bluuebunny/crossref_metadata_2025 huggingface dataset:
Lymphomatoid papulosis: a study of 18 cases*
Authors: Ortiz‐Romero Pablo L. , Lopez‐Estebaranz Jose L. , Gil‐Martin Ricardo , Corell‐Almuzara Alfredo , Ballestin‐Carcavilla Claudio , de Pablo‐Martin Pilar , Iglesias‐Diez Luis
Published: July 2006

Lymphomatoid papulosis (LyP) is a cutaneous eruption that is clinically benign but histologically malignant. To date, more than 300 cases have been published. About 10–20% of the patients develop a lymphoma. The purpose of this study was to make a clinicopathological study of 18 patients diagnosed with LyP in our hospital from 1973 to 1990, to characterize cellular infiltrates in the lesions, to find clonal populations of T‐cells and to look for predictive factors of malignant lymphoma in LyP patients. Mean age was 48.7 years. The most frequent clinical lesions were papules (88.8%) followed by plaques (38.8%). The localizations were on extremities (100%), trunk (88%), face (22%), palms or soles (11%), perigenital (11%) and scalp (5%). Two patients have been free of disease for more than 5 years. IgA levels are increased in LyP patients. Neither HTLV I nor III can be considered as a cause of the LyP in any of our patients. Associated diseases were found in 6 cases (1 mycosis fungoides, 1 Hodgkin's disease, 2 anaplastic large‐cell lymphoma and 2 large plaque parapsoriasis). Some types of parapsoriasis should be included in the ‘spectrum of Ki‐1 lymphomas’. 52 skin biopsies were studied. 17% were type A of Willemze, 67% were type B and 15% were transitional. In 12 of the samples follicular or perifollicular infiltration was found. Follicular LyP should not be considered as a distinct type of LyP. Vasculitis is an uncommon finding in LyP. In all the cases studied, large atypical cells were CD30 +; 5/7 cases had lost CD5 and 4/5 cases had lost CD7. In one case, all T‐cell antigens were negative. Cerebriform mononuclear cells were always recognized by T‐cell antibodies and they were CD30 positive in only two cases. In one case there were more CD8 + than CD4 + cells. In 5 patients skin and blood samples for genetic rearrangement (beta‐T) were taken. Only germinal line was found. We did not find any significant difference between those cases in which malignant lymphoma developed and those in which it did not.
Twice daily dosing of erythromycin in the treatment of venereal chlamydial infections
Authors: Lehtonen Lasse , Hirsjärvi‐Lahti Tuula , Wilen‐Rosenqvist Gunilla
Published: July 2006

Background. Tetracyclines are recommended as primary choice for the treatment of venereal chlamydial infections. Erythromycin has been used in high doses as an alternative. Erythromycin acistrate (EA) is a 2′‐acetyl ester prodrug of erythromycin that can be used in lower doses.

Objective. To show the efficacy of EA 400 mg twice daily in the treatment of venereal chlamydial infections.

Study design. A randomized, double‐blind parallel group study. Chlamydia‐positive patients were randomized to treatment with either EA or erythromycin stearate (ES) for 10 days. Follow up cultures were performed at 28 days after the start of therapy. The sexual consort was treated with erythromycin stearate.

Subjects. A total of 151 patients participated (47 males, 104 females). Seventy‐two patients received EA and 79 ES.

Intervention. EA (0.4 g) and ES (0.5 g) were given twice daily for 10 days.

Results. The bacteriological cure rate was 98% in the EA group and 97% in the ES group. There were no statistically significant differences between the treatment groups. No patient discontinued the medication in either group, although 30% of the EA group and 27% of the ES group reported adverse effects, mainly transient gastrointestinal symptoms.

Main outcome. Treatment with erythromycin acistrate or stearate twice daily is a simple and efficient alternative for the treatment of sexually transmitted chlamydial infection in both male and female patients.
CD30 ± cutaneous T‐cell lymphoma associated with sarcoidosis*
Authors: Prignano F. , Mori M. , Santucci M. , Vallecchi C. , Pimpinelli N.
Published: July 2006

We observed a 61‐year‐old woman, presenting with deeply infiltrating, erythemato‐cyanotic, sometimes ulcerated or crusted plaques and nodules, mainly located on the lower limbs. Similar lesions had been present for more than 4 years, with a typical evolution: fast growth, followed by ulceration and necrosis, resulting in hyperpigmented, atrophic patches. The patient had had Rx‐confirmed, symptomatic lung sarcoidosis for 5 years. Histological examination of skin lesions showed diffuse dermal and hypodermal lympho‐histiocytic infiltrate, mainly composed of pleomorphic cells. On immunohistochemistry, the infiltrate was mainly composed of CD2 ±, CD3 ±, CD45RO ±, CD4 ±, CD30 ±, CD25 ‐ T‐cells, with sparse CDla ± dendritic cells. The typical clinical evolution (relapsing, self‐regressing plaques and nodules), morpho‐immuno‐logical features of skin lesions, and strong expression of CD30 antigen by neoplastic T‐cells suggest the possible classification of this case as CD30 ± (Ki‐1 ±) cutaneous T‐cell lymphoma. The association with systemic sarcoidosis, together with a down‐regulated cell‐mediated immune response, suggests the possibility that this latter may be a common denominator in the development of the two diseases.
New methods of HPV identification*
Authors: Kapranos Nikiforos C.
Published: July 2006

