma cell infiltrates were studied. Primary cutaneous plasmacytoma can be reactive (polyclonal) or neoplastic (monoclonal). In four of the patients skin lesions were associated with multiple myeloma. Specific skin lesions usually consisted of reddish or purple nodules located on the trunk. In one case the cutaneous lesions developed at the site of previous herpes zoster. Histologically, the cutaneous plasmacytic infiltrate was mainly diffuse and monomorphous. Most of the plasma cells were mature, but in some cases immature immunoblasts and mitoses were observed. Serum immunoelectrophoresis findings correlated with the monoclonality or polyclonality of the plasmacytoma. Presence or absence of systemic involvement cannot be predicted from the appearance of clinical lesions or from maturity of plasma cell infiltration in the skin.
Lupus Erythematosus‐like Eruption due to D‐Penicillamine in Progressive Systemic Sclerosis
Authors: Tsankov Nikolai K. , Lazarova Aneta Z. , Vasileva Snejina G. , Obreshkova Elena V.
Published: May 2007

ABSTRACT: A 58‐year‐old woman with progressive systemic sclerosis developed a butterfly erythematous erruption, hemorrhagic maculae, crusting, and erosions on the face 15 days be a lupus erythematosus‐like eruption due to an adverse drug reaction to D‐pencillamine because of the rapid recovery from the general symptoms, the total involution of skin lesions with topical treatment only, the transient demonstration of autoantibodies and their fast negativation, negative ANA, and the histologic features of lupus erythematosus combined with marked exudative changes.
The Role of Fish Oil in Psoriasis
Authors: GUPTA ADITYA K. , Ellis Charles N. , Goldfarb Michael T. , Hamilton Ted A. , Voorhees John J.
Published: May 2007

ABSTRACT: In a randomized, double‐blind, placebo‐controlled study, patients received 10 fish or olive oil capsules three times daily for the whole study in addition to applying betamethasone diproprionate to their psoriatic plaques for the first 3 weeks. Most patients gradually worsened upon discontinuation of corticosteroids. Using survival analysis methods, no significant difference was found between the fish and olive oil groups. The authors attempt to put the role of fish oil in the therapy of psoriasis into perspective and discuss the efficacy of fish oil when used alone versus in combination therapy.
Sporotrichosis in Nepal
Authors: Rajendran C. , Ramesh V. , Misra R. S. , Kandhari S.
Published: May 2007

The first case of sporotrichosis from Nepal is reported in a 25–year‐old man from a village about 60 km east of Kathmandu. He never travelled outside of Nepal before and had acquired the lymphocutaneous form of the disease after an accidental injury to the right foot while cutting wood. The diagnosis of the case was made by culturing Sporothrix schenckii from the lesions, proving the dimorphic character of the fungus in vitro, its pathogenicity in mice, and its serology. Oral potassium iodide therapy resulted in complete cure.
Psychiatric Aspects of the Treatment of Mild to Moderate Facial Acne
Authors: Gupta Madhulika A. , Gupta Aditya K. , Schork Nicholas J. , Ellis Charles N. , Voorhees John J.
Published: May 2007

The improvement of acne appears to be associated with decreased depression and anxiety and greater satisfaction with aspects of body image that are generally unrelated to the appearance of the skin, ie, body shape and weight. The latter emphasizes the profound effect of the appearance of the skin upon the patient's overall body image. Our preliminary findings underline the need for larger controlled studies of psychosomatic factors among patients with mild to moderate acne.
Superficial Migratory Thrombophlebitis and the Lupus Anticoagulant
Authors: Blum Fredric , Gilkeson Gary , Greenberg Charles , Murray John
Published: May 2007

