bluuebunny/crossref_metadata_2025 huggingface dataset:
Multiple Biological Predictors for Vulnerable Carotid Lesions
Authors: Pelisek Jaroslav , Rudelius Martina , Zepper Peter , Poppert Holger , Reeps Christian , Schuster Tibor , Eckstein Hans-Henning
Published: October 2009

Background: In this study a multiscore analysis of various biomarkers including matrix metalloproteinases (MMPs), inflammatory factors and other clinical parameters was performed to establish a set of reliable biomarkers for improved detection of plaque instability in patients with advanced carotid stenosis. Methods: Study patients (n = 101) were classified as histologically stable (n = 37) or unstable (n = 64). Serum levels of MMP-1, -2, -3, -7, -8, -9, MMP inhibitors TIMP-1, -2, and inflammatory factors such as tumor necrosis factor (TNF-α), interleukin (IL)-1β, -6, -8, -10, and -12 were measured by ELISA assays. Multiscore analysis was performed using multiple receiver operating characteristics analysis and determination of appropriate cutoff values. Results: Circulating levels of MMP-1, -7, TIMP-1, TNF-α, and IL-8 were significantly enhanced in patients with unstable plaques compared to individuals with stable lesions, mean differences being 1.2 (p = 0.032), 2.5 (p = 0.004), 30.0 (p = 0.014), 1.3 (p = 0.047), and 2.2 (p = 0.033), respectively. The combination of MMP-1, -7, TIMP-1 and IL-8 demonstrated the highest positive predictive value of 89.4% and negative predictive value of 60.1% for patients correctly classified as individuals with unstable and stable carotid lesions by means of blood sample analysis. Conclusions: Multiple relevant biomarkers that play a decisive role in plaque instability can improve the correct determination of vulnerable carotid plaques in patients with advanced carotid artery stenosis.
Pemphigus erythematosus with Suprabasilar Acantholysis and Lichenoid Tissue Reaction or a Combination of Pemphigus vulgaris and Lupus erythematosus: A New Entity?
Authors: Megahed M. , Goerz G. , Kind P. , Plewig G.
Published: October 2009

We present a 36-year-old woman with pemphigus erythematosus that showed histopathologically suprabasilar acantholysis and lichenoid tissue reaction. To our knowledge this is the first case of pemphigus erythematosus with such unusual histopathologic presentation to be reported.
Cutaneous Ulceration: An Unusual Complication of Intravenous Pentamidine Therapy
Authors: Bolognia J.L.
Published: October 2009

Pentamidine is one of two agents currently used to treat infections with Pneumocystis carinii. The intramuscular route of administration is associated with cutaneous side effects such as dermal necrosis, sterile abscesses and ulcer formation at the injection site, while urticaria may develop near the site of intravenous drug infusion. This is a report of a renal transplant patient with Pneumocystis pneumonia who developed chemical cellulitis and ulceration following the extravasation of intravenous pentamidine into the soft tissues of the left hand and forearm. The area healed slowly over 7 weeks but there was a residual loss of cutaneous sensation. In a review of the literature no report of a similar case was found.
Concomitant Granuloma annulare and Necrobiosis lipoidica
Authors: Crosby D.L. , Woodley D.T. , Leonard D.D.
Published: October 2009

A case of concomitant granuloma annulare (GA) and necrobiosis lipoidica (NL) is presented. The etiology of these two disorders remains obscure. The similarity of the histopathology in GA and NL might suggest a common origin. However, a review of the 5 previous cases of concomitant GA and NL and recent biochemical, immunological and immunohistochemical studies comparing GA to NL indicates an independent etiology for these two histologically related disorders. Some evidence points toward a closer relationship of NL with diabetes than GA, while GA may be related to delayed-type hypersensitivity reactions.
Coexistent Urticaria pigmentosa, Acromegaly and Acanthosis nigricans
Authors: Akiyama M. , Sasaki Y. , Takahashi S. , Hayakawa K. , Suzuki H. , Nishikawa T.
Published: October 2009

We report a case of urticaria pigmentosa, acromegaly and acanthosis nigricans in a 25-year-old male. The patient exhibited multiple pigmented papules on the trunk and the extremities. Histological examinations of the papules revealed infiltrates of mast cells in the upper dermis. Ultrastructurally the mast cells were fully matured and exhibited no atypical features. A typical appearance of acromegaly, frontal bossing, prominence of the jaw and bony overgrowth and cutaneous changes of acanthosis nigricans on the neck, the axillae and the groins were observed. Growth hormone hypersecretion and insulin resistance were detected in the patient. A pituitary tumor was found and resected surgically. After the operation, endocrinological abnormalities and cutaneous manifestations of acanthosis nigricans improved markedly. As far as we know, this is the first report of the coexistence of urticaria pigmentosa, acromegaly and acanthosis nigricans.
Verrucous Carcinoma of a Leg Amputation Stump
Authors: Schwartz R.A. , Bagley M.P. , Janniger C.K. , Lambert W.C.
Published: October 2009

Verrucous carcinoma of the skin is a rare cancer which tends to appear on the soles of the feet, although it can appear elsewhere on the cutaneous surface. It has not, to our knowledge, been previously reported on a leg amputation stump.
A Case of Delayed Hypersensitivity Reaction Following a Sea Urchin Sting
Authors: Asada M. , Komura J. , Hosokawa H. , Akaeda T. , Asada Y.
Published: October 2009

The case of a 28-year old woman with pruritic and erythematous eruptions on the knees and ankle about 10 days after being stung by sea urchin is reported. The spines of a sea urchin were ground, extracted and patch-tested, to which the patient showed a positive delayed skin reaction. Based on the clinical course and positive patch tests, it was concluded that the patient developed a delayed hypersensitivity reaction to the sea urchin’s stinger.
‘Flagellate’ Erythema from Bleomycin
Authors: Cortina P. , Garrido J.A. , Tomas J.F. , Unamuno P. , Armijo M.
Published: October 2009

