bluuebunny/crossref_metadata_2025_split huggingface dataset:
Idiopathic unilateral circumscribed hyperhidrosis
Authors: Koöse Osman , Baloglu Huüseyin 
Published: August 2010

A 21‐year‐old man presented with a hyperhidrotic area on the extensor aspect of the right forearm and wrist. The lesion was 8 × 15 cm in size and was sharply demarcated. The patient complained of profuse sweating that lasted 10–80 min and that was sometimes precipitated by heat.We obtained two different punch biopsies from the left and right wrists. The biopsies showed apparently normal histologic findings. Neurologic examination was normal. We then performed a conventional iodinated‐starch test for sweating. Before the test, the right arm was of an orange colour with iodine‐starch powder; dark blue droplets were seen on the hyperhidrotic area after provocation by heat (Figs 1 and 2).Laboratory findings revealed a normal complete blood cell count and normal results of renal and liver function tests. Aluminium chloride cream (20%) was used as treatment, but the hyperhidrosis was not controlled.
Chronic leg ulcers associated with hereditary protein S deficiency
Authors: Kulthanan Kanokvalai , Krudum Tawat , Pintadit Pakaimas , Khokkaseam Rajapat , Kullavanijaya Preya 
Published: August 2010

A 17‐year‐old Thai man developed erythematous papules on the dorsal surfaces of both feet 7 years previously. The papules progressed to superficial ulcers which slowly increased in size and, although treated by several modalities, never completely healed.Physical examination revealed two irregular‐shaped superficial ulcers, 4 × 1 and 5 × 1 cm in size, on the dorsal surface of his right and his left foot, respectively (Fig. 1). The ulcers had granulation tissue at the bases with well‐defined borders surrounded by brownish patches. During admission, the superficial vein of the patient's right arm showed painful, warm, cord‐like induration.A biopsy specimen from the edge of the ulcer of the left leg showed ulcerated epidermis with pseudoepitheliomatous hyperplasia. Diffuse mixed cellular infiltration composed of lymphocytes, histiocytes, and neutrophils was seen in the dermis with fibrosis and some capillary proliferation. The results of skin biopsy cultures for fungus, bacteria, and mycobacteria were negative. The biopsy specimen from the superficial vein of the right arm showed obliteration of the vessel lumen and mixed cellular infiltration composed of lymphocytes, histiocytes, and neutrophils within the wall compatible with thrombophlebitis.Laboratory studies revealed a normal complete blood cell count, SMA 18, prothrombin time, and partial thromboplastin time. The erythrocyte sedimentation rate was 29 and lupus anticoagulant was not present. Anticardiolipin IgG, IgM, ANA, cryoglobulin, and anti‐HIV antibody were all negative. Levels of C3, C4, and CH50 were normal. Bilateral venogram showed deep vein thrombosis of the left leg. The free protein S level was 41% (normal 60%‐140%) (Microlatex particle‐mediated immunoassay), the protein C level was 90% (normal 75%‐150%), and the antithrombin III level was normal.Heparin treatment (Nadroparine 20,000 units subcutaneous Injection twice a day for 10 days) was followed by coumadin 3 mg/day, 2 days per week (days 1 and 4), and 2 mg/day, 5 days per week (days 2, 3, 5, 6 and 7), to keep the prothrombin time between 1.5 and 2 times normal control. The ulcers completely healed 3 months after treatment.The studies of the patient's family members were consistent with hereditary protein S deficiency as in the pedigree shown in Fig. 2. The patient's brother (III‐2), mother (11–2), and aunts (11–1, 11–5) all had low levels of protein S (35%, 63%, 51%, and 69% respectively). His uncle (11–3) died with pulmonary embolism in a private hospital. Unfortunately an autopsy was not permitted. We could not obtain blood samples from the patient's father and grandfather.
Evaluation of oral methotrexate in the treatment of systemic sclerosis
Authors: Krishna Sumanth M. , Sharma Vinod K. , Khaitan Binod K. , Kapoor Anu , Tejasvi Trilokraj 
Published: August 2010

