bluuebunny/crossref_metadata_2025 huggingface dataset:
The Clinical and Epidemiologic Features of Tropical Ulcer (Tropical Phagedenic Ulcer)
Authors: Robinson D. C. , Adriaans B. , Hay R. J. , Yesudian Patrick
Published: May 2007

ABSTRACT: A comparative survey of patients with tropical ulcer has been carried out in Zambia, Gambia, Southern India and Papua New Guinea. The clinical features, socioeconomic background and nutritional correlates have been compared in 170 patients. In 96% of cases the condition occurred on the foot or lower leg. In only 70 instances did the ulcer last for over six months. There was one patient with a squamous cell carcinoma arising in situ from the ulcer margin. No significant differences in clinical features were seen in the countries surveyed. In all areas apart from southern India most cases were seen in the rural population and in children or teenagers. There was no correlation between the development of an ulcer and nutritional status found in this survey. Evidence is presented that there is an association between tropical ulcer and exposure to mud or slow moving fresh water.
Beta‐Adrenoceptor Antagonist‐Induced Psoriasiform Eruption
Authors: Heng Madalene C. Y. , Henc Ming Kiat
Published: May 2007

ABSTRACT: A number of beta‐adrenoceptor blocking drugs have been reported to induce a papulosquamous eruption which resembles psoriasis. We report distinctive clinical, histopathologic, immunocytochemical, and electron microscope features in beta‐blocker‐induced psoriasiform eruptions that differentiate this syndrome from psoriasis. Preliminary data suggest that biopsy specimens from eruptions caused by beta‐selective adrenoceptor blocking agents (metoprolol and atenolol) were characterized by excessive de‐granulation of the neutrophils in the dermis, while the nonselective beta blockers (propranolol, nadolol, and sotalol) were marked by excessive release of proteolytic enzymes from macrophages, which are thought to possess beta‐adrenergic receptors. Surprisingly, excessive release of enzymes by lymphocytes were noted in both the beta1‐selective and in the nonselective induced syndromes. It is believed that excessive lysosomal enzyme release by neutrophils, lymphocytes, and macrophages is responsible for the presence of basal keratinocyte herniations, which have previously been shown to correlate with hyperproliferation and psoriasiform changes, as well as with the presence of excessive proteolytic enzymes in the skin. It is. postulated that the beta‐blocher‐induced syndrome may result from enhanced proliferation, motility, and activity of lymphocytes, neutrophils, and cells of the macro‐phage‐langerhans cell series, stemming from depressed in‐tracellular cyclic adenosine monophosphate levels caused by the beta blockade.
Polymorphonuclear Leukocyte Functions in Psoriasis
Authors: Goihman‐Yahr Mauricio , Molina Tulio , Martin Blanca San , Pereira José , de Román Ana , de Gómez María Helena , Villegas José Jesús
Published: May 2007

ABSTRACT: Circulating polymorphonuclear leukocyte (CPMN) functions were studied in patients with widespread psoriasis as well as in persons with chronic alcoholic liver disease (CALD), paracoccidioldomycosis, diverse granulomatous diseases, and normal individuals. We were unable to find stimulation or increase in CPMN functions in patients with psoriasis compared to normal individuals. Leukocytes, from individuals with CALD had a lowering of their metabolic activation, chemotaxis, random movement, and adherence, CPMNs from patients with paracoccidioldomycosis showed a significant deficiency in their ability to digest Paracoccidioides brasiliensis. Our results are against the concept that functions of circulating PMNs are stimulated in psoriatics.
Peripheral Leukocytes in Psoriasis
Authors: Liu Chenghuanc , Ji Meirong , Fang Xu , Wang Huiving , Lin Guifu
Published: May 2007

ABSTRACT: The white blood cell (WBC) count and differential count, including the morphology and acid α‐naphthyl acetate esterase (ANAE) activity of lymphocytes, in psoriatic patients of different types, stages, and extensiveness of skin lesions were analyzed. The number of total WBC and polymorphonuclear leukocytes was markedly increased in psoriasis erythrodermica and psoriasis pustulosa. Lymphocytopenia, especially T‐lymphocytopenia, was noticed in all types of psoriasis. Antineoplastic drugs and immunosuppressants intensified the degree of T‐lymphocytopenia. This might be the cause of recurrence and more recalcitrant course of the disease. Therefore, it is considered that these drugs should not be the first choice in the treatment of psoriasis.
Acitretin (Ro 10‐1670) in the Treatment of Severe Psoriasis
Authors: Ledo A. , Martín M. , Geiger J. M. , Marrón J. M.
Published: May 2007

ABSTRACT: A randomized double‐blind parallel trial comparing acitretin and etretinate was performed in 20 patients with severe psoriasis during treatment period of 12 weeks. The initial dose was 30 mg/day for 4 weeks, and the mean dose at the end of the study was slightly tower in the acitretin group when compared to the etretinate group (30.7 mg/day and 33,4 mg/day, respectively). Follow‐up examinations were carried out every 2 weeks, and the efficacy of treatment was evaluated by using the PASI score. Percentage improvement in the PASI score was 50% at week 10 in both groups, and the difference between them at week 12 was insignificant. Both quantitatively and qualitatively, acitretin and etretinate do not significantly differ.
Sézary Cell Count in Exfoliative Dermatitis
Authors: Duangurai Krisada , Piamphongsant Thada , Himmungnan Thongbai
Published: May 2007