A case of erythema in a ‘flagellate’ pattern due to administration of bleomycin in a patient with Hodgkin’s disease is described. Emphasis is placed on the low dose of bleomycin administered – 15 mg parenterally – and the short time interval between drug administration and beginning of symptoms: 24 h. The histopathological findings were consistent with a mechanism of inflammatory oncotaxis: the attraction of tumor cells by the skin perhaps due to the bleomycin accumulated and the trauma caused by scratching subsequent to pruritus.
Plasma Cardiac Necrosis Markers C-Troponin I and Creatine Kinase, Associated with Increased Malondialdehyde Levels, Induced in Rabbits by Means of 5-Aminolevulinic Acid Injection
Authors: Pinelli Arnaldo , Trivulzio Silvio , Brenna Sergio , Rossoni Giuseppe
Published: October 2009

A number of papers have described high levels of 5-aminolevulinic acid in cases of heart damage due to acute myocardial infarction, acute intermittent porphyria or chronic kidney failure, but it is not known whether the heart damage is directly associated with 5-aminolevulinic acid. The aim of this study was to verify whether such an association exists by injecting rabbits with 5-aminolevulinic acid and searching for the appearance of cardiac necrosis markers and histological heart alterations, and investigate whether the cardiotoxic activity of 5-aminolevulinic acid may involve peroxidation by seeking the presence of the peroxide marker malondialdehyde. The administration of 5-aminolevulinic acid led to the appearance of c-troponin I and creatine kinase, induced histological heart alterations and increased the malondialdehyde levels. The plasma levels of malondialdehyde and cardiac necrosis markers were also measured after the injection of 5-aminolevulinic acid in combination with the daunorubicin agent inducing peroxidation. The combined administration very significantly increased the plasma levels of 5-aminolevulinic acid, malondialdehyde, and the cardiac necrosis markers c-troponin I and creatine kinase. It therefore seems that there is a close relationship between altered 5-aminolevulinic acid levels, malondialdehyde and cardiac necrosis markers, which is attributable to the capacity of 5-aminolevulinic acid to generate toxic oxygen species that damage the heart. High plasma 5-aminolevulinic acid levels should be considered a factor contributing to cardiotoxicity and to the appearance of cardiac necrosis markers.
Syphilis and HIV Infection
Authors: Rufli T.
Published: October 2009

Treponema pallidum and HIV are both sexually transmitted agents of infectious diseases with epidemiological similarities. Ulcerous genital diseases such as primary syphilis facilitate transmission of HIV. An increasing number of case reports gives evidence that in HIV-infected patients secondary syphilis runs a more severe course and may present as syphilis maligna and that neurological complications of secondary and tertiary syphilis seem to occur more frequently and at an earlier stage. The clinical evaluation, interpretation of serology and choice of treatment schedules must take these considerations into account.
Fixation of Pemphigus vulgaris and foliaceus Antibodies in Shedding Snake Epidermis
Authors: Grando S.A.
Published: October 2009

The fixation of pemphigus antibodies was revealed by indirect immunofluorescence in shedding grass snake epidermis. The antibodies of patients with pemphigus vulgaris (PV) were specifically binding to the antigenic substance which appears in the snake epidermis at the initial stage of integument change. At the peak of shedding, the fixation of PV antibodies was observed only in the upper layers of the ‘old’ epidermis although the intensity of fluorescent staining was considerably reduced. At the same stage of shedding, there was marked fixation of antibodies of patients suffering from pemphigus foliaceus (PF).The specific binding of PF antibodies was noted predominantly on the cell membranes of the ‘old’ keratinocytes, localized in the upper layers of the epidermis. In contrast to bullous pemphigoid antibodies, PV and PF antibodies failed to fix in the skin of the snake prior to or after physiologic shedding. The data obtained suggest that pemphigus may have an atavistic origin.
Clear-Cell Syringoma
Authors: Ambrojo P. , Requena Caballero L. , Aguilar Martínez A. , Sánchez Yus E. , Furió V.
Published: October 2009

Clear-cell syringoma is a histologic variant of syringoma that is otherwise clinically indistinguishable from ordinary syringoma. This variant is formed by cells that have pale or clear cytoplasm as a result of glycogen accumulation. There is a high association of clear-cell syringoma and diabetes mellitus. A case of clear-cell syringoma associated with diabetes mellitus is described. Electron microscopic examination revealed that periluminal cells showed intra- and extracytoplasmic multivesicular bodies that may be characteristic of the clear-cell variant. Immunohistochemistry for carcinoembryonic antigen (CEA) showed ordinary syringomas as in the presence of CEA within and surrounding duct-like spaces.
Death from Metastatic, Cutaneous, Squamous Cell Carcinoma in Autosomal Recessive Dystrophic Epidermolysis bullosa despite Permanent Inpatient Care
Authors: Keefe M. , Wakeel R.A. , Dick D.C.
Published: October 2009

A 36-year-old female patient with severe autosomal recessive dystrophic epidermolysis bullosa, who had spent her entire life from age 2 as an inpatient in the dermatology unit, recently died of metastatic squamous cell carcinoma of the skin. The development of malignancy was not prevented by continuous medical and nursing supervision and, despite early detection, rapidly led to her death. Oral phenytoin and topical mupirocin ointment had not reduced blistering.
Multiple Clustered Dermatofibromas
Authors: Berbis P. , Benderitter T. , Perier C. , Frey J. , Privat Y.
Published: October 2009