The lupus anticoagulant is an antiphospholipid antibody found in association with systemic lupus erythematosus and in a variety of other diseases, as well as in healthy individuals. In the laboratory, the antibody interferes with the conversion of prothrombin to thrombin and prolongs the partial thromboplastin time. In vivo, it exerts a procoagulant effect resulting in thrombosis, mainly of the larger veins and arteries. The case of a young woman who developed superficial migratory thrombophlebitis in association with a high titer lupus anticoagulant is presented. Her diagnosis was initially missed because the partial thromboplastin time was not elevated. This appears to have resulted from the use of a specific thromboplastin relatively insensitive to the presence of the antibody. Retesting with a more sensitive reagent showed a markedly prolonged partial thromboplastin time.
Penicillamine‐Induced Pemphigus Erythematosus
Authors: Willemsen Maria J. , De Coninck Arlette L. , De Raeve Linda E. , Roseeuw Diane I.
Published: May 2007

Pemphigus erythematosus occured in a patient with rheumatoid arthritis who was treated with D‐penicilla‐mine. The skin lesions appeared 4 months after the onset of D‐penicillamine treatment and persisted 14 years after cessation of this drug. Topical betamethasone dipropionate applications resulted in complete regression of the cutaneous lesions.
Myelofibrosis Discovered After Diagnosis of Sweet's Syndrome
Authors: Su W. P. Daniel , Alecre Victor A. , White William L.
Published: May 2007

Multiple edematous plaques and nodules suddenly developed on the face and neck of a 26–year‐old man whose physical examination was said to be normal. Because the patient's condition fulfilled the diagnostic criteria of Sweet's syndrome, a further general medical examination and hematologic evaluation were performed. Extensive myelofibrosis was revealed by bone marrow biopsy. This case supports the belief that Sweet's syndrome is a reactive phenomenon. Because myelofibrosis was discovered in this patient after Sweet's syndrome was diagnosed, the importance of having the diagnostic criteria of Sweet's syndrome is emphasized. Careful systemic evaluation is indicated, especially when cutaneous lesions are severe or hematologic values are abnormal.
Pig Handler's Itch
Authors: Chakrabarti Amalendu
Published: May 2007

Forty‐six humans who contacted pigs infested with Sarcoptes scabiei were investigated. Thirty (65.2%) had symptoms of sarcoptes scabies, and S. scabiei mites could be recovered from 20 (66.6%) skin scrapings. Itching was the main symptom. People within the age group of 26–35 years were infested the most. Hands and legs were the most common sites of the lesions, which subsided within 2–3 weeks when the infested pigs were treated and the intimate contact with the pigs was prevented.
Once‐Daily Naftifine Cream 1% in the Treatment of Tinea Cruris and Tinea Corporis
Authors: Jordon Robert E. , Rapini Ronald P. , Rex Ira H. , Katz H. Irving , Hickman Janet G. , Bard James W. , Medansky Roland S. , Lew‐Kaya Deborah A. , Sefton John , DeGryse Ronald E. , Killey Frank P.
Published: May 2007

Seventy patients with tinea cruris or tinea corporis were treated with naftifine cream 1% or vehicle once daily (or 4 weeks in this double‐blind, randomized study. After two weeks, the patients using naftifine had a significantly higher mycologic cure rate than the vehicle‐treated patients (79% vs. 31 %, p < 0.001), and they showed significantly better resolution of signs and symptoms. Statistically significant differences favoring naftifine over its vehicle were found throughout the treatment period and 2 weeks posttreatment.
Learning Dermatology on a Dermatology Elective
Authors: Sherertz Elizabeth F.
Published: May 2007

ABSTRACT: The format of the 4‐week dermatology elective rotation at the University of Florida is presented. A 20‐item case example slide test was given as a pre‐test and as a post‐test to 12 internal medicine residents and 41 fourth‐year medical students during the elective. Results indicate that the residents (48% correct) and students (46% correct) did not differ in their recognition abilities for common dermatoses at the beginning of the elective. Both groups improved their scores significantly at the end of the dermatology elective (residents, 87% correct; students, 82% correct). These results indicate the usefulness of a dermatology elective program in improving dermatologic skills and of a clinical pre‐ and post‐test approach for the crude assessment of such acquired knowledge for both rotating students and residents. This feedback can be helpful in modifying teaching programs for dermatology educators.
Pemphigus Therapy with Oral Prednisolone Regimens A 5‐Year Study
Authors: Ratnam K. V. , Phay K. L. , Tan C. K.
Published: May 2007

