bluuebunny/crossref_metadata_2025_split huggingface dataset:
Erythema Gyratum Repens Associated with Transitional Cell Carcinoma of the Bladder
Authors: Li Lian-Jie , Weinberg Jeffrey M. , Tangoren Ibrahim A. , Sleater Joseph P. , Klein Lynn M. 
Published: July 2017

Background: Erythema gyratum repens (EGR) is a gyrate erythema found in association with underlying malignancy, most commonly that of the lung, esophagus, and breast. Since 1952, there have been 51 cases of this condition reported. Objective: Only one case of EGR associated with transitional cell carcinoma of the bladder (TCCB) has been previously reported. Methods: The second case of EGR is the subject of a case report presentation. Results: An elderly patient presented with EGR and subsequent work-up revealed the presence of malignancy of the bladder. Conclusion: Erythema gyratum repens can be found in association with a variety of malignancies, including TCCB.
Follicular Lymphoma with Widespread Skin Lesions and Chromosome 14;18 Translocation in the Skin
Authors: Ho Vincent C. , Almofadhi Ali , Tron Victor A. 
Published: July 2017

Background: We report a case of systemic follicular B-cell lymphoma presenting with widespread skin lesions. Objective: The clinical features, histology, and treatment of primary and secondary cutaneous follicular lymphomas are discussed. Conclusion: The demonstration of chromosome 14; 18 translocation in the skin that is commonly found in primary, but rare in secondary, cutaneous follicular lymphoma can be helpful in confirming the diagnosis.
True Electrocautery in the Treatment of Syringomas and other Benign Cutaneous Lesions
Authors: Langtry James A.A. , Carruthers Alastair 
Published: July 2017

Background: A number of methods to treat benign cutaneous lesions are available, including surgical excision, electrosurgery, chemical cauterizing agents, cryotherapy, and carbon dioxide laser vaporization. Electrocautery has been used for more than a century and is in danger of becoming a forgotten treatment modality. Objective: The aim of this review is to describe the procedure of electrocautery and bring attention to this treatment method. Methods: The principles of electrocautery and our experience in selected cases are reviewed. Results: Excellent results were achieved using electrocautery to treat syringomas, linear epidermal nevus, and dermatosis papulosa nigra. Conclusion: Electrocautery is a useful technique for treating selected benign cutaneous lesions and should not be discarded in the rush to embrace new technologies.
Idiopathic Atrophoderma of Pasini and Pierini
Authors: Braun Alicia , Poulton James , Kauffman C. Lisa 
Published: July 2017

Background: Idiopathic atrophoderma of Pasini and Pierini (LAPP) is a rare pattern of dermal atrophy, with less than 300 cases reported worldwide. Currently, there is controversy surrounding the classification of LAPP; some consider it to be a variant of morphea, while others view it as a separate disease entity. Objective: Our purpose was to further elucidate the nature and course of this unusual disease. Methods: We present a case report, with long-term follow-up of a case of IAPP of 30 years' duration. Results: The patient's lesions were primarily atrophic, without progression to morphea, scleroderma, or other systemic disease. Biopsy of a long-standing plaque demonstrated dermal thinning, and minimal dermal infiltrate. Conclusion: This case supports the findings of the literature on this subject: the majority of patients with IAPP have an entirely benign course, without progression to other disease.
Genetic Studies in Skin Disease Research: Flare-up of Psoriasis Genes
Authors: Bale Sherri J. 
Published: July 2017

Background: The chromosomal location of several genes for familial psoriasis has recently been reported. Objective: This article reviews these recent reports of genetic linkages in psoriasis. Methods: An explanation and discussion of the type of family material studied and the statistical approaches used are presented. Results: Linkage of psoriasis-susceptibility loci have been reported on chromosomes 17, 4, and 6. Conclusion: Due to genetic heterogeneity and decreased penetrance, confirmation of reported genetic linkages is likely to be difficult. The use of single, large families in which many members are affected with psoriasis may yield the most information.
Lymphoid Markers, Activation Markers, and Adhesion Molecules in Cutaneous Biopsy Specimens from HIV+ Patients with Disease Progression
Authors: Smith Kathleen J. , Skelton Henry G. , Yeager Josef , Baxter Donald , Nelson Ann T. , Angritt Peter , Chu Wei-Sing , Wagner Kenneth F ,   Military Medical Consortium for the Advancement of Retroviral Research
Published: July 2017

