bluuebunny/crossref_metadata_2025 huggingface dataset:
Angiolymphoid Hyperplasia with Tissue Eosinophilia
Authors: Ai‐Jitawi Salah , Oumeish Oumeish Y.
Published: May 2007

ABSTRACT: Angiolymphoid hyperplasia with eosinophilia is a rare but distinctive clinicopathologic entity. A study of seven cases and review of the literature strongly suggests that both conditions represent a single disease spectrum. The relation of this condition to Kimura's disease is controversial. The descriptive term angiolymphoid hyperplasia with tissue eosinophilia is proposed.
Book Reviews
Authors: BEERMAN HERMAN
Published: May 2007

Book review in this article:

PRACTICAL CUTANEOUS CRYOSURGERY. Douglas Torre, Ronald Lubritz, and Emanuel Kuflik.

HAIR TRANSPLANTATION. Walter Unger and Rolf E. A. Nordstrom.

SKIN SIGNS IN AIDS. Kaare Weismann, Carsten Sand Petersen, Jorgen Sondergaard, Gunhild Lange Wantzin.
Use of Phenytoin in Healing of War and Non‐War Wounds
Authors: Modaghegh S. , Salehian B. , Tavassoli M. , Djamshidi A. , Rezai A. Shiekh
Published: May 2007

ABSTRACT: Nineteen patients with war‐related missile wounds and six with refractory civilian ulcers were treated with topical phenytoin sodium powder daily for up to 4 weeks. The mean healing time was 2 weeks for missile wounds, compared to historical controls requiring 6–8 weeks. Healing time was 4 weeks for civilian ulcers that had been unresponsive to any treatment over the previous 5 months. Twenty‐two patients had complete healing, three required skin grafts. Wider use of this safe, inexpensive, readily available and easy‐to‐use agent is suggested because of its positive effect on wound healing and rapid pain relief.
Clinical Trial with Clofazimine for Treating Erythema Dyschromicum Perstans Evaluation of Cell‐Mediated Immunity
Authors: Piquero‐Martían Jaime , Péarez‐Alfonzo Ricardo , Abrusci Vito , Briceno Luis , Gross Ana , Mosca Walter , Tapia Felix , Convit Jacinto
Published: May 2007

Eight patients were studied to determine the possible use of clofazimine for treating erythema dyschromicum perstans (EDP). The T‐helper/T‐suppressor cytotoxic ratio (CD‐4/CD‐8) and the in vitro lymphoproliferative response on stimulation with phytohemaglutin (PHA) and concanavalin A (Con A) were determined in peripheral blood before and after treatment. Of the eight patients studied, seven had excellent to good responses, whereas only one had a marginal response. The immunologic evaluation before and after treatment showed a significant change in the CD‐4/CD‐8 ratio, a decrease of the response to PHA, and no change in the response to Con A. The results obtained show that clofazimine is useful for treating this nosologic entity because of its cosmetic effect, and also because it induces changes in cell‐mediated response, which could be very important therapeutically.
Peripheral Neural Involvement in Cutaneous Leishmaniasis
Authors: Satti Mohamed B. , El‐Hassan Ahmed M. , Al‐Gindan Yousuf , Osman Mirghani A. , Al‐Sohaibani Mohamed O.
Published: May 2007

ABSTRACT: Peripheral neural involvement in cutaneous leishmaniasis has recently been recognized. A man presented with several tender hyperesthetic skin nodules. Histopathologic examination confirmed the diagnosis of cutaneous leishmaniasis. Of most interest was the presence of a striking lymphohistiocytic inflammatory infiltrate around and within cutaneous nerves in addition to demonstrable leishmania organisms in the perineural space. This observation led to a detailed histopathologic evaluation of leishmanial skin lesions that developed in 13 mice after subcutaneous injection with leishmania major promastigotes. Varying degrees of neural involvement was noted in skin lesions from nine animals. In some lesions, in addition to inflammatory cells in the nerves, organisms were demonstrable within probable schwann cells. Three pathologic stages of dermal neural involvement were identified, namely, an early, intermediate, and late stage, depending on the severity of damage; however no correlation was found between the pathologic stage and the duration of the leismanial skin lesion of a specific animal.
Staphylococcus aureus in Atopic Dermatitis and in Nonatopic Dermatitis
Authors: Masenga John , Garbe Claus , Wagner Jutta , Orfanos Constantin E.
Published: May 2007

ABSTRACT: Skin colonization with Staphylococcus aureus (S. aureus) was examined in 30 patients with atopic dermatitis (AD), in 25 patients with nonatopic eczema (NAE) and in 30 individuals as healthy controls (HC). Bacteria growth was examined in aerobic cultures and the population densities per dish were estimated; S. aureus colonization was found in the eczematous skin of 24 of 30 (80%) AD patients and in 13 of 25 (52%) NAE patients (NS, p > 0.1). In nonaffected skin S. aureus colonization was found in 19 of 30 (63%) of all AD patients compared with 6 of 25 (24%) in NAE patients and 1 of 30 (3%) in HC, respectively (p < 0.05). In nonaffected skin, coagulase negative strains of Staphylococcus were found in 25 of 30 (84%) controls and in 18 of 25 (72%) NAE patients compared with 12 of 30 (40%) patients with AD. It seems that colonization with S. aureus is not a characteristic feature for atopic dermatitis but is a frequent event in damaged skin; significantly elevated values were also observed in nonatopic eczema. The degree of colonization may depend on the severity and duration of the eczematous lesions.
Skin Diseases in Children with HIV Infection and Their Association with Degree of Immunosuppression
Authors: Lim Wilma , Sadick Neil , Gupta Anil , Kaplan Mark , Pahwa Savita
Published: May 2007