A 37 year-old man developed, over 20 years, multiple clustered dermatofibromas on the left thigh. Three similar cases have been described previously and the benign course of this lesion has been referred to. Analysis of collagen amino acids revealed a sharp increase of hydroxylysine on the fibrous central zone, suggesting an abnormal accumulation of type IV collagen.
Ninety-Eight Fixed Drug Eruptions with Provocation Tests
Authors: Kanwar A.J. , Bharija S.C. , Singh M. , Belhaj M.S.
Published: October 2009

Ninety-eight patients having fixed drug eruptions were subjected to provocation tests. Cutaneous involvement was seen in 43, mucous membrane in 33 patients, while cutaneous and mucous membrane involvement was seen in 22 patients. The causative drugs were found to be trimethoprim-sulphamethoxazole (45), acetylsalicylic acid (24), hyoscine butylbromide (Buscopan®) (8), ibuprofen (Brufen®) (6), oxyphenbutazone (6), tetracycline hydrochloride (2), phenolphthalein (1) and phenobarbitone (1). There was evidence of cross-sensitivity between oxyphenbutazone and phenylbutazone.
Metastatic Eccrine Sweat Gland Carcinoma: Case Report
Authors: Borradori L. , Hertel R. , Balli-Antunes M. , Zala L.
Published: October 2009

Eccrine sweat gland carcinoma is a rare malignancy of skin adnexa with potential aggressive growth and metastatic spread. We report here a case of eccrine carcinoma arising on a finger with widespread pulmonary metastasis. A brief synopsis of the pathological and clinical aspects of eccrine sweat gland carcinoma is presented and currently available therapeutic modalities are discussed.
Atypical Early Syphilis in an HIV-Infected Homosexual Male
Authors: Cusini M. , Zerboni R. , Muratori S. , Monti M. , Alessi E.
Published: October 2009

A homosexual male, seropositive to HIV and with previously documented syphilitic infections, developed a slowly growing nodule on his left wrist (possibly a chancre) followed, after 2 months, by a few scattered, large papular lesions. Serological evidence of active syphilis was obtained and treponema were identified in the initial lesion by means of immunofluorescent staining. Treatment with both aqueous crystalline penicillin G and benzathine penicillin G healed the lesions. This represents a further case of an atypical presentation of early syphilis in an immunocompromised host.
Pitted Keratolysis: A Manifestation of Human Dermatophilosis
Authors: Gillum Ronald L. , Qadri Hussain , Al-Ahdal Mohammed N. , Connor Daniel H. , Strano Alphonso J.
Published: October 2009

A case of pitted keratolysis caused by Dermatophilus congolensis is reported. The organism was isolated from the lesion and identified by its morphological, cultural, and biochemical characteristics. A survey of the literature revealed that it rarely causes human infections, but is a common causative agent of disease in domesticated and wild animals. Human infections reported previously were traced to contact with infected animals or contaminated soil. We report pitted keratolysis in a 44-year-old physician with no known history of such a contact.
Dermatitis herpetiformis Associated with Relapsing Polychondritis
Authors: Laurent René , Humbert Philippe , Fellman Dominique
Published: October 2009

A 35-year-old woman developed typical relapsing polychondritis within a year following the onset of dermatitis herpetiformis. This occurred during a reduction in the dapsone dose regimen. To our knowledge, the coexistence of these two conditions in a single patient has not yet been reported in the literature. Both the parallel course and the good response to dapsone suggest a pathogenic link between these two diseases.
White Sponge Nevus with Epidermolytic Changes
Authors: Aloi Filippo G. , Molinero Alfredo
Published: October 2009

A 42-year-old man with extensive white spongy lesions of the oral mucosa from childhood is reported. Histologic examination of two punch biopsies revealed many foci of epidermolytic hyperkeratosis. Similar lesions were present in one of his two brothers but he refused the biopsy. The problems of differential diagnosis are discussed.
Development of Cutaneous Pseudolymphoma Following Ciclosporin Therapy of Actinic Reticuloid
Authors: Thestrup-Pedersen Kristian , Zachariae Claus , Kaltoft Keld , Pallesen Gorm , Søgaard Helmer
Published: October 2009

The patient is a 57-year-old man with actinic reticuloid, who despite systemic prednisone, azathioprine, topical steroid, and sun-protective cream had to stay indoors in the summer of 1986. In February 1987 he was started on ciclosporin (CS), 5.5 mg per kg body weight, and skin symptoms did not develop as usual in spring and summer 1987. Following 4 months of succesful therapy, he developed an indolent tumor on his right chin and parapsoriasis en plaque on the lower arms and legs. Histological examinations of the tumor showed an intense lymphoid infiltrate of a pseudolymphomatous type. The tumor regressed partly following discontinuation of CS, but additional radiation therapy had to be administered. His clinical symptoms of actinic reticuloid reappeared. Eight months after CS treatment he developed a malignant T cell lymphoma with metastasis in the regional lymph nodes on the neck. CS should not be used in diseases with potential premalignant features even though its therapeutic efficacy in actinic reticuloid was impressive.
Teicoplanin, a New Antibiotic Effective against Gram-Positive Bacterial Infections of the Skin and Soft Tissues
Authors: Bochud-Gabellon I. , Regamey C.
Published: October 2009

Teicoplanin is a new glycopeptide antibiotic chemically related to vancomycin with a similar bactericidal activity against aerobic and anaerobic Gram-positive bacteria but with a longer plasma elimination half-life of 40–100 h allowing a once daily parenteral administration. In an open prospective study, we treated 20 patients with skin and soft tissue infections such as erysipelas, ceilulitis, folliculitis and furunculosis with a a success rate of 84%. The peak and trough serum levels of teicoplanin were above the minimal inhibitory concentrations of the bacteria isolated and the therapeutic index measured at the plateau level was between 24 and 146. We observed a moderate increase of the transaminases in 3 patients which returned to normal at the end of treatment. We conclude that this new antibiotic, teicoplanin, is safe and effective in the treatment of skin and soft tissue infections. It can be administered once daily and is well tolerated even in long-term therapy.
Fibrous Hamartoma of Infancy – Infantile Subcutaneous Myofibroblastoma
Authors: Aberer E. , Mainitz M. , Entacher U. , Gebhart W.
Published: October 2009

