bluuebunny/crossref_metadata_2025 huggingface dataset:
Clostridium difficile toxin expression is inhibited by the novel regulator TcdC
Authors: Matamouros Susana , England Patrick , Dupuy Bruno
Published: May 2007

Clostridium difficile, an emerging nosocomial pathogen of increasing clinical significance, produces two large protein toxins that are responsible for the cellular damage associated with the disease. The precise mechanisms by which toxin synthesis is regulated in response to environmental change have yet to be discovered. The toxin genes (tcdA and tcdB) are located in a pathogenicity locus (PaLoc), along with tcdR and tcdC. TcdR is an alternative RNA polymerase σ factor that directly activates toxin gene expression, while the inverse relationship between expression of tcdR, tcdA and tcdB genes on the one hand and tcdC on the other has led to the suggestion that TcdC somehow interferes with toxin gene expression. This idea is further supported by the finding that many recent C. difficile epidemic strains in which toxin production is increased carry a common tcdC deletion mutation. In this report we demonstrate that TcdC negatively regulates toxin synthesis both in vivo and in vitro. TcdC destabilizes the TcdR‐containing holoenzyme before open complex formation, apparently by interaction with TcdR or TcdR‐containing RNA polymerase holoenzyme or both. In addition, we show that the hypertoxigenicity phenotype of C. difficile epidemic strains is not due to their common 18 bp in‐frame deletion in tcdC.
Localized Cutaneous Cryptococcosis in an Immunosuppressed Man
Authors: Geyer Stanley J. , Werber John C.
Published: May 2007

ABSTRACT: Isolated cutaneous cryptococcosis developed in a 62‐year‐old white man with an idiopathic deficiency of J‐lymphocytes. The patient was healthy, except for the cutaneous infection, and displayed no other evidence of an immunodeficiency disorder. An immunologic workup should be conducted in all patients with cryptococcal infection, regardless of their apparent health status.
A New Topical Antifungal Drug:
Authors: Vander Ploec Darl E. , De Villez Richard L.
Published: May 2007

ABSTRACT: Following 4 weeks of treatment, 32 of 35 tioconazole treated patients (91.4%) and 29 of 34 miconazole treated patients (85.3%) achieved clinical and mycologic cures. At follow‐up four weeks after completion of treatment, 29 of 31 tioconazole treated patients (93.5%) and 25 of 28 miconazole treated patients (89.3%) remained cured. There was no significant difference between clinical, mycologic or clinical plus mycologic response to the two medications. The 96.2% positive culture correlation in this study is attributed to the selection of multiple culture sites.
Larva Currens and Systemic Disease
Authors: Amer Mohamed , Attia Mohamed , Ramadan Ali S. , Matout Kamal
Published: May 2007

ABSTRACT: Of 26 patients infested with Stronglyoides stercoralis 10 (38.5%) were asymptomatic without systemic or cutaneous signs. Nine patients (34.6%) presented with systemic complaints only and seven patients (26.9%) had systemic and cutaneous manifestations. Further observations of the skin lesions on four of those with systemic and cutaneous manifestations revealed linear urticarial bands, extending to several centimeters within 1 hour and persisting up to many days, waiting and waning. Blood examination showed eosinophilia in all patients. These findings confirm the concept that larva currens even alone should be considered a cutaneous sign of systemic disease.
Leukocyte Chemotaxis and Pyoderma Gangrenosum
Authors: Nerella Petrini , Daniela Acampa , Guido Modi , Fabbri Paolo
Published: May 2007

Abstract: Leukocyte chemotaxis (in five patient with pyoderma gangrenosum) was studied using a modification of the Boyden chamber method. In all patients the chemotactic response was significantly lower than in the controls. This abnormal chemotaxis was a result of an intrinsic neutrophil dysfunction. No significant difference was detected between the chemotactic response of leukocytes from patients with minimal or no skin involvement and those from patients with extensive lesions.
Basal Cell Carcinoma Following Chronic Otitis Media
Authors: Myskowski Patricia L. , Safai Bijan
Published: May 2007

Abstract: A 36‐year‐old white woman presented with a gradually enlarging lesion in the right preauricular area of 15 years duration. The patient had a 25‐year history of chronic otitis media of the right ear; in spite of multiple courses of systemic antibiotics, she frequently noted a slight discharge from the affected ear, draining across the right preauricular area, causing a mild pruritic eruption. She recalled having had approximately 30 roentgenographs of mastoids, but denied any history of fluoroscopic examination. The patient denied a history of excessive sun exposure or exposure to arsenic or other carcinogenic factors. There was no family history of skin cancer.
Basal Cell Carcinoma and Breast Carcinoma Following Repeated Fluoroscopic Examinations of the Chest
Authors: Myskowski Patricia L. , Gumpertz Esti , Safai Bijan
Published: May 2007

Abstract: A 69‐year‐old white Italian woman was first seen at Memorial Sloan‐Kettering Cancer Center in 1981 concerning several skin growths on her back. The patient had had several basal cell carcinomas surgically removed from her back during the preceding 5 years. There was no history of arsenic ingestion or prolonged sun exposure and her family history was negative for skin cancer. The patient had developed pulmonary tuberculosis in 1938 and was treated with pneumothorax therapy. She had had more than 50 fluoroscopic examinations of the chest following this therapy, as well as multiple diagnostic x‐ray films since that time. She recalled that she had faced the fluoroscopy beam during the procedure. In 1959, she had a transabdominal hysterectomy for fibroid tumors. In 1980 she underwent a right modified radical mastectomy for adenoid cystic carcinoma of the breast; biopsies of lymph nodes were negative. Physical examination revealed a thin, white woman with a right mastectomy scar. On the back, clustered in the interscapular region, were multiple scars and nine erythematous nodules with pearly borders, telangiectasia, and translucent surfaces. Within several nodules there were areas of light and dark brown pigmentation. There were no other suspicious lesions on the head, chest, or extremities, nor did the patient show any evidence of the basal cell nevus syndrome. Biopsy of all lesions revealed basal cell carcinoma, some of which were pigmented, without evidence of chronic radiodermatitis. All lesions were treated with curettage and electrodesiccation three times with good cosmetic results (Fig. 1).
Halo Eczema Around Melanocytic Nevi
Authors: Brenan John , Kossard Steven , Krivanek Joseph
Published: May 2007