Since the recognition of the acquired immunodeficiency syndrome (AIDS) in 1981, several dermatologic manifestations have been associated with the syndrome, including candidiasis, dermatophyte infection, molluscum contagiosum, herpes simplex and zoster, bacterial infection, and malignancy. Skin diseases have been observed in both the adult and the pediatric human immunodeficiency virus (HIV) infection in an academic hospital setting in relationship to the correct CDC classification of pediatric HIV infection. The severity of dermatologic manifestations is correlated with the immune status of the patients. The latter was determined by T4 helper cell numbers and lymphoproliferative responses to mitogens and recall antigens. More severe T helper cell depletion was associated with a wider spectrum and increased severity of dermatologic manifestations.
Psoriasis Without Neutrophils
Authors: Paslin David
Published: May 2007

Histologic studies suggest that polymorphonuclear leukocytes (polys) may initiate, enable, and/or enhance the development of psoriasis. A man with long‐standing psoriasis developed acute myelogenous leukemia. His psoriasis disappeared after treatment with daunorubicin and cytosine arabinoside. Smears of his peripheral blood showed essentially zero polys from day 10 to day 22 after start of chemotherapy. His psoriasis began to reappear on day 14, became prominent by day 76, and persisted. Polys may not be requisite for the development and maintenance of psoriasis.
The Effect of Superficial X‐Radiation on Epidermal Langerhans Cells in Human Skin
Authors: Edwards E. K. , Edwards E. K.
Published: May 2007

The anti‐inflammatory effects of superficial x‐radiation may be due, in part, to their depleting effect on the Langerhans cell in the epidermis.
Ectopic Geographic Tongue and AIDS
Authors: Grinspan David , Blanco Graciela Fernández , Agüero Susana , Bianchi Oscar , Stringa Sergio
Published: May 2007

A 23–year‐old man with AIDS developed a lesion with the clinical characteristics of an ectopic geographic tongue in the lower lip, near the right commissure.
Clinical and Genetic Study of Xeroderma Pigmentosum
Authors: Rubaie S. M. Al , Darouti M. A. El
Published: May 2007

Seven patients with xeroderma pigmentosum are presented. Abnormal karyotyping, found in one case, could be associated with an increased risk of the development of neoplasia.
Insect Bite Lesions in Kuwait Possibly due to Leptodemus minutus
Authors: Selim M.M. , Khalifa T. , Al‐Awadi I. , Al‐Humaidi A. , Al‐Faris M.
Published: May 2007

ABSTRACT: Leptodemus minutus, an hemipteran insect previously not known to attack man, was suspected as causing an outbreak of pruritic eruptions in 100 patients in Kuwait.
Basal Cell Carcinoma Treated with Interferon
Authors: Lkić Drago , Padovan Ivo , Pipić Nedim , Knežević Mirko , Djaković Nikola , Rode Bojan , Košutić Iva , Belicza Mladen
Published: May 2007

Abstract: Human natural leukocytic interferon (HNLI) and re‐combinant interferon (rIFN) alpha 2c can be used in the therapy of basal cell carcinoma. Seventy‐two patients were treated for 3 to 6 weeks with a single dose of 400,000 to 1,200,000 units (HNLI) and 2,000,000 to 5,000,000 units (rIFN alpha 2c). According to histopathologic and clinical findings, 52 patients were cured, and cancer cells were not found in the biopsy material taken after HNLI treatment for the second biopsy. In nine of 72 patients the cancer lesion was reduced 25% to 90%. In 11 patients it was not reduced or was reduced less than 25%. With rIFN alpha 2c therapy given five times per week for 4 weeks, histopathologic and clinical findings showed that five patients out of 12 were cured, and cancer cells were not found in the biopsy material taken after treatment. In seven patients out of 12 the cancer lesion was reduced 25% to 90%. Both types of interferons are effective in the treatment of basal cell carcinoma. Side effects were mild.
Book Reviews
Authors: Beerman Herman
Published: May 2007

DNA Damage and Repair in Human Tissues. Betsy Sutherland, Avril D. Woodhead.

Eczema: Basic Information for Medical Practitioners. S. J. Yawalkar, G. Blum.

Practice of Skin Surgery. P.N. Behl.

Year Book of Dermatology 1990. Arthur J. Sober, Thomas B. Fitzpatrick.
Florid Cutaneous Papillomatosis, Malignant Acanthosis Nigricans, and Pulmonary Squamous Cell Carcinoma
Authors: Gheeraert Patrick , Goens Jean , Schwartz Robert A , Lambert W. Clark , Schroeder Fabienne , Debusscher L.
Published: May 2007

Abstract: A 72‐year‐old man had florid cutaneous papillomatosis (FCP), which is an obligatory paraneoplastic syndrome always associated with an internal malignancy. The cancer, which is usually intraabdominal and most often gastric in origin, evolves parallel to the FCP. This patient is the first case of FCP occurring in association with a lung malignancy. An association of FCP with other signs of internal cancer is common, with malignant acanthosis nigricans usually appearing many times with the sign of Leser‐Trélat. FCP, malignant acanthosis nigricans, and the sign of Leser‐Trélat are part of a continuum, developing by a common or similar pathogenic pathway due to an underlying malignancy producing a factor possibly similar to human epidermal growth factor.
Antibasement Membrane Zone Antibodies In Localized Pretibial Pemphigoid
Authors: Muramatsu Tsutomu , Iida Takashi , Shirai Toshihiko
Published: May 2007

Abstract: To clarify the nosologic position of localized pretibial pemphigoid, Western immunoblotting analysis was carried out using the sodium dodecyl sulfate extracts of normal human epidermis. Sera from patients with localized pretibial pemphigoid and generalized bullous pemphigoid reacted with 220‐ to 240‐kd polypeptide, which is a critical point for a definite diagnosis of bullous pemphigoid. This result suggests that localized pretibial pemphigoid belongs to the same nosologic position as bullous pemphigoid.
Genetically Determined Coincidence of Kaposi Sarcoma and Psoriasis in an HIV‐Negative Patient After Prednisolone Treatment
Authors: Tebbe Beate , Mayer‐da‐Silva Augusto , Garbe C. , von Keyserlingk Hans‐Joachim , Orfanos Constantin E.
Published: May 2007