AbstractBackground  Treatment of scleroderma is difficult and currently no treatment can induce complete remission of the disease.Objective  To evaluate weekly oral methotrexate in the treatment of Indian patients with systemic sclerosis.Methods  Thirty‐three patients with systemic sclerosis presenting to the department of dermatology (outpatients) who satisfied the inclusion criteria were enrolled into the study. All cases were admitted into the dermatology ward for detailed evaluation. A detailed history and physical examination, including assessment of disease severity by Rodnan skin scoring, was carried out. Baseline investigations included complete blood counts, blood glucose, serum electrolytes, renal function test, liver function tests, urine examination (albumin, sugar, microscopic examination, 24‐h protein), ANA, chest X‐ray, Barium swallow, pulmonary function test, electrocardiogram (ECG), HRCT of chest, and 4‐mm punch skin biopsy from dorsum of the hand. All the patients were treated with oral methotrexate (15 mg/week) for 6 months, following standard guidelines.Results  The patients included 29 (87.9%) females and four (12.1%) males with a mean age of 31.45 ± 8.76 years. The mean duration of disease was 5.6 ± 4.5 years (range 2 months to 15 years). All the patients had binding down of skin, 31 (93.9%) had Raynaud's phenomenon, 31 (93.9%) had pigmentary change, 21 (63.6%) had hand contractures, 17 (51.5%) had fingertip ulcers, 15 (45.5%) had dyspnoea, 14 (42.4%) had restricted mouth opening, 13 (39.4%) had telangiectasia, 11 (33.3%) had fingertip resorption, eight (24.2%) had joint complaints, six (18.2%) had dysphagia, and one (3.03%) had gangrene. On laboratory investigation ANA was positive in 29 (87.9%) patients, dsDNA was raised in only four (12.1%), baseline chest X‐ray was abnormal in 18 (54.5%), HRCT was abnormal in 27 (81.8%), abnormal PFT in 32 (96.9%), abnormal ECG in five (15.2%), and barium swallow abnormality in 19 (57.5%) patients.Twenty‐five patients completed the 6‐month follow up. There was subjective improvement in binding down (80%), Raynaud's phenomenon (96%), fingertip ulceration (88.8%), hyperpigmentation (77.2%) and dyspnoea (45.5%). The objective parameters showed statistically significant improvement in mouth openingm, but improvement of skin score, lung function (chest radiograph, PFT, HRCT), and dysphagia was not significant at the 6‐month follow up. In eight patients, treatment was continued for 1 year of methotrexate, which showed statistically significant improvement in skin score.Conclusion  It was concluded that methotrexate for 6 months only provides subjective improvement, and further studies after 1 year of treatment with methotrexate are recommended.
Cervical cancer metastasis to the scalp presenting as alopecia neoplastica
Authors: Chung John J. , Namiki Thomas , Johnson Douglas W. 
Published: August 2010