Abstract: Nine patients developed multiple areas of eczema surrounding centrally located pigmented nevi. There was no significant history of atopy or evidence of external contact factors to account for the reaction. The eczema did not appear to influence the central melanocytic nevi, which persisted after resolution of the inflammation. The pathogenesis of this striking phenomenon remains unclear but differs from that associated with classical halo nevi.
A Marsupialization Procedure for Repair of Large Cutaneous Surgical Wounds
Authors: Lewis JohnEdgar
Published: May 2007

Abstract: An open method of surgical management of large postoperative surgical excision defects of the head and neck is a pragmatic alternative to more conventional methods of management.
Bazex Syndrome: Follicular Atrophoderma and Basal Cell Epitheliomas
Authors: Mehta V. R. , Potuar R.
Published: May 2007

Abstract: A dominant inheritance leading to development of nevoid basal cell epitheliomas on the face and follicular atrophoderma on the extremities constitute the two constant manifestations of Bazex syndrome. A patient with both manifestations on the trunk who fulfilled all the criteria for a diagnosis of nevoid basal cell epitheliomas is described. Histopathology of the basal ceil cancer corresponded to that of the fibroepithelial tumor, thus differing from the more common nodular and trichoepitheliomatous persentations. Difficulty in associating the atrophoderrna with a hair follicle (histologically) arises because the latter ceases to exist as a functional unit.
Cryotherapy Versus Podophyllin in the Treatment of Genital Warts
Authors: Bashi SamiAnwer
Published: May 2007

Abstract: 572 patients with solitary or multiple genital warts attending the Department of Genitourinary Medicine at the Royal Victoria Hospital, Bournemouth, U.K. between lanuary 1981 and December 1981 were allocated to either pedophilic or cryotherapy for the treatment of their warts. Of 350 patients successfully treated for their warts and returned for a follow‐up examination 6 weeks or more after completing their treatment, 206 (139 men and 67 women) were treated with pedophilic, and 144 (86 men and 58 women) with cry therapy. One hundred five (51 %) of those treated with pedophilic and 114 (79%) treated with cryotherapy were free of warts at their follow‐up examination. Patients treated with podophyllin required a mean of 6,7 SD 3.5 treatments over a mean of 4.7 SD 2.4 weeks, whereas those receiving cryotherapy required a mean of 2.6 SD 2.0 applications over a mean of 2.3 SD 1.2 weeks.
Linear IgA Bullous Dermatosis
Authors: Wilson B.Dale , Beutner Ernst H. , Kumar Vijay , Chorzelski Tadeusz P. , Jablonska Stefania
Published: May 2007

Abstract: Linear IgA bullous dermatosis (LABD) can mimic bullous pemphigoid (BP) and/or dermatitis herpetiformis (DH) both clinically and histologically. LABD. however, can be distinguished from BP and DH by direct immunofluorescent (IF) demonstration of linear IgA. deposits along the basement membrane zone. A retrospective study of 234 cases of BP, 27 cases of LABD, 60 cases of DH, and 20 cases of cicatricial pemphigoid (CP) revealed that BP patients are significantly older than LABD or DH patients and LABD patients are significantly older than DH patients. BP and CP occur more frequently in women (65–70%) than LABD or DH (44–48%). The frequencies of C3 deposits in the basement membrane zone (BMZ) are significantly higher in BP (85%) compared with LABD (18.5%) and DH (28.3%). LABD patients varied in their response to various therapeutic agents. Some responded to corticosteroids and some to sulfones alone. whereas others required a combination of corticosteroids and sulfones.
Reactive Perforating Collagenosis
Authors: Yuzuk S. , Trau H. , Stempler D. , Sofer E. , Schewach‐Millet M.
Published: May 2007

Abstract: Seven patients with reacting perforating collagenosis (RPC) were diagnosed from 1974 to 1982. Experimental production of lesions in two patients confirmed the contributory role of superficial trauma. The pathogenesis of RPC involves transepithelial elimination of altered collagenous bundles, This process may he observed in a wide variety of disparate skin diseases.
Stevens‐Johnson Syndrome
Authors: Ting H. C. , Adam B. A.
Published: May 2007

Abstract: Stevens‐Johnson syndrome is relatively rare. The authors report a retrospective study of 34 patients seen at the University Hospital in Malaysia over 16 years and discuss the epidemiology, clinical features, complications, investigations, etiologic association, mortality, sequelae, course of the disease, and the use of steroid.
Treatment of Alopecia Areata with Topical Nitrogen Mustard
Authors: Arrazola J. M. , Sendagorta E. , Harto A. , Ledo A.
Published: May 2007

Abstract: Eleven patients with severe alopecia areata (localized and totalis types) were treated with topically applied nitrogen mustard. Nine patients had terminal hair regrowth; in 7 of the 11 patients, it was cosmetically acceptable. Hair regrowth began approximately 1–2 months after the initiation of therapy. Two patients had an allergic contact dermatitis reaction to the mechloretamine solution; no systemic side effects were seen. During a follow‐up period of 12 months, only two patients had a recurrence. These preliminary results indicate that topically applied nitrogen mustard has a significant effect in alopecia areata.
Cytochemical and Ultrastructural Studies of the Langerhans' Cells
Authors: Bian Zhao , Bing‐He Wang
Published: May 2007

