bluuebunny/crossref_metadata_2025_split huggingface dataset:
Recent Advances in Bioinformatics in the Medical Research Environment and Applications to the Study of Skin Diseases
Authors: Cuticchia A. Jamie 
Published: July 2017

Background: The computer has become increasingly intertwined in society for the past 30 years. Within the academic health science centre, there is an increasing need for researchers to become skilled at using the Internet as a mechanism for the retrieval of scientific results and the underlying data. The discipline of bioinformatics, which uses computer technology to provide answers to biological questions, has been expanding in scope and utility for the past decade. Increasing numbers of research groups have been investing in bioinformatics infrastructure to aid in the research process. These continuing investments have led to the establishment for the first time of a supercomputing facility within a hospital. Such computational power is being used for the mapping of genes and the study of human disease. Objective: A discussion of the increasing role of computational biology in the research environment of the clinician scientist is presented here. Conclusions: Though the investment in a supercomputer may not be possible in most research settings, several less expensive alternatives relying on existing desktop computers can provide supercomputer-like performance within nearly any environment.
Are Sterile Conditions Essential for All Forms of Cutaneous Surgery? The Case of Ritual Neonatal Circumcision
Authors: Naimer Sody A. , Trattner A. 
Published: July 2017

Background: Many aspects of cutaneous surgical interventions have been perfected, employed, and then scientifically examined. Conversely, ubiquitous, indiscriminate demand for sterile conditions while performing an invasive procedure remains a field devoid of satisfactory critical appraisal. Objective: Ritual neonatal circumcision served as a prototype to assess scientifically the safety of performing a dermatologic intervention under clean, uncontaminated, but nonsterile conditions. Methods: Two hundred subjects, mostly neonates, who were unselectively referred for ritual circumcision, served as the study group. The guillotine excisional technique was employed in the community setting under clean, uncontaminated, nonsterile conditions, in line with traditional practice. Follow-up was continued until full recovery. Results: No wound infections or septic complications were observed in any of the babies at either early (24–36 hours after the procedure) or late follow-up. Many subjects had an exudative discharge at the healing site several days after the procedure. This is a common finding associated with circumcision and was found to be nonindicative of infection. Conclusions: This preliminary study suggests that strict sterile conditions are superfluous for ritual neonatal circumcision, and the effort and expense invested in maintaining an aseptic environment for this sort of intervention may not be justified. Further large-scale investigations are warranted to validate these findings and to determine if they can be extrapolated to other patient populations and other types of cutaneous surgery.
Merkel Cell Carcinoma of the Skin
Authors: Tai Patricia TH , Yu Edward , Tonita Jon , Gilchrist James 
Published: July 2017

Background: Neuroendocrine/Merkel cell carcinoma (MCC) of the skin is an uncommon tumour. Currently, there are only limited data available on the natural history, prognostic factors, and patient management of MCC. Objective: To review our experience and build the largest database from the literature. Methods: Twenty-eight cases from the London Regional Cancer Center were combined with 633 cases obtained from the literature searched in English, French, German, and Chinese for the years 1966 to 1998. The database included age, sex, initial disease status at presentation to the clinic, site of primary, any coexisting disease, any previous irradiation, sizes of primary/nodal/distant metastases, management details, and final disease status. A new modified staging system was used: stage Ia (primary disease only, size < 2 cm), stage Ib (primary disease only, size > 2 cm); stage II (regional nodal disease), and stage III (beyond regional nodes and/or distant disease). Results: Age > 65 years, male sex, size of primary > 2 cm, truncal site, nodal/distant disease at presentation, and duration of disease before presentation (< 3 months) were poor prognostic factors. Surgery was the initial treatment of choice and it significantly improved overall survival (p = .004). Conclusion: We identified poor prognostic factors that may necessitate more aggressive treatment. The suggested staging system, incorporating primary tumour size, accurately predicted outcomes.
Multiple Indurated Papules on Penis and Scrotum
Authors: Wei Huachen , Friedman Kaiman A. , Rudikoff Donald 
Published: July 2017