ABSTRACT: We report the case of drug‐induced, acrolocalized Kaposi sarcoma (KS), arising multicentrically in both palms and soles of a male patient who has had widespread psoriasis since 12 years of age. This 59‐year‐old man, of Mediterranean origin, was HIV antibody‐negative and had received oral prednisolone treatment over 5 months for chronic obstructive lung disease (initial dose: 75 mg/d). Eight months after discontinuing oral treatment the KS nodules regressed spontaneously and finally disappeared completely without additional treatment. Light and electron microscopic investigations confirmed the diagnosis of KS, whereas laboratory tests excluded HIV infection and suggested mild immune dysfunction. The existence of HLA loci predisposing to KS and to psoriasis (A1, DR5, DR7, DR11) was characteristic for the simultaneous occurrence of these two diseases. This case report demonstrates the complex interrelationships between genetic predisposition, drugs leading to immune suppression, and the evolution of an unusual neoplasm.
Tinea Capitis in the United Arab Emirates
Authors: Lestringant Gilles G. , Qayed Khalil , Blayney Benedict
Published: May 2007

ABSTRACT: The authors reviewed the causative agents for tinea capitis in United Arab Emirates nationals attending Tawam Hospital, Al Ain, between 1981 and 1988. Microsporum canis was the most prevalent organism isolated. Oral griseofulvin remained the treatment of choice. The addition of isotretinoin appeared promising in the chronic inflammatory forms.
The Black Disease of Arabia, Sowda‐Onchocerciasis
Authors: Siddiqui Mohammed Afaq , Al‐Khawajah Marwan Mohd
Published: May 2007

ABSTRACT: Sowda, the localized asymmetrical lesion of onchocerciasis endemic in Yemen and Southern Saudi Arabia, is characterized by hyperpigmented lichenified papular lesions on one leg with intense pruritus. There is enlargement of femoral and inguinal lymph glands. In our study, even the long standing cases do not show elephantiasis of the leg or genitalia. Microfilaria appeared to be scarce and adult worms could not be detected clinically, as well as by ultrasonography (except in one case). There was no significant lymphatic obstruction; such cases were studied by contrast lymphangiography and isotope lymphangiography.
Atypical Clear Cell Acanthoma
Authors: Grunwald Marcelo H. , Rothem Arieh , Halevy Sima
Published: May 2007

Abstract: Two cases of clear cell acanthoma (CCA) with marked signs of cellular atypia and mitotic figures are reported. Although the nature of CCA is not completely understood, it is considered to be a benign epithelial tumor. Our cases show that these lesions can develop malignant features.
Anglosarcoma of the Face and Scalp
Authors: Haustein Uwe‐F
Published: May 2007

Abstract: Angiosarcoma of the face and scalp developed in 12 patients. The patients were five women and seven men with an average age of 71 years. Initial features were solitary or multiple violaceous vascular nodules or plaques. The clinical course was complicated by ulceration, secondary infection, bleeding, anemia, infiltration into the underlying bones, tumor cachexia, and death. Metastases were not observed. Histologically, seemingly benign hemangiomatous capillary‐like structures were found in some areas of the tumors, with richly cellular, solid sarcomatous proliferations in other areas. Early and extensive surgical excision is the therapy of choice, but generally it does not alter the relentless course of the disease. Neither palliative radiation therapy nor polychemotherapy is capable of interfering with tumor progression.
Specificity of Human Keratinocyte X HeLa Cell Hybrid Murine Monoclonal Antibodies
Authors: Kwiatkowska Beata , McCullough Jerry L. , Weinstein Gerald D. , Stanbridge Eric J.
Published: May 2007

Abstract: The immunofluorescent staining patterns of three differentiation‐specific monoclonals (HLK3, HLK7, HLK20) that display different immunofluorescent (IF) reactivity in normal and psoriatic epidermis, were examined in basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), as well as other human normal epithelial and nonepithelial tissues. Similar staining patterns within epidermis were seen with HLK3 (intercellular) and HLK7 (perinuclear) in psoriasis, SCC, and BCC. HLK20 selectively stained BCC and SCC within epidermis and dermis, and was negative in psoriasis. The monoclonals did not react with nonepithelial tissues, but repetitively displayed positive, granular reactivity with simple epithelia and transitional epithelium. Stratified squamous epithelia showed IF staining similar to normal epidermis for all three monoclonals. These new monoclonal antibodies offer new investigative tools to study abnormalities in keratinocyte differentiation in benign and malignant hyperplastic skin diseases.
Elevated Plasma Histamine in Chronic Uremia Effects of Ketotifen on Pruritus
Authors: Francos George C. , Kauh Young C. , Gittlen Stanford D. , Schulman Edward S. , Besarab Anatole , Goyal Sudir , Burke James F.
Published: May 2007

Abstract: A role for histamine in the pathogenesis of uremic pruritus was investigated in maintenance hemodialysis patients. Venous plasma histamine levels, as determined by radioenzymatic assay, were significantly higher (p < 0.05) in hemodialysis patients with pruritus (368 ± 103 pg/ml [mean ± SEM], n = 6) than in those without pruritus (146 ± 22 pg/ml, n = 5) and in normal controls (142 ± 16, n = 5). Arteriovenous fistula histamine levels (202 ± 52 pg/ml, n = 6) were significantly lower (p < 0.05) than simultaneously drawn venous samples. Markedly elevated histamine‐degrading enzyme (histaminase) activities were found in both hemodialysis patients with (2.95 ± 0.18 pg histamine degraded/minute) and without (2.44 ± 0.28) pruritus, but was undetectable in normal controls. Histaminase activities did not significantly differ in simultaneously drawn venous and fistula samples. With hemodialysis, histaminase activities fell significantly (p < 0.01), whereas plasma histamine did not change. We further examined the effects of ketotifen, a putative mast cell stabilizer, on severe uremic pruritus. Five of five patients had significant (p <0.01) reductions in pruritus, as judged on a six‐point pruritus index, after 8 weeks of drug (x = 2.3), as compared to conventional therapy (x = 5.9). Despite these improvements, no significant differences were noted in pre‐ versus post‐drug plasma histamine levels, histaminase activities, or the histamine content per gram of skin biopsy specimen. These data support prior hypotheses that mast cell activation contributes to the pruritus of uremia.
Cutaneous Leishmaniasis in Nigeria
Authors: Obasi O. E.
Published: May 2007