A 45‐year‐old Japanese woman was diagnosed in 1996 with squamous cell cancer of the cervix following an abnormal Papanicolaou smear and subsequent diagnostic conization. She underwent total abdominal hysterectomy with pelvic lymphadenectomy and was found to have poorly differentiated squamous cell carcinoma, International Federation of Gynecology and Obstetrics (FIGO) stage IB1. She remained asymptomatic until 2003 when she presented with obstructive uropathy with acute renal failure and hydronephrosis, suspected to be from the recurrence of cervical cancer. This was confirmed when computerized tomography (CT)‐guided lymph node biopsy showed squamous cell carcinoma of the para‐aortic lymph nodes histologically consistent with the cervical primary. In addition, there was evidence of lumbar spine metastasis by positron emission tomography (PET) and bone scans. She received several courses of chemotherapy with cisplatin and 5‐fluorouracil (5FU), as well as radiation therapy.In July 2004, she was hospitalized for acute renal failure, nausea, vomiting, and anorexia. CT of the abdomen identified widespread metastases in the liver, pancreatic head, and lumbar spine. During this hospitalization, she complained of severe scalp tenderness and patchy hair loss first noticed 3 days prior to presentation. On examination of her scalp, two patches of alopecia were observed (Fig. 1). In the largest patch, there was a 5 × 2.5‐cm, tender, erythematous plaque with atrophy. In the smaller patch, there was a 2 × 1.5‐cm, erythematous, scaly plaque. A punch biopsy of the larger patch revealed atypical epithelial cells in nests with intravascular involvement and diminished numbers of focally miniaturized hair follicles (Fig. 2a). The scalp specimen was histologically identical with biopsy specimens of the cervical primary (Fig. 2b). There was also seborrheic dermatitis, with thick greasy scale, noted on the scalp, which resolved with fluocinolone solution. The patient decided against further treatment for her advanced cervical cancer but did accept hydromorphone for pain. She died 3 months after admission.Erythematous patches of alopeciaimage(a) Biopsy of scalp metastasis. Note nests of atypical epithelial cells and diminished number of focally miniaturized hair follicles. (b) Biopsy of cervical specimen (hematoxylin and eosin stain, ×100)image
Alopecia areata
Authors: Wasserman Dan , Guzman‐Sanchez Daniela Araucaria , Scott Kimberly , McMichael Amy 
Published: August 2010

AbstractAlopecia areata (AA) is a nonscarring, autoimmune, inflammatory, hair loss on the scalp, and/or body. Etiology and pathogenesis are still unknown. The most common site affected is the scalp. Histopathology is characterized by an increased number of the catagen and telogen follicles, the presence of inflammatory lymphocytic infiltrate in the peribulbar region (“swarm of bees”).Corticosteroids are the most popular drugs for the treatment of this disease. Etiologic and pathogenic mechanisms, as well as other current treatments available will be discussed in this article.
Measurement of pruritus in a Chinese woman with pemphigoid gestationis using a wrist movement detector
Authors: Hon Kam‐lun Ellis , Chiu Lai‐shan Mona , Lam Man‐chin Adrian , Choi Cheung‐lung Paul , Chan Shirley , Luk Nai‐ming 
Published: August 2010

AbstractPemphigoid gestationis (PG) is a rare itching bullous disease of pregnancy and the postpartum period. We describe the use of a new methodology for measuring the nature and intensity of itching in a 21‐year‐old woman with pemphigoid gestationis. At 19 weeks gestation, she developed an itchy rash over the limbs, which spread to the trunk. Blisters then appeared on the hands which subsequently also involved the feet. Intense nocturnal wrist activities in this patient, measured with a wrist monitor and defined as average acceleration in the early hours of sleep, were even higher than that in patients with severe eczema, with an average value of 181.00 ± 43.49 (mean ± standard error) g/min for the first three hours, versus 84.47 ± 8.53 g/min for the group of 24 eczema subjects. Most wrist activities were slower movements at 0 to 1 Hz. This is in striking contrast to the scratching activities at 0 to 3 Hz in eczema subjects. There have been no therapeutic trials for PG. Topical steroid and oral antihistamines are usually ineffective, but worked in our patient. We also discuss the potential application of the monitor in assessing the nature of various dermatological or systemic itching disorders.
Lack of association between the G‐2548A polymorphism of the leptin gene and psoriasis in a Turkish population
Authors: Kara Nurten , Aydin Fatma , Senturk Nilgün , Gunes Sezgin , Canturk M. Tayyar , Bagci Hasan , Bek Yüksel , Turanli Ahmet Yasar 
Published: August 2010