Identification of human papilloma viruses (HPV) is of major clinical importance because certain types are strongly associated with neoplastic transformation, especially in the uterine cervix. These viruses are not reliably detected by serological tests or culture. The detection of viral capsid antigens by immunohistochemical techniques is of low sensitivity and cannot be used in typing of HPV. Molecular biology techniques based on nucleic acid hybridization are the most sensitive and specific for identification of HPV. Blot methods are applied on DNA extracted from cells or tissues. In the Southern blot technique, nucleic acid probes are bound with the electrophoresed DNA fragments whereas, in the dot blot test, the intact DNA is directly spotted onto filters and hybridized. Although the first method is considered the ‘gold standard’, the latter has a comparable sensitivity, is simpler and can also be used with non‐isotopic probes. In the filter in situ hybridization method, whole cells are denatured and hybridized on a membrane, and this results in high background and low specificity. In situ hybridization is applied directly to the cells and tissues and, although it is not as sensitive as blot methods, it permits comparison of pathological features and the retrospective study of archive material. Amplification of genomic sequences by polymerase chain reaction (PCR) makes possible their detection with non‐isotopic blot techniques. PCR, which is applicable on cells, fresh and fixed tissues, is an extremely valuable and sensitive technique for the identification of HPV in the clinical laboratory.
The sign of Leser‐Trélat: fact or myth?
Authors: Bräuer J. , Happle R. , Gieler U. , Effendy I.
Published: July 2006

Abstract

A 46‐year‐old woman presented with multiple seborrheic keratoses disseminated over her trunk and thighs. A screening for internal malignancies revealed an adenocarcinoma of the colon that was successfully treated by surgery. During a follow‐up period of 18 months, the seborrheic keratoses remained unchanged. There was no evidence of recurrence of the malignancy. We conclude that this case does not fulfill the criteria of the ‘sign of Leser‐Trélat’; according to present knowledge the existence of this cutaneous paraneoplastic syndrome cannot be taken as a certain indication. Patients with multiple seborrheic keratoses do not necessarily present internal malignancies.
The management of Darier's disease
Authors: Burge Susan M.
Published: July 2006

Darier's disease (keratosis follicularis) is a rare, dominantly inherited condition which is characterised by the presence of warty papules and plaques on the trunk, scalp and flexures. Diagnostic nail changes are present in most patients. Suprabasal clefting, acantholysis and dyskeratosis are present in involved skin and the diagnosis may be confirmed by a skin biopsy. The disease never remits. Exacerbating factors such as heat, sweating and ultraviolet light should be avoided. Topical therapy with emollients, moderately potent corticosteroids and antimicrobials may provide some symptomatic relief, but have no effect on the progress of the disease. Oral retinoids are effective in most patients. Complications such as cutaneous infections, blistering and salivary gland obstruction may occur in some patients.
Mucosal presentation of Behçet's disease
Authors: Moyle Graeme , Chard Sue , Boag Fiona
Published: July 2006

Behçet's disease is a multisystem disease with both mucosal and systemic presentations, infrequently seen in the UK and Northern Europe. We present the case of a 23‐year‐old Caucasian girl who presented with mucosal ulceration and in whom diagnosis was assisted by HLA testing.
The natural history of demodectic mites on the skin of the eyelid margin
Authors: English Frank P. , Zhang Guang Wen , McManus Don P. , Home Felicity
Published: July 2006

Background Demodectic mites can be readily studied on the eyelid margin.

Methods This was undertaken by scanning electron microscopy of the skin of the lid margin of full thickness eyelid specimens obtained by surgery.

Results The whole life cycle of Demodex folliculorum, including the egg, nymph and adult stages was observed by electron microscopy of this region. The tails of adult mites protrude from hair follicles and also lie close to eyelashes either singly or in groups.

Conclusions The eyelid littoral appears to be a significant site for egg laying by demodectic mites, and both intact and broken eggs have been seen. At the other end of the life cycle when adult mites die the protruding opisthosoma develops cracks in the carapace and the tail breaks off. Spillage of abdominal contents occurs which can carry fungi and bacteria on to the skin surface. All stages of the parasite including numerous casts of the ecdysed carapace contribute to debris found on the skin surface of the eyelid.
High‐frequency sonography of the skin
Authors: Fornage Bruno D. , Duvic Madeleine
Published: July 2006

This article reviews and illustrates the current applications of high‐frequency (20‐MHz) ultrasound imaging of the skin. This new imaging technique for the skin has gained popularity with the advent of commercially available dedicated ultrasound equipment. The normal ultrasound appearance is described first. Ultrasound features of benign and malignant skin tumors and inflammatory conditions are then described. The accurate delineation of the deep margins of a lesion and the non invasive measurement of its thickness represent an aid in evaluating skin tumors and monitoring the response to therapy of inflammatory conditions.
Pemphigus vegetans of Hallopeau following pemphigus foliaceus
Authors: Cecchi R. , Tuci F. , Brunetti L. , Bartoli L. , Pavesi M. , Giomi A.
Published: July 2006

A 69‐year‐old woman previously affected with pemphigus foliaceus developed pustular lesions followed by verrucous vegetations, localized in the left sub‐mammary fold. Histological examination of vegetating lesions showed consistent acanthosis and papillomatosis with intraepidermal microabscesses containing eosinophils. Direct immunofluorescent examination evidenced intraepithelial IgG and C3 deposits. Circulating pemphigus antibodies were positive at titre 1: 160. This case suggests a clinical link between pemphigus vegetans and pemphigus foliaceus.
Occupational allergic contact dermatitis and composition of acrylates in dentin bonding systems
Authors: Kanerva Lasse , Henriks‐Eckerman Maj‐Len , Estlander Tuula , Jolanki Riitta , Tarvainen Kyllikki
Published: July 2006

Background Dentin‐bonding systems contain sensitizing acrylates. They are increasingly used in dentistry, but only few cases of allergy have been encountered.