Abstract: In the guinea pig, experimental allergic contact dermatitis (ACD) And primary irritant contact dermatitis (PICD) were induced with different concentrations of dinitrochlorobenzene (DNCB). The epidermal Langerhans' cells (LCs) were observed sequentially by both adenosine triphosphatase (ATPase) and electron microscopy. Light microscopically, in ACD, the density and dendritic processes of LC decreased markedly within 12 h after antigen challenge. Almost no recognization LCs could be seen within 2 to 5 days. Later, LCs began to repopulale in the epidermis. Within 14 days, the density and shape of the LCs returned to normal. On the contrary, LCs changed more rapidly in PICD. The dendritic processes of LC decreased within 2 h and cell density decreased dramatically within 6 h after DNCB application. LCs also repopulated more rapidly in the epidermis. Electron microscopically, in ACD, we observed that lymphocyte‐like cells apposed to LCs; LCs were activated and damaged; however, in PICD, we found neither the apposition of lymphocyte‐like cells to LCs, nor the activation of LCs. LCs play an important role in the convalescence phase as well as in the early and later phases of contact allergic reaction.
HLA and β2‐microglobulin Expression in Basal and Squamous Cell Carcinomas of the Skin
Authors: Hua LinAi , Kacen Charles N. , Carpenter Randall J. , Goltz Robert W.
Published: May 2007

Abstract: Histologic sections of seven squamous cell carcinomas (SCC), 13 basal cell carcinomas (BCC), and a Bowenoid actinic keratoses were examined for expression of HLA class 1 antigens (HLA‐ABC) using a monoclonal antibody and an immunoperoxidase technique. Expression of β2‐microglobulin was examined with a polyclonal antibody method. Neither cell marker was detected within the Bowenoid actinic keratoses. Squamous cell carcinomas and basal cell carcinomas exhibited decreased expression of both HLA‐ABC and β2‐microglobulin and often did not express these antigens at all. HLA‐ABC was present in only two of 13 basal cell carcinomas and four of seven squamous cell carcinomas. β2‐microglobulin was present in one of 13 basal cell carcinomas and two of seven squamous cell carcinomas. When present, these antigens often were present in a few areas of the tumor, but absent in others. In both SCC and BCC. both antigens were usually lost simultaneously. In all tumors with β2‐microglobulin, HLA‐ABC a/so was retained. There was no apparent relationship of anatomic site or type of tumor with retention of surface antigens. Since some tumors or portions of tumors retained HLA‐ABC and β2‐microglobulin on their surfaces, the absence of these antigens is not an absolute marker for malignancy.
The Dermatology of Kauai, Hawaii, 1981–1982
Authors: Elpern David J.
Published: May 2007

ABSTRACT: The distribution of skin disease within a population can be used as the basis for research as well as planning for the delievery of health services. In this prospective study, the cutaneous diagnoses and demographic data on all patients seen in the only dermatology clinic on Kauai, Hawaii, were recorded form March 1981 to February 1982. Kauai is relatively unique in that the population in comprised of four aracial groups with roughly equal representation; these groups live under similar conditions. A total of 3,277 patients were seen and 4,106 diagnoses were made. Three hundered twenty‐four separate diagnoses were rendered: acne vulgaris, contact dermatitis, verrucae, and dermatophytosis were the most common. Various diseases were not equaly divided among the racial groups. These data are compared to similar previous studies
Halo Eczema Around Melanocytic Nevi
Authors: Brenan John , Kossard Steven , Krivanek Joseph
Published: May 2007

ABSTRACT: Nine patients developed multiple areas of eczema surrounding centrally located pigmented nevi. There was no significant history of atopy or evidence of external contact factors to account for the reaction. The eczema did not appear to influence the central melanocytic nevi, which persisted after resolution of the inflammation. The pathogenesis of this striking phenomenon remains unclear but differs from that associated with classical halo nevi.
Is the Year Book Really Necessary?
Authors: Dupont Charles
Published: May 2007

ABSTRACT: The 1980 Year Book of Dermatology was analyzed in detail. Articles were arbitrarily classified as useful, laboratory, and exotic. “Useful” was defined as mainly clinical in content or with obvious clinical relevance. “Laboratory” implied that the author was unable to understand the article because of the predominant biochemical, immunologic, histochemic, or electron‐microscopic content involved. “Exotic” meant the article was about a disease that the author had never seen. Of 346 articles analyzed, 270 were found to be useful, 35 laboratory, and 41 exotic. Only 95 of 270 useful articles were in journals that the author normally reads. The Year Books of 1969, 1970, and 1979 contained 1/4, 1/3, and 2/5 useful articles, respectively. Detailed analysis of the above categories was done by subject. Many important articles were present in the literature but were not quoted in the Year Book. It is concluded that the Year Book varies from year to year in its relevance but is still essential reading. The dermatologist must nevertheless amplify it with the standard specialist and general journal; otherwise, important contributions will be missed.
Long‐term Ketoconazole Treatment of Chronic Acral Dermatophyte Infections
Authors: Hersle Kjell , Mobacken Håkan , Moberg Sven
Published: May 2007

ABSTRACT: Ketoconazole 200–400 mg was given once daily for a maximum period of 12 months to 31 patients with chronic (mean duration, 12 years) dermatophyte infections of the hands and/or feet. Griseofulvin had previously been withdrawn due to intolerance or lack of effect. All skin and nail infections improved clinically. Fifty percent of the patients with skin infections and 26% of those with nail infections became clinically clear and culture‐negative. Six months later, relapses had occurred in 8 of 12 patients (67%) with cleared skin lesions, and in 2 of 5 (40%) with cleared nail infections. Ketoconazole was discontinued in one patient due to asymptomatic transient elevation of hepatic laboratory tests. Ketoconazole is an alternative when a replacement for griseofulvin in required, provided the degree of disability justifies the risk of durg toxicity.
Etretinate in the Treatment of Disseminated Porokeratosis of Mibelli
Authors: Zadeh Shoshana Hacham , Holubar Karl
Published: May 2007

