bluuebunny/crossref_metadata_2025_split huggingface dataset:
Solar Facial Porokeratosis
Authors: Sharquie Khalifa E. , Al‐Baghdady Bahaa A. 
Published: July 2014

AbstractPorokeratosis is comprised of a heterogeneous group of disorders that are inherited in autosomally dominant fashion. It has a wide variety of manifestations. In the last ten years, we have treated cases of porokeratosis that don't fit into the well known categories of porokeratosis. For this reason, the present study was carried out. This study included 15 cases whose ages ranged from 19–37 years with a mean ± SD of 26.93 ± 4.52. There were 12 females and 3 males. The duration of the disease ranged from 1–10 years with a mean ± SD of 4 ± 2.85 years. Their lesions were located only on the face, mostly on the distal part of the nose and the surrounding perinasal area. The number of lesions on each patient ranged from 1–15, with a mean ± SD of 4.73 ± 4.35. The morphology of these lesions consisted of papules with a size range from 0.1–1 cm and a warty appearance. They were skin colored and surrounded by a keratotic rim in the form of a collar. The histopathology showed the picture of porokeratosis with cornoid lamellae and additional features characteristic of this disease. We concluded that facial solar porokeratosis is a variant of porokeratosis and is a disease of the nose of young females with a characteristic clinical and histopathological picture.
Cutaneous Undifferentiated Small (Merkel) Cell Carcinoma, that Developed Synchronously with Multiple Actinic Keratoses, Squamous Cell Carcinomas and Basal Cell Carcinoma
Authors: Aydin Abdullah , Koçer N. Emrah , Bekerecioğlu Mehmet , Sari Ibrahim 
Published: July 2014

AbstractMerkel Cell Carcinoma (MCC) is an uncommon undifferentiated neuroendocrine tumor, arising in skin mainly on sun‐exposed areas. We present an unusual case of primary cutaneous undifferentiated small cell carcinoma that co‐existed with six other lesions; 2 actinic keratoses, 3 squmaous‐cell carcinomas and a basal‐cell carcinoma. HE stained sections revealed MCC located in the mid‐dermis, co‐existing with severe actinic keratosis. Immunohistochemically, the tumor cells reacted to cytokeratin 20, epithelial membrane antigen, chromogranin and neuron specific enolase. This is an unusual case of cutaneous MCC co‐existing with six other different lesions. The concurrent development of MCC, squamous‐cell and basal‐cell carcinoma in the same patient indicates the pluripotent epidermal stem cell origin of these tumors. Further research is needed to enlighten the factors inducing this divergent differentiation.
Purpura with Cold Urticaria in a Patient with Hepatitis C Virus Infection‐Associated Mixed Cryoglobulinemia Type III: Successful Treatment with Interferon‐β
Authors: Ito Akiko , Kazama Takashi , Ito Kaoru , Ito Masaaki 
Published: July 2014

AbstractWe describe a 54‐year‐old man with hepatitis C virus (HCV) infection‐associated cryoglobulinemia type III. The patient had suffered from cold‐induced urticaria that left purpuric eruptions up to 1 cm in diameter, intermittent migratory joint pain for seven years and mild liver dysfunction for nine years. Hemophilia A was diagnosed when the patient was 26 years old, and he was then given infusions of factor VIII for a short time. In both skin biopsy samples from urticarial and purpuric eruptions, mild inflammatory infiltration by polymorphonuclear leukocytes with nuclear dust, extravasation of erythrocytes and deposition of IgM and C3 in the superficial blood vessels were observed. After antiviral treatment with interferon‐β, the clinical symptoms and the cryoglobulin and HCV‐RNA in the serum disappeared. There has been no recurrence in the subsequent nine years.
A Case of Bullous Pemphigoid Successfully Treated by Plasmapheresis: Assessment of the Change in Titers of Circulating Antibodies by Immunoblotting and Enzyme‐Linked Immunosorbent Assay
Authors: Lee Jee Bum , Fumimori Takeaki , Kurose Koichiro , Mori Osamu , Hashimoto Takashi 
Published: July 2014