Background: One important factor in understanding the pathogenesis of human immune deficiency virus (HIV) disease is documenting the patterns of immune dysregulation present in HIV-positive patients. The cells which home to skin are mainly certain subsets of T cells and, as opposed to the peripheral blood, where circulating factors may inhibit terminal phenotypic differentiation, the cutaneous environment potentiates differentiation during cutaneous eruptions. Objective: The authors' aim was to characterize the inflammatory dermatoses in biopsy specimens from HIV-positive patients with immunohistochemical stains for lymphoid markers, activation markers, and adhesion molecules and to determine if there was any correlation with the type of dermatosis and the HIV-disease stage. Methods: Lymphoid and activation markers as well as adhesion molecules were studied on cutaneous biopsy specimens from 96 inflammatory dermatoses in HIV-positive patients. The dermatoses included psoriasiform dermatoses with and without a lichenoid component, perivascular lymphoid dermatoses, perivascular and periadnexal inflammatory dermatoses, spongiotic dermatoses, granulomatous dermatoses, and neutrophilic dermatoses with and without vasculitis. Results: Although there was a decrease in CD4/CD8 ratios in the cutaneous inflammatory dermatoses with progression of the disease, the ratios of CD4/CD8 cells were far higher than those in the peripheral blood. There were also increasing numbers of CD23+ cells and increased E-Selectin expression on endothelial cells from the early stages of disease, with no consistent pattern of ICAM-1 expression on epithelial cells with disease progression. Conclusions: The expression of lymphoid markers, activation markers, and adhesion molecules in the skin with progression of HIV disease, is consistent with a T helper (Th)1 to Th0/Th2 cytokine pattern of immune dysregulation. This cytokine pattern may be modified by the cytopathic effects of HIV on lymphoid and dendritic populations and by effects of other concurrent infections. Significant numbers of CD4+ T cells in skin infiltrates, with low peripheral CD4 T-cell counts, suggest that the cutaneous T-cell populations may be distinctive.
Phase 1 Clinical Trials
Authors: Muglia Jennie J. , DiGiovanna John J. 
Published: July 2017

Background: In the United States, drug development and approval is a complex process regulated by the Food and Drug Administration under the authority outlined in the Code of Federal Regulation. The goal of this multi-step process is to determine safety and efficacy of new therapeutic entities. Initially, exposure of humans to new therapeutic agents is accomplished in a graded and limited fashion. This approach seeks to minimize risks to study participants from exposure to damaging agents. During early phases, limiting exposure to a few individuals results in the accumulation of preliminary data on pharmacology, short-term toxicity, and efficacy. The inherent limitations of this process necessitate careful critique and caution in extrapolation of phase 1 data. Objectives: The purpose of this article is to provide a review of the drug approval process focusing on phase 1 trials, which are the earliest human exposure to a new drug. The purpose, variations, and significance of phase 1 trials are described, and a framework is provided to critically evaluate data published from these trials. Conclusions: Phase 1 trials are primarily designed to accumulate short-term safety (toxicity) and pharmacological data. Although preliminary efficacy may be addressed (“proof of concept” efficacy), it is a secondary endpoint. The numbers of patients are small, the numbers of patients receiving efficacious doses are very small, and controls are absent. Evaluation of efficacy and of long-term toxicity requires longer, larger, and controlled studies.
Androgen Receptor Polymorphisms (CAG Repeat Lengths) in Androgenetic Alopecia, Hirsutism, and Acne
Authors: Sawaya Marty E. , Shalita Alan R. 
Published: July 2017