Background: Sarcoidosis is a chronic disease with involvement of multiple organs. Cutaneous lesions may appear as the only manifestation or may be accompanied by systemic disease. Objective: To learn that genital sarcoidosis is a rare entity that should be included in the differential diagnosis of genital papules and nodules. Methods and Results: A 31-year-old African-American man presented with cutaneous lesions on his penis and scrotum existing for 2 years. The genital lesions were so prominent as to interfere with his sexual life. Sarcoidosis was demonstrated on biopsy. Conclusions: Sarcoid lesions may affect any skin area, but are rarely described on the genitalia. Dermatologists should be aware that genital sarcoidosis is a rare entity that should be included in the differential diagnosis of genital papules and nodules. Additionally, genital sarcoidosis may cause urinary problems and may represent a therapeutic challenge.
Cicatricial Pemphigoid Diagnosed by the Use of Indirect Immunofluorescence
Authors: Mutasim Diya F. , Adams Brian B. 
Published: July 2017

Background: A thorough work-up is paramount in the accurate diagnosis of oral erosive diseases. Objective: A case of pemphigoid with negative direct immunofluorescence but positive indirect immunofluorescence is presented. Methods and Results: A 77-year-old man presented with erosions of the oral and glans mucosa and with esophageal stenosis. Histologic examination revealed nonspecific mucositis. Indirect immunofluorescence was characteristic of pemphigoid. Conclusion: This case illustrates the importance of performing a complete diagnostic work-up in the evaluation of patients with oral erosive disease.
Calciphylaxis: Seven New Cases
Authors: Alain Jimmy , Poulin Yves P. , Cloutier Richard A. , Gagné Eric , Baril Joelle 
Published: July 2017

Background: Calciphylaxis is a rare condition occurring most frequently in patients with end-stage renal disease (ESRD). It is characterized by vascular calcifications with a large variety of skin lesions. Even though this entity was first reported almost 50 years ago, the pathogenesis is still not well understood. Objective: Having retrieved seven new cases from a single tertiary care hospital, the disease occurs probably more frequently than reported until now. The potential mechanism of action in this disease is discussed, particularly the hypercoagulability state. We also review potential treatments described in the literature. Methods: Seven patients with calciphylaxis that occurred at the Hôtel-Dieu hospital between 1992 and 1998 were identified and their case histories reviewed and analyzed. Conclusion: Although hyperparathyroidism and imbalance of calcium-phosphorus homeostasis are paramount for calciphylaxis to occur, other mechanisms must be involved because the disease manifests itself in only a minority of ESRD patients. As the majority were under anticoagulation therapy and as we found abnormalities of the coagulation pathway in one patient, we suggest emphasizing these phenomena in the future. Along with evaluation of putative risk factors (abnormalities of the calcium:phosphate axis, diabetes), a detailed evaluation of the coagulation system should be done in every patient with calciphylaxis until more data are available.
Anchorage-Independent Growth of p53-Knockout Dermal Fibroblasts is Reversed by Wild-Type p53
Authors: Bush Jason A. , Li Gang 
Published: July 2017

Background: p53 is a 393-residue nuclear phosphoprotein. Mutation of p53 occurs in over half of all human cancers and thus is a crucial step in the process of cell transformation and tumorigenesis. Since tumorigenesis is a multistep process, it generally requires the mutation of certain key oncogenes and/or tumor-suppressor genes. Using p53-deficient mice, we can investigate the p53-dependent mechanisms leading to tumorigenesis. Objective: To examine the unique anchorage-independent growth characteristics of dermal fibroblasts isolated from p53-deficient mice. Methods: The growth characteristics of highly confluent cultured dermal fibroblasts from wild-type ( p53+/+) and p53-deficient ( p53−/−) mice were compared by DNA fragmentation assay, colony formation in soft agar, and overexpression of a wild-type p53 transgene in p53-deficient cells. Results: p53−/− fibroblasts have a growth rate dramatically higher than p53+/+ cells and detach from plastic cultureware at high density. The detachment of p53−/− cells is not due to apoptosis. Furthermore, these cells have the capacity to grow in soft agar—a hallmark of cell transformation—and this anchorage-independent growth can be reversed by the introduction of a wild-type p53 transgene. Conclusion: Dermal fibroblasts isolated from p53-deficient mice show anchorage-independent growth. Therefore, the absence of p53 is sufficient for the initiation of cell transformation in this cell type and establishes this model system as an excellent tool to dissect the molecular steps involved in oncogenesis.
A Case of Cutaneous Mycobacterium Chelonae Abscessus Infection in a Renal Transplant Patient
Authors: Endzweig Carin H. , Strauss Eric , Murphy Frank , Rao Babar K. 
Published: July 2017

