bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tonsil Metastasis from Cutaneous Melanoma: First Clinical Sign of Recurrence after Complete Lymph Node Dissection
Authors: Cecchi Roberto , Pavesi Mario , Calamandrei Pierantonio , Rapicano Valentina , De Gaudio Cataldo 
Published: March 2015

Background: The development of melanoma metastasis to the palatine tonsil is a very rare event, generally associated with advanced-stage disease and poor prognosis. Case Presentation: A 29-year-old man presented with a melanoma metastasis to the right palatine tonsil 6 months after the surgical excision of an ulcerated nodular melanoma (tumor thickness 1.8 mm, Clark level IV) on the left shoulder. A metastatic sentinel lymph node had been removed from the left axilla, and a subsequent complete lymph node dissection had disclosed no further metastatic lymph nodes. Although staging tests had revealed multiple visceral metastases, a palliative tonsillectomy was performed. The patient died of metastases 5 months later. Conclusion: The case presentation suggests that careful examination of the head and neck should be part of the routine follow-up visit in all melanoma patients.
Detection of Occult Melanoma by Preoperative Positron Emission Tomography–Computed Tomography and Intraoperative Ultrasonography
Authors: Shoo Brenda A. , Kangelaris Gerald , Callen Peter W. , Kashani-Sabet Mohammed , Leong Stanley P.L. 
Published: March 2015

Background: 18F-Fluorodeoxyglucose positron emission tomography–computed tomography (PET-CT) has become a common imaging modality for detecting metastatic melanoma. However, the identification of lesions intraoperatively can be difficult. Objective/Methods: We describe an innovative multimodality approach to tumor localization using preoperative PET-CT and intraoperative ultrasonography and describe cases in which this technique was used. Results: The use of these two modalities together enabled resection of multiple occult metastatic lesions in the patients presented. Conclusion: The use of this multimodality approach will be important in ensuring that all known metastatic disease sites are resected and represents an important concept in the setting of metastatic melanoma resection.
Nevus Spilus and Melanoma: Case Report and Review of the Literature
Authors: Corradin Maria Teresa , Zattra Edoardo , Fiorentino Renzo , Alaibac Mauro , Belloni-Fortina Anna 
Published: March 2015

Background: Nevus spilus is characterized by a pigmented patch with scattered flat or maculopapular speckles. Nevus spilus was first described by Burkley in 1842. Since then, this lesion has been widely debated in the literature, particularly for the possible occurrence of melanoma within the lesion. Objective: We describe the case of a 65-year-old female presenting with a nodular achromic melanoma that occurred within a nevus spilus on the left thigh. Conclusion: Our observation is consistent with the idea that this entity in some circumstances may have the ability to evolve into a malignant melanoma.
Antepartum Intravenous Immunoglobulin Therapy in Refractory Pemphigoid Gestationis: Case Report and Literature Review
Authors: Doiron Philip , Pratt Melanie 
Published: March 2015

Background: Pemphigoid gestationis is an autoimmune blistering disease affecting pregnant women. Treatment often consists of topical corticosteroids, oral antihistamines, and oral prednisone followed by immunosuppressants. Refractory cases in antepartum patients present a particular therapeutic challenge as the majority of second-line agents are contraindicated until the patient has delivered. Objective: The following report describes the case of a 34-year-old woman pregnant for the third time at 16 weeks' gestation. Her previous two pregnancies were complicated by pemphigoid gestationis but were successfully managed with oral prednisone and topical agents. During her third pregnancy, the initial lesions were controlled with oral prednisone, but attempts to decrease her dose resulted in disease flare. Conclusion: Monthly infusions of intravenous immunoglobulin (40 g intravenously for 3 consecutive days for 120 g total) proved to be successful in reducing the dose of oral prednisone required to maintain disease remission. A healthy baby was delivered at 37.5 weeks.
Lupus Vulgaris Occurring in a Locus Minoris Resistentiae
Authors: Long Richard , Beatch Anita , Lee Mao-Cheng , Cheung-Lee Melody , Wasel Norman 
Published: March 2015