Objective This study reports observations on eleven patients sensitized by acrylates in dentin‐bonding compounds. Furthermore, the composition of dentin‐bonding products was analysed and compared with the information given in the material safety data sheets.

Methods Patch testing was performed to reveal allergic contact dermatitis, and chamber provocation tests to reveal possible respiratory sensitivity. Gas chromatography/mass spectrometry was used to analyse the chemical composition of the bonding products.

Results The most common sensitizer in our material of eleven patients was 2‐hydroxyethyl methacrylate (2‐HEMA). Another putative sensitizer, BIS‐GMA, used in dentin adhesives, did not cause sensitization. The typical allergic dermatitis localized to the fingertips (pulpitis). Seven of the eleven patients also developed paresthesia of the fingertips. One patient with positive patch test reactions to (meth)acrylates had pharyngitis hut no skin symptoms. One patient was sensitized because she had been patch tested with too high a concentration (undiluted) of dentin‐bonding components. Material safety sheets gave inaccurate or wrong information about the contents.

Conclusion Dentin‐bonding acrylates are strong sensitizers, and even a single exposure may sensitize.
Single endolabial cysticercosis
Authors: Rodríguez‐Díaz E. , Armesto‐Alonso S. , Benito J.A. Velasco , Armijo M.
Published: July 2006

Cysticercosis is infestation of human tissues by Cysticercus cellulosae, the encysted larva of Taenia solium. An endemic disease in tropical countries, especially in Latin America, an increase is expected in its frequency in Europe because of increasing shifts in population. We report the case of a Spanish woman who had lived for some time in Bolivia and Peru who presented at our Department with a tumoral growth on the mucosa of her lower lip. Clinically, this was interpreted as a mucocele (salivary mucoid ‘cyst’); but histological study of the excised piece revealed, surprisingly, that it was a single–element cysticercosis.
Clinical features and outcome of first presentation anogenital warts in men and women
Authors: Birley Humphrey D.L. , Kupek Emil , Byrne Micheline , Whitaker Luke , Renton Adrian M.
Published: July 2006

Objective Correlation of clinical features of patients on initial presentation of anogenital warts to outcome of treatment.

Setting Outpatient genitourinary medicine clinic.

Method Retrospective cohort analysis.

Subjects Eighty‐three male and 60 female patients attending the clinic with first episode anogenital warts within a 3‐month period.

Main outcome measures Relapse of warts following treatment. Total time for which treatment was given.

Results Following one course of treatment, warts relapsed in 15% of the men, hut in only 37% of the women. After two courses, further relapse occurred in 31% of males and 18% of females (P < 0.001). Treatment for more than 6 months was required for 39% of men, but only 22% of women. Poorer outcome of treatment was related to larger size of warts at presentation. No significant relation was found between outcome and number, site or type of treatment used for warts, or for sexual behaviour or orientation of patients. A previously diagnosed sexually transmitted disease (STD) was reported by 34% of men and 28% of women: 28% of men and 23% of women had an STD diagnosed at the time of presentation with warts. No significant relation was found between outcome and STDs past or concurrent, including HIV. Female patients tended to have smaller warts than men but their better outcome remained significant after controlling for the size of warts.

Conclusions Treatment outcome for genital warts is poor and significantly predicted by size of warts at presentation. Female patients have a better outcome from treatment of genital warts than male patients.
Schistosomiasis: an unusual cause of pruritus vulvae
Authors: Desmond Noreen , Hanna Nashat , Coker Richard J. , Fish David , Harris John R.W.
Published: July 2006

Presentation pruritus vulvae with nodular lesions.

Diagnostic pointers foreign travel, cosinophilia, urine microscopy, punch biopsy.

Diagnosis vulval sehistosomal granulomas.

Outcome responded to praziquantel.
HMB‐45 expression in the epidermis overlying juvenile xanthogranulomas
Authors: Misery Laurent , Boucheron Simone , Claudy Alain L.
Published: July 2006

Aim HMB‐45 staining of melanocytes has been described in vascular proliferations and surgical scars. We studied this staining on inflammatory tumours.

Methods Histiocytic tumors were stained with HMB‐45 monoclonal antibody.

Results Only juvenile xanthogranulomas stained with HMB‐45.

Conclusion HMB‐45 expression may be induced by cytokines synthesized by inflammatory cells.
Multiple keratoacanthomas in hypertrophic lichen planus: treatment with systemic retinoids (etretinate)
Authors: Paul Maria A. , Stonecipher Marcus R. , Abernethy John , Leshin Barry , White Wain L. , Jorizzo Joseph L.
Published: July 2006

A 75‐year‐old woman was referred for treatment of multiple keratoacanthomas and hypertrophic lichen planus. Surgical excision was considered but was not possible given the multiplicity of the lesions. Etretinate, potent topical corticosteroids and gradient support stockings were initiated. Complete resolution was achieved in four months and oral and topical therapy was discontinued. Four months after discontinuation of all therapy there has been no recurrence.
Real hair on the tip of the tongue: a very rare phenomenon
Authors: Laskaris George , Hatziolou Ephtihia , Vareltzidis Antony
Published: July 2006