Background: Mycobacterium chelonae is an atypical “fast-growing Mycobacteria” that is a rare cause of human infection. There have been several reports of cutaneous infection among immunosuppressed patients, as well as in immunocompetent individuals following trauma. Most cases to date seem to have occurred among renal transplant recipients, raising the possibility that there is something inherent to the renal transplant patient that increases their susceptibility more than other immunocompromised patients. Objective: The differential diagnosis of subcutaneous nodules distributed in a sporotri-choid pattern is extensive, particularly in an immunocompromised host. Although several cases of cutaneous M. chelonae abscessus infection have been reported among both immunosuppressed and immunocompetent patients, the clinical presentation has varied, and few cases have reported the appearance of lesions in a sporotrichoid pattern. We present a case of a renal transplant patient with a reported history of trauma to the lower extremities, who presents with subcutaneous nodules distributed in a sporotrichoid pattern. The patient is found to have M. chelonae abscessus infection, fails several treatment regimens, and presents with a recurrence. The literature of M. chelonae infection is reviewed, and the various treatment options are discussed. Methods: An initial skin biopsy was stained with Hematoxylin and Eosin and revealed deep dermal abscesses with acid-fast bacilli in clusters. The culture became positive for Mycobacterium chelonae abscesses in four days and was found to be sensitive to multiple antibiotics. The patient underwent surgical excision of 14 nodules, which revealed findings consistent with the skin biopsy, and was subsequently treated with the appropriate antibiotics. Results: Despite treatment with a full course of an organism-sensitive antibiotic regimen, the patient returned with persistent and recurrent nodules six weeks later. The patient was then treated as an inpatient with a seven-week course of intravenous antibiotics and was discharged home on a combined intravenous and oral regimen. Conclusion: Although M. chelonae abscessus is an extremely rare cause of infection among humans, there seems to be a predominance of cases reported among renal transplant patients. The explanation for this is not entirely clear; however, the organism must be considered as a cause of infection in any renal transplant recipient who presents with subcutaneous nodules. Eradication of the organism presents a tremendous challenge to the clinician, and, as presented here, even with appropriate antibiotics, there is a high rate of recurrence.
Human Papillomavirus Infections: Epidemiology, Pathogenesis, and Therapy
Authors: Severson Jessica , Evans Tanya Y. , Lee Patricia , Chan Teh-Sheng , Arany Istvan , Tyring Stephen K. 
Published: July 2017

Background: Human papillomaviruses (HPV) are common human pathogens and are classified into more than 80 different types. These viruses produce benign warts in many cases and aggressive squamous cell carcinomas in other cases. Objective: The goal of this review is to update the reader on the epidemiology, pathogenesis, and therapy of HPV infections. Nonanogenital warts are transmitted by skin-to-skin contact while anogenital warts are usually transmitted sexually. Both types of warts produce much morbidity but rarely undergo malignant transformation. They are commonly treated with surgical or cytodestructive therapy, but immunomodulatory agents, such as imiquimod, have been proven to be very effective in anogenital warts and are being evaluated in nonanogenital warts. Other types of HPV have marked oncogenic potential such that over 99% of all cervical cancers and over 50% of other anogenital cancers are due to infection with oncogenic HPV. Many cofactors, such as cigarette smoking, genetics, and helper viruses, have potential roles in HPV oncogenesis, but their relative contributions are poorly understood. Other control measures for warts and HPV-associated cancers are under study, but the greatest future potential may be from the development of prophylactic and therapeutic vaccines. Conclusions: Infection with HPV is very prevalent as are the clinical manifestations of this family of pathogens. Improved therapies for warts (e.g., imiquimod) have recently become available. Vaccines for HPV offer hope for future interventions for warts as well as for prevention of anogenital malignancies.
Tacrolimus in Dermatology
Authors: Tran Quang Hieu Dé , Guay Elizabeth , Chartier Suzanne , Tousignant Jacqueline 
Published: July 2017