This paper presents light and electron microscopic findings in a case of fibrous hamartoma of infancy. Histological examination revealed different tissue components: irregular trabecular collagen fibers among mature adipose tissue, and mesenchymal cells at the border of fibrocollagenous trabeculae as well as around blood vessels. Ultrastructurally most of the tumor cells represented myofibroblasts. According to the predominance of a distinct cell type, fibrous hamartoma of infancy cannot be regarded as a hamartomatous lesion but should be included in the group of juvenile fibromatoses under the term ‘infantile subcutaneous myofibroblastoma’.
Exocrine Pancreatic Function in Chronic Urticaria Patients Is Normal
Authors: Barba A. , Schena D. , Chieregato G.C. , Riela A. , Brocco G. , Scuro L.A. , Cavallini G.
Published: October 2009

25 patients with chronic urticaria suspected to be of ‘alimentary origin’, were studied for a quantitative or qualitative deficiency of pancreatic enzyme secretion. All showed a normal fecal chymotrypsin excretion and 23/25 a normal bentiromide (PABA) and pancreolauryl test. In 2 females the urinary PABA and pancreolauryl tests were borderline pathological. This does not support the hypothesis that a pancreatic deficiency (of the kind which could be identified with the methods used) is associated with chronic urticaria in patients in whom improvement of urticaria occurs under a hydric or low antigenic diet.
Seborrhoea in Acne-Prone and Acne-Free Patients
Authors: Piérard G.E. , Piérard-Franchimont C. , Lê T.
Published: October 2009

We have studied the relationship between seborrhoea and acne by using the Lipometre® and Sebutape® films. Seborrhoea is more intense in acne-prone than in acne-free patients. For a given overall amount of sebum excreted, the individual activity of sebaceous follicles differs in the two groups of individuals tested. Seborrhoea in acne-prone patients is due to the presence of some highly active follicles that are almost never encountered in acne-free patients.
Skin Lesion Resembling Malignant Atrophic Papulosis in Lupus erythematosus
Authors: Doutre M.S. , Beylot C. , Bioulac P. , Busquet M. , Conte M.
Published: October 2009

This case demonstrates, as do the 3 others reported in literature, that a diagnosis of malignant atrophic papulosis can only be made once the possibility of a lupus erythematosus has been totally excluded.
Domoprednate, a New Nonhalogenated Topical Steroid: Comparison to Hydrocortisone Butyrate
Authors: Schmidt Henning , Hjorth Niels , Holm Per
Published: October 2009

Thirty-nine patients with mainly psoriasis vulgaris and atopic dermatitis were treated for 4 weeks with 0.1% domoprednate and hydrocortisone butyrate ointment according to a right-left, randomized design. Various assessments of efficacy only revealed marginal, but statistically insignificant differences. Patients’ preferences for one of the two treatments favored domoprednate in 20 cases and hydrocortisone butyrate in 12 cases; 6 cases were ties (p > 0.2). The efficacy of domoprednate, a new, nonhalogenated topical steroid, is evidently at least of the same order as that of the hydrocortisone butyrate, and the tolerance of the two ointments is equally good.
Single Nodule on the Glans penis: Metastatic Lesion from an Unusual Carcinoma of the Prostate
Authors: Berbis P. , Andrac L. , Daou N. , Privat Y.
Published: October 2009

An inflammatory nodule developed on the glans penis of a 79-year-old man. Histological examination confirmed the diagnosis of metastasis from a carcinoma of the prostate. This case is of interest in view of the rarity of this metastatic localization and the very unusual microscopic pattern of the primary cancer (epidermoid carcinoma).
Comparative Study of Natural and Synthetic Retinoids as Inhibitors of Arachidonic Acid Release and Metabolism in Rat Peritoneal Macrophages
Authors: Fiedler-Nagy Christa , Wittreich Barbara H. , Georgiadis Alex , Hope William C. , Welion Ann F. , Coffey John W.
Published: October 2009

The effect of several natural and synthetic retinoids on the release and metabolism of arachidonic acid (20:4) in rat peritoneal macrophages (Mø), stimulated in vitro by either Ca2+ ionophore A23187 (A23187), opsonized zymosan (OZ) or 12–0-tetradecanoylphorbol-13-acetate (TPA), was investigated. With the exception of Ro 10–1670, the retinoids containing a free carboxylic acid group [i.e., all-trans-retinoic acid (all-trans-RA), 13-cis-RA, Ro 13–7652, Ro 12–7310 and Ro 13–7410] inhibited 20:4 metabolite formation in A23187- and OZ-stimulated Mø at 1–33 μM However, only all-trans-RA, Ro 12–7310 and Ro 13–7410 inhibited the formation of 20:4 metabolites in TPA-stimulated Mø. These data suggest that part of the therapeutic effect of retinoids in inflammatory, hyperproliferative dermatologic conditions might be attributed to reduced 20:4 metabolite production.
Short-Term and Long-Term Considerations in the Management of Psoriasis with Retinoids
Authors: Goldfarb Michael T. , Ellis Charles N. , Voorhees John J.
Published: October 2009