Twenty‐one of 18,000 (0·1%) dermatology patients seen at the Ahmadu Bello University (ABU) Teaching Hospital, Kaduna, Nigeria, during the 9‐year period October, 1979‐August, 1988, had cutaneous leishmaniasis (CL). Their age range was 14 to 50 years (mean 28.7 years), with a peak at the 14‐to 25‐year age group. Eleven of the 21 patients (52%) were students in Government Colleges located within the leishmaniasis belt of Nigeria.
Prevention of Post‐herpetic Neuralgia
Authors: Benoldi Donata , Mirizzi Stella , Zucchi Alfredo , Allegra Fuluio
Published: May 2007

The effects of prednisone, oral acyclovir, and radiotherapy were compared with placebo in the prevention of post‐herpetic neuralgia. No treatment used was able to prevent, with statistical significance, post‐herpetic neuralgia, although prednisone and acyclovir showed some pain reduction in the acute phase. Radiotherapy was of no value in either the acute or post‐herpetic phase.
Facial Contact Dermatitis
Authors: Bian Zhao , Weixin Fan
Published: May 2007

Abstract: In 107 cases of facial contact dermatitis, routine Finn chamber epicutaneous tests with TROLAB European Standard Allergens (ESAs) were performed. Sixty‐one (57%) had positive reaction. The most frequent contact allergens were paraphenylenediamine dihydrochloride (16%), followed by fragrance mix (15%), and nickel sulfate (13%). The major sensitized contactants were rims of spectacles, hair dyes, cosmetic creams, and topical medications. Among the cases caused by cosmetic cream, the positive allergens were fragrance mix, formaldehyde, wood alcohols, and balsam of Peru. In ten season‐incidence cases in which ESAs and cosmetic cream epicutaneous tests were negative, the chamber and scratch‐chamber tests were performed using five kinds of pollen. The results show that all chamber tests were negative, but two cases with scratch‐chamber tests were positive.
Cutaneous Leishmaniasis in Kuwait
Authors: Al‐Fouzan Abdulwahab S. , Al Saleh Qassim A. , Najem Nabeel M. , Rostom Amr I.
Published: May 2007

Abstract: Twenty‐four patients suffering from single or multiple lesions of cutaneous leishmaniasis were included In this study. Most of the lesions were on the extremities. The patients were randomly divided into two groups. Most of the patients in the first group who were given oral itraconazole for a period of 6–8 weeks showed excellent clinical response. On the other hand, only one patient in the second control group who was given placebo showed good clinical improvement. Systemically administered itraconazole may prove to be a valuable modality for the treatment of cutaneous leishmaniasis.
The Role of Plasminogen Activators in Alopecia Areata1
Authors: Lotti T. , Teofoli P. , Senesi C. , Fedi A. M. , Bonan P. , Palleschi G. M. , Panconesi E.
Published: May 2007

ABSTRACT: Plasminogen activators are serine proteinases which transform the serum zymogen, plasminogen, into plasmin, a broad‐spectrum protease with fibrinolytic effect. Two main plasminogen activators have been described in humans: urokinase (UK; molecular weight, 55,000) and tissue‐type plasminogen activator (tPA; molecular weight, 74,000). Thirteen subjects were studied who had alopecia areata (AA), nine in the active phase and four in remission. There were alterations in the perivascular and peribulbar fibrinolytic activity in the nine subjects in the active phase of disease, suggesting a possible role of plasminogen activators in AA. A modified Todd's autohistographic method was used to evaluate cutaneous fibrinolytic activity (which depended on the activity of plasminogen activators) in the 13 AA subjects and five volunteer controls. Cutaneous fibrinolytic activity was reduced in perivascular areas, but increased in peribulbar areas, in the nine subjects in the active phase of disease. Tests with monoclonal antibodies directed against the catalytic sites of tPA and UK showed that the perivascular fibrinolytic activity was tPA dependent, and the peribulbar fibrinolytic activity was UK dependent.
TSUTSUGAMUSHI DISEASE (SCRUB TYPHUS)
Authors: TANIGUCHI YOSHIKI , KANNO YUKO , ANDO KATUHIKO , INACHI SHIN , SHIMIZU MASAYUKI
Published: May 2007

Two patients with Tsutsugamushi disease (fever) were successfully treated with tetracycline derivatives after typical eschars were found, although one of the patients was initially misdiagnosed as having a drug reaction eruption. Prompt diagnosis and treatment are important because this disease can be associated with considerable morbidity and simple effective treatment is easily available.
MUDI‐CHOOD: AN UNUSUAL TROPICAL DERMATOSIS
Authors: GHARPURAY MOHAN B. , KULKARNI VINAY , TOLAT SUNIL
Published: May 2007

Mudi‐chood is an unusual dermatosis seen in India. It affects the nape of the neck and the exposed part of the upper back in girls and young women. It is characterized by mildly pruritic pigmented papular lesions. It probably represents the comedogenic activity of various oils applied to the hair, which is aggravated by the typical climatic conditions. We present three cases of mudi‐chood.

