bluuebunny/crossref_metadata_2025 huggingface dataset:
Immunohistological Study of Captopril-Induced Late Cutaneous Eruptions
Authors: Bretin N. , Dreno B. , Bureau B. , Litoux P.
Published: October 2009

Immunohistological study of dermal infiltrate from two pempigus- and one captopril-induced lichenoid eruption showed the presence of a CD8 (T suppressor) infiltrate that resembled that found in skin eruptions induced by graft-versus-host disease. It is suggested that a T cell cytotoxic reaction occurs in the epidermis that might be triggered by captopril-induced modification of keratinocytic antigens
Eruptive Pyogenic Granulomas and Acne fulminans in Two Siblings Treated with Isotretinoin
Authors: Blanc D. , Zultak M. , Wendling D. , Lonchampt F.
Published: October 2009

We report the case of two siblings, one of whom presented isotretinoin-induced eruptive pyogenic granulomas in the course of severe acne, and the other developed isotretinoin-induced acne fulminans. A possible underlying common pathogenic process of these two side-effects of isotretinoin is discussed.
Measurement of Erythema and Tanning Responses in Human Skin Using a Tri-Stimulus Colorimeter
Authors: Seitz John C. , Whitmore Claire G.
Published: October 2009

A ‘Minolta Tri-Stimulus Colorimeter II’ was evaluated for obtaining objective measurements of early changes in erythema and tanning. The meter showed a subtle, continuous transition between the primary erythematous response and the delayed tanning of skin which was below the visual threshold for detection. Thereafter, the a* (redness) value of the meter showed a significant linear correlation with the dermatologist’s perception of erythema while the b* (yellow) value showed a significant correlation with the perception of tanning. This capability of the tri-stimulus colorimeter to simultaneously evaluate the hue and saturation of skin color affords an improved opportunity to quantitate the transition from erythema to tanning without subjective bias.
Efficacy and Tolerance of a Miconazole-Benzoyl Peroxide Cream Combination versus a Benzoyl Peroxide Gel in the Topical Treatment of Acne vulgaris
Authors: Flückiger R. , Furrer H.-J. , Rufli T.
Published: October 2009

62–65% reduction in the number of lesions was obtained in the treatment of 52 patients with acne vulgaris in this randomized single-blind study comparing a 5% benzoyl peroxide/2% miconazole cream (BPO-MCZ) with a 5% benzoyl peroxide gel (BPO). While BPO gel was equally effective in male and female patients (66 and 73% reduction of lesions), the BPO-MCZ cream was significantly more effective in the latter (50 vs. 74% mean reduction of lesions). Tolerance was significantly better with the BPO/MCZ cream preparation, particularly in females.
A Case of Candida albicans Skin Abscess Associated with Intravenous Catheterization
Authors: Mochizuki T. , Urabe Y. , Hirota Y. , Watanabe S. , Shiino A.
Published: October 2009

We report a case of Candida albicans skin abscess, which developed on the left knee of a 59-year-old male, who had been bedridden for the past 2 months because of subarachnoid haemorrhage. The route of the infection was considered to be an intravenous catheter that had been inserted into the left great saphenous vein at the medial malleolus. The prolonged systemic administration of antibiotics and corticosteroids, as well as prostration, were suspected to be the factors that led to the infection. The patient was successfully treated with intravenous miconazole and subsequent high-dose oral amphotericin B therapy.
Familial Aplasia cutis congenita of the Scalp without other Defects in 6 Members of Three Successive Generations
Authors: Itin Peter , Pletscher Martin
Published: October 2009

Six cases of isolated aplasia cutis congenita of the scalp among family members over three successive generations are described suggesting an autosomal dominant inheritance. Five family members were examined in our clinic while one member is abroad. A review of the literature concerning isolated congenital aplasia cutis of the scalp in three or more generations is done.
Randomized Double-Blind Multicenter Study Comparing Acitretin-PUVA, Etretinate-PUVA and Placebo-PUVA in the Treatment of Severe Psoriasis
Authors: Saurat J.-H. , Geiger J.-M. , Amblard P. , Beani J.-C. , Boulanger A. , Claudy A. , Frenk E. , Guilhou J.-J. , Grosshans E. , Mérot Y. , Meynadier J. , Tapernoux B.
Published: October 2009

A randomized double-blind study was designed with 65 patients in order to clarify two points: (1) does addition of a retinoid to psoralen-ultra violet A photochemotherapy (PUVA) of severe psoriasis decrease the UVA energy required to achieve remission, and (2) is there a difference between two retinoids, i.e. etretinate and acitretin. Acitretin-PUVA treatment was significantly superior to placebo-PUVA with respect to several items (decrease in lesional scores after 6 weeks of therapy, number of PUVA exposures, and total dose of UVA until remission). There were also differences between the etretinate-PUVA and placebo-PUVA groups, but only the decrease in lesional scores reached statistical significance.
Paraneoplastic Dermatomyositis in an Adolescent
Authors: Deroo Hilde , De Bersaques Jean , Naeyaert Jean-Marie
Published: October 2009

An 18-year-old adolescent with previous nasopharynx cancer developed dermatomyositis. The evolution was fatal because of metastases. In spite of the young age, we believe this to be a case of paraneoplastic dermatomyositis.
Development of the Performance Measure for Activities of Daily Living-8 for Patients with Congestive Heart Failure: A Preliminary Study
Authors: Shimizu Yuko , Yamada Sumio , Suzuki Makoto , Miyoshi Hiroko , Kono Yuji , Izawa Hideo , Kato Rinya , Murohara Toyoaki
Published: October 2009