ABSTRACT: A 30‐year‐old man with disseminated porokeratosis of Mibelli (DPKM) was treated with oral etretinate. The dose ranged between 75 mg/day and 50 mg/day for 21 weeks. An improvement of the lesions was observed, especially of very painful verrucous plaques of the left shin. No serious side effect was seen. The patient, who had been incapacitated, is now able to work. The benefit of long‐term therapy of etretinate should be considered against its side effects.
Etretinate Improves Localized Porokeratosis of Mibelli
Authors: Campbell Janis P. , Voorhees John J.
Published: May 2007

ABSTRACT: A 60‐year‐old woman with plaque‐type psoriasis of 30 years' duration was treated with etretinate. The lesion resolved while the patient was on the drug and continued to resolve after she had discontinued therapy. The continuation of resolution after the patient had discontinued the drug is probably due to its long half‐life.
A Marsupialization Procedure for Repair of Large Cutaneous Surgical Wounds
Authors: Lewis John Edgar
Published: May 2007

ABSTRACT: An oppen method of surgical management of large postoperative surgical excision defects of the head and neck is a pragmatic alternative to more conventional methods of management.
Reactive Perforating Collagenosis
Authors: Yuzuk S. , Trau H. , Stempler D. , Sofer E. , Levy A. , Schewach‐Millet M.
Published: May 2007

ABSTRACT: Seven patients with reacting perforating collagenosis (RPC) were diagnosed from 1974 to 1982. Experimental production of lesions in two patients confirmed the contributory role of superficial trauma. The pathogenesis of RPC involves transepithelial elimination of altered collagenous bundles. This process may be observed in a wide variety of disparate skin diseases.
Stevens‐Johnson Syndrome
Authors: Ting H. C. , Adam B. A.
Published: May 2007

ABSTRACT: Stevens‐Johnson syndrome is relatively rare. The authors report a retrospective study of 34 patients seen at the University Hospital in Malaysia over 16 years and discuss the epidemiology, clinical features, complications, investigations, etiologic association, mortality, sequelae, course of the disease, and the use of steroid.
Congenital Self‐Healing Reticulohistiocytosis (Hashimoto‐Pritzker Type)
Authors: Hashimoto Ken , Bale George F. , Hawkins H. K. , Langston C. , Pritzker Martin S.
Published: May 2007

ABSTRACT: Sixteen documented cases of congenital self‐healing reticulohistiocytosis were reviewed and clinical and histologic clues for diagnosis were summarized.
Pityriasis Rosea in the Sudan
Authors: Ahmed Mohammed Ali
Published: May 2007

ABSTRACT: Pityriasis rosea presents in the Sudan with the same picture as it does in other countries of Africa. The seasonal incidence is highest in the cold, dry months. The erythematous or rosea picture seen in whites is never encountered in blacks. The term pityriasis rosea may not be descriptive of the disease as it presents in black and brown skins.
Dapsone‐induced Peripheral Neuropathy
Authors: Ahrens Edwin M. , Meckler Roy J. , Callen Jeffrey P.
Published: May 2007

ABSTRACT: A young man with dermatitis herpetiformis developed fatigue and neurologic complaints 4 years after he began oral dapsone therapy. Neurologic examination and nerve conduction studies confirmed the presence of a combined motor and sensory peripheral neuropathy. The symptomatic improvement reported by the patient was supported by improvement in the nerve conduction studies after cessation of dapsone therapy. Substitution of sulfapyridine did not adversely affect the resolution of his neuropathy.
Treatment of Generalized Lichen Nitidus with PUVA
Authors: Randie Henry W. , Sander Hans M.
Published: May 2007

ABSTRACT: Generalized lichen nitidus refractory to topical and systemic corticosteroids completely responded to PUVA. The similarity of lichen nitidus to lichen planus and the presumed lymphocytotoxic effect of FUVA were the bases for our use of oral photochemotherapy.
Presumed Arachnidism
Authors: Hillis Timothy J. , Grant‐Kels Jane M. , Jacoby Lawrence M.
Published: May 2007

ABSTRACT: An 8‐year‐old boy with multiple (up to 12) hemorrhagic and necrotic blisters was eventually diagnosed as being the victim of probable spider bites. Arachnidism, specifically loxoscelism (brown recluse spider bite), is unusual in the northeastern United States.
Herpetiform Protothecosis
Authors: Goidstein Glenn D. , Bhatia Paramjit , Kalivas James
Published: May 2007

A 61‐yerir‐old white woman with myasthenia gravis presented at the University of Kansas Medical Center with a 2‐month history of painful, grouped, blister‐like lesions on an erythematous base localized to the presternal area (Fig, 1). The patient previously had been treated with a 2% topical erythromycin solution, triamcinolone cream 0.1%, 0.25% menlhol, and camphor in Acid Mantle Creme. There was no history of previ(His trauma, infection, or foreign travel. The patient also denied the use of well water for bathing.

The patient's past history included treatment with clotrimazole solution for onycholysis, secondary to Candida. The family history was unremarkable for blistering disorders.

Laboratory evaluation revealed negative pemphigus and pemphigoid antibody titers. Viral culture ot the lesions showed no growth. Inoculation of a skin biopsy on Sabour‐aud's agar was negative.