The occurrence of hair and hair follicles inside the oral cavity is a very rare finding. A review of the literature revealed that only four cases of oral hair have been reported previously. In this article we present an additional case of hair located on the tip of the tongue in a 31‐year‐old white man.
Idiopathic anetoderma with concomitant lesions of the Jadassohn‐Pellizzari and the Schweninger‐Buzzi types
Authors: Haligah Charles E.K. , Zouboulis Christos C. , Abdel‐Naser Mohamed Badawy , Detmar Michael , Ehlers Günther , Gollnick Harald
Published: July 2006

Anetoderma is a rare disease of unknown etiology, today classified as a subtype of the circumscribed elastotic disorders. The clinical picture shows atrophic patches located mainly on the upper trunk which characteristically give the palpating finger the sensation of a hernial orifice. Our patient with primary idiopathic anetoderma presented a rarely reported concomitance of the inflammatory type of lesions described by Jadassohn and Pellizzari together with the non‐inflammatory Schweninger‐Buxzi type. Historically and ultrastructurally, both kinds of lesions revealed similar pictures with a scanty perivascular lymphomononuclear cell infiltrate, with rarefied, partly fragmented elastic fibres and normal collagen fibrils. These findings indicate that these two types of lesions represent different stages of the same disease and not a simple association. Furthermore, they support the opinion that the classification of anetoderma into two separate Jadassohn‐Pellixzari and Schweninger‐Buzzi types may he unnecessary. After treatment with oral tetracycline 1 g/day for 3 weeks, no new lesions appeared; however, no improvement of the already present lesions occurred during a 6‐month follow‐up period.
Concomitance of lichen sclerosus et atrophicus and morphea in the same lesions
Authors: Rongioletti F. , Caratti F. , Rebora A.
Published: July 2006

A 65‐year‐old woman presented atrophic, slightly indurated plaques on the trunk and a sclerotic, hemorragic plaque on the right forearm. In three biopsies, diagnostic features of both lichen selerosus et atrophicus (LSA) and morphea coexisted. Elastic fibers were absent in the papillary dermis and present in the sclerotic reticular dermis. Although many patients with lesions of both morphea and LSA have been reported, the coexistence of the two histological features in the same lesion is less frequent.
Vulvar cicatricial pemphigoid in a child
Authors: Gürbüz Oya , Khalilazar Rehaleh , Ergun Tüiilin , Yücelten Deniz , Demirçay Zeynep
Published: July 2006

Cicatricial pemphigoid is a rare disease primarily affecting the elderly. Only a few cases of childhood cicatricial pemphigoid have been reported in the literature. We present a case of cicatricial pemphigoid involving the vulvar region in a child.
Incidence of sexually transmitted diseases amongst a elderly cohort attending a genito‐urinary medicine clinic
Authors: Bergin C. , O'Reilly M. , Goha J. , O'Neill D. , Mulcahy F.
Published: July 2006

Background There is a general perception that sexual interest and activity does not persist into later life, with consequential failure to appreciate the potential prevalence of sexually transmitted diseases in the elderly.

Methods Retrospective analysis of case notes of all patients over the age of 65 years who attended a Genito‐Urinary Medicine Clinic: 81 patients were identified over a 6 year period.

Results Referral because of positive serology for syphilis accounted for 20% of patients and was the most common reason for presentation. Significantly, another 14% of patients attended for HIV testing. Of the 61 patients whose sexual history was available, 32 had sexual intercourse within the 6 months prior to attendance.

Comment This review confirms the need for the medical profession to be more aware of the sexual activity and the possibility of sexually transmitted diseases in this patient group.
Intramuscular gold therapy for young patients with pemphigus vulgaris: a prospective, open, clinical study utilizing a dermatologist/rheumatologist team approach
Authors: Sutej Paul G. , Jorizzo J.L. , White Wain
Published: July 2006

Pemphigus vulgaris is a severe dermatosis, often requiring systemic corticosteroid therapy. The attempt to find disease‐modifying and corticosteroid‐reducing drugs is ongoing. In this open study, a combined dermatologist‐rheumatologist Learn approach is utilized in attempting to control pemphigus vulgaris with intramuscular gold therapy. Intra‐muscular gold seems to have been a particularly useful agent.
Treatment of psoriasis by dermabrasion
Authors: Zachariae Hugh , Søgaard Helmer
Published: July 2006

Aim The aim of the study was to utilize the so‐called reversed Köbner phenomenon to treat psoriasis by dermabrasion.

Background The background has been reports on long term remissions following other surgical procedures such as dermatomy or laser surgery.

Methods 11 psoriatics with localized, chronic heavily infiltrated plaques, which had not responded sufficiently to topical treatment with steroids and/or ditranol or tar, were treated with dermabrasion, using a diamond fraise.

Results All treated lesions healed within 3‐4 weeks without recurrence with the exception of a 0.5 X 0.5 cm minor recurrence in one patient. The observation period has been from 6 months to 5 years.