ABSTRACT: Twenty‐two newly diagnosed patients with pemphigus were randomly divided into two groups of 11 each. One group was placed on a high‐dose prednisolone (120 mg/day) therapy and the other group on a low‐dose (60 mg/day) therapy. The patients were followed for 5 years. Although a rapid initial control of the pemphigus appeared to be achieved with the high‐dose regimen, this regimen did not have any long‐term benefit over the low‐dose regimen with respect to the frequency of relapse or in the incidence of complications.
Morphea Coexisting with Lichen Sclerosus et Atrophicus
Authors: Tremaine R. , Adam J. E , Orizaga M.
Published: May 2007

ABSTRACT: A 65‐year‐old woman presented with four autoimmune diseases. These include morphea, lichen sclerosus et atrophicus insulin‐dependent diabetes mellitus, and autoimmune thyroid disease. The relationship between morphea and lichen sclerosus et A is discussed, as is the link between these conditions and autoimmunity.
Outbreak of Paederus Dermatitis in Southern Nigeria
Authors: George A.O. , Hart P.D.
Published: May 2007

ABSTRACT: An outbreak of Paederus dermatitis in Southern Nigeria is reported to illustrate that the epidemiological approach can be very useful in solving some dermatological problems in Tropical Africa where medical equipment is generally lacking.
Conditions for Dermatological Treatment in a Developing Country
Authors: Lomholt Gunnar
Published: May 2007

ABSTRACT: Malaria is the most common disease in the world, with 100 million new cases a year. Statistics, however, seem to show that skin diseases are next on the list of most common diseases in developing countries.
Scabies and Pyoderma in Lilongwe, Malawi
Authors: Kristensen Johannes K.
Published: May 2007

Abstract: From January 1988 to June 1989, data were collected daily on the patients who were seen at the Dermatology Clinic attached to the Kamuzu Central Hospital, Lilongwe, Malawi. Cases were diagnosed and patients were treated under the supervision of a dermatologist. A total of 34,002 patients were seen during the study period. Of these patients, 15,526 (45.7%) were children and 18,476 (54.3%) were adults. The prevalence of scabies was 40.4% in children and 31.6% in adults, whereas the prevalence of impetigo/bacterial skin infections was 26% in children and 10.4% in adults. Based on data accumulated for periods of 1 month, the incidence rate of scabies was highest during the cold, dry season (May‐November) and the incidence rate of skin infection was highest during the hot, rainy season (December‐April). Since the patients who were studied lived predominantly in rural settings, an explanation for the higher incidence rate of scabies during the cold season could be close body contact resulting from the overcrowding within the houses. The reason for the increase in the incidence rate of pyoderma during the rainy season might be linked to deficiencies in hygienic precautions. A community‐based intervention strategy with children as its target population is proposed to combat these diseases.
Scabies in the Extended Care Facility Revisited
Authors: Parish Lawrence Charles , Witkowski Joseph A. , Millikan Larry E.
Published: May 2007

Abstract: Infestations with Sarcoptes scabiei var hominis re‐main a problem in nursing home patients. While the traditional signs of scabies include burrows and red papules found on the fingerwebs, chest, waist, or genitalia, the elderly or infirm patient may have only a nonspecific pruritic eruption. Epidemics in skilled care facilities may be controlled and the scabies mite even eradicated from the institutions with appropriate diagnosis and adequate treatment of both patients and personnel and their contacts.
Squamous Cell Carcinoma Developing in Epidermolysis Bullosa Dystrophica
Authors: Yoshioka K. , Kono T. , Kitajima J. , Nakagawa K. , Yashiro N. , Taniguchi S. , Furukawa M. , Hamada T.
Published: May 2007