Background: Functional limitations often lead to hospitalization, disease progression, and mortality in patients with congestive heart failure (CHF). Functional limitations become a particular problem among older patients. Self-reported questionnaires have been found to be a reliable and accurate methodology for obtaining information on functional limitations. However, current measures have been criticized for their inability to guide therapy on the basis of outcome data and for the lack of specificity of questions related to disease-specific symptoms. Objective: To develop the Performance Measure for Activities of Daily Living-8 (PMADL-8) to assess functional limitations in CHF patients and to provide preliminary data on internal consistency of the PMADL-8, as well as its reliability and validity. Methods: Using the International Classification of Functioning, Disability and Health model, functional limitation questionnaire items to assess difficulty in 8 common daily tasks in CHF patients were developed. The instrument was constructed based on input from a panel of experts and by pilot testing. Its construct and convergent validity, Rasch analysis, internal consistency, and test-retest reliability were evaluated in 50 CHF patients. Discriminative/known-group validity was investigated by comparing 37 elderly CHF patients and 37 age- and sex-matched controls from the general population. Results: Cronbach’s α of the PMADL-8 was 0.94. The intraclass correlation coefficient was 0.96. The PMADL-8 was unidimensional and fitted the Rasch model. Expected differences in the PMADL-8 scores of known-groups show its discriminative/known-group validity. The PMADL-8 had good correlations with the dyspnea (r = 0.77, p < 0.01) and fatigue scores of the Marianna Heart Failure Questionnaire (r = 0.69, p < 0.01) and the New York Heart Association classification (F = 26.7, p < 0.01), demonstrating its convergent validity. Between 2 groups divided by the median scores of PMADL-8, there were significant differences in some disease-specific measures: grip strength, knee extensor muscle strength, and brain natriuretic peptide levels. Conclusion: The PMADL-8 had good internal consistency and test-retest reliability, as well as discriminative and convergent validity in CHF patients. Therefore, the PMADL-8 has the potential to be used to assess disease-specific functional limitations in CHF patients.
Familial Porphyria cutanea tarda in a 7-Year-Old Girl
Authors: Lambert Daniel G. , Beer Françoise , Dalac Sophie , Hourdain Maire-José
Published: October 2009

We report a case of familial porphyria cutanea tarda (FPCT) in a 7-year-old girl. The condition was exacerbated by low dose of hydroxychloroquin, but controled by venesection. The favorable prognosis of FPCT should be further established by long-term prospective studies.
Hidrotic Ectodermal Dysplasia: A Clinical and Ultrastructural Observation
Authors: Ando Yoshihiro , Tanaka Toshihiro , Horiguchi Yuji , lkai Kouichi , Tomono Hitoshi
Published: October 2009

Hidrotic ectodermal dysplasia (HED) was observed in a 49-year-old Japanese man. His clinical signs included alopecia, dystrophic nails and palmoplantar keratoderma, but his teeth, facial appearance and sweating were normal. In his family, 9 members in 5 generations were affected, suggesting that the disorder has an autosomal dominant mode of inheritance. Biopsy specimens of the hyperkeratotic lesions of the palm and sole were studied with an electron microscope. The most prominent feature was the increase of the number of desmosomal discs in the thickened stratum corneum, suggesting that hyperkeratosis observed in HED is due to the delayed desquamation of the stratum corneum.
Presence of Human Papillomavirus DNA in Benign and Precancerous Oral Leukoplakias and Squamous Cell Carcinomas
Authors: Gassenmaier A. , Hornstein O.P.
Published: October 2009

A variety of benign squamous epithelial lesions of the mucosa are associated with human papiUomaviruses (HPV). Recently virus-specific DNA was also detected in oral invasive carcinomas. In sections of 373 formalin-fixed and paraffin-embedded samples taken from benign and precancerous leukoplakias and squamous cell carcinomas, HPV DNA could be identified in 56 specimens by in situ hybridization technique. The biological significance of viruses of the HPV group in the carcinogenesis of oral epithelial lesions is still unknown.
Effects of Widespread Dermatitis and Topical Steroid Therapy on Thyroid Function Tests
Authors: Ormerod A.D. , How J. , Bewsher P.D. , Reid I.W.
Published: October 2009

Five patients with extensive dermatitis and 5 normal subjects were treated with topical betamethasone valerate 0.1% (Betnovate, Glaxo) 19–34 g daily for 4 days. Thyroid functions tests were not affected by the treatment but some patients with widespread inflamed skin demonstrated altered serum thyroid hormone levels as a result of the euthyroid sick syndrome.
Interaction of Phospholipids, Retinoids and PMA with Calcium, Phospholipid-Dependent Protein Kinase-Catalyzed Reaction in Skin
Authors: Kumar Raj , Holian Oksana , Fiedler Virginia C.
Published: October 2009