Conclusions For this particular group of patients we can recommend dermabrasion as a suitable surgical therapy for psoriasis.
Lymphangioma circumscriptum associated with elephantiasis lymphangiomatosa
Authors: Beard Gwen , Abernethy Lisa , Callen Jeffrey P.
Published: July 2006

Lymphangioma circumscriptum is a cutaneous entity which may rarely be associated with a deep, visceral lymphangiomatous involvement. We present a child with extensive lower extremity lymphangiomatosis complicated by recurrent cellulitis in combination with diffuse intra‐abdominal disease. Appropriate management of patients with widespread lymphangiomatosis includes initial determination of the extent of involvement and careful selection of therapy for symptomatic areas. Maintenance of skin integrity over lesions of lymphangioma circumscriptum is critical in prevention of recurrent cellutitis which may result in sepsis and even death.
Unprofessional tattoos in Bulgaria – psychological aspects
Authors: Kazandjieva J. , Kamarashev J. , Kadurina M. , Tsankov N.
Published: July 2006

Background People suffered many psychic traumas during the period of the communist rule which altered their perception of the outer world and of themselves. For many their skin became a place where their frustration could be expressed. Up to now the psychological aspects of tattoos in the countries from Eastern Europe have been decidedly understudied.

Method We have studied over 100 tattoos, done after the end of World War II in Bulgaria.

Aim To examine the motivations for getting tattoos and their symbolic meanings.

Conclusions On the ground of motivation three main groups were differentiated. The first group comprises lines and drawings without any meaning or sense, which could be interpreted as a pure form of autoaggression. The second group consisted of symbols of resistance – anticommunist, promonarchic, etc. The closed character of the socialist society brought to life the third group of motives – symbols of the “west” and of the so called “western way of life”. Many of the tattoos observed by us were self‐made and carried an element of self‐inflicted injury.
Awarness to photodamage versus the actual use of sun protection methods by young adults
Authors: Harth Yoram , Schemer Avner , Friedman‐Birnbaum Rachel
Published: July 2006

Objective There is accumulating evidence that in spite of the large campaigns against excessive solar exposure undertaken by dermatologists worldwide, children and adolescents are still spending long periods in the sun, and do not follow the recommended sun protection guidelines.

The purpose of the present study was to evaluate sun exposure in a group of young Israeli adults and to compare it to their knowledge and application of the various sun protection methods.

Methods 202 Caucasian volunteers, (mean age 21.4 ± 2.6), filled out detailed questionnaires on their sun exposure and sun protection habits.

Results More than 80% of our study participants are regularly sun exposed for longer than 2 h per day whereas sunscreens are utilized only by 64.9%. Sunscreen use was significantly more prevalent in females than males (81.3% vs. 46.5%). The majority of sunscreen users and nonusers believed that sunscreen could prevent skin cancer (94.3% and 82.0%, respectively) and that these compounds can slow skin aging (90.8% and 76.4% respectively). The understanding of the meaning of the “SPF” was significantly higher in the sunscreen users (85%) than in the nonusers (62.0%). The majority of sunscreen users utilized less than 150 ml of the compound per year which is probably an inadequate amount for a year for full body protection. The two most common reasons for not using sunscreens regularly, were that the application is time consuming, and that sunscreens prevent tanning.

Conclusion Our data reveals a discrepancy between a considerably good understanding of the need for sun protection and the still deficient application of these measures especially in young adult males.
Penetration of selected Dead Sea minerals through a healthy rabbit skin, from a sustained‐release transparent varnish, as a prospective treatment for psoriasis
Authors: Shani Jashovam , Sulliman Ahmed , Katzir Itzhak , Brenner Sarah
Published: July 2006

Bathing in the Dead Sea is an established treatment for psoriasis. Penetration of Dead Sea minerals into psoriatic skin is an effective factor in this treatment, but applying it clinically requires frequent bathing in the Dead Sea or in its bath‐salt solution. We tested an ethyl‐cellulose‐based transparent varnish with a sustained‐release property, for its penetrability of such minerals. Minerals tested were MgBr2, and KBr, known for their relevance in psoriatic proliferation. They were applied for up to three weeks. We could demonstrate that two weekly applications of the salt‐containing varnish on healthy rabbit skin are enough to obtain elevated levels of magnesium and potassium in their plasma. We propose the application of Dead Sea minerals containing varnish as a clinical treatment for psoriasis.
Zygomycotic cellulitis in a renal transplant recipient
Authors: Rotoli Maurizio , La Parola Ilaria Lesnoni , Serino Francesco , Nanni Giuseppe , Citterio Franco , Zannoni Gian Franco , Capelli Arnaldo , Cerimele Decio
Published: July 2006

Zygomycosis is a rare complication in immunosuppressed patients and is caused predominantly by‐species of Rhizomucor, Absidia and Rhizopus. Lungs and central nervous system localization are the most commonly observed, while skin localization has been observed only in 15% of the patients. We describe a case of zygomycotic cellulitis, with severe edema, inflammatory lesions and a nonimmune bullous eruption, in a renal transplant recipient.
White sponge nevus. Seven cases in the same family
Authors: Rodriguez‐Serna Mercedes , Pérez Amparo , Febrer Isabel , Botella‐Estrada Rafael , Aliaga Adolfo
Published: July 2006

Seven cases of white sponge nevus in seven women of the same family are reported. At birth the patients had lesions consisting of asymptomatic white spongy plaques located on the oral mucosa; in two patients the lesions also involved the vaginal mucosa. The lesions improved after antibiotic treatment. Histology was performed in four cases and an ultrastructural study in one. The findings were consistent with the diagnosis of white sponge nevus in all cases. Differential diagnosis was made with other conditions presenting as white lesions of the oral mucosa.
Bacillary angiomatosis in an HIV‐positive patient. Good response to Dapsone
Authors: Fernandez‐Bussy R.A. , Alonso A.B. , Carlson D. , Ramonda S. , Salerni G. , Reeves G.
Published: July 2006

Object Report the case of a 25 year old HIV patient who developed bacillary angiomatosis.