The skin biopsy ot an intact lesion was characterized by hyperkeratosis, focal parakeratosis, and pseudoepitheliomatous hyperplasia. A dense, chronic, inflammatory cell infiltrate of lymphocytes, histiocytes, and plasma cells was present in the upper and middle dermis, Scattered in the infiltrate were numerous giant ceils and ill‐defined granulomas without ne‐crosis (Fig, 2), Numerous algal organisms were present in the upper dermis and in the hypcrkeratotic layer of the epider‐mis. The organisms were thick‐walled, oval, or spheric al. and measured from 3 to 15 μm in diameter. Internal spore for‐mation and a distinct moriila paftern was present, consistent with prototbecosis (Fig. 3), No vesicles were present histo‐logically. The organism stained intensely with periodic acid‐Schiff and Comori's methenamine silver stains (Fig, 4), Direct immunofluorescence staining was negative for complement or immunoglobulin deposition.

Treatment with topical polymyxin B, bacitracin, and neomycin four times daily for 1 month was followed by resolution of all lesions.
A Rapid Immunoperoxidase Technique to Distinguish Herpetic Types
Authors: Ganderup Grace , Newburger Amy E. , Barr Ronald J. , Riley Robert J.
Published: May 2007

ABSTRACT: The United States is experiencing an epidemic of herpetic infections. Rapid specific diagnosis of herpes simplex types And herpes zoster is important epidemiohgically and also for individual cases since treatment as well as prognosis for recurrence or dissemination varies with virus type. We report a rapid test for the diagnosis and differentiation of these infections. This test uses scrapings from viral vesicles. It employs standard immunoperoxidase techniques and takes 2 hours to perform at UC Smears from 1 3 patients with clinical and/or culture confirmation of viral type were tested. Eleven of eleven who had fresh smears (vesicles present less than 5 days) had positive staining for the viral type expected clinically. Two patients with vesicles 5 days or older showed nonspecific staining.
Suitable Bases for Patch Testing in Tropical Countries
Authors: Bajaj A. K. , Gupta S. C. , Chatterjee Arun
Published: May 2007

ABSTRACT: Patients suspected of having contact dermatitis due to topical medicaments were patch tested with various bases to evaluate the most suitable base for tropical countries. Plastibase and polyethylene glycol 400 produced the least positive reactions. Both were therefore found to be suitable bases, although polyethylene glycol had more positive results than plastibase.
Maculae Ceruleae
Authors: Miller Robert A. W.
Published: May 2007

Maculae ceruleae means sky‐blue (ceruleae) spots (maculae). It refers to the bluish macules that are occasionally seen on the bodies of persons infested with Pthirus pubis (the pubic or crab louse). As this cutaneous manifestation is infrequently seen and rarely photographed and reproduced in medical journals, I present a case for illustration.
Chromoblastomycosis Can Mimic Keratoacanthoma
Authors: Wiss Karen , Mcneely M. Carol , Solomon Alvin R.
Published: May 2007

A 59‐year‐old white man presented to the Dermatology Clinic at the University of Texas Medical Branch with ti verrucous nodule on the right forearm. The patient was a retired woodworker. He had polytiiyositis with pulmonary fibrosis for 5 years. Prednisone and mcthotrexate were required to control his disease.

A crusted verrucous nodule 2.5 by 2.5 cm in diameter with adjacent similar‐sized atrophic scars were present on the extensor surface of the right forearm (Fig. 1). This particular nodule had been present for 2 years, and its growth was characterized by a rapid onset with progressive enlargement and intermittent partial regression. The adjacent scars represented similar lesions that had spontaneously regressed. Although the patient had not worked since his illness began, he continued to actively pursue woodworking as a hobby.

Histologic sections of the excised nodule revealed massive pseudoepitheliomatous hyperplasia with prominent hyper‐keratosis. Intraepidermal microabscesses were numerous and a suppurative neutropbilic infiltrate with scattered foreign body type multinucleated giant cells was present in the dermis (Fig. 2). At higher magnification, numerous light brown yeasts, approximately 10 μm in diameter (Fig. 3) were noted both within tbe giant cells and free within the dermis. Chains of yeast cells were common. These histologic findings are diagnostic of chromoblastomycosis.3
Association of Syringoma and Intradermal Nevus
Authors: Malhotra R. , Bhawan J. , Stadecker M.
Published: May 2007

A 73‐year‐old man presented with a skin‐colored, asymptomatic, 3‐mm papule on the right infraorbital region of the face. The duration of the lesion was not known. A clinical diagnosis of papilloma was made. The patient did not have any other skin lesions. Past and family history were noncontributory. A simple excision of the lesion was performed. Histologic examination of the papule revealed two lesions next to each other: the first one consisted of an intradermal nevus, the second, of a typical syringoma (Fig. 1).
Contact Sensitivity to Proflavine
Authors: Goh C. L.
Published: May 2007

ABSTRACT: Proflavine lotion is a commonly used topical antiseptic in the tropics, hut its sensitizing potential was never emphasized and many who developed allergic contact dermatitis were never aware of it. In a study of 45 patients, most presented with acute or subacute dermatitis which started on the arms and legs. Concomitant cutaneous sensitivity to other medicaments, and lanolin occurred in 66% of the patients.
Comparing 2.5%, 5%, and 10% Benzoyl Peroxide on Inflammatory Acne Vulgaris
Authors: Mills Otto H. , Kligman Albert M. , Pochi Peter , Comite Harriet
Published: May 2007

ABSTRACT: A 2.5% formulation of benzoyl peroxide was compared with its vehicle, and with a 5% and a 10% proprietary benzoyl peroxide gel preparation in three double‐blind studies involving 153 patients with mild to moderately severe acne vulgaris. The 2.5% benzoyl peroxide formulation was more effective than its vehicle and equivalent to the 5% and 10% concentrations in reducing the number of inflammatory lesions (papules and pustules). Desquamation, erythema, and symptoms.of burning with the 2.5% gel were less frequent than with the 10% preparation but equivalent to the 5% gel. The 2.5% formulation also significantly reduced Propionibacterium acnes and the percentage of free fatty acids in the surface lipids after 2 weeks of topical application.
Thesis Reviews
Authors: MAIBACH HOWARD I.
Published: May 2007