Previous investigations suggested that a mechanism independent of cAMP may be associated with the action of some retinoids. An alternative pathway involving calcium, phospholipid-dependent protein kinase (C-kinase), was therefore studied. In order to demonstrate this, C-kinase was partially purified from skin of hairless, Balb/c normal and Balb/c nude mouse. Interaction and effects of various response modifiers such as phospholipids, retinoids and phorbol ester tumor promoters showed both major and minor differences among these enzymes. In general, retinal, retinoic acid, 13-cis-retinoic acid and etretinate stimulated skin enzyme activity in the absence of the natural stimulants, phosphatidyl serine and diacylglycerol (DAG). However in their presence the C-kinases were inhibited by retinoids. Our data further indicated that the active retinoids may compete with DAG for binding sites on the enzyme. However, the high concentrations of retinoids needed to elicit these effects suggested a pharmacological role for retinoid action as a result of hydrophobic interaction with lipid domains on the enzyme. These investigations also revealed some of the complexity associated with retinoid effects on C-kinase. Tumor promoter, phorbol-12-myristate 13-acetate (PMA) interacted with its receptor (C-kinase) from hairless and normal mouse skin and stimulated enzyme activity. However, PMA-dependent stimulation of nude mouse C-kinase was about half of that noted with the other two C-kinases. Furthermore, unlike its effect on hairless and Balb/c normal C-kinases, PMA was unable to potentiate the retinoid-stimulated activity of nude mouse skin enzyme. This behavior suggested that nude mouse C-kinase may be a variant form of the normal enzyme. The presence of this variant C-kinase may, therefore, be responsible for the lack of phorbol ester-induced tumor promotion observed earlier in nude mouse skin by other investigators. Endogenous substrate phosphorylation catalyzed by C-kinase from hairless and Balb/c normal mice resulted in 32P incorporation into four target polypeptides of molecular weights 75–78, 47–50, 25–29 and 14–18 kilodaltons. However, with the nude mouse enzyme, only the 75- to 78-kilodalton protein served as the target supporting the suggestion that this may be a variant C-kinase. Neither retinoic acid (10––3M) nor PMA (10––6M) seemed to affect the phosphorylation of any of the four polypeptides. These data seem to suggest that the mechanism of interaction of retinoids with C-kinase may be unrelated to protein phosphorylation reactions in vivo or that the substrates isolated by TCA precipitation may not be the proper ones whose phosphorylation is subject to modulation by retinoids.
Isotretinoin – An Explanation for Its Long-Term Benefit
Authors: Cunliffe W.J. , Norris J.F.B.
Published: October 2009

Isotretinoin is of undisputed benefit in the treatment of acne. In doses of 1 mg/kg/day for 4 months the drug produces a highly significant reduction in sebum excretion rate (90 ± 3%) in comedone formation as measured by assessing follicular casts (70 ± 5 %), and in surface Propionibacterium acnes. However, the mechanisms of long-term clinical remission are not well understood. There are however, risk factors which predetermine the outcome to treatment with isotretinoin. Younger subjects (14–19 years) and those who have had acne for less than 6 years, respond less well than older subjects. Subjects with more truncal acne also fare less well than those with predominantly facial acne. A return of the reduced sebum excretion rate to within lO% of the pre-treatment level also is a poor prognostic factor. This and future studies could lead to development of more logical dose regimes depending, for example, on the age of the patient; duration of acne and its site. However, until proven otherwise, this study confirms our earlier data, and that of the German multi-centres and Strauss et al (1), that the optimum dose schedule for treating acne patients is 1 mg/kg/day regime.
Long-Term Retinoid Therapy Is Needed for Maintenance of Cancer Chemopreventive Effect
Authors: Peck Gary L.
Published: October 2009

Two patients with multiple basal cell carcinomas, due either to the nevoid basal cell carcinoma syndrome (NBCCS) or arsenical insecticide exposure, were treated with oral isotretinoin for 7 or 8 years, respectively. Gradually decreasing dosage levels were employed. During the initial courses of therapy, high doses (2.0–3.0 mg/kg/day) were intended as chemotherapy. In these patients only 6 of 40 (15%) lesions underwent complete clinical regression. In subsequent courses aimed at chemoprevention, the dose was progressively reduced from 1.5 to 0.25 mg/kg/day. During therapy, no new lesions were observed in the patient with the arsenical exposure. The NBCCS patient developed 1 new lesion during therapy at 1.0 mg/kg/day, 1 new lesion at 0.5 mg/kg/day and 5 new lesions at 0.25 mg/kg/day. Treatment was discontinued and the patient with the arsenic exposure developed his first new tumor 17 months afterwards; in contrast, the NBCCS patient developed 29 tumors within 13 months. These findings suggest that long-term therapy with isotretinoin is needed for the continuation of the cancer chemopreventive effect. However, the need for continuous rather than intermittent maintenance therapy, and the determination of the optimal dose for this purpose may depend on the etiology of the multiple carcinomas and on the tolerability of the lowest effective dose by the individual patient. With these encouraging data, it now appears appropriate to expand this pilot study and perform larger trials to dertermine the usefulness of isotretinoin in the chemoprevention of basal cell carcinoma in patients with multiple tumors.
Junctional Epidermolysis bullosa with Urethral Stricture
Authors: Ichiki Mikio , Kasada Mamoru , Hachisuka Hiroshi , Sasai Yoichiro
Published: October 2009

We present a case of junctional epidermolysis bullosa (EB) associated with urethral tract involvement. He was a 27-year-old man who had symblepharon of the right eye, hoarseness and urethral stricture in addition to generalized blister formation. Ultrastructural examination of a biopsy skin specimen demonstrated the characteristic morphology of junctional epidermolysis, a form of EB that has not been previously associated with urethral stricture.
Annular Elastolytic Giant Cell Granuloma Occurring in Covered Areas
Authors: Ishibashi Akira , Yokoyama Aiko , Hirano Kyoko
Published: October 2009

A 72-year-old male had 7 erythematous infiltrated areas of 3–7 cm in diameter on the sun-unexposed areas, i.e., the chest, abdomen and inguinal region. While the centers of the lesions were flat and slightly reddish or normal skin-colored, the margins were flesh-colored and elevated, and the lesions were generally annular or of letter C form. An old lesion on the nucha was depigmented, slightly depressed and soft on palpation. Histological sections revealed giant cell granuloma with loss of elastic fibers.
Symmetrical Peripheral Gangrene in Disseminated Tuberculosis
Authors: Itin Peter , Stalder Hans , Vischer Wolfgang
Published: October 2009