Setting Department of Dermatology, Centenary Hospital, Rosario, Argentina.

Objective The patient tailed to respond to the standard treatment with erythromycin.

Result The patient showed improved by the administration of Dapsone along with Zidovudine.

Conclusion This case is reported both because it is a rarely seen disease as well as because a good therapeutic response is obtained.
Direct profilometry of the skin: its reproducibility and variability
Authors: Kautzky Florian , Dahm Michael W. , Drosner Michael , Köhler Lars D. , Vogt Hermann‐J. , Borelli Siegfried
Published: July 2006

Objective The degree of reproducibility and precision of the mechanical direct profilometry and the intra‐ and interindividual fluctuations of 7 surface parameters were investigated.

Material and methods Negative replicas were sampled from defined areas of the skin of 31 volunteers an evaluated with the profile‐tracking device TKC 300 Hommeltester in order to derive data about the inter‐ and intraindividual fluctuations. To determine the precision of this method 6 roughness parameters and J of waviness of each replica were repetitively evaluated. The practicability was tested introducing minimal changes in the experimental set‐up. Further, the effect of urea‐containing creme on the skins topography was investigated in a double‐blind clinical setting on a collective of 11 patients.

Results The precision of this method is shown by nearly unchanged topographic parameters. Moreover, our data show smaller intra‐ than interindividual fluctuations of roughness (Ra) and waviness (Wt), being an important demand for clinical investigations.

Conclusion In this paper we demonstrate that the parameters of both roughness as well as the recently introduced waviness can be conveniently evaluated with a high degree of precision with the direct profilometry.
Multiple pilomatricomas associated with myotonic distrophy
Authors: Calderon María J. , Manrique Pilar , Gonzalez Rosario , Garcia‐Monco JC , Zabalza I.
Published: July 2006

Calcifying epithelioma of Malherbe, pilomatricoma, is a benign neoplasm of the skin, originating from primitive cells of the hair matrix, Myotonic dystrophy (Steinert's disease) is an uncommon hereditary disease characterized by myotonia, muscle wasting, cataracts, testicular atrophy and frontal baldness. We present the case of a woman with pilomatricomas and myotonic dystrophy and then we review the relationship between these two disorders.
Effectiveness and usability of short‐time treatment of psoriasis vulgaris with two different corticosteroids under occlusion with a hydrocolloid dressing (ContreetR)
Authors: Faber W.R. , van Joost Th. , de Hoop D. , Berretty P.J.M. , Boelen R.E. , Neumann H.A.M.
Published: July 2006

Objectives To evaluate the efficacy of treatment of plaque‐type psoriasis with a moderate and a strong corticosteroid under continuous hydrocolloid occlusion, with weekly change of dressing, compared with treatment with the same corticosteroids alone, and the acceptance by the patients of his type of treatment.

Setting Dermatological Departments of two University Hospitals and four General Hospitals.

Design Open parallel study divided in two parts depending on the two different corticosteroid preparations applied. Each part was an intrasubject half‐side study with left‐right comparison.

Subjects Fifty five patients with symmetrical, stable psoriasis plaques on elbows or knees.

Methods Twenty nine patients were treated with clobetason butyrate cream (EmovatcR) twice daily as well as once weekly covered with a hydrocolloid dressing (ContreetR) for four weeks. Twenty six patients were treated with clobetasol propionate cream (DermovateR) twice daily as well as once weekly covered by the hydrocolloid dressing for 2 weeks. Induration, erythema and scaling were assessed using a four‐point scale. Plaque size was measured by multiplying the largest and the smallest diameter. Healing was defined as score 0 for scaling and induration and score 0 or 1 for erythema. Acceptance was evaluated by questions related to the wearing of the dressings: comfort of wearing, pain, itching, adhesiveness and sticking to clothing, and the performance of daily activities.

Statistics analysis Sign test for the score values, parametric paired Student t‐test for plaque size, chi‐square test for healing.

Results With occlusion a statistically significant increased reduction of severity was obtained compared to treatment without occlusion; this effect was more pronounced with the application of the strong corticosteroid. The questions related to the wearing of the dressing were answered positively by the majority of the patients.

Conclusions Treatment of psoriasis plaques with, especially strong, corticosteroid creams under occlusion with a hydrocolloid dressing with a high adherence is rapid and effective. The acceptance of this type of treatment by the patients is high, and it permits normal daily activities.
Increased IgE‐levels in bullous pemphigoid correlate to soluble low affinity Fc‐II‐receptor for IgE and soluble IL‐2‐receptor
Authors: Schaller J. , Schult R. , Jeromin T.
Published: July 2006

Background Increased serum‐IgE levels in patients with bullous pemphigoid (BP) are one of the well known immunological deviations in this autoimmune dermatosis.

Aim and methods Since the mechanism that leads to an increase of IgE in BP is still unclear, we investigated serum‐IgE levels and IgE regulating cytokines (soluble low affinity Fc II receptor for IgE, IL‐4, IFN‐g and soluble IL‐2 receptor) in sera and blister fluids of 15 BP patients before and during treatment with immunosuppressants using an ELISA‐technique.