Etretinate is a valuable addition to the treatment of psoriasis. Because of its numerous side effects, it should be reserved for only pustular, erythrodermic, and severe cases of plaque-type psoriasis. Many patients whose psoriasis has been recalcitrant to conventional therapy may greatly benefit from this drug.
Retinoids in Cutaneous T Cell Lymphomas
Authors: Mahrle Gustav , Thiele Bernd
Published: October 2009

Sixteen patients – 12 with cutaneous T cell lymphoma (CTCL), 1 with Sézary syndrome, 1 with actinic reticuloid, and 2 with parapsoriasis variegata – were treated with either a new, potent arotinoid alone or with combined etretinate (Tigason®) and PUVA therapy (Re-PUVA). 92% of all patients showed a minor up to a distinct response of their skin lesions within 12.6 ± 7.4 weeks. More than 50% of the skin lesions cleared in 67% of the patients. After discontinuation of the retinoid therapy, relapses occurred in all cases within 3–10 weeks. There was no difference between the therapeutic efficacy of arotinoid alone and the Re-PUVA regimen, but the latter was less toxic.
Biochemical Mechanisms by Which Minoxidil Sulfate Influences Mammalian Cells
Authors: Meisheri K.D. , Cipkus L.A.
Published: October 2009

The antihypertensive effect of minoxidil has been shown to occur via direct vasodilation induced by its active metabolite, minoxidil sulfate (MxSO4). Thus, an in vitro vascular smooth muscle preparation was used as a model to investigate cellular biochemical mechanisms influenced by MxSO4. In rabbit isolated superior mesenteric artery, the contractions produced by receptor agonists such as norepinephrine (NE) were relaxed by about 85% with MxSO4. In contrast, MxSO4 was without any effect on 80 mM KCl-induced contraction. Furthermore, pretreatment of the tissues with tetraethylammonium (TEA, a K+ channel blocker), or ouabain, or 10–25 mM KCl, all caused pronounced inhibition of MxSO4-induced relaxation of NE-induced contraction. These investigations revealed that MxSO4-induced relaxation could be effectively inhibited by treatments that interfere with plasmalemmal K+ permeability. It is proposed that MxSO4 acts like a K+ channel agonist to enhance K+ permeability; this should result in hyperpolarization and cause reduction in agonist-stimulated Ca2+ influx. The end result is a decrease in cytoplasmic free Ca2+ concentration, and thus relaxation. Consistent with this, we could also demonstrate enhancement of 42K efflux as well as inhibition of NE-stimulated 45Ca influx. The above-proposed mechanism appears specific for MxSO4 since it was not shared by forskolin (a cyclic-AMP-increasing agent), sodium nitroprusside (a cyclic-GMP-increasing agent) or D600 (a Ca2+ antagonist). The relevance of the proposed unique cellular mechanism (i.e. K+ permeability) of MxSO4 to its hair growth effect remains to be examined. However, it is suggested that the understanding of the cellular mechanism of one biological effect of minoxidil (i.e. antihypertensive action) may provide a basis for further understanding its other biological effect (i.e. hair growth).
Aetiology and Pathophysiology of Hair Loss
Authors: Dawber R.P.R.
Published: October 2009

The prevalence of androgenetic alopecia has not been accurately recorded but it is probably true that, at least in caucasoid races, some degree of transformation of terminal to vellus hair follicles on the vertex from puberty onwards is a universal phenomenon in both sexes, although androgenetic alopecia in women more often assumes a diffuse form. Our knowledge of the pathogenesis of ordinary baldness is far from complete but a genetic predisposition is necessary and androgen production must be present. In general it can be concluded that whatever the level of circulating androgens, free or total, the major genetic factor must reside in the end-organ response – in this case follicular receptivity and reactivity to the androgens delivered to the papilla/matrix unit. The pathophysiology of common baldness is strictly a misnomer as used in clinical practice since only rarely does it signify endocrine disease or other than normal physiological loss. In many patients the problem posed is essentially psychological and this aspect may be so predominant as to cause psychiatric disease.
Penetration Kinetics of Liposomal Hydrocortisone in Human Skin
Authors: Wohlrab W. , Lasch J.
Published: October 2009

The applicability of liposomal hydrocortisone (HC) as a selective drug delivery system for cutaneous administration of glucocorticoids has been studied. With the liposomal form, a considerably better concentration-time profile was obtained in the individual layers of human skin than with the corresponding HC ointment. The pronounced carrier ability of liposomes for HC holds promise for an increase in its therapeutic efficacy, thus reducing unwanted side effects of the topical glucocorticoid therapy.
Association of Vesiculobullous Eruptions with Mycosis fungoides
Authors: Maeda Kazuo , Jimbow Kowichi , Takahashi Makoto
Published: October 2009

Mycosis fungoides (MF) is, on extremely rare occasions, associated with vesiculobullous eruptions. This report describes clinical, histological and immunohistochemical findings of a case of MF with vesiculobullous lesions. Characteristic features of our case included: (a) bullous lesions evolving rapidly in 12–24 h with severe itch on erythematous and normal-appearing skin; (b) a positive Nikolsky sign; (c) an intraepidermal blister; (d) direct and indirect immunofluorescence stainings were all negative with IgG, IgA, IgM and C3, and (e) atypical lymphocytes in the infiltrates were of helper/inducer T cell type.
Functional Subtypes of Renal α1-Adrenoceptor in Spontaneously Hypertensive Rats with Streptozotocin-Induced Experimental Diabetic Nephropathy
Authors: Khan Md. Abdul , Sattar Munavvar Abdul , Abdullah Nor Azizan , Abdulla Mohammed H. , Salman Ibrahim M. , Kazi Raisa N. , Swarup K.R.L. Anand , Rathore Hassaan A. , Basri Fathihah , Hussain NurJannah M. , Dewa Aidiahmad , Johns Edward James
Published: October 2009