Background: The androgen receptor (AR) is a structurally conserved member of the nuclear receptor superfamily. The amino-terminal domain is required for transcriptional activation and contains a region of polyglutamine encoded by CAG trinucleotide repeats. In humans, the number of CAG repeats is polymorphic. Expansion of CAG repeats in the AR has clinical implications for human disease. Objective: Androgens influence androgenetic alopecia (AGA), hirsutism, and acne; the polymorphisms in CAG repeat length may affect the clinical course of patients with these cutaneous disorders. The purpose of this study is to test for an association between these disorders and CAG repeat length. Methods: We analyzed normal lymphocyte genomic DNA from a total of 48 men and 60 women. The CAG repeat region of the AR was amplified by polymerase drain reaction (PCR) and the products were sized on polyacrylamide gels. Results: In normal men and women controls, a range of 12 to 29 trinucleotide repeats was found, with men having 22 ± 4 (M ± SD), women 21 ± 3. Men with AGA had 19 ± 3, whereas women with AGA had 17 ± 3. Men with acne had 21 ± 3, whereas women had 20 ± 3; men with AGA and acne had 18 ± 4; and women with hirsutism had 16 ± 3. Women with a combination of at least two disorders also had 16 ± 3 trinucleotide repeats. Conclusion: Shorter CAG-repeat lengths may be associated with the development of androgen-mediated skin disorders in men and women. These data suggest that CAG-repeat length in AR may affect androgen mediated gene expression in hair follicles and sebaceous glands in men and women with these androgenic skin disorders.
Immunophenotyping of a Sarcoidal Granuloma in a Scar, a Manifestation of a Possible Autoimmune Process
Authors: Morhenn Vera B. , Smoller B. R. 
Published: July 2017

Background: Old scars rarely develop sarcoid lesions. To determine whether the immunophenotype of the cellular infiltrate found in sarcoid in scarred skin resembled that seen in sardoidosis, we performed routine staining with hematoxylin and eosin, as well as immunophenotyping of a sarcoid lesion in a scar. Currently, there is controversy about the etiology of sarcoidosis in general and about sarcoidal granulomas in scars in particular. A new hypothesis is suggested in this case report. Objective: The purpose was to determine whether the cellular infiltrate in a sarcoidal granuloma in an old scar was similar to that in sarcoidosis. Methods: Staining with hematoxylin and eosin as well as immunophenotyping was performed using standard techniques. Results: The dermis of the sarcoid lesion demonstrated predominantly macrophages, followed by CD-4+ T-helper cells. CD-8+ cytotoxic suppressor cells were rare. Conclusions: The lymphoid cell infiltrate in a sarcoidal granuloma found in a scar is similar to that found in sarcoidosis. Furthermore, the staining pattern of sarcoid described in this paper and a review of the data in the literature suggest that sarcoidosis shares many characteristics of diseases with an autoimmune origin. Thus, we suggest that sarcoid isolated to scars represents a more benign variant of sarcoidosis, a possible systemic autoimmune disease.
Sun-Protective Clothing
Authors: Adam John 
Published: July 2017

Background: Topical sunscreens have been used for many years on exposed areas (i.e., hands, face) to protect the skin from the damaging effects of ultraviolet radiation. Most people do not use sunscreens on their bodies when they are wearing clothes. An average weight cotton T shirt gives only a sun protection factor (SPF) of 7. This is inadequate protection when out of doors. Therefore, clothing with adequate sunscreening properties should be worn. Objective: The purpose of this study is to identify the factors in clothing fabrics that contribute to or detract from blocking ultraviolet radiation and to recommend criteria for establishing a standard for sunprotective clothing. Method: The study involves a review of the dermatologic and textile literature to identify various factors in fabrics that contribute to blocking ultraviolet radiation through textiles. Conclusion: For fabrics, the term ultraviolet protection factor (UPF) is used as the measure of ultraviolet radiation penetration through the fabric. The UPF of a fabric depends upon fiber content and weave, fabric colour, finishing processes, and the presence of additives. The performance of a fabric depends upon stretching, shrinkage, hydration, laundering, and wear of the fabric over time. Based upon these criteria the minimum CDA standard UPF for clothing should be 40 to 50+.
Sunlight Exposure, Hat Use, and Squamous Cell Skin Cancer on the Head and Neck
Authors: Bajdik Chris D. , Gallagher Richard P. , Hill Gerry B. , Fincham Shirley 
Published: July 2017