ABSTRACT: Sézary cells were present in a number of less than 1000/mm3 in 52 of 78 cases of various benign diffuse dermatoses and mycosis fungoides. The count was higher than 1000/mm3 in two cases of Sézary syndrome in which the histopathology was that of mycosis fungoides and in six cases of exfoliative erythroderma of undetermined etiology with the histopathology of nonspecific chronic dermatitis. One of these six cases developed palmoplantar keratoderma, but abnormal cells were not present in the tissue. The diagnosis of Sézary syndrome in these cases of exfoliative erythroderma could not be established, even though the Sézary cell count was more than 1000/mm3, because the abnormal cells were absent in the skin biopsy specimen. It is concluded that the number of Sézary cells present is not significant for the diagnosis of Sézary syndrome. Our cases with the diagnosis of Sézary syndrome are an erythrodermic variant of mycosis fungoides rather than a progressive conversion from exfoliative erythroderma.
Embedded Foreign Body Presenting as an Umbilicated Dermal Nodule
Authors: Wong Reynold C.
Published: May 2007

A 71‐year‐old woman who lived alone was seen for a nodule on her right volar wrist. She was brought in by her son, who stated he had noted the lesion a week ago. The last time he had seen his mother was 4 months ago, and she did not have a lesion at that time. The patient did not remember how long the lesion had been present and stated that it was not associated with any symptoms. She repeatedly denied any history of trauma. Her medical records did show that she had a diagnosis of dementia, probably Alzheimer's disease, and suffered from memory loss, both short‐ and long‐term, fearfulness, poor judgment, inability to learn necessary skills, and difficulty in solving simple problems.

On examination, the lesion was 5–6 mm in size and slightly hyperpigmented with a 5–6 mm border of erythema (Fig. 1). There was a central umbilication measuring about 0.5 mm. The overall configuration of the lesion was volcano‐shaped. There was no tenderness. There was no exudation on palpation, neither was there any palpable evidence of a foreign body. There was no epitrochlear or axillary lymphadenopathy.

Since the diagnosis was uncertain, it was recommended that the lesion be totally excised. An elliptic excision was performed, and a small spicule representing a tooth of a comb was discovered (Fig. 2). The lesion was repaired, and the defect healed without any complications. Histologic examination of the excised specimen revealed a mildly acanthotic epidermis with a localized area of dermal inflammation and scarring that surrounded a nidus of keratinizing epithelium. The findings were consistent with an inflamed epidermoid cyst. Foreign material was not identified.
Myasthenia Gravis and Lupus Erythematosus
Authors: Ciaccio Marina , Parodi Aurora , Rebora Alfredo
Published: May 2007

ABSTRACT: Two patients are described in whom myasthenia gravis was associated with systemic lupus erythematosus. The review of the literature shows that such association is not frequent and that it affects mostly women (6 women:1 man), and that myasthenia gravis usually precedes lupus erythematosus. Thymectomy was a precipitating factor in 25% of the cases. Most of those patients present with general symptoms rather than with dermatologic signs.
Squamous‐cell Carcinoma and Lobomycosis (Jorge Lobo's Disease)
Authors: Baruzzi Roberto G. , Rodrigues Douglas A. , Mighalany Nilgeo S. , Salomáto Reinaldo
Published: May 2007

Among the Cayabi Indians in Central Brazil, we found a high and unexpected prevalence of lobomycosis, which represents 21% of all the cases reported in the world medical literature until now. Most of the Cayabi patients have been observed for many years, and recently two developed cauliflower‐like tumours in old lobomycosis scar lesions. The diagnosis of squamous cell carcinoma was confirmed histologically. In both cases, the tumor was surgically removed, but several months later tumors recurred in both patients. The appearance of squamous cell carcinoma in chronic scar lesions and ulcers of various etiologies has been reported by many authors, and should include lobomycosis.
T Lymphocyte Subsets in Leprosy
Authors: Ashamalla L. , Yang S. J. , Michel M. , Rafla Leila
Published: May 2007

Phenotypic analysis was done on 24 Egyptian leprosy patients and 11 healthy controls. The type of leprosy, duration of disease at the time of testing, and age were found to affect T cell subset distribution. As compared with controls, neural leprosy tended to have a decreased total T cell percentage, borderline leprosy an increased T suppressor cell percentage, and reactional borderline leprosy an increased T helper/suppressor ratio. Patients with the disease for less than 1 year had a higher mean percentage of T suppressor cells and a lower mean T helper/suppressor ratio than patients with leprosy for more than 1 year. The same was true in older (50–70 years old) versus younger (12–41 years old) patients.
Papillon‐Lefèvre Syndrome in Four Siblings Treated with Etretinate A Nine‐Year Evaluation
Authors: Kellum Robert E.
Published: May 2007

Four siblings with Papillon‐Lefèvre syndrome (3 boys and 1 girl), aged 8 to 12 at time of first diagnosis in 1978 are reported. These four patients represent the second largest sibship reported in the literature, and the only familial cases treated with etretinate for 6 years with an additional 3 1/2 year follow‐up evaluation. No long‐term side effects of etretinate were found in the children. All four patients are the product of a second cousin marriage; all demonstrate the B5 locus on HLA typing.
PUVA Treatment Inhibits Nonimmunologic Immediate Contact Reactions to Benzoic Acid and Methyl Nicotinate
Authors: Larmi Eva
Published: May 2007

The effect of trioxsalen bath PUVA therapy on nonimmunologic immediate contact reactions (NIICRs) induced by benzoic acid (BA) and methyl nicotinate (MN) was studied in 12 dermatologic patients. One half of the back skin was covered with a cloth before each of ten irradiations on subsequent days. Four concentrations of each test substance were applied to the PUVA‐exposed and nonexposed areas before any irradiation and after the 1st, 5th, and 10th PUVA treatment. Erythema and edema reactions were observed visually 40 minutes after BA and MN application, and changes in the skin blood How were monitored using laser Doppler flowmetry (LDF). PUVA therapy suppressed the NIICRs in all concentrations of BA and MN on the PUVA‐exposed area and occasionally on the nonexposed test sites. The suppressive effect was intesified during therapy.
What Lichen Planus Patients Die Of
Authors: Anonide Antonie , Rebora Alfredo
Published: May 2007