We report the case of a 66-year-old man who developed a symmetrical peripheral gangrene (SPG) on both feet during disseminated miliary tuberculosis. Mycobacterium tuberculosis was not only isolated from sputum, gastric juice, and urine, but also from a blood culture. Since a disseminated intravascular coagulopathy was very likely to be excluded, it is possible that the SPG was due to embolization of arterioles by the tubercle bacilli. The literature of SPG is reviewed and the different possible pathogenic mechanisms of SPG, such as hypoxemia, vasoconstriction, primary endothelial damage, and vascular obstruction, are discussed. SPG is another cutaneous manifestation of disseminated tuberculosis.
Irritant Potential of Dithranol
Authors: Haustein Uwe-F. , Lohrisch Ingo
Published: October 2009

The minimal irritation dose (MID) for dithranol in 5% salicylic acid vaseline was determined by open patch testing. From the MID, the irritation dose 50 (ID50) was evaluated. It was 0.057% in 100 controls and 0.046% in 100 psoriatic patients, which is not statistically different due to the great differences between individuals. 20 other patients claimed a dithranol hyperreactivity in their history. Only 13 of them, however, showed a decrease in the MID, which was between 0.01 and 0.02% (x = 0.014%), i.e. outside the confidence interval found in the 100 psoriatic patients. 8 of these 13 reacted with blister formation after exposure to 0.1–0.16% dithranol. An allergic contact dermatitis was excluded as the cause of the hyperreactivity. The tolerance to increasing dithranol concentrations after beginning with the MID up to clearance of the lesions, as well as the predominance of granulocytes as compared to lymphocytes in blisters due to dithranol testing, suggest an irritant inflammatory mechanism. In such hyperreactive cases therapy should be started with the MID established in the open patch test.
Pseudopelade of Brocq
Authors: Braun-Falco Otto , Imai Seiji , Schmoeckel Christian , Steger Oskar , Bergner Thomas
Published: October 2009

41 cases with scarring alopecia seen from 1979 to 1983 were analyzed and differentiated. After exclusion of 7 cases with lichen planopilaris, of 5 cases with discoid lupus erythematosus, of 2 cases with scleroderma, and of 1 case with folliculitis decalvans, there remained 26 cases. The clinical histological and direct immunofiuorescence (DIF) findings in these patients suggest that pseudopelade of Brocq might be a distinct disease unrelated to other known types of scarring alopecia. The histopathology is characteristic, and shows the following features: little or only moderate lymphocytic infiltrate, absence of significant follicular plugging, and absence or decrease of sebaceous glands. DIF is negative, occasionally only IgM can be found at the basement membrane. The course of the disease is slowly progressive (in spite of little or no visible erythema), becoming eventually stationary after several years and resulting in a more or less severe permanent hair loss.
Merkel Cells Do Not Express Bullous Pemphigoid Antigen
Authors: Mérot Yves , Carraux Pierre , Didierjean Liliane , Saurat Jean-Hilaire
Published: October 2009

Merkel cells (MC) are epithelial cells expressing cytokeratin-type intermediate filaments. They often are localized within the basal cell layer of the epidermis. Since basal cell layer keratinocytes synthetize basal membrane components, it was of interest to investigate whether or not MC could also do so. We used both double-labeling immunofluorescence and immune electron microscopy techniques with a panel of antibodies allowing the identification of MC as well as the staining of basal membrane zone components (including bullous pemphigoid antigen, laminin, type IV collagen and epidermolysis bullosa antigen). A specific loss of BP antigen expression was observed below all MC directly in contact with BMZ. This suggests that, although being an epithelial cell and in contrast to basal keratinocytes, MC does not secrete BP antigens.
Prednisolone Pulse Therapy for Childhood Systemic Lupus erythematosus with Prominent Dermatomyositis
Authors: Wollina U. , Schreiber G.
Published: October 2009

A 10-year-old boy with systemic lupus erythematosus exhibiting prominent features of dermatomyositis has been treated with 600 mg prednisolone intravenously per day on 3 consecutive days. Clinical and serologic improvement started after the first course of pulse therapy, and was remarkable during a second course. Basic treatment using oral prednisolone is recommended.
Erythema multiforme (Stevens-Johnson Syndrome) – Chart Review of 123 Hospitalized Patients
Authors: Nethercott James R. , Choi Bernard C.K.
Published: October 2009

The charts of 123 patients hospitalized with erythema multiforme were reviewed. Antecedent infections and the administration of drugs were associated with 15 and 32% of the cases, respectively. Pyrexia arthralgia, photosensitivity, abnormal liver function tests and abnormal urine sediment were common findings. The length of stay in hospital was 12.6 ± 0.7 days (mean ± SE), time to initial improvement after onset was 10.3 ± 0.6 days and time to complete resolution was 23.0 ± 2.4 days. The presence of bullous skin lesions and greater overall severity were associated with longer hospitalization. Antecedent respiratory tract symptoms were related to shorter hospitalization. Steroid therapy was not associated with a shorter time for initial improvement to occur, while the average length of stay in hospital was 4.2 days longer than that for the patients not treated with corticosteroid.
Xanthomes plans normolipémiques et myélome IgGĸ à activité anti-lipoprotéine
Authors: Doutre M.S. , Conri C. , Beylot C. , Fleury B. , Chapoulard H. , Bioulac P.
Published: October 2009