Background: The pathogenesis of lupus vulgaris, a form of cutaneous tuberculosis, is not always clear, especially in patients who do not have coexistent extracutaneous tuberculosis and in patients with single lesions. Objectives: To report a case of lupus vulgaris in a locus minoris resistentiae (a site of reduced resistance) and to use a unique set of clinical circumstances and laboratory tests to reconstruct the pathogenesis of the lesion and the response to treatment. Conclusion: Lupus vulgaris can occur in a locus minoris resistentiae; local trauma and possibly other factors, such as increased temperature, topical corticosteroids, and the virulence of the infecting strain, may facilitate the growth of Mycobacterium tuberculosis present at a locus minoris resistentiae as a result of a silent bacillemia.
Long-Term Evolution of Cytophagic Histiocytic Panniculitis
Authors: Fernández Raquel Rios , Rubio José-Luis Callejas , Cano Daniel Sánchez , Vicent Juan-Ramón Dominguez , Solano Juan Linares , Centeno Norberto Ortego 
Published: March 2015

Background: Cytophagic histiocytic panniculitis is a disorder manifested by multiple subcutaneous nodules, characterized by lobular panniculitis, and occasionally accompanied by severe systemic manifestations, which require an aggressive medical approach. Several case reports with a good response to immunosuppressive therapy in the acute phase can be found in the literature. Objective and Conclusion: Nevertheless, the long-term evolution of this entity has not been described yet, nor have precise recommendations regarding the most adequate posology and duration of therapy. We report the result of switching from a long-term cyclosporine therapy to tacrolimus in a patient with a severe form of cytophagic histiocytic panniculitis.
Permanent Alopecia following Cranial Irradiation in a Child
Authors: Al-Mohanna Hind , Al-Khenaizan Sultan 
Published: March 2015

Background: Cranial irradiation is commonly used in childhood leukemia, with many potential cutaneous adverse effects. Radiation-induced permanent alopecia owing to scalp fibrosis is a rare but disturbing side effect. Objective and Conclusion: Here we report a Saudi boy with acute T-cell lymphoblastic leukemia who developed radiation-induced cicatricial alopecia. Topical treatment using minoxidil solution was tried but was ineffective.
Are Excipients Really Inert Ingredients? A Review of Adverse Reactions to Excipients in Oral Dermatologic Medications in Canada
Authors: Noiles Kristin , Vender Ronald 
Published: March 2015

Background: Whereas several literature reviews have discussed the role of excipients in drug-related reactions, no article has focused specifically on those found in oral dermatologic medications. Methods: The Compendium of Pharmaceuticals and Specialties (CPS) was used to reference the inert ingredients found in oral dermatologic medications. An extensive literature review was subsequently conducted using PubMed and MEDLINE to document adverse reactions to these excipients. Results: Sixty-three oral dermatologie medications were reviewed. Lactose was commonly used as a filler. Several medications indicated that they were dye, tartrazine, or gluten free. Three medications were found to contain soybean oil and one was found to contain peanut oil. Conclusions: Although there are documented reactions to excipients in other products in the literature, few reports outline reactions to excipients in oral dermatologie medications. Whether this low frequency is accurate or whether it is due to a lack of reporting remains unknown. If the latter reasoning is correct, dermatologists must be more aware of these possible reactions. This article serves as a reference guide for dermatologists to aid in prescribing medications to individuals with known sensitivities and to assist in working up patients with suspected reactions to inert ingredients.
Pyrethroid Pediculicide Resistance of Head Lice in Canada Evaluated by Serial Invasive Signal Amplification Reaction
Authors: Marcoux Danielle , Palma Kathleen G. , Kaul Nalini , Hodgdon Hilliary , Van Geest Andrea , Previte Dominic J. , Abou-Elghar Gamal Elsayed , Yoon Kyong Sup , Clark J. Marshall 
Published: March 2015