Mudi‐chood is an unusual papulosquamous dermatosis affecting the nape of the neck and the exposed parts of the upper back of girls and young women. Mudi‐chood in the regional language means “hair‐heat.”1 It is commonly seen in the southern parts of India, especially in the state of Kerala. The women in these regions wash their long hair daily and apply a variety of hair‐oils. Many herbal products are added to these oils, which vary from place to place. After washing, the hair is tied loose and dried in the sun. The humidity and the heat in these tropical areas, and also the peculiar habits of the women, seem to act as etiologic factors for mudi‐chood. Though commonly seen, there are few references in the literature to similar entities. The only exception is the original paper by Sugathan and Balaraman Nair.1

We report three cases of mudi‐chood. Our cases are from parts of Western India where the climate is not as humid. The application of hair‐oils is not a daily ritual, and the disease is relatively uncommon in these parts of India. There is apparently no hereditary influence. An atmospheric influence, attributable to increased heat and moisture in the late summer, is responsible for an increase in mudi‐chood during this season.
BASAL CELL CARCINOMA IN TROPICAL AUSTRALIA
Authors: CZARNECKI D. , COLLINS N. , NASH C.
Published: May 2007

A survey of people with skin cancer in tropical Australia detected a change in site of the prevalent cancer. In the post‐war generation more basal cell carcinomas are occurring on the back and fewer on the head and neck. A reversal of the sex ratio was also detected, with more women being afflicted.
OFLOXACIN VERSUS CEPHALEXIN FOR TREATING SKIN AND SOFT TISSUE INFECTIONS
Authors: LIPSKY BENJAMIN A. , YARBROUGH DABNEY R. , WALKER FREDERIC B. , POWERS ROBERT D. , MORMAN MANUEL R.
Published: May 2007

Patients with acute localized skin or soft tissue infections were randomized to receive either ofloxacin (300 mg orally, b.i.d.) or cephalexin (500 mg orally, b.i.d.). Among 401 enrolled patients, 382 were evaluable for safety and 148 for microbiologic response. Microbiologic cure occurred in 93.4% of ofloxacin‐treated patients and in 94.0% of those treated with cephalexin. Clinical cure or improvement, respectively, was found in 85.2% and 11.1% of patients treated with ofloxacin, and 83.6% and 14.9% of patients receiving cephalexin. Adverse effects (primarily associated with the gastrointestinal tract and central nervous system) were considered to be drug‐related in 7.9% of those receiving ofloxacin and 4.8% of those receiving cephalexin. Thus, ofloxacin is as effective and well tolerated as cephalexin and a good alternate antibiotic for treating skin and skin structure infections caused by a variety of pathogens.
Primary Exudative Ascites in Systemic Sclerosis
Authors: GOIHMAN‐YAHR MAURICIO
Published: May 2007

The Correspondence Section serves as a forum for opinion exchange about subject of general interest such as dermatologic training, relations between dermatologists and pharmaceutical 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 publications, as well as other concerns the readership might have. Contributions are welcome and should conform to the usual former for correspondence. Manuscripts will undergo standard editorial procedures. Submit all correspondence to Mauricio Goihman‐Yahr, M.D., Editor, Jet International M‐154, P.O. Box 020010, Miami, FL 33102.
SQUAMOUS CELL CARCINOMA IN SOUTHERN AND NORTHERN AUSTRALIA
Authors: CZARNECKI D. , COLLINS N. , MEEHAN C. , O'BRIEN T. , LEAHY S. , NASH C.A.
Published: May 2007

Squamous cell carcinoma (sec) of the skin was studied in two similar populations, one living in the temperate zone of Australia, the other living in the tropics. In the tropics, the patients were significantly younger, the man to woman ratio approached unity, and women had significantly more sees on the legs. In the temperate zone, men had significantly more on the head and neck, but women had significantly more on the upper and lower limbs.
SEVERE ACUTE FORM OF ADULT DERMATOMYOSITIS TREATED WITH CYCLOSPORINE
Authors: CORREIA OSVALDO , POLONIA JORGE , PEDRO NUNES J. , RESENDE CARLOS , DELGADO LUIS
Published: May 2007

The classical treatment of severe forms of dermatomyositis includes high doses of steroids and/or cytotoxic agents. Acute forms are frequently life threatening. Because cyclosporine is a fast‐acting immunosuppressive drug, it appears to be a good candidate for the treatment of refractory forms of acute dermatomyositis. We report a dramatic improvement of a severe, acute, steroid‐resistent adult form after cyclosporine administration. A rapid clinical and biochemical improvement is reported, and the reversibility of immunologic abnormalities is emphasized.
PATTERN OF SKIN DISEASES AT THE NATIONAL SKIN CENTRE (SINGAPORE) FROM 1989–1990
Authors: CHUA‐TY G. , GOH C.L. , KOH S.L.
Published: May 2007

At the National Skin Centre, 74,589 new attendances were seen from 1989 to 1990. The M:F ratio was 1:1. The majority of the patients belonged to the 20–39 year age groups (40%). Frequencies of psoriasis (20.4%) and alopecia (17.2%) were higher among Indians; exfoliative dermatitis was higher among Malays (19.72%); and insect bites were higher among Chinese (87%) [P < 0.05] compared with ethnic distribution (9.9%, 7.6%, and 77.2% respectively) of NSC patient population. Dermatitis (34.2%) and acne (10.9%) were the most common skin disorders seen. The more common dermatoses seen in 1989/90 differ slightly from those reported in 1950s and 1980s; however, the frequencies of contact dermatitis, fungal infection, and insect bite reactions of 5.8%, 10.9%, and 7.6%, respectively, in 1980 have decreased to 4.7%, 5.4%, and 2.3%, respectively, in 1989/90. There was no seasonal variation in the frequency of various dermatoses except for psoriasis, which was more prevalent during the first quarters of 1989 and 1990. Our results showed that the pattern of skin diseases in Singapore is slowly approximating that of developed countries. The changes in the pattern of skin diseases are probably due to improved economic status, better education and hygiene, ready availability of dermatology services, as well as changes in occupational and environmental contactants over the last decade.
CUTANEOUS LEISHMANIASIS IN RIYADH REGION: FOUR‐YEAR STUDY OF THE EPIDEMIOLOGIC AND CLINICAL FEATURES
Authors: AL‐SHAMMARI SULAIMAN A. , KHOJA TAWFIK A. , FEHR ABDULAZIZ
Published: May 2007