Clinicopathologic findings are reported of a woman with plane xanthomatosis, multiple myeloma (IgGĸ) and normolipemia. Plasma lipoproteins were bound to the monoclonal immunoglobulin. The complex was separated by ultracentrifugation, then the proteins were measured by radial immunodiffusion and laser immunonephelometry. Monoclonal IgGĸ interact with the low-density lipoproteins. The literature about the association between normolipemic or hyperlipemic xanthomatosis and myeloma was reviewed and the physiopathology of this association discussed. Several hypotheses are suggested but, at present, it is shown that lipoprotein-paraprotein complexing in some patients may be due to autoantibody activity of the myeloma protein against serum lipoprotein; immune complexes interfere with normal lipoprotein catabolism resulting in xanthomas and normolipemia or hyperlipemia.
Micropapular Sarcoidosis Simulating Lichen nitidus
Authors: Okamoto Hiroyuki , Horio Takeshi , Izumi Takateru
Published: October 2009

A 28-year-old woman with sarcoidosis had miliary, skin-colored papules localized on the upper back. The lesions closely simulated lichen nitidus. Histologic examination of the papule demonstrated the naked granuloma encircled by epidermal collarettes in the papillary dermis. Therefore, the microscopic reaction pattern also resembled those of lichen nitidus. This case is a unique form of micropapular sarcoidosis in respect to the clinical appearance and microscopic changes.
T-Cell Subsets in Acne rosacea Lesions and the Possible Role of Demodex folliculorum
Authors: Rufli T. , Büchner S.A.
Published: October 2009

Skin biopsy specimens from 4 patients with typical acne rosacea lesions were examined for the presence of T-cell subsets using monoclonal antibodies. The infiltrates consisted chiefly of LEU-1 reactive T cells with a predominance of LEU-3a antibody positive helper-inducer T cells, while LEU-2a staining suppressor-cytotoxic T cells were scarce. These cells penetrated regularly into the follicular wall and the epidermis. The study showed that most T cells in the dermal granulomatous infiltrates around Demodex parts, which were displaced extrafoUicularly, were helper-inducer T cells. The predominance of helper-inducer T-cell subsets in the dermal infiltrates of acne rosacea lesions in frequent association with Demodex supports the hypothesis that a cell-mediated immune response plays an important role in the pathogenesis of rosacea.
Bluefarb-Stewart Syndrome – Report of a New Case
Authors: Aiessi Elvio , Sala Francesco
Published: October 2009

Cutaneous lesions resembling Kaposi’s sarcoma may develop on legs and feet of patients with acral arteriovenous malformation. A case of this rare syndrome is reported and the main features of the·17 published cases are summarized in a table.
Papuloerythroderma
Authors: Ofuji Shigeo , Furukawa Fukumi , Miyachi Yoshiki , Ohno Sayoko
Published: October 2009

The main macroscopic features of 4 cases presented here are erythroderma-like lesions and solid papules. The former covers extensive areas over entire trunk and extremities, especially extensor surfaces. The latter is observed mainly on flexor surfaces of extremities and around the former. The axillae, inguinal regions, cubital and popliteal fossae, and big furrows on abdomen are spared from these lesions. Rashes appear first as papules and form erythroderma-like lesions through their assembly and confluence. Histologically, both show almost the same findings. Patients are older males with no general symptoms except itching. Although the course is chronic, lesions improve slowly and heal only after years.
Assessment of In Vivo Activity of Bifonazole against Dermatophytic Infection in Guinea Pigs on the Basis of the Amount of a Specific Fungal Cell Wall Component Chitin in the Infected Skin
Authors: Uchida K. , Yamaguchi H.
Published: October 2009

The severity of experimental dermal infection with Trichophyton mentagrophytes in guinea pigs with or without receiving topical treatment with 1% creams of bifonazole1 or clotrimazole1 were estimated on the basis of fungal chitin content in the infected tissue. This criterion was favorably comparable with that based on local symptoms and, therefore, proved to be useful as a more objective and quantitative measure for assessment of therapeutic efficacy of such antifungal agents in the animal model of dermatophytosis.
Non-Traumatic Removal of the Nail and Simultaneous Treatment of Onychomycosis
Authors: Nolting S.
Published: October 2009

There are no doubt a great many therapeutic recommendations for the treatment of onychomycoses. However, as so often, it soon becomes evident that the number of therapeutic regimens appear to indicate a wide range of therapeutic possibilities, but the rates of cure actually achieved are in complete contrast to these. The prerequisite for treatment is the identification of the causative fungi on direct microscopic examination and in culture to avoid the use of antifungals in changes of the nails other than onychomycoses. Another very important prerequisite for systematic treatment is the removal of as much fungus-infected nail material as possible, or else bioavailability at the site of infection cannot, or only hardly, be guaranteed. In our investigations into the treatment of onychomycosis we studied the use of bifonazole1 (1%)-urea ointment and the therapeutic possibilities in connection with its application.
Dermatophyte Infections in Hereditary Palmo-Plantar Keratoderma
Authors: Gamborg Nielsen P.
Published: October 2009

The frequency of dermatophyte infections in hereditary palmo-plantar keratoderma (HPPK) of the Unna-Thost variety was investigated in 280 patients admitted to the Department of Dermatology, Central Hospital, Boden, during 1977–1981, and was found to be 35.0%. The distribution of fungi did not differ from that found for the total number of dermatophytes. An almost complete therapeutical resistance was found especially in Trichophyton rubrum infections, when patients were treated with micronized griseofulvin and topical econazole cream. Treatment of dermatophyte infections in HPPK with 50% propylene glycol in distilled water gave poor results but when 1% econazole nitrate was added negative cultures were found in 86.4% of the patients treated for 3 weeks.
An Evaluation of PUVA-Therapy for Alopecia areata
Authors: van der Schaar W.W. , Sillevis Smitt J.H.
Published: October 2009