ABSTRACT: The causes of death of 50 patients who had had lichen planus have been investigated and compared with those of 50 patients with psoriasis and with those of the general population. Patients with lichen planus were as old as those with psoriasis and in the general population at the time of death, but the diseases causing death differed. Malignant tumors, particularly those of the gut and the bladder, and malignant hemopathies exceeded the expected prevalence. In addition, autoimmune diseases were more common than in patients with psoriasis and in the general population. Multiple sclerosis and primitive pulmonary fibrosis have never been described before in patients with lichen planus.
Reproductive Factors and Melanoma of the Skin Among Women
Authors: Wyshak Grace , Frisch Rose E. , Albright Nile L. , Albright Tenley E. , Schife Isaac
Published: May 2007

ABSTRACT: A higher risk of reproductive system disorders, (which include benign tumors, endometriosis, dilation and curettage, hysterectomy, and other disorders requiring gynecologic biopsies) exist among women with cutaneous melanoma as compared to women with skin cancers: The odds ratio (OR) is 3.2, 95% confidence limits (1.0,10.1), p = 0.049; as compared to a random sample of women with no melanoma or skin cancers, the OR is 3.9, 95% confidence limits (1.2, 12.4), p = 0.021. Confirming the observations of others, the authors found that melanoma was associated with red hair. The data also confirmed the finding that melanoma is associated with significantly fewer pregnancies. The mean numbers of pregnancies in the melanoma group is 1.83 ± 1.6 (mean and standard deviation) compared to 2.99 ± 1.9 in the skin cancer group and 2.93 ± 1.9 in the random sample (p ≤ 0.05).
Vitiligo Therapy with Oral and Topical Phenylalanine with UVA Exposure
Authors: Antoniou C. , Schulpis H. , Michas T. , Katsambas A. , Frajis N. , Tsagaraki S. , Stratigos J.
Published: May 2007

ABSTRACT: The administration of phenylalanine (Phe) combined with UVA exposure was found to be effective in treating vitiligo. Twenty‐one patients with vitiligo were divided in two groups: eleven patients were treated with oral L‐Phe in a dose of 100 mg/kg body weight and with UVA exposure and ten patients were treated with oral L‐Phe in a dose of 100 mg/kg body weight and with UVA exposure. In addition, in the second group, a cream containing 10% L‐Phe was applied to the vitiliginous areas. The best results occurred in the second group. No side effects were found in either group.
Atopic Dermatitis in Nigeria
Authors: George A. O.
Published: May 2007

ABSTRACT: The incidence of atopic dermatitis rose from 0.3% in 1962 at the University College Hospital, Ibadan, Nigeria, to 2.6% in 1972. A prospective study was designed to find the incidence nearly three decades after, as well as the presenting clinical features, factors influencing the disease, and the laboratory profile. The analysis of the 64 patients diagnosed during the 1.5–year study period is documented and discussed. The incidence of atopic dermatitis was 6.1%. The increase was attributed partly to increased hospital awareness in this university town and partly to a fall in infective dermatoses. There was paucity of the history of atopic diseases. Sixty‐two and one half percent of parents and patients had postprimary education. Two thirds of the people belonged to the middle and high social classes. Self‐medication was a frequent finding. No seasonal influence was implicated in 49 cases (76.5%). Heat was the most implicated aggravating factor (21.8%). Postinflammatory dyspigmentation was a common clinical feature. The proportion of patients with significantly high serum IgE stood out clearly.
Dissemination in Cutaneous Leishmaniasis
Authors: Al‐Gindan Yousuf , Kubba Raj , El‐Hassan A. M. , Omer A. H. S. , Kutty M. K. , Saeed Mahmoud B. M.
Published: May 2007

ABSTRACT: In a study of zoonotic cutaneous leishmaniasis (CL) due to leishmania major in an endemic focus in Saudi Arabia, lymph node enlargement was observed in 66 of 643 patients (10.26%). The epitrochlear lymph nodes were most commonly involved (68%), but cervical (11%), axillary (15%), and inguinal (18%) lymph nodes were also involved. In eight patients (12%), two lymph node areas were involved. The affected lymph nodes were typically solitary, firm, mobile, nontender, only moderately enlarged, and appeared to persist beyond the clinical healing of the associated skin lesions. The results of pathologic and immunopathologic studies carried out on eight lymph nodes obtained from this group of patients supported the leishmanial etiology. Although amastigotes were only demonstrated in two lymph nodes, the leishmanial antigen was found in all eight specimens. The lymph node involvement is another manifestation of dissemination in infection with a dermotropic leishmania. It appears that in some cases, instead of the parasite, it may be the leishmanial antigen that disseminates and produces lymphadenitis.
Spring Eruption of the Ears
Authors: Requena L. , Alegre V. , HASSON A.
Published: May 2007

ABSTRACT: Spring eruption of the ears is a distinctive photodermatosis characterized by the onset of papules and vesicles on the light‐exposed helix of the ears that usually develop in the early spring months and mainly affect juvenile males. Histologically the picture evolves according to evolutionary stage of the lesions from a nodular dermal inflammatory infiltrate in papular lesions to subepidermal blisters in vesicles. The striking and isolated location on the ears and its onset as small outbreaks are clinical features resulting from unknown mechanisms.
Malignant Syphilis in HIV‐Infected Patients
Authors: Tosca A. , Stavropoulos P. G. , Hatziolou E. , Arvanitis A. , Stavrianeas N. , Hatzivassiliou M. , Stratigos J. D.
Published: May 2007

ABSTRACT: Two cases of atypical syphilis in HIV‐infected patients assuming characteristics of malignant syphilis are described with special emphasis on the peculiarities of histologic and immunohistochemical findings.
Cutaneous Infections in Trinidad
Authors: Suite Marilyn
Published: May 2007