Results All 15 patients examined proved to have high IgE levels in blister fluids (> 100 KU/l) and 13 of the 15 patients had elevated serum‐IgE levels. Soluble low affinity Fc II receptor for IgE (sCD23R) was also increased in sera (7.9 ± 2.4 pg/ml) and ten fold higher in blister fluids (76.7 ± 15.3 pg/ml). Investigation of cytokines interfering with IgE production showed significantly increased levels of the soluble IL‐2 receptor in sera whereas the concentrations of IL‐4 and IFN‐g revealed no significant differences compared to controls. In blister fluids we detected all the cytokines investigated. During treatment with immunosuppressants the elevated concentrations of sCD23R and soluble IL‐2 receptor were reduced to normal values.

Conclusions The results show a direct correlation between IgE levels, sCD23R and soluble IL‐2‐receptor concentrations and suggest a connection between increased IgE levels and T‐cell activation in BP.
Detection of Borrelia burgdorferi in skin biopsies from patients with morphea by polymerase chain reaction
Authors: Trevisan Giusto , Stinco Giuseppe , Nobile Carla , Bonin Serena , Stanta Giorgio
Published: July 2006

Aim We looked for the evidence of Borrelia infection in patients with morphea by serologic means and by polymerase chain reaction (PCR) analysis of skin biopsy samples.

Background The possible relationship between Lyme borreliosis and morphea has been suggested by certain clinical, immunological and microbiological findings, but many authors were not be able to demonstrate Borrelia burgdorferi infection in patients with morphea and cast doubts on an etiological role for B. burgdorferi in this skin lesion.

Patients and methods Ten patients with morphea, 9 females (range: 8–65 years) and one 44‐year‐old man were examined. Serological tests for Lyme borreliosis were performed by immunofluorescence assay and flagellin enzyme‐linked immunosorbent assay. Skin biopsy specimens were taken from the periphery of morphea lesions for histological examination and PCR.

Results Antibodies to B. burgdorferi were detected in 3 patients and B. burgdorferi DNA was demonstrated in 5 patients.

Conclusions The amplification of DNA with PCR analysis seems to open new prospects for the detection of Borrelia genome in tissues, in the present study we were able to demonstrate the presence of B. burgdorferi DNA in patients with morphea, even in seronegative patients. These data confirm that PCR is an interesting tool in skin lesion diagnosis and support the hypothesis of an etiological association between B. burgdorferi infection and some cases of morphea.
Coping and psoriasis – a framework for targeted intervention
Authors: Metz D. , Jemec G.B.E.
Published: July 2006

Background Dermatological patients often suffer from psycho‐social problems in relation to their disease. These problems may affect the outcome of the treatment and should therefore be dealt with in an appropriate way. A framework suitable for the analysis of psycho‐social problems of disease exists in psychological literature, and can be applied to dermatological patients in particular.

Methods Examples of qualitative analysis are presented. The examples are based on focused, semi‐structured interviews transcribed into case stories. Four patients with long‐standing psoriasis vulgaris were studied.

Results The coping strategies used by patients are identified using the proposed framework. The cases show that minimising is a much used strategy by patients with psoriasis. The underlying mechanisms are analysed. The analysis can serve as background for additional psycho‐social intervention on the key points of Appraisal and Sense of Coherence, which are the processes of recognising the personal significance of situations and the ability to understand the significance of a given situation in a meaningful way.

Conclusion The presented model of coping is simple and allows rational and explicit identification of the required mode of psychological intervention necessary in order to offer the best possible help to patients.
Variations in the course of recurrent aphthous stomatitis in women taking hormone replacement therapy or oral contraceptives
Authors: McCartan Bernard E. , Sullivan Aine
Published: July 2006

Aim To investigate the outcome of therapeutic ovarian hormones on concurrent aphthous stomatitis.

Background Studies of therapeutic hormones in recurrent aphthous stomatitis have shown conflicting results, mostly not amenable to statistical analysis.

Methods 114 clients attending a well woman clinic were evaluated by means of a structured interview.

Results Women with menstrual cycle associated aphthae were more likely to have complete or partial remission when receiving therapeutic ovarian hormones; women with menstrual cycle unassociated aphthae were more likely to have no change or exacerbation. These differences were statistically significant (p < 0.001).

Conclusions The findings are consistent with the postulated role of ovarian hormones in the aetiology of menstrual cycle associated aphthous stomatitis.
A rare variant of incontinentia pigmenti ‐ disseminated papules and vesicles
Authors: Schaller J. , Schaller Sibylle
Published: July 2006

The case report of a 2 week‐old Turkish girl suffering from incontinently pigmenti (IP) with atypical disseminated papules and vesicles as a rare clinical manifestation at the onset is presented.

The diagnosis result from the histological examination with eosinophilic spongiosis, the peripheral blood eosinophilia and the development of typical striated lesions is the course of the disease.
Papillon‐Lefevre syndrome in two sisters
Authors: De Giorgi V. , Martini L. , Prignano F. , Donati E. , Moretti S.
Published: July 2006

Papillon‐Lefevre syndrome is a rare disorder of keratinization inherited as an autosomal recessive trait. It is characterized by thickening of palms and soles, perindonlopathia, tendency to pyogenic skin infections and sometimes mental impairment. The authors report Papillon‐Lefevre syndrome in two sisters in whom the familial pedigree shows the autosomal recessive inheritance of the trait. Two oilier important disorders of keratinization transmitted by an autosomal recessive gene. Richner‐Hanhart syndrome and Mal de Meleda, are excluded by clinical and metabolic criteria. Systemic therapy with etretinate and acitretin could not be performed because one of the patients has a hepatopathy and the other refuses the treatment. Application of local keratolytics is giving quite good results.
Dowling‐Degos disease localized in the vulvar area
Authors: Sacerdoti G. , Amantea A. , Donati P. , Menaguale G. , Fazio M.
Published: July 2006