Background: Tacrolimus (FK 506), a metabolite of the fungus Streptomyces tsukubaensis, is an anti-T-cell drug. It acts by inhibiting the production of IL-2, IL-3, IL-4, TNFα, and GM-CSF. More potent and with slightly less secondary effects than cyclosporine, it has been the object of considerable interest, especially in conditions that could benefit from the latter. Objective: In psoriasis, a placebo-controlled double-blind study has shown oral tacrolimus at 0.1 mg/kg/day to be effective in controlling recalcitrant lesions. In human, small studies have reported tacrolimus ointment to be effective in controlling acute contact dermatitis. Short-term trials of topical tacrolimus in the treatment of atopic dermatitis have recently shown excellent results in both adults and children. In animal studies of hair growth disorders, topical tacrolimus induces anagen and protects from chemotherapy-induced alopecia. Animal studies with the ointment for the prevention of skin graft rejection, lupus dermatoses, and skin papilloma formation have also shown to be promising. Conclusions: There are case reports of pyoderma gangrenosum, Sezary's syndrome, and Behçet's disease successfully treated with oral tacrolimus but, because of their small number, they remain anecdotal at this point.
Reduction of Postherpetic Neuralgia in Herpes Zoster
Authors: Vander Straten Melody , Carrasco Daniel , Lee Patricia , Tyring Stephen K. 
Published: July 2017

Background: Persons 50 years of age and older are not only at increased risk of developing herpes zoster, they are also more likely to suffer the long-term morbidity of postherpetic neuralgia (PHN). PHN is pain persisting after the rash of herpes zoster has healed. PHN affects at least 40% of all herpes zoster patients over age 50 and over 75% of herpes zoster patients over age 75; PHN is the single most common neurologic condition in elderly patients. Objective: The objective of this review is to evaluate interventions that may reduce or even eliminate PHN. No single therapy has been consistently effective for PHN. The most effective approach appears to be with the use of antiviral therapy early in the course of herpes zoster. The goals of ongoing studies in herpes zoster are to develop interventions that will further reduce the symptoms of PHN and/or to eliminate PHN by prophylaxis using the varicella vaccine. Conclusions: Reduction of PHN can best be achieved with the use of antiviral medication early in the course of herpes zoster; other classes of drugs are minimally effective in treating established PHN. Widespread use of the varicella vaccine may lead to secondary reductions in PHN in the distant future.
Multiple Sebaceous Adenomas and Extraocular Sebaceous Carcinoma in a Patient with Multiple Sclerosis: Case Report and Review of Literature
Authors: Akhtar Saad , Oza Krishna K. , Roulier Randolph G. 
Published: July 2017

Background: Sebaceous carcinomas are relatively rare cutaneous tumors; there are fewer than 600 cases reported. They most commonly arise within the meibomian gland of the eyelid; fewer than 150 of the reported cases were extraocular. These tumors have a high incidence of local recurrence and regional metastasis. The relationship of sebaceous tumors and visceral malignancy is well established in the literature. Objective: We describe a 44-year-old white female with chronic progressive multiple sclerosis who developed multiple scalp sebaceous adenomas and a solitary sebaceous carcinoma. Conclusion: Extraocular sebaceous carcinomas are rare tumors with high incidence of local recurrence and regional metastasis. Surgery with wide surgical margins is the standard treatment. We report the first case of multiple sebaceous tumors in a patient with multiple sclerosis. The presence of sebaceous tumors warrants a search for an internal malignancy. Literature on sebaceous tumors and their relationship with visceral malignancies and immunologic disorders is discussed. Literature on sebaceous carcinoma with special attention to extraocular sebaceous carcinoma is also discussed.
Effects of Finasteride on Apoptosis and Regulation of the Human Hair Cycle
Authors: Sawaya Marty E. , Blume-Peytavi Ulrike , Mullins Diane L. , Nusbaum Bernard P. , Whiting David , Nicholson Donald W. , Lotocki George , Keane Robert W. 
Published: July 2017