Aim: This study investigated the impact of hypertension combined with diabetic nephropathy on rat renal α1-adrenoceptor subtype composition. Methods: In streptozotocin-induced diabetic spontaneously hypertensive rats (SHR), diabetic nephropathy developed as reflected by increased kidney index, plasma creatinine, albumin excretion, creatinine clearance and fractional excretion of Na+ (all p < 0.05). Renal vasoconstrictions caused by electrical stimulation of renal nerves and intrarenally administered noradrenaline (α-adrenoceptor agonist), phenylephrine (α1-adrenoceptor agonist) and methoxamine (α1A-adrenoceptor agonist) were determined in the presence and absence of intrarenally administered amlodipine (Ca2+ channel blocker), 5-methylurapidil (α1A-adrenoceptor antagonist), chloroethylclonidine (α1B-adrenoceptor antagonist) and BMY 7378 (α1D-adrenoceptor antagonist). Results: In diabetic nephropathy SHR, there was a significant (all p < 0.05) attenuation of all adrenergically induced vasoconstrictor responses in the antagonists, except chloroethylclonidine, which caused a significant (all p < 0.05) enhancement of the responses. Conclusion: The data demonstrated that there was a functional coexistence of α1A- and α1D-adrenoceptors in the renal vasculature of SHR irrespective of the presence of diabetic nephropathy. However, there was a minor contribution of pre-synaptic α-adrenoceptors to the adrenergically mediated vasoconstrictor responses in the diabetic nephropathy SHR.
Genetic and Clinical Spectrum of Aromatase Deficiency in Infancy, Childhood and Adolescence
Authors: Belgorosky A. , Guercio G. , Pepe C. , Saraco N. , Rivarola M.A.
Published: October 2009

Introduction: cP450aromatase deficiency provides clues for the understanding of the role of aromatase in prepubertal and pubertal human health and disease. Placental aromatization of androgens protects the female fetus against the virilizing action of fetal androgens. After birth, the dual effect of aromatase deficiency, excessive androgens, and insufficient estrogens is responsible for a variable clinical picture. Nineteen cases of aromatase gene (CYP19) deficiency have been reported. Phenotype: Phenotype is dependent on sex and age. In newborns, aromatase deficiency should be considered in the etiology of 46,XX DSD, after ruling out congenital adrenal hyperplasia. In prepubertal aromatase deficient girls, high levels of ovarian androgens and gonadotropins facilitate the formation of ovarian cysts. Bone mineralization can be affected and bone aging is delayed. In pubertal girls, there is poor sexual development and abnormal virilization. The phenotype may be variable according to enzyme activity level. Insulin sensitivity may be abnormal in both men and women. Finally, aromatase might also play a role in the regulation of testicular cell mass in the newborn testis. Conclusion: Adequate interpretation of clinical data should lead to the analysis of the CYP19 gene for diagnostic confirmation and implementation of appropriate management.
A Favorable Metabolic and Antiatherogenic Profile in Carriers of CYP21A2 Gene Mutations Supports the Theory of a Survival Advantage in This Population
Authors: Livadas Sarantis , Dracopoulou Maria , Lazaropoulou Christina , Papassotiriou Ioannis , Sertedaki Amalia , Angelopoulos G. Nick , Chrousos George P. , Dacou-Voutetakis Catherine
Published: October 2009

Context: The very high carrier frequency of 21-hydroxylase deficiency worldwide has been postulated as indicating a survival advantage. The ‘mediators’ of such an effect remain speculative. Objective: To look for possible differences in the metabolic and atherogenic risk profile of carriers and noncarriers of CYP21A2 gene mutations at puberty in order to identify possible mediators of the presumed survival advantage for the carriers. It is anticipated that by studying atherogenic risk factors at such an early developmental stage, age-related alterations in these factors may be minimized. Methods: The study group included 45 adolescent girls diagnosed in our center with premature pubarche, 29 of whom were noncarriers and 16 carriers of CYP21A2 mutations. The two groups did not differ in chronological age, age at pubarche or menarche, pubertal stage, body mass index and waist-to-hip ratio. Biochemical and hormonal profile markers as well as markers of endothelial dysfunction were determined by appropriate methodology. Additionally, in each subject, an oral glucose tolerance test and a gonadotrophin-releasing hormone GnRH analogue stimulation test were carried out. Results: Endothelin-1 values were lower in the carriers compared to the noncarriers (p = 0.031). Higher tissue plasminogen activator and lower plasminogen activator inhibitor-1 values were found in carriers compared to noncarriers (p = 0.02 and <0.001, respectively). The ratio of the insulinogenic index/homeostasis model assessment for insulin resistance, which reflects β-cell function, was higher in carriers (p = 0.048), indicating a more favorable β-cell function in the carriers. Conclusions: Our findings that carriers of CYP21A2 gene mutations have a more favorable internal milieu with regard to the metabolic syndrome and atherogenesis support the theory that heterozygous CYP21A2 mutations provide a survival advantage. The mechanisms involved may be related to the insulin secretion-action pathway, hypothalamic-pituitary-adrenal axis responsiveness or other still unrecognized factors.
Tyrosinemia Type II in Two Cases Previously Reported as Richner-Hanhart Syndrome
Authors: Balato Nicola , Cusano Francesco , Lembo Giuseppe , Santoianni Pietro
Published: October 2009

Two sibs with palmo-plantar keratosis and dendritic corneal opacities, previously described as suffering from Richner-Hanhart syndrome by other authors, about 25 years ago, showed increased plasma and urine tyrosine levels. Their neurological and mental features were within normal limits. A comprehensive review of the literature showed a total of 47 cases of fully documented tyrosinemia type II; 8 more patients also had the clinical features of the disease, but aminoacidemia had never been observed. The importance of early diagnosis is stressed, since a low tyrosine-phenylalanine diet dramatically improves the symptoms and may prevent mental retardation.
Failure of Etretinate in Epidermodysplasia verruciformis
Authors: Kowalzick Lutz , Mensing Hartwig
Published: October 2009