The authors present a case of a woman with Dowling‐Degos disease in which the reticular pigmentation clearly involved the perianal and vulvar area. The extreme rarity of this localization and the importance of recognizing this disease in the mucosa is emphasized to permit identifying forms with few cutaneous characteristics and to distinguish them from other dermatoses.
Acquired reactive perforating collagenosis following diclofenac therapy in a patient with parapsoriasis
Authors: Bugatti Leonardo , Filosa Giorgio , Ciattaglia Giovanni
Published: July 2006

A case of acquired reactive perforating collagenosis in a 70‐year old man with a long standing digitate parapsoriasis is reported. Multiple asymptomatic cutaneous hyperpigmented papules with a central adherent keratotic plug developed simultaneously with widespread purpuric eruption following a single i.m. diclofenac injection. Histologic examination of a keratotic lesion revealed an epidermal crater with centrally degenerated collagen and elastic fibre extrusion. This case is interesting for the lack of pruritus, the transepithelial elimination of both collagen and elastic fibres and the association with parapsoriasis. The etiologic role of diclofenac is discussed. The term acquired perforating dermatosis may be more suitable for this case.
Tacalcitol ointment is an efficacious and well tolerated treatment for psoriasis
Authors: Scarpa Carmelo
Published: July 2006

Aim To demonstrate the efficacy and tolerability of tacalcitol ointment on plaque psoriasis.

Subject Vitamin D3 derivatives are now on world trial for plaque psoriasis treatment and we submit the results of a multicenter Italian trial (13 University and Hospital centers) with topical tacalcitol ointment, one of these new derivatives, which has less effect on calcium metabolism.

Method A multicenter, randomized, double‐blind, left‐right compared 6 weeks clinical study was performed using tacalcitol ointment (4 μg/g) and betamethasone valerate ointment (0. 1%) on 76 Italian subjects with plaque‐type (vulgar) psoriasis.

Results 63 subjects completed the treatment. The overall evaluation of our data gave a roughly equal improvement of plaque psoriasis with both types of treatment.

Conclusions A new drug for topical treatment of plaque psoriasis vulgaris is now available: tacalcitol ointment.
In vitro cytotoxicity of antimicrobial agents to human keratinocytes
Authors: Kautzky Florian , Hartinger Anton , Köhler Lars D. , Vogt Hermann‐J.
Published: July 2006

Backround The degree of bacterial contamination in the wound bed plays a key role in determining the level of “take” of keratinoeyte grafts in burn patients. This study was done to evaluate the best suited antimicrobial agent for topical application in relation to antimicrobial activity and cytotoxic effect on graft cells.

Objective The cytotoxicity of 7 antibacterial agents (gentamicin sulphate, ciprofloxacin hydrochioride, bacitracin, polymyxin B sulphate, diethanolamin salt of fusidic acid, teicoplanin, vancomycin hydrochtoride), one anlifungal substance (amphotcricin B sodium deoxycholate) and one antiseptic agent (povidone iodine) on cultured human keratinocytes, HaCaT keratinocytes and fibroblasts was investigated.

Material and methods The effects of these agents were tested using two separate assays ‐ the neutral red assay and the Bradford protein assay. In order to assess toxicity of the agent, the obtained midpoint cytotoxicity (MC50) was compared to the respective minimal inhibitory concentration (MIC) for receiving the cytotoxic potential in microbiologically effective doses.

Results Antibiotics effective against Staphylococcus aureus with a small potential of toxicity are Bacitracin, Fusidic acid, Vancomycin and Tcicoplanin. Gentamicin and Ciprofloxacin are effective against both Staphylococcus aureus and Pseudomonas aeruginosa with a low potential of toxicity.

Conclusion The use of antimicrobial agents with a midpoint cytotoxicity (MC50) higher than the minimal inhibitory concentration (MIC) by at least a factor of 100 might reduce the risk of toxic injury to graft cells.
Cryotherapy for lentigo maligna — is clinical acumen combined with a single punch biopsy good enough for staging?
Authors: Yell J.A. , Baigrie C. , Dawber R.P.R. , Millard P.R. , Goodacre T.
Published: July 2006

Aim We aimed to clarity the effectivenes of our staging of LM over a I‐year period.

Background Cryosurgery has become accepted as a simple and effective treatment for lentigo maligna (LM) but not necessarily lentigo maligna melanoma (LMM). Pigmented epithelial cells are extremely sensitive to cold injury. If adequate freezing is delivered to the proper depth into the dermal appendages, LM should be eradicated. However, if the initial staging does not detect invasion the lesion may be inadequately treated.

Methods Over 1 year prospectively. all patients presenting with LM(n= 12) wore stayed clinically by experienced dermatologists and by a single punch biopsy. This was then checked by complete excision of the lesion.

Results In 9 patients the clinical and punch biopsy diagnosis was confirmed after excision. Two melanomas were missed clinically but detected on punch biopsy. In one patient the punch biopsy described a “LM with probable invasion elsewhere in the lesion”. Surgical excision yielded a melanoma, 0.8 mm thick. Clark's level 4. In a second patient, punch biopsy diagnosed superficial spreading melanoma (‐SSM) in situ, confirmed on excision.

Conclusions We therefore feel that clinical diagnosis combined with a single punch biopsy will diagnose invasion when present. We emphasise that cryotherapy should not be performed without punch biopsy confirmation of the clinical diagnosis.