A retrospective study of 11,802 patient records with cutaneous leishmaniasis in Riyadh region was conducted during the period 1987 to 1990. The following findings resulted from the study. The incidence rate declined from 244.2 to 106.5 per 100,000 population. The infection was mainly among non‐Saudi men in their working years. The Saudis represented 33% of the total number of patients. The Saudi patients were mainly young, below 15 years of age, with almost equal men/women distribution. The non‐Saudis were found to have more multiple lesions; 65% of them had three or more lesions compared with 10% in Saudis. The lesions were mainly on the exposed parts of the body such as the face (20%), neck (3.3%), upper limbs (23.3%), and lower limbs (15%). Agricultural areas such as Riyadh vicinity, Al‐Kharj, Shagraa, and Al‐Koweeya showed consistently the highest foci of infections. The infections were highest in winter and lowest in summer.
ASHY DERMATOSIS AND LICHEN PLANUS PIGMENTOSUS: A CLINICOPATHOLOGIC STUDY OF 31 CASES
Authors: VEGA MARIA ELISA , WAXTEIN LEON , ARENAS ROBERTO , HOJYO MA. TERESA , DOMINGUEZ‐SOTO LUCIANO
Published: May 2007

The clinical and histopathologic characteristics of patients with ashy dermatosis (n=20) and lichen planus pigmentosus (n=11) were analyzed. We found significant clinical differences between both dermatoses, supporting our opinion that they are two separate conditions. Both dermatoses were histologically similar.
LOOSE ANAGEN HAIR SYNDROME
Authors: O'DONNELL BRIAN PATRICK , SPERLING LEONARD C. , JAMES WILLIAM D.
Published: May 2007

This recently described entity begins in childhood and is characterized by actively growing hairs that can be easily and painlessly removed from the scalp, leading to alopecia.
SIMPLIFIED EXPERIMENTAL HUMAN DERMATOPHYTOSIS MODEL
Authors: ALY RAZA , MAIBACH HOWARD I. , HO IRWIN , ABRAMS BEATRICE B.
Published: May 2007

The authors have improved and simplified previous methods for producing localized mycotic skin infections in an attempt to compare topical antifungal agents for their bioequivalency. Healthy human volunteers who had negative results for commercial, purified Trichophyton antigen (Trichophytin) were inoculated with Trichophyton mentagrophytes on two sites on each forearm in a randomized study designed to compare the antifungal activities of two ciclopirox olamine formulations. The lesions, easily induced by the authors' method, were localized and did not spread under the occlusive dressings. Infections established at the four sites on 26 subjects were treated twice daily for 14 days with the two active drug formulations and their vehicles. There were no significant differences in culture‐documented cure rates or alleviation of clinical signs and symptoms between ciclopirox olamine lotion and cream. Each drug was significantly better than its vehicle. The authors' method seems to be effective and suitable for therapeutic studies.
PELGEROID‐LIKE ANOMALOUS CELLS IN THE DIAGNOSIS OF NEUTROPHILIC DERMATOSIS ASSOCIATED WITH MYELODYSPLASTIC SYNDROME
Authors: NOGITA TOSHITATSU , MORIOKA NAOKO , ISHIBASHI YASUMASA , KAWASHIMA MAKOTO , MIZOGUCHI MASAKO , OTSUKA FUJIO
Published: May 2007

Neutrophilic dermatoses (ND), with or without accompanying myelodysplastic syndrome (MDS), were examined in terms of nuclear abnormality like pelgeroid anomaly of infiltrating cells into skin lesions. Six IMD accompanying MDS showed 1.0 to 13.5% of such anomalous cells among infiltrating cells. In contrast, ND without accompanying myeloproliferative disorders rarely had such anomalous cells. Our findings suggest that pelgeroid‐like anomalous cells infiltaring into ND are probably a good marker of underlying MDS.
SENIOR MEDICAL STUDENT CLINICAL AND RESEARCH ELECTIVES IN DERMATOLOGIC SURGERY
Authors: WAGNE RICHARD F. , WAGNER KAREN D.
Published: May 2007

Five senior medical students enrolled in the 4 week clinical elective in dermatologic surgery and cutaneous oncology (DSCO); two of these students also enrolled in a 4 week research elective in DSCO. During the elective(s) the students made significant improvement in the six areas of clinical diagnosis, histopathologic diagnosis, clinical management, DSCO procedures, research skills, and general information about the subspecialty. Following their elective(s), these students submitted a total of six abstracts, one letter, and seven manuscripts for presentation or publication.
MORPHEA WITH HIGH TITER OF FIBRONECTIN ANTIBODIES
Authors: STEFANATO CATHERINE M. , GORKIEWICZ‐PETKOW ANNA , JARZABEK‐CHORZELSKA MARIA , JABLONSKA STEFANIA , CHORZELSKI TADEUSZ
Published: May 2007

A 20‐year‐old man with a 9‐year history of unusual subcutaneous morphea with nodular lesions in a circular arrangement and wooden‐hard symmetrical induration of the arms, had high liters of fibronectin antibodies. A possible role of fibronectin and antifibronectin antibodies in the pathogenesis of scleroderma is discussed.
SURVEY OF SKIN LESIONS IN THE FILIPINO ELDERLY
Authors: TIANCO ELIZABETH AMELIA V. , BUENDIA‐TEODOSIO GRACIA , ALBERTO NENITA L.
Published: May 2007

One hundred elderly Filipino patients, aged 60 and over were surveyed to identify past and present skin complaints, and the dermatologic findings on a total cutaneous examination. All patients were consulting at the dermatology clinical of a teaching hospital in the Philippines. The elderly were keen to recall past hypersensitivity reactions because of their dramatic symptoms. The most common dermatologic problem prompting consultation was lichen simplex chronicus. Although the population size was limited, dermatoses in the Filipino elderly were not uncommon, and they were also subject to the stigmata of aging. Similarities and differences to two American surveys are noted.
FACIAL PYOGENIC GRANULOMA‐LIKE LESIONS UNDER ISOTRETINOIN THERAPY
Authors: HAGLER JOSEPH , HODAK EMMILIA , DAVID MICHAEL , SANDBANK MIRIAM
Published: May 2007