Books reviewed in this article:

AETIOLOGICAL STUDIES OF PSORIASIS: A SURVEY. Flemming Brandrup

A CLINICAL AND IMMUNOLOGICAL STUDY OF EGG ALLERGY. Tor Langeland

IMMUNOLOGICAL STUDIES IN PATIENTS WITH NICKEL, COBALT, AND CHROMIUM SENSITIVITY. Nabil Al‐Tawil

PEMPHIGUS. Jarkko Hietanen

HAND ECZEMA AND LONC‐TERM PROGNOSIS IN ATOPIC DERMATITIS. Ingela Rystedt
Lichen Striatus
Authors: Toda Ken‐ichi , Okamoto Hiroyuki , Horio Takeshi
Published: May 2007

ABSTRACT: The possible relationship between lichen striatus and atopy was studied. Twenty‐six patients with typical lichen striatus were studied, and 22 (84.6%) had a positive history of atopic disorders. This might indicate that the pathogenesis of lichen striatus has a close relationship to that of atopic disorders.
Tapwater Iontophoresis in the Treatment of Hyperhidrosis
Authors: Elgart Mervyn L. , Fuchs Glenn
Published: May 2007

ABSTRACT: Tapwater iontophoresis is a recognized method of reducing sweat In various parts of the body. The Drionic Device is a battery‐operated method of inducing tapwater iontophoresis. This simple device may be used at home and is effective in reducing hyperhidrosis for as long as 6 weeks.
Pityriasis Rosea in Lagos
Authors: Olumide Yetunde
Published: May 2007

ABSTRACT: A recent 5‐year period study of the incidence of pityriasis rosea among dermatologic outpatients was conducted at the Lagos University Teaching Hospital. Three hundred fifty‐two patients with pityriasis rosea were seen. The average annual incidence was 4.8 per 100 dermatologic patients. Women predominated by a margin of 1.2:1.0. More than 91% of the patients were between the ages of 5 and 35 years, with a peak at ages 10–14. The incidence of the disease was significantly higher in the early part of the rainy season. No declining incidence was observed over the years. A blood picture of a leukopenia with relative lymphocytosis was observed early in the disease. Ampicillin, when consumed after the onset of the eruption, made the patient with pityriasis rosea clinically worse.
5‐Methoxy Psoralen, Etretinate, and UVA for Psoriasis
Authors: Lane‐Brown Malcolm
Published: May 2007

This first Australasian randomized trial of 5‐methnxy psoralen (5‐MOP) PUVA for psoriasis shows, conclusively, less acute side effects than 8‐MOP PUVA. Daily addition of oral etretinate to the PUVA regimen (Re‐PUVA) produces a valuable reduction in total joules and more so with 5‐MOP than with 8‐MOP. The clearing phase with 5‐MOP Re‐PUVA is quicker than with 8‐MOP Re‐PU VA in skin types 1, 2, and 3 (most Anglo‐Saxon‐Celtic Australians). Doses, when adapted to total body surface rather than mg/kg, allow superior control of therapy. Emollient creams, tar gels, non‐steroidal scalp applications, etc. allow more patient comfort.
Severe Reactional State in Lepromatous Leprosy Simulating Sweet's Syndrome
Authors: Kuo Tseng‐Tong , Chan Heng‐Leong
Published: May 2007

ABSTRACT: A male patient with underlying lepromatous leprosy mimicked Sweet's syndrome clinically. He was believed to be in an atypical reactional state recognized as a variant form of erythema nodosum leprosum In addition to the anti‐leprosy treatment, steroid hormone was required to control the systemic symptoms.
Etretinate Treatment of the Nevoid Basal Cell Carcinoma Syndrome
Authors: Hodak Emmilia , Ginzburg Aleiandro , David Michael , Sandbank Miriam
Published: May 2007

ABSTRACT: A patient suffering from the nevoid basal cell carcinoma syndrome, in whom various surgical and conservative treatment modalities had been tried previously, was placed on oral etretinate therapy. A therapeutic effect of the etretinate on existing basal cell carcinomas and a prophylactic effect in inhibiting new tumor formation were well demonstrated during the T3‐montri period of treatment.
Trimethoprim‐Polymyxin B Sulfate Cream versus Fusidic Acid Cream in the Treatment of Pyodermas
Authors: Jaafar Radzi Bin , Pettit J. H. S. , Gibson J. R. , Harvey S. G. , Marks P. , Webster A.
Published: May 2007

ABSTRACT: One hundred patients with a clinical diagnosis of a primary or secondary superficial pyoderma were entered into a double‐blind study. They were allocated treatment with either trimethoprim‐polymyxin B sulfate cream or fusidic acid cream according to a fully randomized treatment code. Data suitable for evaluation were obtained from 87 patients, and statistical analysis revealed trimethoprim‐polymyxin B sulfate (TP) cream to be significantly better than fusidic acid cream in alleviating several of the individual signs and symptoms associated with pyogenic infection of the skin as well as in reducing the overall severity score at the end of the 2‐week study period.
Clinicopathology and Immunohistochemistry of Genital Warts
Authors: Sehgal Virendra N. , Koranne Ravinder V. , Srivastava Shyam B. , Gupta M. M. , Luthra Usha K.
Published: May 2007