Abstract: Two patients with epidermolysis bullosa dystrophica recessiva who had squamous cell carcinoma are presented. Case 1 is a 40–year‐old woman who had ulcers on her left lower leg. Case 2 is a 42–year‐old man who had a tumor on his left first toe. Wide surgical excision with skin coverage by autograft was performed in case 1. Amputation of the toe in case 2 was performed. A review of the cases of epidermolysis bullosa dystrophica associated with cancer reported in Japan is also presented.
Verrucae Treated by Levamisole
Authors: Amer M. , Tosson Z. , Soliman A. , Selim A. G. , Salem A. , AI‐Gendy A. A.
Published: May 2007

Abstract: To assess the role of levamisole in treatment of different types of warts, a double‐blind study was conducted on 40 patients with different types of warts. Patients were divided into two equal groups, A and B. Group A received levamisole 5 mg/kg body weight on 3 consecutive days every 2 weeks for a period up to 5 months, while patients of group B received placebo for the same period. In group A, 12 patients showed complete cure (60%), two showed partial cure (10%), and the remaining six patients showed no response (30%). In group B, complete cure was achieved only in one case. The higher cure rate was observed in plane and common warts, while plantar warts showed no improvement with levamisole treatment.
Primary Localized Amyloidosis in One Family
Authors: Hashimoto Hiroyuki , Itami Satoshi , Kurata Sotaro , Takayasu Susumu , Yokota Tadaaki
Published: May 2007

Abstract:Primary localized amyloidosis was found in a family. A 66‐year‐old woman had suffered from hoarseness for 18 years. A biopsy specimen from the larynx showed amyloid deposits in the submucosal connective tissue. Her 40‐year‐oid daughter noticed a subcutaneous nodule on her philtrum. Histologic examination showed the deposition of amyloid in the middle and lower dermis, which also encased the blood vessels and epidermal appendages. In both cases the amyloid deposits were positively stained with Congo red and the staining was resistant to potassium permanganate treatment. These amyloid deposits were strongly positive against the anti‐amyloid antibody of the λ light chain. These results indicate that the amyloid substance is derived from protein AL. There was no clinical or laboratory evidence of systemic amyloidosis or multiple myeloma in either patient.
Naftifine Treatment of Trichomycosis Pubis
Authors: Rosen Ted , Krawczynska Anna M. , McBride Mollie E. , Ellner Kenneth
Published: May 2007

Abstract: Naftifine hydrochloride 1% cream is a recently developed material of proven efficacy in superficial cutaneous fungal infections. The drug has also been reported to have significant antibacterial properties as well. A case of trichomycosis pubis, a bacterial disorder that can easily be mistaken for several fungal diseases, responded to application of naftifine cream. The authors suggest that this medication may be the drug of choice when the clinical presentation consists of nodules encircling pubic or axillary hair.
Intralesional Alpha 2b Recombinant Interferon for Basal Cell Carcinomas
Authors: Boneschi V. , Brambilla L. , Chiappino G. , Mozzanica N. , Finzi A. F.
Published: May 2007

Basal cell carcinoma (BCC) is a rather common skin neoplasm, particularly in white patients. It grows slowly, has a locally malignant behavior, and metas‐tases occur only exceptionally. It is considered to be derived from pluripotential epithelial cells that can partially differentiate towards adnexal structures and sebaceous, apocrine, and sometimes eccrine glands. Prolonged exposure to the sun, a fair and freckled complexion, x‐rays, burn scars, and arsenic by mouth are all predisposing factors for basal cell epithelioma. The face and the trunk are the parts most often affected. Some patients, especially those with a fair complexion, may have dozens of BCCs at one time.
Pemphigus in Families
Authors: Feinstein Abraham , Yorav Shmuel , Movshovitz Moshe , Schewach‐Millet Miriam
Published: May 2007