A male patient with severe cystic acne was treated with 13‐cis‐retinoic acid in a dosage of 1 mg/kg/day. Early flare‐up of his acne and multiple pyogenic‐like lesions on his face appeared during the second week of isotretinoin treatment. Histologic study of the lesions revealed granulation tissue. Possible etiologies for this phenomenon are discussed.
BENIGN NEONATAL HEMANGIOMATOSIS
Authors: DYALL‐SMITH DELWYN , COWEN PETER
Published: May 2007

Three neonates with numerous cutaneous hemangiomas are presented. Although all three had serious medical problems, in none of these three could visceral hemangiomas be demonstrated. Neonatal hemangiomas can be restricted to the skin.
LYMPHEDEMA TREATED BY MICROWAVE AND ELASTIC DRESSING
Authors: OHKUMA MORIYA
Published: May 2007

For lymphedema, surgical treatment is contraindicated and other conservative treatments including oral medicine are not sufficient. Treatment with microwave and elastic dressing has been evaluated in 30 cases of lymphedema with 11 control patients who received only one of the two treatments. Twenty‐four patients were effectively treated. In six, edema was not decreased as compared with reduction due to daily physical activity. It was observed that the earlier the patient was treated after onset of edema, the better the results. Six of 10 control patients who received only elastic dressing showed slight decrease in edema. A patient who received only microwave did not show any improvement. There was no recurrence in half of the treated patients. Treatment of lymphedema by microwave and elastic dressing appears satisfactory, particularly when given at an early stage of the disease.
BIOEQUIVALENCE OF TOPICAL CORTICOSTEROIDS: A REGULATORY PERSPECTIVE
Authors: WILLIAMS ROGER L
Published: May 2007

After reviewing the history of generic drug substitution policy in the United States, this paper discusses issues of equivalence as they apply to topical drug products. Documentation of bioequivalence of topical products has been problematic, and current methods are being re‐evaluated by the Food and Drug Administration, The FDA is currently evaluating various extensions of the basic methodology of the Stoughton‐McKenzie vasoconstrictor assay, in order to develop a more comprehensive pharmacodynamic methodology for documenting topical drug bioequivalence. A modern pharmacodynamic model is described, based on nonlinear dose‐response relationship, a baseline effect, and a maximum or plateau effect. The Agency's goal is a bio‐equivalent methodology that will be simple, readily performed, and based on more objective methods of measuring the vasoconstrictor response.
TOPICAL CORTICOSTEROIDS: QUALITY CONTROL CONSIDERATIONS
Authors: SHAH VINOD P.
Published: May 2007

A simple procedure is developed, which can be used as a quality control test. The method utilizes commercially available diffusion cell assembly, synthetic membrane, and an appropriate receptor phase. The amount of drug released over time is determined using an HPLC method. From this, the drug release rate, flux, μg/cm2/min0.5 is calculated. This drug release rate can serve as a good quality control test to assure batch‐to‐batch uniformity.
PEDIULOSIS CAPITIS IN ISTANBUL
Authors: AYDEMIR ERTUǦ;RUL HASBI , ÜNAL GAVE , KUTLAR MELTEM , ONSUN NAHIDE
Published: May 2007

Background. Pediculosis capitis is a worldwide problem. We studied the prevalence of this infestation in Istanbul.

Methods. We reviewed the records of the Dermatology Clinic of istanbul University Cerrahpaşa Medical Faculty from a 20–year period (1970–1989).

Results. The number of cases of pediculosis capitis have gradually increased over this period, with a peak in 1981. Women are more involved than men. There has been a significant increase in cases in children of school and preschool ages.

Conclusions. Many factors may have contributed to this increase: poor hygiene and socioeconomic conditions, lack of medical training, and probably some resistance to pediculicide preparations in the lice. The stigma attached to the disease may prevent people from coming forward.
ERYTHEMA NODOSUM VERSUS NODULAR VASCULITIS
Authors: VICO MARIA‐DOLORES SANZ , DE DIEGO VICTOR , YUS EVARISTO SÁNCHEZ
Published: May 2007

Background. Erythema nodosum (en) is usually considered to be a septal panniculitis, and nodular vasculitis (nv) a lobular panniculitis. We tested the usefulness of this histologic classification in clarifying a frequent clinical dilemma: en versus nv.

Methods. Over 3 years 109 patients with panniculitis were included in this study. After a history and a physical examination, a clinical diagnosis was made according to well‐established criteria.

Results. From the study of 88 patients, we concluded that in the clinically typical cases, the clinico‐pathologic agreement was 93% and 94% for en and nv respectively, whereas it diminished to 79%, 72%, and 67% in the cases clinically diagnosed as en migrans, atypical en, and atypical nv, respectively. Moreover, septal and lobular panniculitis were always two clear‐cut, different, opposite patterns of hypodermal inflammation to these conditions.

Conclusions. In the absence of a known pathogenetic mechanism, the histopathology remains the most objective discriminating marker between en and nv, mainly in the clinically atypical and doubtful cases.
NON‐MELANOMA SKIN CANCER AND KERATOACANTHOMA IN FILIPINOS: AN INCIDENCE REPORT FROM KAUAI, HAWAII
Authors: CHUANG TSU‐YI , REIZNER GEORGE T. , ELPERN DAVID J. , STONE JENNY L. , FARMER EVAN R.
Published: May 2007

Background. Non‐melanoma skin cancer is the most common malignancy in the white population of the United States with an estimated 700,000 new cases each year. Regrettably, data on minority racial groups are either scarce or lacking entirely.

Methods. This study was designed as a 5‐year prospective incidence study of non‐melanoma skin cancer and keratoacanthoma by using an island‐wide survey of Kauai's Filipino residents and covers the years of 1983 to 1987.

Results. Seven basal cell carcinoma (incidence: 12.3/ 100,000), one squamous cell carcinoma (incidence: 1.8/ 100,000) and four keratoacanthoma (incidence: 7/100,000) patients are reported.