Background: Most people in the United States and Canada with pediculosis will be treated with neurotoxic pediculicides containing pyrethrins or pyrethroids. Their widespread use led to significant resistance reported from various countries. Although treatment failures are frequently observed in Canada, the resistance frequency to pyrethroid pediculicide of human head lice (Pediculus humanus capitis) has not been determined. Objective: To determine the knockdown resistance ( kdr) allele frequency in human head louse populations in Canada. Methods: Patients infested with Pediculus humanus capitis, aged 4 to 65 years, residents of Ontario, Quebec, and British Columbia, were participants. Head lice were collected by combing and picking the enrolled subjects' hair. Lice were analyzed by serial invasive signal amplification reaction (SISAR) for genotyping the T917I mutation of lice indicating permethrin resistance. The permethrin-resistant kdr allele (R allele) frequency could then be evaluated in the head lice collected in Canada. Results: Of the head louse populations analyzed, 133 of 137 (97.1%) had a resistant (R) allele frequency, whereas only 4 of 137 (2.9%) had a susceptible (S) allele frequency. Conclusions: The 97.1% resistant (R) allele frequency in head lice from Canada could explain the treatment failures encountered with pyrethrin and pyrethroid pediculicide treatments in Canadian populations infested with Pediculus humanus capitis as the latter will not be eliminated by those pediculicides.
Dermatologic Manifestations of Sjögren Syndrome
Authors: Kittridge Ashley , Routhouska Shannon B. , Korman Neil J. 
Published: March 2015

Background: Sjögren syndrome (SS) is a chronic autoimmune inflammatory disease that involves primarily the exocrine glands, resulting in their functional impairment. SS typically presents as dry eyes (xerophthalmia) and dry mouth (xerostomia). This process can manifest either as the independent phenomenon of primary SS or as secondary SS when found in the context of another autoimmune process, most commonly rheumatoid arthritis or systemic lupus erythematosus. Nearly half of the patients with SS develop cutaneous manifestations, which may include dry skin (xeroderma), palpable and nonpalpable purpura, and/or urticaria-like lesions. These cutaneous manifestations have been underemphasized because they are often overshadowed by the more prominent sicca symptoms. However, certain skin findings are of paramount clinical and prognostic importance as they confer an increased risk for the development of life-threatening conditions, including multisystem vasculitis and non-Hodgkin lymphoma. Objective and Conclusions: In this review, the cutaneous manifestations of primary SS are discussed, with an emphasis on those findings that portend an increased risk of mortality. Antécédent: Le syndrome de Sjögren (SS) est une maladie autoimmune inflammatoire chronique qui affecte principalement les glandes exocrines, menant à leur incapacité fonctionnelle. SS se caractérise typiquement par une xérophtalmie (sècheresse des yeux) et une xérostomie (bouche sèche). Ces symptômes peuvent apparaître en tant que manifestations indépendantes du SS primaire ou comme SS secondaire, c'est-à-dire comme conséquence d'une autre affection autoimmune, le plus souvent l'arthrite rhumatoïde, ou le lupus érythémateux systémique. Près de la moitié des patients présente des manifestations cutanées de la maladie, dont une peau sèche (xérodermie) et des lésions palpables ou non de purpura ou ressemblant à l'urticaire. Ces manifestations cutanées n'ont pas été suffisamment soulignées car elles sont souvent éclipsées par des symptômes plus notables de la maladie. Toutefois, certaines manifestations cutanées sont d'une grande importance dans le diagnostic clinique et dans le pronostic, car elles représentent une indication d'un risque plus élevé de développer une maladie mortelle telle que la vascularite multisystémique et le lymphome non hodgkinien.
Novel Case of Generalized Multinucleate Cell Angiohistiocytoma
Authors: O'Blenes Catherine A.E. , Walsh Noreen M.G. , Green Peter J. , Tremaine Robert D.L. 
Published: March 2015

Background: Multinucleate cell angiohistiocytoma is a rare benign fibrohistiocytic and vascular proliferation, typically characterized by the development of solitary papules, in an acral distribution in otherwise healthy late middle-aged to elderly women. Objective: Our objectives are to present a novel case of generalized multinucleate cell angiohistiocytoma and to review the current literature regarding the clinical and histologic findings in this condition, as well as its potential causes and treatments. Observations: We describe a 35-year-old man who presented with generalized asymptomatic firm violaceous papules. Histopathology revealed dermal vascular proliferation; a perivascular infiltrate of lymphocytes, histiocytes, neutrophils, and plasma cells; thickened surrounding collagen bundles; and characteristic multinucleate cells with scalloped borders. Conclusion: Our patient is one of three patients reported to date with generalized lesions of multinucleate cell angiohistiocytoma who were all in a younger age group (20–40 years old) than previously reported for solitary lesions.
Treatment Decision Needs of Psoriasis Patients: Cross-sectional Survey
Authors: Tan Jerry , Stacey Dawn , Fung Karen , Barankin Benjamin , Bissonnette Robert , Gulliver Wayne , Lui Harvey , Shear Neil , Jackson Christine , Zhang Xuemao 
Published: March 2015