AbstractWe report a case of bullous pemphigoid successfully treated with double filtration plasmapheresis. The changes in titers of circulating autoantibodies were assessed by immunoblotting and enzyme‐linked immunosorbent assay (ELISA) using a recombinant protein of the non‐collagenous 16a (NC16a) domain of the 180 kDa bullous pemphigoid antigen (BP180). The ELISA was shown to be more sensitive in detecting disease‐specific antoantibodies in the bullous pemphigoid sera. The reduction of titers of circulating autoantibodies in the sera correlated well with the decrease in the disease activity in both the first and second rounds of plasmapheresis treatment in this case.
A Case of Nodular Cutaneous Lupus Mucinosis
Authors: Terao Hiroshi , Moroi Yoichi , Urabe Kazunori , Koga Tetsuya , Furue Masutaka 
Published: July 2014

AbstractThe patient was a 44‐year‐old female. She was diagnosed as having systemic lupus erythematosus at the age of 21 years and had been receiving systemic steroid treatment (5 mg prednisolone/day). Nodules began to appear on her neck, chest and back from June in 2000, and she was referred to our clinic for examination and treatment. Examination of a biopsy sample of an eruption on the neck revealed mucin deposition in the dermis. Based on the clinical and histopathological findings, she was diagnosed as having typical nodular cutaneous lupus mucinosis. The dose of steroid was increased, and the eruptions gradually disappeared.
Vitamin D and the Skin
Authors: Kira Masahiro , Kobayashi Teruaki , Yoshikawa Kunihiko 
Published: July 2014

AbstractVitamin D was originally discovered as a factor that regulates calcium and bone metabolism. Recent advances in investigation have shown that vitamin D also functions as a regulator of cellular growth and differentiation in various tissues. The skin is not an exception from such effects of vitamin D; it is regarded as a site of its activation and action. Evidence has accumulated showing that the active form of vitamin D and its analogs suppress growth and stimulate the terminal differentiation of keratinocytes. In psoriatic lesions, epidermal keratinocytes exhibit hyper‐proliferation and impaired differentiation triggered by inflammation. Therefore, it is quite reasonable that vitamin D is effective on psoriasis. Indeed, within the past decade, analogs of vitamin D3 have been used as topical therapy for psoriasis. In this review, we summarize the fundamental features of vitamin D and the development of vitamin D therapy for psoriasis. Clinical application to other skin diseases and the future of vitamin D therapy in dermatology are also discussed.
Cutaneous Concerns of Scleroderma Patients
Authors: Paquette Dana L. , Falanga Vincent 
Published: July 2014

AbstractThe clinical features of facial and oral involvement in scleroderma are striking. We conducted a survey of patients with systemic sclerosis (scleroderma). The purpose of our study was to ascertain what was most bothersome aesthetically to scleroderma patients. We also looked at the differences between age groups and genders. The survey was mailed to 1,000 individuals who subscribe to a national lay group organization. We received 303 completed surveys indicating the patient's age, gender, age at onset of disease, and a checklist of 14 physical variables involving the central face and non‐face. The respondents were asked to rate their level of concern [on a scale of great (1) ‐moderate (2) ‐little (3) ‐none (4)] in regards to 14 different physical variables. The respondents consisted of 92% females and 8% males. The mean age was 59 years +/– 13 (SD), and the median age was 60. The mean and median age at diagnosis was 45 years +/– 15 (SD). The percentage of respondents expressing concern for specific features was the following: for thin lips (73%), mouth furrows (80%), loss of facial lines (68%), and a smaller, tighter mouth (77%). There was less concern over the non‐face features. The percentage of respondents expressing no concern was the following: for absence of sweating (57%), skin darkening (50%), nail dystrophy (57%), and skin atrophy (63%). There was a highly statistically significant difference (p<0.0001) between those respondents concerned with central face features vs. non‐face features. With advancing age and longer disease duration, there was increased concern over the aforementioned central face features (p<0.0001). The vast majority of patients with systemic sclerosis have great concerns over changing facial features, and this worsens with age.
Effectiveness of Iontophoresis with Alternating Current (AC) in the Treatment of Patients with Palmoplantar Hyperhidrosis
Authors: Shimizu Hirokazu , Tamada Yasuhiko , Shimizu Junko , Ohshima Yuichiro , Matsumoto Yoshinari , Sugenoya Jun‐ichi 
Published: July 2014