ABSTRACT: Genital warts are a fairly common sexually transmitted disease and often affect young, illiterate subjects of poor socioeconomic status in India. The mean incubation period was 2.4 months, and the duration varied from 10 days to 4 years. Hyperplastic sessile, verruca vulgaris‐like, and flat variants of warts were seen in that sequence, with distinct clinical features. The epidermal and the dermal changes were largely identical; however, the flat type in the epidermal changes were inconspicuous. Koilocytosis was a pathogno‐monic feature in 28, whereas human papilloma virus (HPV) antigens were detected through peroxidase‐antiperoxidase technique in 18 patients.
Keratitis, Ichthyosis, and Deafness (KID) Syndrome With Cerebellar Hypoplasia
Authors: Hsu Huan‐Chang , Lin Guan‐Shayn , Li Wei‐Min
Published: May 2007

ABSTRACT: A 6‐year‐old boy with features of the keratitis‐ichthyosis‐deafness (KID) syndrome 1 and cerebellar hypoplasia is the second case in which abnormality of cerebellum was detected by computed tomography,2 but is the first report of KID syndrome with cerebellar hypoplasia. This finding, together with neurosensory deafness and other neuromuscular defects, may suggest that there is an underlying inborn error of nervous system in the KID syndrome. In vitro immunologic studies in this patient also showed a possible deficit in cellular immunity.
Melasma in Men
Authors: Vázquez Miguel , Maldonado Héctor , Benmamán Coty , Sanchez Jorge L.
Published: May 2007

ABSTRACT: Melasma is characterized by a facial hypermelanosis of light to dark brown color, being more common in women of Hispanic origin, in this study, 27 men with melasma were evaluated clinically and histologically to compare their features with those of previous studies. Three patterns of localization were recognized, namely, centrofacial, malar, and mandibular. On the basis of Wood's light examination, an epidermal, a dermal, and a mixed type were identified. Epidermal hyperpigmentation only and epidermal and dermal hyperpigmentation were found in histologic analysis of the cases. Significant etiologic factors included exposure to sunlight in 66.6% as well as a familial predisposition in 70.4% of the cases.

This study demonstrated that melasma in men shares the same clinicohistologic characteristics as in women, but hormonal factors do not seem to play major significant role.
Somatostatin Treatment of Psoriatic Arthritis
Authors: Matucci‐Cerinic M. , Lotti T. , Cappugi P. , Boddi V. , Fattorini L. , Panconesi E.
Published: May 2007

ABSTRACT: Eighteen patients with psoriatic arthritis were treated for 48 hours with an infusion of somatostatin 250 fig/hr diluted in a 5% glucose solution. This therapy led to a reduction of joint pain and satisfactory clearing of cutaneous lesions immediately after treatment in eight patients, less marked results in four, and null in four. Two patients were dropped from the study because of negative side effects during administration of the drug. Fifteen days after treatment, the clearing of lesions and joint pain reduction were even more pronounced. The most encouraging results were obtained on erythrodermic and large plaque psoriasis and on the polyarticular involvement. We suggest that the use of this drug, whose side effects are discussed, should be limited to patients with polyarthritis showing severe cutaneous involvement.
Epidemiology of Contact Allergy in Singapore
Authors: Goh C. L.
Published: May 2007

ABSTRACT: The prevalence of contact allergy in 2471 patients patch tested in Singapore was 49.2% (571/1160) in women and 49.8% (653/1311) in men (sex difference not significant). The rate appeared to increase with age (43.7% in those <20 years, 50.6% between 20 and 49 years, and 63.1% in those >49 years). There was no significant difference in the prevalence of contact allergy among the major races (Chinese, Malay, and Indian) of Singapore. Contact allergies in 16.8% (96/571) of women and 38.9% (254/653) of men (p < 0.001) were occupational. Nickel, fragrance mix, proflavine, and chromate were common sensitizers. The male:female prevalence of nickel allergy was 1:2 (sex difference p < 0.001) and for chromate was 7:1 (sex difference p < 0.001). Chromate sensitivity was occupational in 87.7% (121/138) of men and 47.1% (8/17) of women (sex difference p < 0.001). Proflavine, neomycin, and clioquinol were the more common medicament sensitizers.
Role of Cell‐Mediated Immunity in Spontaneous Regression of Plane Warts
Authors: Rogozinski Tomasz T. , Jablonska Stefania , Jarzabek‐Chorzelska Maria
Published: May 2007

ABSTRACT: Human papillomavirus‐induced plane warts most often occur in the second decade of age. Afterward, they either spontaneously regress or are eradicated in the course of various treatments. As proved by in vivo and in vitro tests as well as clinical observations, they most often affect and persist longer in immunocompromised hosts. In this work it was confirmed that specific—ie, anti‐HPV‐directed, cell‐mediated immunologic response plays a role in spontaneous regression of plane warts and that preservation of nonspecific immunity is prerequisite for spontaneous regression of plane warts.
Hendersonula toruloidea Infection in Thailand
Authors: Kotrajaras Renoo , Chongsathien Supimol , Buddhavanich Precha , Viriyayudhakorn Somchai
Published: May 2007

ABSTRACT: Hendersonula toruloidea infection is present in Thailand, where the clinical picture of tinea pedis is scales 61%, erythema 22%, maceration 10.8%, and hyperkeratosis 9%. The diagnosis was confirmed by repeated isolation of H. toruloidea. The slow‐growing type was found more often than the fast‐growing in the ratio of 2.8:1. In patients with H. toruloidea infection, skin test with Hs antigen of 1:10 was positive. Criseofulvin sensitivity test revealed that the MIC of 20 cultures was more than 100 μg/ml. Only 2 out of 93 cases (0.02%) were cured with half‐strength Whitfield ointment for 4 months. Pathomechanism of the infection is being studied.
The Prodrome of Bullous Pemphigoid
Authors: Amato David A. , Silverstein Judith , Zitelli John
Published: May 2007