Skin infection is common in patients with any skin diseases where pruritus is a prominent feature. A retrospective analysis was performed on the results of skin swab cultures from patients with eczema and a variety of other conditions. This paper presents the findings of bacteriologic culture and sensitivity testing of 131 swabs from 122 patients over a period of 22 months and examines the results in terms of the reported relationship between scabies and acute post‐streptococcal glomerulonephritis. Staphylococcus aureus was most often isolated, and this appears to indicate that antistaphylococcal antibiotics should be the first line of treatment in the absence of the results of cultures.
Cryptococcal Cellulitis in Congenital Lymphedema
Authors: Krywonis Nancy , Kaye Valda N. , Lynch Peter J.
Published: May 2007

A 27‐year‐old woman with intestinal lymphangiectasia and congenital lymphedema developed cryptococ‐cal cellulitis as a result of her underlying depressed cell‐mediated immune responsiveness. Prompt therapy with amphotericin B and 5‐fluorocytosine resulted in an excellent outcome. The authors believe that the increasing population of patients with depression of cellmediated immune response will lead to an increase in the frequency with which cryptococcal cellulitis is seen and emphasize that proper evaluation of a patient with presumptive cellulitis includes consideration of fungal, as well as bacterial, etiology.
The Biological Effects of a Pulsed Electrostatic Field with Specific Reference to Hair Electrotrichogenesis
Authors: Maddin W. Stuart , Bell Peter W. , James John H. M.
Published: May 2007

This comparative, controlled study demonstrates the positive biologic effect on hair regrowth of a pulsed electrical field administered according to a regularized treatment schedule over 36 weeks. Mean hair count comparisons within the groups significantly favor the treatment group, which exhibited a 66.7 % hair count increase over baseline. The control group increase over baseline was 25.6%. It is notable also that 29 of the 30 treatment subjects (96.7%) exhibited regrowth or no further hair loss. The process is without side effects and untoward reactions. The rationale of this phenomenon is unclear but is considered to be due to an electrophysiologic effect on the quiescent hair follicle, similar to that documented with respect to bone fracture and soft tissue repair enhancement. The electrical pulse may cause increased cell mitosis through calcium influx, involving both the hair follicle sheath and dermal papilla cells.
Onychomycosis and AIDS
Authors: Dompmartin D. , Dompmartin A. , Deluol A. M. , Grosshans E. , Coulaud J. P.
Published: May 2007

ABSTRACT: The results of a study on onychomycosis in AIDS related complex and AIDS patients presenting for dermatology consultation at an infectious diseases department are reported. The clinical results showed that most patients presented a proximal white superficial onychomycosis. The association with a clinical interdigital involvement was rare, but the association with a mycotic plantar keratoderma was more frequent. The laboratory results showed that dermatophytes were the most frequent etiologic agents, especially Trichophyton rubrum (58%). Although most of these patients presented an oral candidiasis, Candida albicans was isolated only in seven patients'nails. Surprisingly, Pityrosporum ovale was the only etiologic organism that was found in two patients. This result was confirmed with a histologic examination.
Aluminum Chloride Hexahydrate Versus Palmar Hyperhidrosis
Authors: Goh C. L.
Published: May 2007

ABSTRACT: The efficacy of topical aluminium chloride hexahydrate 20% W/W ethanol (ACH) in the treatment symptomatic palmar hyperhidrosis was studied in 12 patients. A half‐sided control single blind (assessor blind) study was done. Patients applied ACH on one palm daily for 4 weeks. The response to treatment was measured objectively with an evaporimeter. There was significant fall of skin water vapor loss (SVL) on treated palms compared with untreated palms. The basal mean SVL of treated palms and untreated palms were 79·9 and 77·9 g water/m2/h, respectively (n.s.). The mean SVLs of treated vs. untreated palms at week 7, 2, 3, and 4 were 66·4 vs. 79·7 (p < 0·05), 56·6 vs. 72·2 (p < 0·001), 58·2 vs. 72·5 (p = 0·1), and 51·4 vs. 72·7 (p < 0·001) g water/m2/h, respectively. The mean SVL of treated palms returned near basal rate within 1 week of stopping treatment. Four patients developed skin irritation from ACH; in three this disappeared after 1 week and they were able to continue with treatment; one withdrew from the study because of the severe irritation. All patients reported that the ACH reduced palmar sweating within 48 hours of application; its effect disappeared within 48 hours after stopping treatment. ACH appeared to be useful in rapid control of palmar hyperhydrosis.
Nadularity of Nerves in Treated Leprosy
Authors: Saxena U. , Ramesh V. , Misra R.S. , Mukherjee A.
Published: May 2007

ABSTRACT: Ten patients with fully treated pauchibacillary leprosy, mainly tuberculoid, had asymptomatic nodules present along the peripheral nerves that persisted even after the skin lesions had completely subsided and treatment was stopped. Histopathology of the nodules revealed no signs of activity of the disease. The evolution, follow‐up care, and significance of these nodules are discussed.
Annular Erythema
Authors: Katayama Ichiro , Teramoto Noriko , Arai Harue , Nishioka Kiyoshi , Nishiyama Shigeo
Published: May 2007

Abstract: Annular erythema developed in 22 patients with Sjögren syndrome. Clinically, the annular erythema was subdivided into three forms: Sweet disease‐like annular erythema with an elevated border (14 cases): subacute cutaneous lupus erythematosus (SCLE)‐like marginally scaled erythema (5 cases): and papular erythema (3 cases). Histopathologically, features commonly seen in annular erythema are deep perivascular and/or periappendageal infiltration of the lymphocytes with an admixture of neutrophils or plasma cells and less frequent epidermal changes suggestive of cutaneous lupus erythematosus. Immunoglobulin or complement deposition along the dermoepidermal junction of lesional skin was observed in 8 of 18 cases, and most of the dermal infiltrates consisted of CD4(+), 4B4(+) cells. The appearance of anti‐SS‐A(Ro) (100%) and anti‐SS‐B(La) (77%) was significantly higher in patients with annular erythema. These results suggest that patients with Sjögren syndrome might have a distinct annular erythematous lesion that is both clinically and histopathologically different from SCLE, although dose immunologic abnormalities exist in these two diseases.
Inflammatory Tinea Capitis (Kerion) Mimicking Dissecting Cellulitis
Authors: Sperling Leonard C.
Published: May 2007