AbstractConventionally, iontophoresis employing direct current (DC) has been used in the treatment of palmoplantar hyperhidrosis, but this is accompanied by side effects such as pain and burns. In the present study, a prototype apparatus using alternating current (AC) was constructed, and iontophoresis with AC was performed in palmoplantar hyperhidrosis patients to determine its effectiveness. The average amount of perspiration of the palmoplantar hyperhidrosis patients was significantly reduced after the third session when iontophoresis treatments were performed once per week. By the eighth treatment, perspiration was reduced to nearly the normal level, and there were no particular side‐effects during the treatment period. This treatment therefore appears to be both safe and effective. The treatment effect tended to appear sooner when alternating current iontophoresis was combined with the administration of anticholinergic drugs than when alternating current iontophoresis was used alone. Alternating current iontophoresis is an effective treatment for palmoplantar hyperhidrosis. Guidelines for this treatment for patients with palmoplantar hyperhidrosis will need to be established in the future.
Efficacy and Safety of Cyclosporine versus Methotrexate in Severe Psoriasis: A Study from North India
Authors: Sandhu Kamaldeep , Kaur Inderjeet , Kumar Bhushan , Saraswat Abir 
Published: July 2014

AbstractTreatment of patients with severe psoriasis is difficult. Among the number of systemic drugs that are available, methotrexate has long been used, but cyclosporine has been recently recommended for the management of severe psoriasis. The purpose of this study was to compare the efficacy and safety of daily cyclosporine with weekly methotrexate in the management of severe psoriasis. Thirty consecutive patients with severe psoriasis were randomly assigned to treatment with cyclosporine or methotrexate. The initial dose of cyclosporine was 3 mg/kg/day, which was increased to a maximum of 4 mg/kg after two weeks of therapy when the response was not adequate. Methotrexate was administered weekly at a dose of 0.5 mg/kg. Clinical response was assessed by calculating PASI score in all patients at biweekly intervals. Patients were followed up fortnightly up to a maximum of 12 weeks. The doses of both drugs were gradually tapered once >75% reduction in disease severity was attained. Marked improvement (>75%) reduction in PASI was noted in all patients except for one in the cyclosporine group. The median time for marked improvement was 5.3 weeks with methotrexate and 6.8 weeks with cyclosporine. Patients on methotrexate were found to have more rapid and complete clearance than those on cyclosporine. Both drugs were well tolerated. Side effects in both the treatment groups were minor, transient, and manageable. At doses with comparable safety profiles, methotrexate resulted in more rapid and cost effective clearance of patients with severe psoriasis. Cyclosporine can provide an effective and safe alternative.
Acetylator Phenotype in Behçet's Disease
Authors: Najim Rafid A. , Sharquie Khalifa E. , Al‐Janabi Mahmood H. 
Published: July 2014

AbstractThe purpose of this study was to determine the acetylator status in Behçet's disease (BD) patients and compare it to a matched group of normal individuals. Thirty‐seven healthy volunteers and forty‐one BD patients were included. Detailed history was taken from the patients. HLA‐B51 was determined in the BD patients. In addition, the Clinical Manifestation Index (C.M.I.) was determined for each patient. Pathergy test was also done. After an overnight fast, each control subject and patient received a single oral dose of 100 mg of DDS. A blood sample was collected after 3 hours and the plasma was separated for determination of dapsone/monoacetyldapsone by HPLC. The frequency of slow acetylators in healthy individuals was 70.2%, while the frequency of rapid acetylators was 29.8%. The frequency of slow acetylators in BD patients was 53.7%, while the frequency of non‐acetylators (undetected monoacetyldapsone MADDS in plasma) was 46.3%. There were no rapid acetylators among the BD patients. There was a strong negative association between the acetylator status and the severity of BD. In addition, acetylator status correlated with HLA‐B51, in that BD patients with positive HLA‐B51 were characterized by a very slow or non‐acetylator status. Slow or non‐acetylators had more severe BD. We conclude that BD patients have a unique acetylator status. This finding may have implications for the theories for the pathogenesis of the disease as well as for therapeutic aspects.
Cutaneous Metaplastic Synovial Cyst
Authors: Choonhakarn Charoen , Tang Songyos 
Published: July 2014