30 patients with alopecia areata were treated with 8-methoxypsoralen orally combined with whole body UVA exposure. 9 patients showed more than 60% regrowth of hair, 8 of them had recurrences of hair loss within a mean time of 7.7 months. No selecting criteria could be found prophesying good results of PUVA therapy.
Functional Studies of Sessile Macrophages in Liver and Spleen of Psoriatics
Authors: Altmeyer P. , Munz D. , Holzmann H. , Hör G.
Published: October 2009

In 24 psoriatics of either sex aged between 22 and 84 years, functional analysis of sessile macrophages in liver and spleen revealed an accelerated metabolic elimination of Tc-99m labeled human serum albumin millimicrospheres. In psoriatics treated with aromatic retinoid, macrophage activity in liver and spleen was found to be normalized compared to the group of systemically nontreated psoriatics. 3 psoriatics with cirrhosis of the liver demonstrated an unequivocally delayed tracer accumulation in liver and splenic macrophages, the former showing decelerated phagocytosis and proteolysis of ingested albumin particles. The method used allows measuring of phagocytic and proteolytic properties of tissue-fixed macrophages in psoriatics as well as assessing the therapeutic effects of systemically administered drugs on macrophage functions.
Electron-Microscopic Changes in Xerosis senilis Epidermis
Authors: Tezuka Tadashi
Published: October 2009

Skin specimens of patients with xerosis senilis were examined electron microscopically. The changes were as follows: (1) The electron density of the stratum corneum was uniformly low and no keratin pattern was observed in the lowermost cells of the stratum corneum. (2) The number of keratohyalin granules was decreased but their electron density was normal. (3) There were no lamellate membrane-coating granules formed in the cells of the stratum granulosum and there were many small vesicles which were similar in size and shape to membrane-coating granules, but lacked a lamellate internal structure. This abnormal vesicle formation occurred in the epidermis of the same xerosis senilis patients both in winter and summer. This observation indicates that the change in the formation of membrane-coating granules could be an age-dependent disorder of the differentiation of keratinocytes.(4) Being accompanied by an age-related reduction in lipid production, the deficient formation of membrane-coating granules leads to the disappearance of the lipid film which surrounds the stratum corneum cells. This and the reduction in the surface lipid originating in the sebaceous glands could result in an increase in transepidermal water loss leading to the asteatotic scaly stratum corneum seen in the skin of patients with xerosis senilis in winter.
Buschke-Ollendorf Syndrome
Authors: Reymond J.L. , Stoebner P. , Beani J.C. , Amblard P.
Published: October 2009

Two identical twins with the Buschke-Ollendorf syndrome (dermatofibrosis lenticularis disseminata with osteopoikilosis) are described. Ultrastructurally elastic fibers show clumps of electron-lucent elastin material coated with fine fibrils. The fibroblasts show enlarged endoplasmic reticulum containing abnormal fibrillar material. Juvenile elastoma seems to be a better term than dermatofibrosis. The pathogenesis of the elastic defect is discussed.
Sclérose systémique progressive et cancer pulmonaire: à propos d’un cas
Authors: Platteau M. , Knitelius A.C. , Grupper C. , Achten G.
Published: October 2009

We report a case of progressive systemic sclerosis associated with bronchoalveolar cell carcinoma. The frequency of this association has been reviewed in the literature: the frequencies of various types of malignancies with progressive systemic sclerosis vary according to the methods for collecting cases.
Evolution des facteurs d’eczéma de contact dans une population
Authors: Brun Robert
Published: October 2009

Comparative results between positive patch tests found during the periods 1968–1974 and 1975–1981 are presented. The number of sensitised patients to nickel, chromate and Peru balsam has significantly increased. On the other hand, the number of turpentine-oil-positive patch tests has strongly decreased. This mirrors the drop in the imported quantities of this product. A schema concerning factors influencing the apparent allergenicity is given.
Oral Treatment of Acne vulgaris and Oil Acne with Tetracycline
Authors: Czernielewski Antoni , Skwarczyńska-Banyś Ewa
Published: October 2009

In 51 patients with acne vulgaris and 34 patients suffering from occupational oil acne the clinical effect of orally administered tetracycline was evaluated before, during and after a 3-monthly treatment (total dose of antibiotic: 1st month, 28.5 g; 2nd and 3rd months, 15.0 g). Patients treated with placebo were used as controls. Investigations of the skin fluorescence under Wood’s light were performed during the treatment period. In one half of the patients with acne vulgaris and oil acne oral treatment with tetracycline had a very good clinical effect. The purpose of this investigation was the comparison of the results of the treatment of acne vulgaris and occupational oil acne with tetracycline.
Human Ia-Like-Antigen-Expressed Cutaneous T Cell Lymphoma Associated with Epstein-Barr Virus Infection
Authors: Furukawa Fukumi , Oguchi Motoi , Hashimoto Momoyo , Ohkawa Susumu , Ozaki Motoaki , Imamura Sadao
Published: October 2009