Abstract: Tinea capitis is unusual in postpubertal individuals and is frequently misdiagnosed. In cases of inflammatory disease, prompt initiation of therapy is essential to prevent scarring and permanent hair loss. Two examples are presented to illustrate principles of evaluation and treatment.
Psychotherapeutic Strategy and Neurotic Excoriations
Authors: Fruensgaard Kjeld
Published: May 2007

Abstract: This article sketches the planning of psychotherapy as a treatment for neurotic excoriations (NE). The program is developed on the basis of information collected in an investigation of 63 consecutive, first‐time referrals of NE patients to a dermatology department, and the findings from a follow‐up after 1 to 5 years. The offer of social advice and support, but not psychotherapy, was included in the investigation program. At the time of follow‐up, NE had healed for 13 of the 63 patients. The information gathered indicates that a treatment model should be eclectic in form so as to allow for individual variances in, for example, age, intelligence level, and motivation for psychiatric intervention.
Bullous Pemphigoid in Children
Authors: Oranje Arnold P , Vuzevski Vojislav D , van Joost Theoooor , ten Kate Fibo , Naafs Ben
Published: May 2007

Abstract: Three children aged 4 months, 7 years, and 12 years, had bullous pemphigoid (BP). Two children suffered from disseminated BP and one (12 years) from vulvar localized BP. This last form has been described only once before in a girl. The various forms of pemphigoid in childhood are rare and reported in only about 40 instances. Bullous pemphigoid in childhood does not differ clearly from the adult counterpart, although lesions of the mucous membranes seem more common in childhood.
Pemphigus in Children
Authors: Kanwar Amrinder J , Kaur Surrinder
Published: May 2007

Abstract: Six boys with pemphigus vulgaris and one boy with pemphigus foliaceus are reported. The youngest patient had onset of the disease at the age of 7 years. Three patients with pemphigus vulgaris were treated with intravenous dexamethasone pulses, while the remaining four received oral corticosteroid therapy. The prognosis in all patients was excellent.
Book Reviews
Authors: Beerman Herman
Published: May 2007

Book reviewed in this article:

Manuel Pratique De Greffe Des Cheveux. Jean Arouete

Atlas of Cutaneous Facial Flaps & Grafts. Ronald L. Moy

Recent Advances in Dermatology, VoL 8. R. H. Champion, R. J. Pye.

Sexually Transmitted Diseases. Tomasz F. Mroczkowski.

Hair and Hair Diseases. C. E. Orfanos and R. Happle.
Superficial Granulomafous Pyoderma
Authors: Lichter Michael D , Welykyj Sophia E , Gradini Roberto , Solomon Lawrence M
Published: May 2007

Abstract: Superficial granulomatous pyoderma, recently described as a variant of pyoderma gangrenosum, would be better termed pathergic granulomatous cutaneous ulceration as the seven previously described cases, as well as our own two cases, have significant dermal involvement histologically and heal with scarring. In contrast to pyoderma gangrenosum, lesions of superficial granulomatous pyoderma respond to less toxic anti‐inflammatory agents.
Regional Dermatoses in the African Black
Authors: Olumide Yetunde M , Odunowo Bola D , Odiase Abimbola O
Published: May 2007

Abstract: In a survey of dermatitis diagnosed in Lagos, Nigeria, dermatitis cruris pustulosa et atrophicans, lichen planus, lichen simplex chronicus, pretibial achromic lesions, and ichthyosiform dry skin are very common; necrobiosis lipoidica diabeticorum and diabetic dermopathy are moderately common; sporotrichosis and lichen amyloidosis are occasionally seen, but erythema nodosum is rare.
Disseminated Histoplasmosis Presenting as an Ulcerated Verrucous Plaque in a Human Immunodeficiency Virus‐Infected Man
Authors: Cohen Philip R. , Held Jonathan L. , Grossman Marc E. , Ross Mitchell J. , Silvers David N.
Published: May 2007

ABSTRACT: A 46‐year‐Old homosexual man with disseminated histoplasmosis and human immunodeficiency virus (HIV) infection had a histoplasmosis‐related ulcerated verrucous plaque above his left upper lip; systemic and cutaneous disease manifestations of histoplasmosis resolved with daily ketoconazole therapy. Disseminated histoplasmosis, with similar cutaneous features, also was present in his HIV‐seropositive male sexual partner. The possibility of human‐to‐human transmission of histoplasmosis between these patients is considered and the skin lesions of systemic fungal infections in HIV‐infected patients are reviewed.
Drug‐Specific Clinical Pattern in Fixed Drug Eruptions
Authors: Thankappan T. P. , Zachariah Jacob
Published: May 2007

Abstract:One hundred thirteen patients with fixed drug eruption (FDE) were studied for any drug‐specific clinical pattern. The causative drugs were identified and confirmed by provocation tests. A trimethoprim‐suifamethoxazole combination caused maximum incidence (36.3%), followed by tetracycline (15.9%), pyrazolones (14.2%), sulfadiazine (12.4%), dipyrine (9.3%), acetaminophen (7.9%), aspirin (1.7%), thiacetazone (0.88%), and levamizole (0.88%). Sulfas, including trimethoprim‐suifamethoxazole, induced lesions on the lips (91%) and trunk and limbs (89%), with only minimal involvement of mucosae. Tetracycline caused lesions only on the glans penis, sparing other sites. Pyrazolones affected mainly the lips and mucosae, with a few lesions of the trunk and limbs. Dipyrine, aspirin, and acetaminophen caused lesions of the trunk and limbs, sparing the lips, genitalia, and mucosae. Levamizole caused associated constitutional disturbances with extensive skin lesions, as did thiacetazone. The current study indicates that the clinical pattern and distribution of lesions in FDE are influenced by the drug in question, and the study of the pattern may provide useful information in selecting the most likely causative drug, especially when the details of the drugs are unknown.
Multiple Dermatofibromas in Patients with Autoimmune Disorders Receiving Immunosuppressive Therapy
Authors: Cohen Philip R.
Published: May 2007