ABSTRACT: Bullous pemphigoid is an autoimmune bullous dermatosis that can be preceded by a prodromal phase, usually lasting weeks to months, during which the cutaneous changes are dermatitic rather than bullous. Two cases of unusually long prodromal periods, 18 months and 6 years, are reported.
Hypertrophic Lichen Planus and Light Sensitivity in an HIV‐Positive Patient
Authors: Pardo Rube J. , Kerdel Francisco A.
Published: May 2007

ABSTRACT: A 40‐year‐old black man who was HIV positive developed generalized hypertrophic lichen planus in areas previously affected by a photosensitivity eruption. After unsuccessful attempts to induce remission of his lichen planus with conventional therapies, etretinate produced a dramatic response.
Primary Localized Cutaneous Lichen Amyloidosus of the vulva
Authors: Gorodeski I.G. , Cordoba M. , Shapira A. , Bahary C. M.
Published: May 2007

A woman, age 72, gravida 5, para 5, was hospitalized for a vulvar biopsy. Her past history revealed a generally healthy woman, menopausal from the age of 53, who had a vaginal hysterectomy and repair at the age of 68 because of genital prolapse. One year before her present admission, the woman started complaining of pruritus vulvae, which progressively worsened. On admission, general physical examination revealed no outstanding pathologic findings; gynecologic examination revealed advanced atrophy of the external genitalia and the vaginal wall. The clitoris and the small labia were atrophic, scarred, and only slightly elevated off the surface (Fig. 1). The vulvar skin was shiny with scattered white patches that were not elevated and had no shiny borders. The rectal examination was normal, and inguinal lymph nodes were not palpable. Laboratory tests revealed the following: sedimentation rate 15/26, hemoglobin 15 gidl, WBC 6400/mm3 (with normal differential count), thrombocytes 150,000/mm‐3, serum alkaline phosphatase 100 mu/ml (normal 30–85), uric acid 7 mg/dl (upper normal value 6.4). Serum electrolytes, blood urea nitrogen, glucose, cholesterol, creatinine, total proteins, albumin, glutamic ox‐aloacetic transaminase, lactic dehydrogenase, creatine phosphokinase, diastase, urine analysis, chest x‐ray, and electrocardiogram were normal. Vulvar biopsy was per‐formed under general anesthesia. Histologic examination of vulvar skin was as follows: the epidermis was hyperkeratotic with granulosis and acanthosis (Fig. 2). There were enlarged blood vessels in the dermis with thickened and hyalinized walls and foci of infiltration of round cells. The papillaris and reticularis revealed amorphic areas that stained positively with Congo red (Fig. 3). The histologic diagnosis was amy‐loidosis of the vulvar skin.

After the histologic report was received, further investiga‐tions were done, as follows: urine Bence Jones protein was negative, serum protein electrophoresis and immunoelec‐trophoresis were normal, and no free light chains were found in the plasma. Serum antinuclear factor and tubercu‐lin skin test were negative. The patient refused to undergo rectal biopsy. She was initially treated with local application of testosterone ointment. After 2 months of treatment, the itching worsened and we started with applications of iso‐conazole nitrate and diflucortolone valerate. This treatment was followed by prompt relief of symptoms, although the gross appearance of the lesions had not changed. One year later, the patient feels well and refuses repeat biopsy.
Comprehensive Evaluation of Complement Components in the Course of Type I (Lepra) and Type II (ENL) Reactions
Authors: Sehgal VirendraN. , Sharma Vandana , Sharma Vinay K.
Published: May 2007

ABSTRACT: Complement components C1q and C4 of classic pathway; C3d, a breakdown product of C3, and factor B of alternate pathway: and C3, a component both of classic and alternate pathways, were studied in 35 patients, comprising 18 type I (Lepra) and 17 type II (ENL) reactions. There was a significant decrease in C3 and factor B with a concomitant rise of C3d during ENL. These changes indicate their preeminent role in immunogenesis of type II (ENL) reaction. The changes in the classic pathway components, on the other hand, were insignificant, apparently suggesting its limited involvement in ENL. Furthermore, reversion of factor B and C3d after subsidence of reaction is intriguing and may indicate that they are not substantially affected even with contemporary treatment. Complement components, of both classic and alternate pathways, showed no significant alterations either during type I (Lepra) reaction or after its amelioration.
Phototests in Patients with Various Forms of Lupus Erythematosus
Authors: Wolska Hanna , Błaszczyk Maria , Jabłońska Stefania
Published: May 2007

ABSTRACT: Responses to ultraviolet B (UVB; 290–320 nm) were tested in 227 patients with main forms of lupus erythematosus (LE): discoid LE (OLE), discoid disseminated LE (DOLE), systemic LE (SLE), and subacute cutaneous LE (SCLE). Four parameters were evaluated: minimal erythema dose (MED), its distribution, persistence of erythema, and photoreproduction of lesions. Patients with LE differed considerably from controls in their UVB reactivity. In addition, there were significant differences between various LE forms, even after a single UV exposure. Lowered MED in comparison to controls was observed most frequently in SLE patients (64.4%) and least frequently in OLE patients (32.1%). Prolonged persistence of erythema induced by 1–2 MED was a constant finding in SCLE. In SLE and DOLE, it was observed in more than 80% of patients, and in OLE in 56.7% of examined cases. Photoreproduction of lesions after single UVB exposure was observed most frequently in SCLE (62.5%) and only in 10% of OLE patients.
Subacute Cutaneous Lupus Erythematosus in Iceland
Authors: Mooney Ellen , Wade Thomas R.
Published: May 2007

ABSTRACT: Identification of patients with subacute cutaneous lupus erythematosus (SCLE) in Iceland was performed by means of a survey based on the histopathologic or immunofluorescent diagnosis of lupus erythematosus. Respondents underwent serologic studies, gave histories, and, dependent upon the latter, were examined. The resultant proportional rate of patients with SCLE approached 10% of all lupus erythematosus cases.