2 cases of cutaneous T cell lymphoma are reported. In both cases immunological studies revealed that the tumor cells from the cutaneous lesions had human Ia-like antigen on the cell surface, which was considered to be alloantigen primarily present on B lymphocytes. Serum examination showed an extremely high titer of two types of antibody against Epstein-Barr (EB) virus in the 1 st case and a relatively high titer of one type of antibody in the 2nd case, suggesting that the patients had EB virus infection. Recently, some hematologists found the significant correlation of T lymphocytosis and the appearance of human Ia-like antigen in infectious mononucleosis. Based on these findings, it is assumed that EB virus has the ability of the immunological transformation of cutaneous neoplastic lymphocytes, and so we should not overlook the susceptibility of phenotypical changes of the original cell by EB virus when the immunological classification of cutaneous malignant lymphoma is done.
Localized Pustular Vasculitis in Rheumatoid Arthritis
Authors: Miyachi Yoshiki , Ikehata Chikako , Imamura Sadao
Published: October 2009

This report describes a case of sterile pustulosis accompanied by underlying leukocytoclastic vasculitis which occurred in the absence of apparent infection or drug allergy on the lower legs of a 46-year-old housewife with 10 years’ duration of rheumatoid arthritis. Histamine-induced vascular changes studied by immunofluorescence microscopy demonstrated a perivascular C3 deposition suggesting the presence of immune complexes. We speculate that some unknown triggers have induced trapping circulating immune complexes of this rheumatoid patient, probably an immunopathogenetic factor of rheumatoid arthritis, with subsequent vascular inflammation producing a localized form of pustular vasculitis.
Plasma Zinc Concentration in Palmoplantar Pustulosis
Authors: Thune Per
Published: October 2009

In 18 ambulant patients with palmoplantar pustulosis low plasma zinc concentrations were observed. During treatment with an all-trans aromatic retinoid (RO-10-9359) the values increased while at the same time the skin condition improved in particular with regard to the pustule formation. The observed low plasma zinc values may in some way be related to pustulosis but not as causal factor.
Effects of Intravenous and Intracutaneous Bacillus Calmette-Guérin Application on the Drug-Metabolizing System of the Liver
Authors: Ruzicka Thomas , Goerz Günter , Vizethum Wolfgang , Kratka Josef
Published: October 2009

Both single intravenous and repeated intracutaneous injections of bacillus Calmette-Guérin (BCG) resulted in alteration of the hepatic microsomal drug-metabolizing enzymes of the rat liver. The cytochrome P-450 content was not significantly altered; its activity (ethoxycoumarin O-dealkylation) was inhibited in both the intravenous and intracutaneous group. The arylhydrocarbon-hydroxylase and aminopyrine-demethylase activities were also diminished; decrease of cytochrome-c-reductase activity was noted after intravenous application only. Comparison of the results for the intravenous and intracutaneous application routes respectively showed qualitative and quantitative differences. The inhibitory effects of BCG treatment on the drug-metabolizing enzymes of the rat liver can only partly be explained by changes in the cytochrome P-450 system. These findings might lead to reconsideration of dosage of drugs in cancer (malignant melanoma) patients treated by combined chemoimmunotherapy.
Pustulosis Palmoplantaris and Its Relation to Chronic Recurrent Multifocal Osteomyelitis
Authors: Bergdahl K. , Björkstén B. , Gustavson K.H. , Lidén S. , Probst F.
Published: October 2009

In a previous study we found that clavicular lesions in chronic recurrent multifocal osteomyelitis (CRMO) in young patients was associated with palmoplantar pustulosis (PPP). In this work the relationship between sternoclavicular lesions and PPP was studied in a group of adult patients. The sternoclavicular region of 52 patients with PPP and 25 control persons was examined by tomography. Among the PPP patients there were inflammatory lesions in the sternal synchondroses in 3 patients. There were no such lesions in the controls. In this unselected population of adult patients there was thus no definite association between PPP and sterno-clavicular lesions. In young patients on the other hand, CRMO with clavicular lesions may be another, probably noninfectious, cause of PPP.
A Case of Multiple Neonatal Haemangiomatosis Successfully Treated by Systemic Corticosteroids
Authors: Clemmensen O.
Published: October 2009

A case of multiple neonatal haemangiomatosis is reported. The disease entity is rare and probably always combined with haemangiomas of internal organs. When visceral involvement provokes clinical symptoms (cardiac, cerebral, gastrointestinal), the spontaneous course often proves fatal. The prognosis seems to improve substantially if treatment with systemic corticosteroids is instituted. The patient reported, who had concomitant cardiac and gastrointestinal symptoms, recovered completely following corticosteroid treatment. It is concluded that steroid treatment is indicated without hazards in complicated cases of multiple neonatal haemangiomatosis.
Severe Psoriasis – Oral Therapy with a New Retinoid
Authors: Fredriksson T. , Pettersson U.
Published: October 2009

Ro 10–9359 is a retinoic acid derivative, selected for study because of a better tolerance than retinoic acid, shown in animal experiments. Doses of 25 mg b.i.d., 25 mg t.i.d. and 50 mg b.i.d. were administered orally to 27 patients suffering from severe chronic generalized psoriasis. The clinical efficacy was evaluated by means of a new index, psoriasis area and severity index (PASI) based on severity and area of psoriatic lesions. At doses of 25 mg t.i.d. or 50 mg b.i.d. Ro 10–9359 proved to be an extremely potent antipsoriatic drug. A more than 90% reduction of psoriatic lesions could be seen in 10 patients out of 20 after 4–8 weeks of treatment. This good effect lasted about 5 weeks after treatment. Side effects were frequent, but mostly mild and completely reversible after termination of treatment.
Diabetes Duration Is Associated With Increased Thin-Cap Fibroatheroma Detected by Intravascular Ultrasound With Virtual Histology
Authors: Lindsey Jason B. , House John A. , Kennedy Kevin F. , Marso Steven P.
Published: October 2009

Background—

Coronary plaque classified as thin-cap fibroatheroma (TCFA) is believed to be associated with plaque rupture and coronary heart disease–related events. Although an association between duration of diabetes and increased coronary heart disease risk has been demonstrated, the relationship between TCFA and diabetes duration is unknown.