Abstract: A family in which two sisters are affected by pemphigus is described. Literature research has revealed the presence of 25 families, comprising 53 patients, in which pemphigus existed in more than one member. The relationships between those affected were mainly parent‐child or sibling‐sibling. Pemphigus was found to be associated with specific HLA antigens: A26, Bw38, DRw4. and additionally occurred with a higher frequency in certain ethnic groups. The variety of etiologic factors in the pathogenesis of pemphigus is discussed and the significance of a genetic role elucidated. Pemphigus is a chronic bullous disease with an autoimmune etiology. The typical histologic characteristic is acantholysis with intraepidermal cleavage, and immunofluorescent studies show antibodies in the epidermal intercellular substance.
Studies on Criteria of the European Academy of Dermatology and Venerology for the Classification of Cutaneous Lupus Erythematosus
Authors: Beutner Ernst H , Blaszczyk Maria , Jablonska Stefania , Chorzelski Tadeusz P , Kumar Vijay , Wolska Hanna
Published: May 2007

Abstract: A group of 140 cases of various forms of lupus erythematosus (LE) were examined for 24 variables, inducting the 11 criteria of the American Rheumatism Association (ARA) for the classification of systemic lupus erythematosus (SLE), and 13 additional criteria suggested by the European Academy of Dermatology and Venerology (EADV) for studies of cutaneous LE with or without systemic involvement. The EADV study factors included skin histopathology and immunopathology, complement and IgG levels, and other laboratory tests, as well as selected clinical findings, most notably the papulosquamous and/or annular lesions that characterize sub acute cutaneous LE (SCLE). The patients examined included 50 SLE, 35 SCLE, 30 discoid LE (DLE), 25 disseminated DLE (DDLE), and 17 polymorphous light eruption (PMLE) cases. Preliminary analyses of the data reveal the following: (1) The SCLE cases differed significantly from SLE, DLE, and DDLE in 10 of 11 ARA criteria (all but photosensitivity). (2) The frequencies of positive findings in SCLE also differed significantly for 11 of 13 EADV study factors. (3) While no significant differences appeared in the frequency of photosensitivity between the five study groups, photo‐testing revealed significant increases in the frequency of persistence of the photo reactions for 10 days and their Koebnerization in the SCLE cases. (4) The presence of SS‐A (Ro)/SS‐B (La) antibodies had some predictive value for the appearance of systemic involvement in SCLE, as seen by the increased frequencies of five or more ARA criteria, although highly significant differences from SLE occurred in the absence of renal involvement and lower frequency of ANA and LE band test. We conclude from these studies that the classification of the major forms of cutaneous LE, with and without systemic involvement, requires not only the ARA criteria, but also the examination of other factors such as those recommended by the EADV, and that the study groups should include SLE, SCLE, DLE, DDLE, and non‐LE controls such as PMLE.
Cutaneous Malignancies Mimicking Herpes Zoster
Authors: Williams Lynn Ryan , Levine Laurie J. , Kauh Young C
Published: May 2007

Abstract: Cutaneous metastases occur in 2.5% to 5% of patients with malignant disease. The relative frequency of the primary site roughly parallels the frequency of the various malignancies in each sex. We present two cases of cutaneous malignancy occurring in a dermatomal distribution and masquerading as herpes zoster. The differential diagnosis of zosteriform eruptions is reviewed and the possible pathogenesis of metastatic disease in this cutaneous distribution is discussed. Skin biopsy is recommended in these cases to determine the etiology of the eruption.
Kaposi Sarcoma Associated with Human Immunodeficiency Virus Infection
Authors: Hernández Dimas E. , Pérez José Ricardo , Wilder Jaime , Muci Rafael
Published: May 2007