AbstractMetaplastic synovial cyst of the skin is a recently recognized entity characterized by an intradermal nodule that usually occurs at the site of previous surgical trauma. Histologically, the lesion demonstrates a cystic structure with villous‐like projections and a lining resembling hyperplastic synovium. We have studied two patients with rheumatoid arthritis, aged 46 and 55 years, who presented with cystic nodules localized on the thumb and great toes, respectively, without any history of previous trauma or surgical procedures performed in the areas. The presence of vimentin and CD 68 positivity of the cells lining the cyst walls supports the similarities between normal and metaplastic synovium. We hypothesize that constant pressure on the great toe, repeated manipulation of the finger, and chronic inflammation around the affected joints may have played roles in the pathogenesis of the lesions in our patients.
Disseminated Mycobacterium chelonae Cutaneous Infection: Recalcitrant to Combined Antibiotic Therapy
Authors: Kullavanijaya Preya , Rattana‐Apiromyakij Niramol , Sukonthapirom‐Napattalung Palachart , Sirimachand Supreeya , Duangdeeden Imelda 
Published: July 2014

AbstractA 25‐year‐old Thai housewife had a history of tuberculosis of the lymph nodes for six years that had been successfully treated with a course of anti‐TB drugs. She developed several red, circumscribed, infiltrative plaques composed of umbilicated papules and pustules on her face and upper part of the body with cervical lymphadenopathy six months later. A pus smear from the lesion grew acid fast bacilli (AFB). Histopathological examination showed a mixed cell granuloma suggestive of infection. A T cell study showed a low CD4 count, and multi skin tests indicated cutaneous anergy. Culture from a biopsy specimen taken from the skin lesion grew M.chelonae; the cultures from blood, urine, and bone marrow. The lesions were not responsive to an anti TB drug given for 2 months based upon the results of the AFB positive pus smear before the culture and sensitivity reports were obtained. Since then the patient was treated with antibiotics according to the results of the sensitivity tests. A combination of amikacin and clarithromycin was started and hyperthermic therapy was later added with a partial response. Based upon the sensitivity test, kanamycin was introduced but had to be stopped because of ototoxicity. Sparfloxacin was used with an effective result but was discontinued for economic reasons. Finally, clarithromycin in combination with clofazimine and cryotherapy were given for a year before the lesions healed completely. It took a three years duration for the total course of treatment for this patient. She is still in remission after two years of follow‐up period. This extensive cutaneous M.chelonae infection needed a prolonged combination of antibiotics with the addition of cryotherapy for the non‐responsive lesions.
A Case of Antiphospholipid Syndrome with Cutaneous Ulcer and Intrauterine Fetal Growth Retardation
Authors: Nakano Junji , Nakamura Mitsutaka , Ito Takehisa , Murata Masako , Fujiyama Jun‐ichi 
Published: July 2014

AbstractA 28‐year‐old patient presented with severe intrauterine fetal growth retardation (IUGR) at 34 weeks' gestation. There was a prior history of a recurrent cutaneous ulcer on the left thigh. Serological tests for IgG anticardiolipin antibody were positive. A live premature male infant was delivered by an urgent cesarean section because of fetal distress. Histopathological examination revealed that the causes of the cutaneous ulcer and IUGR were thrombosis of the small blood vessels and placental infarction, respectively. Early diagnosis and proper treatment are important in the management of the antiphospholipid syndrome.
Steatocystoma Multiplex in Four Successive Generations
Authors: Kaur Tejinder , Kanwar Amrinder Jit 
Published: July 2014

AbstractA 16‐year‐old girl presented with multiple, yellowish, elastic, non‐tender cysts on the face, trunk, arms and axillae for the last 3–4 years. On pricking, yellowish fluid could be expressed from the lesions. Clinically and histopathologically, the lesions were suggestive of steatocystoma multiplex. There was a family history of similar lesions in five members over four generations.
Expression of Double‐Stranded RNA‐Activated Protein Kinase in Keratinocytes and Keratinocytic Neoplasia
Authors: Kuyama Michiyo , Nakanishi Gen , Arata Jirô , Iwatsuki Keiji , Fujimoto Wataru 
Published: July 2014