Multiple dermatofibromas have been previously reported in ten patients with autoimmune disorders; in six of these, the lesions initially appeared several months after commencing treatment with immunosuppressive medications. Two additional patients with autoimmune disorders receiving systemic corticosteroid therapy who subsequently developed multiple dermatofibromas are described: a 69‐year‐old man with a 24‐year history of pemphigus vulgaris (23 lesions on his legs) and a 22‐year‐old woman with a 2‐year history of systemic lupus erythematosus (four lesions on her legs and trunk). The association of multiple dermatofibromas in individuals with an altered immune system may provide insight into the pathogenesis of this cutaneous condition.
Red Sea Coral Contact Dermatitis
Authors: Addy Jonathan H.
Published: May 2007

Six of nine adults who developed Red Sea coral contact dermatitis had seafood allergies. Contact with the “fire” coral was followed by a series of skin eruptions starting with an immediate pruritic urticaria‐like lesion which forced the victims out of the water. Within minutes the affected area became erythematous and edematous with eventual blister formation approximately 6 hours after the initial contact. The blisters resolved, leaving violaceous papules and plaques in a streaky fashion corresponding to where the coral brushed the skin. The lesions became shiny and lichenoid in 3 weeks while pruritus persisted. Treatment with topical corticosteroids and oral antihistamines reduced the severity of the disease but did not stop its evolution to the lichenoid stage. Complete resolution usually occurred after 15 weeks, leaving residual hyperpigmented macules.
The Treatment of Chondrodermatitis Nodularis Chronica Helicis with lnjectable Collagen
Authors: Greenbaum Steven S.
Published: May 2007

Chondrodermatitis nodularis chronica helicis (CNCH) consists of a painful, erythematous, often crusted, papule most commonly found on the helical rim of the ear of white men over the age of 40 years old (Fig. 1). It is seen less commonly in women and younger individuals, where the anatomic locations may vary to include the antihelix, antitragus, and other areas on the external ear. Over the years there have been many treatments for this disorder. We present the use of injectable collagen implants as a conservative, effective, and practical method for treatment of this disorder.
Exfracorporeal Photochemotherapy in the Treatment of Cutaneous T‐Cell Lymphoma
Authors: Oziemski Margaret A. , Rockman Steven P. , Marks David I. , Green Michael D. , Varigos George A. , Fox Richard M.
Published: May 2007

Abstract: The term cutaneous T‐cell lymphoma (CTCL) encompasses the spectrum of diseases characterized by a monoclonal proliferation of malignant T lymphocytes predominantly of the mature T‐helper cell type. These include mycosis fungoides, which is usually localized to the skin for many years, and the Sezary syndrome, the leukemic variant in which characteristic, bizzare lymphatic cells with deeply indented or cerebriform nuclei, the Sezary cells, infiltrate lymph glands and internal organs such as the spleen, liver, lungs, heart, and bone marrow. The condition is more common in men after their fourth decade. The treatment of CTCL varies depending on the stage of the disease. The skin of the patient is the primary index of effectiveness of therapy. Options range from topical steroids, topical nitrogen mustard, X‐irradiation, electron beam irradiation, and 8–methoxypsoralen (8–MOP) combined with ultraviolet A photochemotherapy (PUVA), to leukapheresis and systemic chemotherapy. More recently, extracorporeal photochemotherapy (ECPC) has been introduced. The safety and efficacy of this modality is further investigated in six patients who fullfilled the criteria of diagnosis of CTCL. The problems encountered in objectively evaluating the clincal responses in the patients are outlined and improvements in the protocol to overcome these are suggested. The proposed mechanism of action is an immunostimulatory one and a procedure that is relatively free from side effects; it offers promise as a potential treatment for a difficult cancer.
Papulonecrotic Tuberculid
Authors: Kullavanijaya Preya , Sirimachan Supriya , Suwantaroj Sirirat
Published: May 2007

Abstract: Eleven cases of papulonecrotic tuberculid (PNT) were seen at the Institute of Dermatology, Bangkok, over a 2‐year period (1985 to 1986). The diagnosis was supported clinically by symmetric, scattered, papulopustular necrotic lesions, healed with atrophic scars; strongly positive tuberculin test; histopathologic findings; and a rapid improvement after antituberculous therapy. Despite multiple‐drug therapy, three cases had recurrences after discontinuation of treatment. Long‐term treatment is recommended for the treatment of PNT.
1α,25‐(OH)2D3 Use on Psoriasis and Ichthyosis
Authors: Okano Masaki
Published: May 2007

ABSTRACT: The present work compared the clinical efficacy of topically applied 1α,25‐dihydroxyvitamin D3 (1α,25‐(OH)2D3) in 16 cases with psoriasis vulgaris, 5 with ichthyosis vulgaris and 8 with X‐linked ichthyosis. Sixty‐nine percent of the psoriatic cases responded to 1α,25‐(OH)2D3 therapy, whereas no ichthyotic patients responded. The present study confirms the previously suggested effectiveness of the active form of vitamin D3 for psoriasis and denies its possible efficiency against the ichthyoses. Direct suppression of hyperproliferative activity of the psoriatic epidermis is considered one of the most plausible mechanisms of 1α,25‐(OH)2D3 efficacy, through examination of the aforementioned evidence.
ENALAPRIL: A POWERFUL IN VITRO NON‐THIOL ACANTHOLYTIC AGENT
Authors: DE ANGELIS ERNEST , LOMBARDI MARIA LUISA , GRASSI MICHELE , RUOCCO VINCENZO
Published: May 2007