Methods and Results—

Prospective registry of diabetic patients undergoing diagnostic coronary angiography and intravascular ultrasound (IVUS) enrolled in a diabetic gene and biomarker banking registry. Plaque composition in the most diseased 10-mm segment of a single coronary artery was assessed using IVUS virtual histology and was classified by phenotype as IVUS-defined adaptive intimal thickening, pathological intimal thickening, TCFA, fibroatheroma, or fibrocalcific. Patients (n=54) were stratified by duration of diabetes (<10 or ≥10 years). Patients with diabetes ≥10 years were older, less likely to have a history of tobacco use, had higher total cholesterol levels, and were more likely to be treated with insulin compared with patients with diabetes <10 years. Longer duration of diabetes was associated with greater plaque burden in the most diseased 10-mm segment (60.4% [53.4% to 66.8%] versus 50.2% [47.7% to 58.4%],
P
=0.008). The proportion of IVUS-defined TCFA in the ≥10-year group was greater than the <10-year group (54.4% [11.6% to 77.5%] versus 10.8% [0.0% to 26.1%],
P
=0.009). This association persisted after adjustment for multiple comparisons, clinical characteristics, and diabetes treatment.

Conclusions—

In this cohort, longer duration of diabetes was associated with IVUS-defined TCFA, a plaque phenotype associated with risk of rupture and coronary heart disease events.

Clinical Trial Registration—

URL: http://www.clinicaltrials.gov. Unique identifier: NCT00428961.
Atrial Arrhythmias in Adults With Congenital Heart Disease
Authors: Bouchardy Judith , Therrien Judith , Pilote Louise , Ionescu-Ittu Raluca , Martucci Giuseppe , Bottega Natalie , Marelli Ariane J.
Published: October 2009

Background—

Atrial arrhythmias increase disease burden in the general adult population. Adults with congenital heart lesions constitute a rapidly growing group of patients with cardiovascular disease. We hypothesized that atrial arrhythmias increase with age and impair health outcomes in this population.

Methods and Results—

We conducted a population-based analysis of prevalence, lifetime risk, mortality, and morbidity associated with atrial arrhythmias in adults with congenital heart disease from l983 to 2005. In 38 428 adults with congenital heart disease in 2005, 5812 had atrial arrhythmias. Overall, the 20-year risk of developing atrial arrhythmia was 7% in a 20-year-old subject and 38% in a 50-year-old subject. More than 50% of patients with severe congenital heart disease reaching age 18 years developed atrial arrhythmias by age 65 years. In patients with congenital heart disease, the hazard ratio of any adverse event in those with atrial arrhythmias compared with those without was 2.50 (95% confidence interval, 2.38 to 2.62;
P
<0.0001), with a near 50% increase in mortality (hazard ratio, 1.47; 95% confidence interval, 1.37 to 1.58;
P
<0.001), more than double the risk of morbidity (stroke or heart failure) (hazard ratio, 2.21; 95% confidence interval, 2.07 to 2.36;
P
<0.001), and 3 times the risk of cardiac interventions (hazard ratio, 3.00; 95% confidence interval, 2.81 to 3.20;
P
<0.001).

Conclusions—

Atrial arrhythmias occurred in 15% of adults with congenital heart disease. The lifetime incidence increased steadily with age and was associated with a doubling of the risk of adverse events. An increase in resource allocation should be anticipated to deal with this increasing burden.
Would Accountability Based on Teacher Value Added Be Smart Policy? An Examination of the Statistical Properties and Policy Alternatives
Authors: Harris Douglas N.
Published: October 2009

Annual student testing may make it possible to measure the contributions to student achievement made by individual teachers. But would these “teacher value-added” measures help to improve student achievement? I consider the statistical validity, purposes, and costs of teacher value-added policies. Many of the key assumptions of teacher value added are rejected by empirical evidence. However, the assumption violations may not be severe, and value-added measures still seem to contain useful information. I also compare teacher value-added accountability with three main policy alternatives: teacher credentials, school value-added accountability, and formative uses of test data. I argue that using teacher value-added measures is likely to increase student achievement more efficiently than a teacher credentials-only strategy but may not be the most cost-effective policy overall. Resolving this issue will require a new research and policy agenda that goes beyond analysis of assumptions and statistical properties and focuses on the effects of actual policy alternatives.
Exploring Student-Teacher Interactions in Longitudinal Achievement Data
Authors: Lockwood J. R. , McCaffrey Daniel F.
Published: October 2009

This article develops a model for longitudinal student achievement data designed to estimate heterogeneity in teacher effects across students of different achievement levels. The model specifies interactions between teacher effects and students' predicted scores on a test, estimating both average effects of individual teachers and interaction terms indicating whether individual teachers are differentially effective with students of different predicted scores. Using various longitudinal data sources, we find evidence of these interactions that is of relatively consistent but modest magnitude across different contexts, accounting for about 10 percent of the total variation in teacher effects across all students. However, the amount that the interactions matter in practice depends on the heterogeneity of the groups of students taught by different teachers. Using empirical estimates of the heterogeneity of students across teachers, we find that the interactions account for about 3–4 percent of total variation in teacher effects on different classes, with somewhat larger values in middle school mathematics. Our findings suggest that ignoring these interactions is not likely to introduce appreciable bias in estimated teacher effects for most teachers in most settings. The results of this study should be of interest to policy makers concerned about the validity of value-added teacher effect estimates.