ABSTRACT: In the present study, 11 patients with epidemic Kaposi sarcoma were evaluated; 55% were in stage IV and 45% in stage II; in addition, 75% had systemic symptoms, 89% had tow total and T‐lymphocyte counts, and all of them had not only low T‐helper lymphocyte counts but also T‐helper/T‐suppressor ratios. The majority of patients (89%) had low proliferative responses with phytohemaggiutinin (PHA). Nine patients were treated with: alpha‐2 interferon (five patients), zidovudine (two patients), doxorubicin and zidovudine (one patient), and radiotherapy (one patient). There were only five patients with stable disease, three treated with alpha‐2 interferon, one with doxorubicin, and one with doxorubicin plus azidothymidine. Two patients (one with doxorubicin and one with doxorubicin plus zidovudine) needed lithium to increase leukocyte and platelet counts, in May 1989, 73% of patients were dead (median survival 8 ± 2 months), it is concluded that: (1) it is important to select the patients who have the best chance to improve with treatment; (2) the response with alpha‐2 interferon or monochemotherapy is low and there is no change in overall survival; (3) a low helper cell count, low T‐helper/T‐suppressor ratio, and low proliferative response with mitogens are features of poor prognosis; (4) toxicity with treatment was acceptable; and (5) lithium increased neutrophil and platelet counts.
Leprvosy in Qatar
Authors: Mahmoud Somaia F. , Azadeh Ben
Published: May 2007

ABSTRACT: Clinical and histopathologic features of 104 cases of leprosy diagnosed between 1982 and 1989 in the State of Qatar were studied. There were 88 male (84.6%) and 16 (15.4%) female patients aged 18 to 64 years. Eighty‐four of the cases were diagnosed during the initial mandatory medical screening on arrival to Qatar. Almost all (103) were expatriates and only one 50‐year‐old woman was a Qatari. Indians formed the largest group (60.6%), followed by Bangladeshi (6.7%), Pakistani (5.8%), and others. The majority of cases were classified as lepromatous (43.3%) or tuberculoid (43.3%). Although Qatar is a relatively leprosy‐free country, the influx of a large number of workers from developing countries seeking employment forms a potential public health hazard.
Mycosis Fungoides with Oral Involvement
Authors: Vicente Asunción , Martí Rosa M. , Martín Encarnación , Estrach Teresa , Herrero Carmen , Mascaró José M.
Published: May 2007

Abstract: Oral mucous membrane involvement occurs uncommonly in mycosis fungoides and reports of it are scarce. We present two patients with severe involvement of the oral mucous membranes.
Psychotherapy and Neurotic Excoriations
Authors: Fruensgaard Kjeld
Published: May 2007

During the period from 1979 to 1985, 22 patients with the primary forms of neurotic excoriations (NE) accepted referral to the author. Twenty of them completed a psychotherapy program which was eclectic in form and allowed for individual weighting of its single elements. At the follow‐up, on average after 5 years, valid evidence was found of a positive effect of goal‐directed psychotherapy in NE patients.
A Rapid Method for the Cytodiagnosis of Multibacillary Leprosy
Authors: Ross Marla , Barr Ronald J. , Bocachica John H.
Published: May 2007

Abstract: The diagnosis of leprosy is made clinically with histologic and cytologic confirmation. The traditional methods for making the cytologic diagnosis of leprosy take time and training, making them unsuitable for rapid office use. We describe a simple, rapid method for cytologic confirmation of the diagnosis of multibacillary leprosy using slit skin scrapings.
Characterization of Circulating Lymphocytes by Monoclonal Antibodies in Childhood and Adult Leprosy
Authors: Sehgal Virendra N. , Chaudhry Anoop , Sharma Vinay K. , Gupta Chander K.
Published: May 2007

Abstract: Peripheral blood lymphocyte assays using monoclonal antibodies were done in 66 patients with leprosy, consisting of 25 children and 41 adults. The results were statistically analyzed for correlations, if any, among the different age groups and matched controls. The results, however, failed to show any significant correlation, nor was it possible to draw any conclusion as to why the disease spectrum in children tends to be incomplete (ie, there is a low incidence of the highly bacilliferous form of disease expression).
Cutaneous Eruptions in Indian Tick Typhus
Authors: Jayaseelan Elizabeth , Rajendran S. C. , Shariff Shameem , Fishbein Dan , Keystone J. S.
Published: May 2007