Drugs containing sulfhydryl groups (thiol drugs) (e.g., penicillamine, captopril, thiopronine) can induce pemphigus in vivo and provoke acantholysis in vitro. Enalapril, like captopril, is an angiotensin‐converting enzyme (ACE) inhibitor largely used as an antihypertensive drug; it has recently been reported to induce pemphigus, though it is not a thiol drug. In this study we investigated the possible in vitro acantholytic effect of enalapril on normal human skin from donors. The drug induced severe acantholytic changes of keratinocytes and complete suprabasal splitting at one tenth the concentration required by thiol drugs in similar experiments, even after a shorter period of culture. All skin samples from different donors was highly susceptible to the acantholytic effect of enalapril. In our experience, enalapril is the most powerful acantholytic drug in vitro.
IMMUNOHISTOCHEMICAL IDENTIFICATION OF PENICILLIUM MARNEFFEI BY MONOCLONAL ANTIBODY
Authors: ARRESE ESTRADA JORGE , STYNEN DIRK , VAN CUTSEM JAN , PIÉRARD‐FRANCHIMONT CLAUDINE , PIÉRARD GERALD E.
Published: May 2007

We present an experimental study on the immunohistochemical identification of Penicillium marneffei in paraffin‐embedded, formalin‐fixed tissue. The monoclonal antibody EB‐A1 detects a specific galactomannan that appears to have at least one epitope identical in P. marneffei and Aspergillus sp. This immunohistochemical approach could be useful in the diagnosis of a rare disease, penicilliosis marneffei, which proves to be difficult to identify by conventional microscopy.
HAIR FOLLICLE NEVUS
Authors: HO CHOI EUNG , KU AHN SUNG , HUN LEE SEUNG , BANG DONGSIK
Published: May 2007

Four cases of hair follicle nevi are described. Hair follicle nevus is an extremely rare hamartoma occurring on the face, which has had no clear histopathologic definition until now. A short review of the clinicopathologic features of this disease is presented.
ACUTE ADULT T‐CELL LEUKEMIA/LYMPHOMA PRESENTING WITH FLORID CUTANEOUS DISEASE
Authors: WRIGHT STEPHANIE A. , JILL ROTHE MARTI , SPORN JONATHAN , VAN VOORHEES ABBY S. , GRANT‐KELS JANE M.
Published: May 2007

Adult T‐cell leukemia/lymphoma (atll) is characterized by cutaneous disease, hypercalcemia, associated htlv‐i infection, and a fulminant course refractory to therapy. A patient with acute atll is described, and the natural history of atll is reviewed.
TREATMENT OF PYODERMA GANGRENOSUM WITH CLOFAZIMINE
Authors: KAPLAN BARUCH , TRAU HENRY , SOFER EHUD , FEINSTEIN ABRAHAM , SCHEWACH‐MILLET MIRIAN
Published: May 2007

We report a case of pyoderma gangrenosum in a 80‐year‐old woman suffering from ulcerative colitis and treated with clofazimine. Significant improvement was evident within 5 days following commencement of therapy, complete healing occurred after only 4 weeks of treatment.
Solitary COndyloma Latum on the Umbilicus
Authors: GOIHMAN MAURICIO
Published: May 2007

The Correspondence Section serves as a forum for opinion exchage about subjects of gereral interest such as dermatologic training, relations between dermatologists and pharmaeutical houses, governmental control of dermatology and medical practice in general, peculiarities of dermatology related to geographic, climatic, or racial factors, the flow of information and publication and should conform to the usual format for correspondence. Manuscripts will undergo standard editorial procedures, Submit all correspondence to Mauricio Goihman‐yahr, M.D., Ph. D., Editor, Jet International M‐154, P.O. Box 020010, Miam, FL 33102.
“TWO‐STEP” PEMPHIGUS INDUCTION BY ACE‐INHIBITORS
Authors: RUOCCO VINCENZO , SATRIANO ROCCO A. , GUERRERA VINCENZO
Published: May 2007

Pemphigus lesions appeared in a 58‐year‐old man who was talking captopril for his hypertension. Drug withdrawal resulted in complete remission of the eruption. The subsequent use of enalapril as an antihypertensive agent caused a recurrence of pemphigus lesions along with onset of itching and dermographism. Intercellular antibodies were not found. Discontinuance of enalapril therapy had no effect on the clinical course. Steroid treatment was needed to resolve the eruption. Recently repeated immunofluorescent studies disclosed intercellular IgG antibodies in the serum at a low titer. Pemphigus induction could be initially related to the thiol acantholytic property of captopril. Subsequent production of intercellular antibodies and drug‐activation of the kinin system could be responsible for relapsing.
BULLOUS DISEASES IN MALAYSIA: EPIDEMIOLOGY AND NATURAL HISTORY
Authors: ADAM BASHEER A.
Published: May 2007