Background: Informed shared decision making is a mutual process engaging both doctor and patient and informed by best medical evidence and patient values and preferences. Objective: Our aim was to identify the needs of psoriasis patients in decisions on selecting treatment. Methods: Psoriasis subjects participated in an online survey on decisional role, postdecisional conflict, and treatment awareness. Results: Of 2,622 people invited to participate, 248 completed surveys. Their most recent treatment decision was either made by subjects alone (42%) or physicians alone (28%) or was shared (29%). Subjects perceived that their doctors lacked time to stay abreast of treatments, to provide counseling, and to access appropriate treatments. Deficiencies most frequently identified were information on options, clarification of values, access to physicians, and decision-making skills. Those with a body surface area (BSA) ≥ 3% more frequently indicated that having the skill or ability to make treatment decisions was important. Limitations: The limitations of this study include sampling, recall, and reporting bias. Percent BSA was not verified. Conclusions: The multiple deficiencies in support of psoriasis patients in treatment decisions may preclude informed shared decision making.
Digital Mucous Cysts
Authors: Li Kayi , Barankin Benjamin 
Published: March 2015

Background: Digital mucous cyst (DMC) is a common benign condition, but consensus has not been reached regarding its pathogenesis and treatment. Objective: This review provides a concise overview of DMCs. Methods: The review presents the literature pertaining to the etiology, pathogenesis, classification, clinical features, epidemiology, differential diagnoses, diagnosis, and management of DMCs. Results: DMCs have a predilection for middle-aged patients, a good prognosis, and a high recurrence rate. DMCs may occur in one of three locations on the distal digit. They arise owing to a metaplastic or degenerative process. Preexisting osteoarthritis is common and may be an etiologic factor in patients with DMCs. A number of conservative and surgical treatments are available depending on the structures and locations involved. Conclusion: Studies with greater sample size and longer follow-up would enrich current knowledge of the benefits, recurrences, and complications for each treatment modality.
Sebaceous Carcinoma Associated with Seborrheic Keratosis
Authors: Tsai Tsung-Ming , Wu Yu-Hung , Yang Kuo-Chia , Yang Chia-Yi , Tsai Tsung-Hua , Chan Jung-Yi 
Published: March 2015

Background: The association of a seborrheic keratosis with other common cutaneous neoplasms such as basal cell carcinoma and Bowen disease has been reported, but the association between a seborrheic keratotis and a malignant neoplasm with sebaceous differentiation is very unusual. Objective: We present a case of two contiguous neoplasms, a seborrheic keratosis and a sebaceous carcinoma, and discuss the possibility of malignant change in a seborrheic keratosis as an explanation for the findings. Methods and Results: A 57-year-old man presented with an asymptomatic tumor on the skin of his abdomen that was composed of two separate but contiguous lesions. The central lesion, about 0.9 cm in diameter, was nodular, irregular, and reddish and was surrounded by a blackish lesion about 3 cm in greatest dimension. Histopathologic examination revealed that the plaque was composed of two different adjacent tumors, including a central portion showing findings consistent with a sebaceous carcinoma and a peripheral part showing a seborrheic keratosis. Conclusion: Although the association is likely to be a coincidence and probably represents a collision tumor, the possibility that the sebaceous carcinoma represents malignant degeneration of the seborrheic keratosis cannot be entirely excluded.
ICOS Gene Polymorphism May Be Associated with Pemphigus
Authors: Narbutt Joanna , Lesiak Aleksandra , Klich Izabela , Torzecka Jolanta Dorota , Sysa-Jedrzejowska Anna , Młynarski Wojciech 
Published: March 2015