Background: A number of studies have provided evidence that apoptosis is a central element in the regulation of hair follicle regression. In androgenetic alopecia (AGA), the exact location and control of key players in the apoptotic pathways remains obscure. Objective: In the present study, we used a panel of antibodies and investigated the spatial and cellular pattern of expression of caspases and inhibitors of apoptosis (IAPs), such as XIAP and FLIP, in men with normal scalp and in men with AGA before and after 6 months of treatment with 1 mg oral finasteride treatment. Methods and Results: Constitutive expression of caspases-1, −3, −8, and −9 and XIAP was detected predominantly within the isthmic and infundibular hair follicle area, basilar layer of the epidermis, and eccrine and sebaceous glands. AGA-affected tissues showed an increase in caspase (−1, −3, −6, −9) immunoreactivity with a concomitant decrease in XIAP staining. After 6 months of finasteride treatment, both caspases and XIAP were similar to levels exhibited by normal subjects. Immunoblot analysis was performed to determine antibody specificity and cellular expression of caspases. Purified populations of keratinocytes, melanocytes, dermal papilla, and dermal fibroblasts derived from human hair follicles were cultured in vitro and treated with 0.5 μm staurosporin. Time-course experiments revealed that processing of caspase-3 is a principal event during apoptosis of these hair cell types. Conclusion: These data suggest that alterations in levels of caspases and IAPs regulate hair follicle homeostasis. Moreover, finasteride appears to influence caspase and XIAP expression in hair follicle cells thus signaling anagen, active growth in the hair cycle.
Induction of Dramatic Hyperpigmentation in a Patient with Generalized Lichen Planus Treated with Re-PUVA
Authors: Carlin Christopher S. , Florell Scott R. , Krueger Gerald G. 
Published: July 2017

Background: Retinoids plus PUVA (re-PUVA) may be used in the treatment of lichen planus in cases that do not respond to monotherapy. Hyperpigmentation is a potential side effect of re-PUVA therapy. Objective: A case of remarkably intense transient hyperpigmentation secondary to re-PUVA therapy is presented. Methods and Results: An 18-year-old male with lichen planus who had been taking isotretinoin 80 mg per day for seven days developed an exaggerated hyperpigmentation following the third dose of PUVA. Conclusion: As the hyperpigmentary reaction did not occur until the third PUVA dose, which was near the steady state of isotretinoin, this case may illustrate a case of photosensitization secondary to isotretinoin alone or isotretinoin in combination.
Psoriasis and Pregnancy
Authors: Tauscher Amanda E. , Fleischer Alan B. , Phelps Kathy C. , Feldman Steven R. 
Published: July 2017

Background: Women comprise half of all psoriasis patients and because the majority of psoriasis cases present before age 40 the disease affects women who may become pregnant. Information regarding the heritability of psoriasis can be used in counseling patients who inquire about the potential risk to their children. Patients with psoriasis who become pregnant will likely notice an associated improvement of their symptoms if any change is noted at all. Objective: Because of potential fetal effects, the treatment of chronic psoriasis in pregnancy involves prudent consideration of whether the severity of the disease warrants treatment and selection of the safest treatments available. Conclusion: Topical corticosteroids and topical calcipotriene as well as topical anthralin and topical tacrolimus appear to be safe choices for control of localized psoriasis in pregnancy. UVB is the safest treatment for extensive psoriasis during pregnancy, particularly when topical application of other agents is not practical. Short-term use of cyclosporine during pregnancy is probably the safest option for management of severe psoriasis that has not responded to topical or UVB treatment.