The characteristics of three primary bullous diseases, pemphigus, pemphigoid, and dermatitis herpetiformis, seen in this country, probably reflecting this region, are discussed and compared to those reported in the literature in the West. One hundred and forty‐eight patients with bullous diseases were seen over a period of 15 years. The criteria for confirmation of clinical diagnosis were the findings of the direct immunofluorescent test. Pemphigus vulgaris was the commonest bullous disease. The incidence of bullous pemphigoid was highest in the Indians of Malaysian origin, and they are also more likely to develop pemphigus vulgaris than any other ethnic group. Linear IgA type formed the entire group of dermatitis herpetiformis. The granular type was not seen at all. The patients were treated with prednisolone alone or together with methotrexate or aza‐thioprine. Dapsone alone controlled the dermatitis herpetiformis. The known association between pemphigus and other diseases with immunologic disturbances was not found in this study. The natural history of the bullous disease as seen in the followup patients is described. Deaths in pemphigus and pemphigoid were more due to either complications of steroid therapy or unassociated diseases than the primary disease itself. Introduction of immunofluorescence as a diagnostic tool in pemphigus’ and extension of this facility to other bullous diseases has led to detailed characterization of these diseases as seen in the West; however, publications in English dealing with epidemiologic aspects of bullous diseases in this region are rare. The three primary bullous diseases, pemphigus vulgaris, bul‐lous pemphigoid, and dermatitis herpetiformis (DH), as seen in Malaysia, probably reflecting the pattern of disease in this region, will be discussed and features peculiar to this region will be highlighted.
KERATITIS, ICHTHYOSIS, AND DEAFNESS (KID) SYNDROME: MANAGEMENT WITH CHRONIC ORAL KETOCONAZOLE THERAPY
Authors: HAZEN PAUL G. , WALKER ALLEN E. , STEWART JOHN J. , CARNEY JAMES F. , ENGSTROM CONLEY W. , TURGEON KAREN LARSON
Published: May 2007

Extensive cutaneous mycoses have been described in patients with the keratitis, ichthyosis, and deafness (KID) syndrome. We present a case occurring in a 48‐year‐old woman where improvement in the ichthyosiform dermatosis, stabilization of her ocular disease, and apparent partial prevention of further cutaneous malignancies occurred in association with ketoconazole therapy.
HORMONAL STATUS IN POSTMENOPAUSAL ANDROGENETIC ALOPECIA
Authors: GEORGALA S. , GOURGIOTOU K. , KASSOULI S. , STRATIGOS J.D.
Published: May 2007

The development of androgenetic alopecia is thought to be caused by increased androgen action on hair follicles with menopause. Testosterone, estradiol and sex hormone binding globulin (SHBG) serum levels were determined in ten postmenopausal women with androgenetic alopecia and in ten sex and age matched healthy controls. No statistically significant differences were found in the hormone levels between the patients and the controls. These findings suggest that a genetically determined functional alteration of androgen receptors and/or a metabolic disturbance may exist in the hair follicle keratinocytes in androgenetic alopecia.
TINEA VERSICOLOR: HISTOLOGIC AND ULTRASTRUCTURAL INVESTIGATION OF PIGMENTARY CHANGES
Authors: GALADARI IBRAHIM , EL KOMY MEDHAT , MOUSA AHMED , HASHIMOTO KEN , MEHREGAN AMIR H.
Published: May 2007

A comparative histopathologic study is made between the hypopigmented and hyperpigmented skin lesions of pityriasis versicolor and normal skin areas utilizing histochemical stains and electron microscopy. There were no differences found between the population of Dopa‐positive melanocytes within the hypopigmented and hyperpigmented lesions and the normal skin areas. The total epidermal pigmentation was diminished in hypopigmented lesions. The keratin layer was found to be significantly thicker in hyperpigmented lesions and contained more organisms. In hypopigmented lesions, melanocytes contained fewer and smaller melanosomes and exhibited signs of degenerative cellular changes.
CUTANEOUS LUPUS ERYTHEMATOSUS IN INDIA: IMMUNOFLUORESCENCE PROFILE
Authors: GEORGE RENU , MATHAI RACHEL , KURIAN SUSY
Published: May 2007

The clinical profile and cutaneous lesions of 65 patients with lupus erythematosus (LE) are described. This included 28 discoid LE (13 disseminated, 15 localized), five subacute cutaneous LE, and 32 systemic LE. The need to recognize a pigmented macular form constituting 25% of discoid LE is emphasized. Increased incidence of involvement of the lower lip in discoid LE and pigmentation in systemic LE is noted. Lupus band test was found to be highly sensitive; it was positive for lesional skin of all untreated patients with subacute cutaneous LE and systemic LE, it was, however, not useful on nonlesional skin.
ACUTE CUTANEOUS GRAFT VERSUS HOST DISEASE: A CLINICOPATHOLOGIC AND IMMUNOPHENOTYPIC STUDY
Authors: RAY CHAUDHURI SIBA P. , SMOLLER BRUCE R.
Published: May 2007

Acute graft versus host disease (GVHD) is a major complication of bone marrow transplantation. This study was undertaken to characterize the histopathologic alterations in early lesions of GVHD and to improve our understanding about the disease process. Histopathologic and immunoperoxidase studies of skin tissue were carried out in 20 patients of GVHD. Sixty percent had grade II histopathologic changes in the skin, grade I and III changes were observed in 35% and 5% respectively. Follicular involvement could be observed in all cases beyond grade I. Immunoperoxidase study revealed 0PD4 (+) (T‐helper) cells in dermis and 0PD4 (−) (probably cytotoxic/suppressor) cells in epidermis.
NONSEGMENTAL VITILIGO: DECREASE OF THE CD45RA+ T‐CELL SUBSET AND EVIDENCE EOR PERIPHERAL T‐CELL ACTIVATION
Authors: ABDEL‐NASER M. BADAWY , LUDWIG WOLF‐DIETER , GOLLNICK HARALD , ORFANOS CONSTANTIN E.
Published: May 2007

Peripheral T‐lymphocytes from 16 randomly selected patients with nonsegmental vitiligo were labeled with monoclonal antibodies recognizing T‐cell receptor (TCR) α/β, TCR γ/δ, CD3, CD4, CD8, CD45RA, CD45RO, CD11b, CD11C, CD16, CD56, CD25, CD54, and HLA‐DR antigens. In comparison with matched controls, a significant decrease of the CD45RA+ subset (P < 0.03) together with significant increase of the circulating HLA‐DR‐I‐ cells (P< 0.02) was found. No other alterations were detected. These findings may point to some autoimmune phenomena involved in the pathogenesis of the disease. The increased HLA‐DR expression indicates the presence of activated peripheral T‐cells. Thus, our data provide new and further evidence for T‐cell dysregulation in nonsegmental vitiligo.