Abstract: Although frequently unrecognized, rickettsial infections may be an important cause for fever and exanthem in persons presenting to physicians in South India. Most often these patients are referred to dermatology departments with a diagnosis of “drug eruption.” In the current study the authors analyzed 12 cases of rickettsial fever that were seen in the dermatology department of St. John's Medical College Hospital, Bangalore, between 1985 and 1989. The distinctive cutaneous eruption was found to be an important clue to an early clinical diagnosis. Specific serodiagnosis enabled us to confirm that Indian tick typhus, a member of the spotted fever group, was the most frequent cause for rickettsial fever presenting at our hospital.
Epidemiology of Chronic Paronychia in a Skin Hospital in Singapore
Authors: Chow E. , Goh C. L
Published: May 2007

Abstract: A retrospective epidemiologic study of 110 patients with chronic paronychia (CP) showed a female‐male ratio of 2·3:1, whereas the ratio of patients attending the same clinic was 1·1:1 (p < 0·001). The peak age range of patients with CP (40–49 years) generally was greater than that of the general dermatologic patients (20–29 years). Seventy‐seven percent of the patients with CP were “manual workers,” of which 48% were homemakers. Chronic paronychia was more common on the right fingers than the left fingers. The most commonly affected fingers were the right thumb (62%), followed by the right middle finger (52%), left thumb (57·6%), and left middle finger (51·5%). Mechanical trauma appears to be an important predisposing factor in CP. Sixty‐two percent of 68 patients who had nail fold smears had positive findings for budding yeast cells, suggestive of candidal infection. All of the six patients for whom nail fold bacterial cultures were performed had positive results for enteric flora.
Kefoconazofe 2% Emulsion in the Treatment of Seborrheic Dermatitis
Authors: Piérard G. E. , Piérard‐Franchimont C. , Van Cutsem J. , Rurangirwa A. , Hoppenbrouwers M. L. , Schrooten P.
Published: May 2007

Abstract: Fifty patients (42 men, 8 women) with seborrheic dermatitis were included in the trial. Ketoconazole 2% emulsion or the same emulsion without active drug was applied b.i.d. for 4 weeks. Two patients dropped out in the ketoconazole group and nine in the placebo group. Pityrosporum ovale was cultured from all patients at the start and from six out of 23 in the ketoconazole group versus nine out of 16 in the placebo group at week 4. The overall assessment showed a significantly better response to treatment for the ketoconazole emulsion (72%) than for the placebo (32%).
Topical Canrenoic Acid
Authors: Noto Giuseppe , Pravatá Gabriella , Bongiorno Maria R. , Bosco Maria , Aricó Mario
Published: May 2007

Abstract: The topical antiandrogenic activity of potassium canrenoate (CAK), compared with that of spironolactone (SP), was assayed in vivo in female golden Syrian hamsters whose flank organs were stimulated by subcutaneous administration of testosterone propionate. Sebaceous glands and hair were measured by a computerized image analyzer. Pigmented spots, sebaceous gland areas, and the diameter of hairs of the treated flank organs were smaller in the groups that received CAK (1·6 mg/day) and SP (0·4 mg/day). The authors' results showed that CAK may act as a topical antiandrogen on the hamster flank organ when applied in concentrations four times greater than the minimal active dosage of SP. Potassium canrenoate may be a useful weak topical antiandrogen, and it could be used in androgen‐related skin disorders involving both sebaceous glands and hair, especially in men. These concentrations could be verified by additional clinical investigations.
Epidermolysis Bullosa and Aplasia Cutis
Authors: McCarthy Madeline A. , Clarke Tom , Powell Frank C.
Published: May 2007

Abstract: Recessive dystrophic epidermolysis bullosa with aplasia cutis occurring in a male infant is described. The association of these two rare conditions is reviewed. Reports of the concurrence of large areas of congenital absence of skin, particularly on the lower limbs, in patients with several different types of epidermolysis bullosa suggest that areas of congenital absence of skin in these patients are an initial manifestation of the bullous disease rather than a distinctive entity.