AbstractDouble‐stranded RNA‐activated protein kinase (PKR) is a interferon‐induced protein initially known for its inhibitory effects on cellular and viral protein synthesis. In recent studies, PKR has been shown to be an important participant in a broad array of cellular processes, including signal transduction, differentiation, apoptosis, cell growth, and tumorigenesis. The expression of PKR in normal human keratinocytes (NHEK) was examined, and its expression in several skin lesions was compared immunohistochemically with that of proliferating cell nuclear antigen (PCNA). Expression of PKR mRNA was detected in NHEK without IFNγ treatment; the level of PKR mRNA increased with IFNγ treatment for two hours. Immunoblot analysis revealed that the monoclonal anti‐PKR antibody reacted specifically with a 68kDa PKR protein in extracts from NHEK. Immunohistochemistry revealed that PKR protein was expressed in normal epidermis and mucosa. PKR expression was not restricted only to suprabasal cells but was also observed in basal cells positive for PCNA. In psoriatic plaques, PKR expression was lower in basal and parabasal keratinocytes and comparable in suprabasal keratinocytes to the levels in normal skin. PKR was partially detected in atypical cells in non‐invasive keratinocytic neoplasia but was completely absent from undifferentiated tumor cells of squamous cell carcinoma. The present study demonstrated that PKR protein is constitutively expressed in epidermal and epithelial keratinocytes of normal skin and mucosa and indicated that a loss of PKR is not associated with the malignant transformation itself but with the increased cell proliferative activity and the altered differentiation of keratinocytes.
Topical Antibacterial Agents in Dermatology
Authors: Singal Anjum , Thami Gurvinder P. 
Published: July 2014

AbstractTopical antibacterials are being widely used for the treatment or prevention of superficial bacterial infections. Emergence of drug resistant mutant strains of microorganisms and development of irritant and allergic contact dermatitis is a common problem with many of the topical antibacterials. Topical antibacterials are being reviewed with special emphasis on their spectrum of activity, resistance patterns, contact sensitivity potential and clinical uses. Factors which help the physician to choose a particular antibacterial for the specific indication in order to have the maximum efficacy and minimum adverse effects are discussed.
Structural Changes in the Glycosaminoglycan Chain of Rat Skin Decorin with Growth
Authors: Nomura Yoshihiro , Abe Yoshiko , Ishii Yasuhiro , Watanabe Mutsuto , Kobayashi Miya , Hattori Akira , Tsujimoto Masafumi 
Published: July 2014

AbstractDecorin controls collagen fibrilogenesis in skin, and its molecular weight changes in wound healing and with age. In this report, the quantitative and structural changes of decorin were investigated with growth in rat skin from the fetus to the young adult. A northern blot analysis showed that the highest level of skin decorin mRNA was at post partus 0.5 days; this level was about 3.7 times the level at embryo 16.5 days. The mRNA level in the rat skin decreased by 1/5 from post partus 0.5 days until 90 days of age. Western blotting showed that the amount of decorin increased with age in protein level. The molecule size of decorin at embryo 18.5 days was about 110 kDa, and that at post partus 90 days was about 70 kDa. There were no changes in molecular size of its core protein, so the reduction in the size of decorin was dependent on the size of the glycosaminoglycan (GAG) as shown by western blot analyses. Electron micrography of the rat skin with cupromeronic blue staining showed that the length of GAG at embryo 18.5 days was about 78.58 ± 13.94 nm, and that at post partus 90 days was about 54.05 ± 4.79 nm. The reduction in length of decorin GAG with age shrunk the distance between the collagen fibrils. We suggested that decorin changes the GAG length in order to control skin reconstruction in response to inflammation and injury.
Skin Graft Fixation with Negative‐Pressure Dressings
Authors: Isago Tsukasa , Nozaki Motohiro , Kikuchi Yuji , Honda Takashi , Nakazawa Hiroaki 
Published: July 2014

AbstractThe tie‐over bolster dressing is the most commonly used method for securing skin grafts. However, it requires surgical skill and experience to make a skin graft adhere closely to a grafting site when the site has a complicatedly curved surface. The lack of appropriate tension and pressure on the skin graft may produce hematoma, dislocation, or wrinkles in the graft. The grafting site for the dorsum of a hand is particularly complicated and irregular and requires delicate changes in pressure when the tie‐over bolster dressing is used for sites supported and not supported by bones. We have obtained a high survival rate at such difficult sites by managing skin grafts with negative‐pressure dressings. This paper describes the details of the technique with case reports. We have used this technique for skin graft fixation in 10 patients and confirmed its high utility as evidenced by a survival rate of 95% or higher of the grafted areas. Unlike existing techniques that apply pressure on skin grafts, this technique applies a negative pressure to the space between the skin graft and the grafting site to remove hematomas and pull the whole skin graft onto the grafting site with uniform force for adhesion.