Conclusions. To the best of our knowledge, this is the first population‐based incidence report on non‐melanoma skin cancer and keratoacanthoma in this population.
RISK OF CANCER IN RELATIVES OF PATIENTS WITH CUTANEOUS MELANOMA
Authors: OSTLERE LUCY S. , HOULSTON RICHARD S. , LAING JAMES HAMISH E. , RUSTIN GORDON J.S. , RUSTIN MALCOLM H.A.
Published: May 2007

Background. Cutaneous malignant melanoma (CMM) is a recognized feature of the Lynch type II cancer‐family syndrome and the Li‐Fraumeni's syndrome. A significant contribution of these syndromes to the total burden of CMM would be reflected in an increased risk of nonmelanoma cancers in first degree relatives.

Methods. Pedigrees were taken from 85 patients with CMM using a family history questionnaire. The relative risk of death from all cancers and individual cancers in first degree relatives was calculated.

Results. Of the 85 questionnaires, those of 79 patients were completed and of adequate quality for analysis. The first degree relatives of CMM patients showed no increased risk of cancer death, the relative risk of cancer death being 1.0. Six patients (7.6%) had first degree relatives with CMM. One patient had a family history compatible with the dominant transmission of a predisposition to cancer.

Conclusions. It is important to establish whether an increased cancer risk is present in relatives of patients with malignancies so that screening programs may be offered. This study provides little evidence to support seeing relatives for noncutaneous malignancies in the absence of a dominant family history of predisposition to cancers. The increased frequency of CMM in relatives suggests that relatives of CMM patients should be counseled on protection from the sun and examination of the skin for melanoma.
AGGRESSIVE TRICHOEPITHELIOMA VERSUS KERATOTIC BASAL CELL CARCINOMA
Authors: SAN JUAN ELIANA B. , GUANA ADRIANA L. , GOLDBERG LEONARD H. , KOLBUSZ ROBERT V. , ORENGO IDA F. , ALFORD EUGENE
Published: May 2007

A 43‐year‐old white man presented with an infiltrative le‐sion on the left nasolabial fold, which had grown slowly over 15 years. There was a history of moderate sun expo‐sure. Prior history was negative for cutaneous carcinomas. Family history was negative for trichoepithelioma. Physical examination revealed a patient with a fair complexion, blue eyes, light skin, and light brown hair. There was evidence of severe actinic damage manifested by marked solar elas‐tosis of the face. A 1.5 × 1.3 cm infiltrative, depressed, skin‐colored plaque, with elevated pearly borders was noted on the left nasolabial fold. There was nodule formation with superficial ulceration in the center of the lesion (Fig. 1). No other skin tumors were present.

A punch biopsy showed a deeply infiltrating tumor. Sub‐sequently, the tumor was excised by Mohs micrographic surgery in six stages, revealing deep and wide clinically un‐detected invasion into the orbicularis oris, zygomaticus minor, and the levator labii superioris muscles. The final size of the defect was 5.0 × 5.0 cm (Fig. 2). Reconstruction was later performed by otolaryngology with satisfactory results.

Pathological Study: The tumor was composed of multiple islands of basaloid cells embedded in a dense fibrotic stro‐ma. Some islands showed peripheral palisading of their cells (Fig. 3). Other areas contain numerous horn cysts with abrupt and complete keratinization surrounded by basaloid cells (Fig. 4). Areas of calcification and foreign body reac‐tion are present secondary to ruptured cysts. Stromal‐stro‐mal clefting characteristic of trichoepithelioma is seen adjacent to some tumor islands (Fig. 5). The tumor infil‐trates into the underlying muscle (Fig. 6). Stromal muco‐polysaccharide deposition and stromal‐tumor separation as seen in basal cell carcinoma (BCC) were not present.
DESMOPLASTIC TRICHOEPITHELIOMA AND MULTIPLE EPIDERMAL CYSTS
Authors: SUMITHRA SAMBAMURTHY , JAYARAMAN MURYGAIYA , YESUDIAN PATRICK
Published: May 2007

A 22‐year‐old peanut vendor presented with an asympto‐matic annular plaque of 2 years duration on his face. It began as a small, firm papule and gradually increased in size and extent. His occupation involved long hours of ex‐posure to sunshine, but there was no associated burning sensation or irritation.

Dermatologic examination revealed an oval, annular plaque over the right temple, about 4 cm × 3 cm. The rim was studded with miliary white papules 1 to 2 mm in size, and the center was depressed (Fig. 1). It had an indurated feel and was freely mobile over the underlying structures. Clinically, a differential diagnosis of colloid milium, granu‐loma annulare, or annular elastolytic granuloma was enter‐tained. In addition, numerous milia were scattered over the cheeks. He also had multiple, well‐defined, firm, white scro‐tal swellings, 1 to 3 cm in size. Systemic examination did not reveal any abnormality.

Skin biopsies of the plaque and a scrotal cyst were per‐formed, and the sections stained with hematoxylin and eosin. The annular plaque, showed mild hyperplasia of the epidermis, numerous keratin cysts, islands of basophilic cells in the dermis, and abundant fibrous tissue compress‐ing the tumor cells into narrow strands (Fig. 2). Tumor stro‐mal retraction was conspicuous by its absence. A diagnosis of desmoplastic trichoepithelioma was made.

The scrotal nodule revealed an epidermal cyst lined by stratified squamous epithelium and containing laminated keratin (Fig. 3). The patient was referred to the department of plastic surgery, where the plaque was excised in toto, and the defect repaired.
NEHUSHTAN: SIDE EFFECTS OF DRUGS
Authors: GOIHMAN‐YAHR MAURICIO
Published: May 2007

The role of the snake is ambivalent in the Bible. The primeval serpent was instrumental in the exile of Adam and Eve from Eden, but It did not really lie. The fruit of the tree did provide knowledge of good and evil and humankind has been blessed (cursed?) with that knowledge ever since (Gen 3:1–24).