Background: Sunlight is the environmental exposure most often associated with squamous cell cancer (SCC) of the skin. It can be difficult to quantify the sunlight exposure of the skin because of the different types of clothing that may be worn. The problem is simplified for studies of SCC on the skin of the head and neck, where a hat is the only type of clothing that needs to be considered. Objective: The purpose of the study was to determine the risk for SCC of sunlight exposure on the skin of the head and neck, and the protective effect, if any, associated with wearing a hat. Methods: A case-control study of squamous cell carcinoma of the skin was conducted amongst men in the province of Alberta, Canada. Analysis was restricted to only those cases where cancer occurred on the head or neck, and their age and sex matched controls. Results: Ethnicity, non-sunexposed skin colour, and hair colour each significantly affected the SCC risk. An increased SCC risk was also associated with greater cumulative sunlight exposure and with sunburns experienced during the ages 5 to 15 years. The risk associated with sunlight exposure was significantly elevated in men who reported that they had always or usually worn a hat. Conclusion: As observed in previous studies, SCC on the skin of the head and neck is associated with host pigmentation, sunburns occurring in childhood, and sunlight exposure during adulthood. The risk observed for wearing a hat may be due to bias or confounding; however, hats remain an unproven means of protection against SCC on the skin of the head and neck.
Lichenoid/Interface Cutaneous Eruptions to IVIg with the Primary Infusion May Be Related to the Re-Regulation of Anti-Idiotype Network
Authors: Smith Kathleen J. , Dutka Andrew L. , Skelton Henry G. 
Published: July 2017

Background: Intravenous immunoglobulin (IVIg) has been used in recent years to treat an increasing number of autoimmune diseases to decrease cytokine secretion and to neutralize toxins, in addition to the therapy of immunodeficiency disorders. In addition to angioedema-like hypersensitivity eruptions, there have been reports of eczematous, purpuric, petechial/purpuric, and vasculitic reactions to IVIg; however, there has been only one previous report of a case in which the patient developed a lichenoid dermatitis after infusion of IVIg. Observations: We present two patients with chronic inflammatory, demyelinating polyneuropathy, who after the first course of IVIg developed a folliculocentric interface/lichenoid eruption that cleared without therapy or with topical steroids. The eruption did not recur with subsequent IVIg infusions in either patient. Conclusions: The multiple diverse effects of IVIg on the immune system, and the re-regulation of the anti-idiotype network with repeat IVIg infusions, may explain why this eruption occurred with the initial infusion of IVIg and not with repeated infusions.
Junctional Epidermolysis Bullosa with Pyloric Atresia: A Case with Favourable Outcome
Authors: Ha Duc , Idikio Halliday , Krol Alfons , Lin Andrew N. 
Published: July 2017

Background: Pyloric atresia is a rare but serious condition that can occur with junctional epidermolysis bullosa (PA-JEB). Early recognition is necessary for timely intervention, but prognosis can be serious and mortality is high. Objective: We describe the case of a patient with PA-JEB who not only survived past infancy, but showed improvement in cutaneous blistering as she grew older. Conclusion: With early surgical intervention, some patients with PA-JEB can survive and look forward to a favourable prognosis, with improvement of cutaneous blistering by early childhood.
Sun and the Skin: Evaluation of a Sun Awareness Program for Elementary School Students
Authors: Gooderham Melinda J. , Guenther Lyn 
Published: July 2017

Background: Research suggests that childhood exposure to ultraviolet radiation is a significant risk factor for the development of melanoma and nonmelanoma skin cancers. Sun awareness education programs for children can positively influence children's sun protective practices to decrease the risk of skin cancer. Objective: The purpose of this study was to evaluate a sun awareness education program, entitled “Sun and the Skin” that had recently been developed and implemented in London, Ontario. Method: The study uses a pre- and posttest design to evaluate both knowledge and behaviour of Grade 4 students participating in the program at baseline, immediately after, and 1 month after the program. Results: The students demonstrated a significant increase in their sun-protective practices after participation in the “Sun and the Skin” program. There was a significant improvement in the students' level of knowledge after the program. Improvement in both behaviour and knowledge were maintained weeks after completion of the program. Minor differences in knowledge due to demographic characteristics were detected after the program. Conclusions: A sun awareness education program for Grade 4 students can improve both their knowledge and behaviour over time. This format should be used in conjunction with changes in school policy in order to make a significant longterm impact.
Parry-Romberg Syndrome with Contralateral and Ipsilateral Extremity Involvement
Authors: Chapman M. Shane , Peraza Jose E. , Spencer Steven K. 
Published: July 2017