In a patient suffering from benign lesions of epidermodysplasia verruciformis due to human papillomavirus type 5 little clinical improvement could be observed after 6 months of oral etretinate. The drug was given 75 mg/day for 1 month before dosage was reduced to 50 mg/day. Control biopsy after 3 months of treatment still revealed large quantities of virions and typical cytopathic effects in light and electron microscopic examination.
HLA in Familial Malignant Melanoma
Authors: Boullie M.C. , Thomine E. , Demenais F. , Daveau M. , Laurent P.
Published: October 2009

In a family displaying the familial atypical multiple-mole melanoma syndrome, linkage analyses were performed between HLA and an assumed dominant gene respectively determining each of the following affected phenotypes: (1) precursor lesions; (2) cutaneous malignant melanoma (CMM); and (3) precursor lesions or CMM or both. The results suggest that there is a complex mechanism involving several factors, genetic and environmental interacting with the gene determining precursor lesions to cause the neoplastic transformation.
Physician-Determined Worsening Heart Failure: A Novel Definition for Early Worsening Heart Failure in Patients Hospitalized for Acute Heart Failure – Association with Signs and Symptoms, Hospitalization Duration, and 60-Day Outcomes
Authors: Cotter Gad , Metra Marco , Weatherley Beth Davison , Dittrich Howard C. , Massie Barry M. , Ponikowski Piotr , Bloomfield Daniel M. , O’Connor Christopher M.
Published: October 2009

Objectives: To evaluate physician-determined worsening heart failure (PD-WHF) in patients admitted with acute heart failure (AHF). Methods: The PROTECT pilot study evaluated rolofylline, an adenosine A1 receptor antagonist, versus placebo in patients with AHF and renal impairment. Signs and symptoms of heart failure (HF) and diuretic administration were prospectively recorded daily for 7 days and patients were followed for 60 days. Patients were categorized into three groups: (A) PD-WHF, based on worsening symptoms and signs of HF and need for additional intravenous (IV) or mechanical therapy (n = 29); (B) increased IV diuretic therapy without PD-WHF (n = 61), and (C) neither PD-WHF nor increase in IV diuretic dose (n = 211). Results: Patients in group A had slower resolution of dyspnea, longer mean (±SD) length of hospitalization (13.8 ± 6.8 vs. 10.5 ± 8.5 and 9.3 ± 5.9 days in groups B and C, respectively; p < 0.05 for both), and higher 60-day death and cardiovascular or renal readmission rates [49.7 (95% confidence interval: 33.1–69.1) vs. 37.3 (26.4–50.9) vs. 19.5% (14.7–25.6) in groups B and C, respectively]. PD-WHF was a strong independent predictor of length of stay and 60-day death and cardiovascular or renal readmission. Conclusions: PD-WHF may be an indicator of short-term risk and treatment efficacy in AHF.
Investigation of the Alterations in Cellular Electrophysiology Underlying Ventricular Arrhythmia in Dogs with the Multiple Organ Dysfunction Syndrome
Authors: Hou Yue-Mei , Song Jian-Guo , Juan Sun , Ullah Shuja , Bin Yang , Zang Xiao-Qing , Ping Fan , Yang Huang , Liu Zheng-Jiang
Published: October 2009

Background: Multiple organ dysfunction syndrome (MODS)-specific cellular electrophysiological changes have so far not been reported and it seemed unlikely that they were related to arrhythmogenesis. Methods and Results: Twelve dogs, weight 12 ± 2 kg, were divided into a control group (n = 6) and an MODS group (n = 6). MODS lasting for 72 h was induced by the ‘two-hit’ method in 6 dogs. Ventricular myocytes were enzymatically isolated. Early afterdepolarizations (EADs), action potential duration (APD) and L-type calcium currents (ICa,L) were assessed. Sinus arrhythmias in all MODS dogs (100%; 6 of 6) and premature ventricular beats in 4 MODS dogs (66%; 4 of 6) were recorded, while no arrhythmias were found in the control animals. The prolongation of the APD was associated with a decreased ICa,L, and frequently provoked EADs were the typical electrophysiological alterations in the myocytes of MODS dogs. The action potential prolongation was shortened, the ICa,L blocked and EAD suppressed by using verapamil (100 μmol/l) in the myocytes of MODS dogs (66%; 4 of 6). Conclusion: The changes in cellular electrophysiology within 72 h in the heart of MODS dogs are APD prolongation, markedly decreased ICa,L as well as frequently provoked EAD, the most common types of arrhythmia being sinus arrhythmia and premature ventricular beats. This study suggests that verapamil appears to be an effective agent in reversing alterations in cellular electrophysiology at the early stage of MODS.
Quantitation of Facial Affection in Scleroderma
Authors: Rasmussen Ida , Serup Jørgen
Published: October 2009

The interincisor distance, the vertical lip distance, and the horizontal oral distance were measured in 68 patients with generalized scleroderma and in 66 healthy individuals. Interincisor distance and vertical lip distance were decreased in scleroderma (p < 0.001 and p < 0.001). Vertical lip distance and horizontal oral distance provided clinically a clear differentiation between minor and major affection (p < 0.001 and p < 0.001), while the interincisor distance provided a weaker differentiation (p < 0.05). The horizontal oral distance correlated with the duration of scleroderma (r = ––0.289, p < 0.05), and the vertical lip distance tended to do so (r = ––0.208, n.s.). In healthy individuals interincisor and vertical lip distances decreased significantly with age (in males only), while the horizontal oral distance showed no significant decrease. In conclusion, interincisor and vertical lip distances are preferable for diagnosis and the horizontal oral distance for follow-up of facial scleroderma. If only one vertical parameter is wanted, the authors prefer the vertical lip distance to the interincisor distance.
Treatment of Hyperhidrosis by a Battery-Operated Iontophoretic Device
Authors: Hölzle E. , Ruzicka T.
Published: October 2009