Background: Pemphigus is an autoimmune blistering disease mediated by circulating IgG autoantibodies directed against desmogleins 3 and/or 1. As pemphigus is a T cell–mediated disease, one may assume that genetically determined disregulation of costimulatory signal may be involved in its pathogenesis. Objective: The aim of the present study was to evaluate the relationship between polymorphisms in genes encoding costimulatory receptors, CTLA4 and ICOS, and pemphigus in the Polish population. Methods: The study included 54 patients with pemphigus: 40 with pemphigus vulgaris (PV) and 14 with pemphigus foliaceus (PF). Additionally, 176 healthy unrelated blood donors served as controls. +49A/G CTLA4 and IVS1+173 ICOS polymorphisms were identified using a modified polymerase chain reaction–restriction fragment-length polymorphism. Results: Analysis of the frequency of genotypes and alleles of +49A/G CTLA4 gene polymorphism showed no statistically significant differences between the PV and PF patients and the controls. The distribution of genotypes in IVS1+173 ICOS polymorphisms was significantly different in both PV ( p < .01) and PF ( p = .0004) patients when compared to controls. The carriers of the allele C were more frequent in PV or PF in comparison with the control group ( p < .001 for both groups). Conclusions: Our results suggest that genetically determined abnormal function of costimulatory receptors in T cells may be associated with the pathogenesis of pemphigus.
Psoriasis and Multiple Sclerosis: Is There a Link?
Authors: Kwok Tiffany , Loo Wei Jing , Guenther Lyn 
Published: March 2015

Background: Psoriasis and multiple sclerosis (MS) are both autoimmune T cell-mediated diseases. Some case series have suggested an association. Objective: To investigate the potential relationship between psoriasis and MS based on a systematic review of the literature. Methods: Medline, Cochrane Library, and EMBASE searches were performed. Results: T-helper 17 cells are involved in the pathogenesis of both psoriasis and MS. Both conditions have been associated with interleukin-23 receptor (IL23R) polymorphisms. Studies have reported psoriasis in 0.41 to 7.7% of individuals with MS. A higher rate of psoriasis compared to controls was noted in a few small MS cohorts, but the number of cases was too small to draw any firm conclusions. In two studies, including a large Canadian study of 5,031 patients with MS, there was no increased prevalence of psoriasis in patients over the control population. Family members of individuals with MS do not appear to be at increased risk for psoriasis in these studies. Psoriasis has developed during treatment for MS, and MS has developed during treatment for psoriasis. Conclusion: Although there are some common genetic linkages in psoriasis and MS, psoriasis does not appear to be more common in patients with MS or their relatives.
Drug-Induced Lichenoid Dermatitis with Histopathologic Features of Mycosis Fungoides in a Patient with Psoriasis
Authors: Wu Jane , Vender Ronald , Jambrosic Jadranka 
Published: March 2015

Background: With recent advancements in the understanding of psoriasis, treatment has evolved toward more targeted therapy in the form of biologics. Although generally safe and well tolerated, various adverse reactions may occur with the use of biologics. Objectives: The objective of this article is to present a case of a biologic-induced drug eruption initially presenting with histopathologic features of mycosis fungoides (MF). Methods and Results: A 47-year-old male presented with an extensive erythematous macular eruption approximately 14 hours after a single dose of etanercept. Histopathology initially revealed a lichenoid dermatitis with features of MF, but immunohistopathology later refuted the presence of MF. Conclusions: It is important for clinicians to be aware that adverse cutaneous reactions with biologic therapy may initially present with histopathologic features of MF.
Pretibial Angioplasia: A Novel Entity Encompassing the Clinical Features of Necrobiosis Lipoidica and the Histopathology of Venous Insufficiency
Authors: Mistry Nisha , Hong H. Chih-ho , Crawford Richard I. 
Published: March 2015

Background: Necrobiosis lipoidica (NL) presents clinically as waxy yellow-brown plaques, commonly on the shins. Venous insufficiency also involves the legs; however, it has distinct clinical and pathologic features. Objective: We present a series of eight patients who had lesions that clinically resembled NL but on pathology showed features resembling venous insufficiency. Methods: Between 1997 and 2008, eight patients were identified at St. Paul's Hospital, Vancouver, to have had skin lesions clinically diagnosed as NL, or a similar morphologic entity, but showing histopathologic features resembling venous insufficiency on biopsy. The clinical records and pathology reports of these patients were reviewed. Results: The patients' ages ranged from 39 to 73 years. Only one patient was female. Members of the group held diagnoses of diabetes, renal failure, or venous or arterial disease. All patients had lesions on the legs, most on the anterior aspect. The clinical diagnosis was generally NL; other clinical impressions included lichen planus, morphea, and Kaposi sarcoma. All patients had features on pathology resembling venous insufficiency and no features of NL. Conclusion: We propose that this unique combination of clinical features of NL and histopathologic features resembling venous insufficiency represents a novel entity for which we propose the name pretibial angioplasia.