Background: The Parry-Romberg syndrome is an acquired progressive hemifacial atrophy involving the subcutaneous tissues of the scalp and face. Involvement of the extremities is uncommon in this syndrome. Objective: A case of contralateral and ipsilateral extremity involvement in the Parry-Romberg syndrome is reported, and the difficulties in distinguishing this syndrome from linear scleroderma en coup de sabre are reviewed. Methods: A MEDLINE search for cases of Parry-Romberg syndrome with contralateral extremity involvement was performed and the cases reviewed. Results: Contralateral extremity involvement in the Parry-Romberg syndrome is rare. Conclusion: This may be the first case reported in the English literature of Parry-Romberg syndrome with contralateral and ipsilateral extremity involvement.
Three Point-Advancement Closure for Skin Defects
Authors: Tamir Gabriel , Birkby Craig S. , Berg Daniel 
Published: July 2017

Background: Circular skin defects are common following Mohs' surgery. Traditional closure (primary, flap, or graft) may involve extensive surgery. Multidirectional advancement closures such as the purse-string closure have been advocated as another useful tool in such cases. Objective: To describe a variation on purse-string closure that, in certain cases, is an excellent alternative to other reconstructions, and will provide good cosmetic and functional outcome. Method: A three-point anchoring suture is placed after undermining to advance the surrounding tissue toward the centre, creating a “Mercedes Benz” or tripod closure following removal of “dog-ears.” Results: Circular wounds in designated areas can be more easily closed, creating well-tolerated, favourable scars. Conclusion: Large wounds may be closed with the advantage of avoidance of larger flaps, of decreased wound healing compared to second intention, and of minimizing removal of healthy tissue. An initial trial of closure with this method does not limit subsequent use of other repairs should it be less than satisfactory.
Comparative Irritancy Study among Retinoid Creams and Gels
Authors: Toole J. W. P. , Lockhart Leslie , Potrebka Joelle , Bowman James P. , Novack Gary D. 
Published: July 2017

Background: Topical retinoids, although very useful in dermatology, may be irritating to some patients. Objective: There are a number of topical retinoids available in Canada, and the objective of the present study was to evaluate the irritancy potential in humans of retinoid gels and creams presently available in Canada. Methods: Thirty healthy adults were administered 10 products (five creams, three gels, petrolatum, and sodium lauryl sulfate (SLS) 0.1% w/v) for up to 21 consecutive days. Results: Early termination of patching due to irritation was required for the tretinoin creams and gels and SLS more frequently and earlier in the study than for adapalene and petrolatum (p = .001). Statistically significant, among-group differences were noted in the severity of irritation at each day and for the cumulative score for both the creams and the gels (p = .0001), in favour of adapalene over the tretinoin products. Conclusion: By several measures, adapalene cream and gel were less irritating upon multiple dosing than various tretinoin creams and gels.
Of Hairless Mice and Men: The Genetic Basis of Congenital Alopecia Universalis/Congenital Atrichia
Authors: Bale Sherri J. 
Published: July 2017

Background: Mouse models of human diseases help identify gene defects. Objective: The methods of homozygosity mapping and mouse/human homology to identify genes are reviewed. The genotype/phenotype correlation in two clinical entities with mutations in the human hairless gene are discussed. Methods: The example of the hairless mouse's contribution to our knowledge of hereditary alopecia is used, and the utility of consanguineous families for genetic studies is highlighted. Results: Mutations in the human homolog of the mouse hairless gene lead to congenital alopecia universalis and atrichia with papules. Conclusion: A mouse model of congenital alopecia has led to understanding the molecular basis of at least one type of severe human alopecia.
Trichoepithelioma Associated with Cellular Blue Nevus
Authors: Al-Ghamdi Abdulmonem M. , Trotter Martin J. 
Published: July 2017

Background: Epithelial elements, such as trichoepithelioma, are occasionally associated with melanocytic nevi. Objective: A case of trichoepithelioma in association with cellular blue nevus is reported. Methods and Results: A solitary, pigmented nodule was removed from the scalp of a middle-aged woman. Histopathologic examination demonstrated a circumscribed cellular blue nevus within which were embedded epithelial strands and cystic structures consistent with trichoepithelioma. Conclusion: Trichoepitheliomas have been described in relation to common acquired nevi, but an association with a blue nevus is rare. The intimate admixture of trichoepithelioma within the nodule of a nevus supports the concept of epithelial induction by melanocytic nevi.