A new iontophoretic device was utilized in the treatment of hyperhidrosis axillaris (5 patients), hyperhidrosis manuum (12 patients) and hyperhidrosis pedum (10 patients). Unilateral treatment was carried out daily for 3 weeks. Degree of sweat inhibition was assessed quantitatively in relation to the untreated control side by means of hygrometry and also estimated by a colorimetric method. In 3 patients with palmar hyperhidrosis and in 2 patients with plantar hyperhidrosis sweating returned to normal levels, thus hyperhidrosis was completely curbed. A moderate reduction of sweat rates was induced in 4 patients on palms and in 3 patients on soles. In the remaining group sweat inhibition was only slight. In treatment of palmo-plantar hyperhidrosis side effects were minimal. Axillary hyperhidrosis was only moderately reduced in some patients. Skin irritation due to iontophoresis posed a problem.
Immune Complexes in Patients with Contact Dermatitis
Authors: Picardo M. , Santucci B. , Pastore R. , Valesini G. , Verducchi D. , Bravi D.
Published: October 2009

By C1q binding assay, circulating immune complexes (cic) were detected in 19 out of 30 patients with contact dermatitis to nickel or chromium. Their presence was correlated with the duration of the disease, while any patients positive for cic showed any signs of type III immunopathological lesions. Atomic absorption analysis of the polyethlylene glycol precipitates (PEG ppt) from the sera of 16 patients – 8 positive and 8 negative for cic – revealed an amount of nickel or chromium significantly higher in the PEG ppt from the sera of patients positive for cic.
Von Recklinghausen Neurofibromatosis and Hereditary Plasminogen Deficiency
Authors: Priollet P. , Roncato M. , Vayssairat M. , Aiach M. , Fiessinger J.N. , Mexme M. , Leclerc M. , Housset E.
Published: October 2009

The authors report the case of a 26-year-old man with Von Recklinghausen neurofibromatosis and hereditary plasminogen deficiency. A hypothesis of a relationship in the inheritance of these abnormalities is discussed.
S-100-Protein-Positive Dendritic Cells in Nodular Vasculitis
Authors: Smolle J. , Kneifel H.
Published: October 2009

We investigated the distribution of S-100-protein-positive dendritic cells in 20 cases of nodular vasculitis (erythema induratum Bazin). The cells were identified by immunohistochemical demonstration in paraffin sections. S-100-protein-positive dendritic cells were present in all cases and comprised up to 11% of the infiltrating cells in lymphohistiocytic areas (mean 3.7%). Because of the dendritic shape and the association with lymphocytes the cells are considered to represent T-zone histiocytes. Our findings suggest a possible role of delayed-type hypersensitivity in nodular vasculitis.
Mollusca contagiosa multiples révélateurs d’une infection à HTLV III
Authors: Delescluse J. , Goens J.
Published: October 2009

We report here a case of cutaneous molluscum contagiosum infection, which led to the diagnosis of HTL V III infection. Profuse mollusca contagiosa are one of the cutaneous lesions indicating the presence of AIDS at any stage.
Diseases Associated with Psoriasis in a General Population of 159,200 Middle-Aged, Urban, Native Swedes
Authors: Lindegård Bengt
Published: October 2009

A defined general population of 159,200 male and female native Swedes born in the period of 1911–1940, from an urban catchment area of the then only general hospital, was followed over a decade (1970–1979) with regard to inpatient hospitalization for all kinds of diagnoses. Psoriasis cases (n = 372) are significantly (p < 0.001) associated with a spectrum of diseases: male as well as female psoriatics seem to show excess rates of viral infections, alcoholism, hypertension, pneumonia, liver cirrhosis, urticaria, and rheumatoid arthritis. Psoriasis in males only seem to be associated with iritis and ankylosing spondylitis, whereas psoriasis in females only is associated with lung cancer, diabetes, obesity, myocardial infarction and asthma.
New Experimental Approach to Measure the Skin-Reflected Light. Application to Cutaneous Erythema and Blanching
Authors: Lévêque J.L. , Poelman M.C. , Legall F. , de Rigal J.
Published: October 2009

By modifying the blood supply in the upper part of the dermis, the colour of the skin is changed by any material in contact with it. This is a great difficulty when we want to measure the colour intensity in erythema or blanching. To avoid this problem, we designed and built a device which measures the skin reflectance value without any contact with the skin. The use of this device on man to study the skin blanching after application of dermocorticoids allows us to determine the more potent drug among a series (clobetasol propionate) and, for a given drug (betamethasone), the more efficient preparation (oil-in-water emulsion). The study of the effect of increasing irradiation doses of ultraviolet light shows that the sensitivity of the device is equivalent to that of the clinical assessment and that the relationship between the irradiation dose and the skin reflectance is sigmoidal.
Phlebotomy Treatment in Porphyria Cutanea Tarda Combined with β-Thalassaemia
Authors: Adjarov D. , Donov M. , Ivanov E. , Naidenova E.
Published: October 2009

In 74 patients with porphyria cutanea tarda, 11 (14.9%) cases of β-thalassaemia were found. The incidence of β-thalassaemia in porphyries is not greater than in non-porphyries and it seems that β-thalassaemia is not a factor triggering the development of porphyria cutanea tarda. The phlebotomy treatment is also a convenient method for porphyria cutanea tarda combined with β-thalassaemia.