AbstractBackground   Psoriasis is a multifactorial disease in which genetic and inflammatory factors play important roles. Leptin is classified as a cytokine and plays an important role in the regulation of the T‐helper response. A common polymorphism in the promoter of the human leptin gene (G‐2548A) may have a role in the pathogenesis of psoriasis.Aim  To investigate the association between psoriasis and leptin gene polymorphism (G‐2548A).Methods  The study involved 109 patients with psoriasis and 125 healthy controls. Analyses of G‐2548A polymorphism of the leptin gene were made by the polymerase chain reaction‐restriction fragment length polymorphism technique. The genotypes (GG, GA, and AA of leptin gene G‐2548A) and alleles (G and A) were scored and the frequencies were estimated. The frequencies of alleles and genotypes in patients and controls were compared. The relationship between leptin gene polymorphism and the clinical features of the patients was analyzed.Results  Both genotype [odds ratio (OR), 0.921; 95% confidence interval (CI), 0.501–1.694; P = 0.792] and allele (OR, 0.864; 95% CI, 0.600–1.242; P = 0.429) frequencies were not significantly different between patient and control groups. In addition, there was no significant association between genotype and allele frequencies and the clinical characteristics of psoriasis.Conclusion  In this case–control study, no evidence of association between the G‐2548A variant of the leptin gene and psoriasis was found.
Systemic exposure to lidocaine and tetracaine is low after an application of a lidocaine 7%–tetracaine 7% peel in adults
Authors: Ogden Lazarre , Love Georgette , Basta Susan 
Published: August 2010

AbstractBackground  The lidocaine 7%–tetracaine 7% (LT) peel has been demonstrated to be useful for a variety of dermatologic applications, including cosmetic, laser, and vascular access procedures.Aim  To measure and evaluate the detectable plasma levels and safety of lidocaine and tetracaine in adult volunteers after a single application of an LT peel, a novel method of topical anesthesia that does not require occlusion.Methods  A randomized, factorial design study was used to evaluate the pharmacokinetic profile of lidocaine and tetracaine after a single application of the LT peel in adult volunteers (n = 36; mean age, 26.6 years). The LT peel was applied to the anterior surface of the left or right thigh of volunteers for 30, 60, or 90 min over a 50‐, 100‐, or 200‐cm2 area. Venous blood samples were collected at 0, 30, 60, 90, 120, 150, 180, 210, 300, and 420 min after the initial application of the LT peel.Results  At all time points, plasma concentrations of lidocaine and tetracaine were below the limits of quantification for the assay: 100 ng/mL and 5 ng/mL, respectively. Because of the lack of concentrations above the limit of quantification, it was not possible to determine the pharmacokinetic parameters, other than the maximum concentrations of < 100 ng/mL for lidocaine and < 5 ng/mL for tetracaine. A single application of the LT peel was well tolerated, and no study subject reported an adverse event.Conclusions  A single application of LT peel to up to 200 cm2 of anterior thigh in adults with a duration of up to 90 min produces systemic levels of lidocaine and tetracaine that are of no clinical significance at all time points measured up to 420 min after the initial application.
Verrucous tuberculid mimicking Kyrle disease
Authors: Khandpur Sujay , Bansal Arika , Ramam M. , Sharma Vinod K. , Das Anup Kumar , Singh Manoj K. , Prasad H. Krishna 
Published: August 2010

AbstractCutaneous tuberculosis shows wide clinical variation depending upon the virulence of the organism and host immunity. Tuberculids are difficult to diagnose since the organism often cannot be identified or isolated by microscopy, culture or polymerase chain reaction. The diagnosis rests primarily on the identification of a tuberculous focus elsewhere in the body and response to antitubercular therapy. We present the clinicopathological features of an unusual tuberculid in a 30‐year‐old man, remarkably mimicking Kyrle's disease. He presented with multiple, symmetrically distributed follicular and perifollicular verrucous papules, nodules and plaques on the face, earlobes and extremities since 4 years. Histopathology revealed parakeratotic follicular plug invaginating into the dermis with multiple caseating epithelioid cell granulomas. PCR for M. tuberculosis was negative. The identification of associated axillary tubercular lymphadenitis, strongly positive Mantoux reaction, tuberculoid granulomas on histopathology and complete resolution of the lesions with antitubercular therapy helped in making the diagnosis. We propose the term “verrucous tuberculid” for this entity.
Direct immunofluorescence study in patients with lichen planus
Authors: Kulthanan Kanokvalai , Jiamton Sukhum , Varothai Supenya , Pinkaew Sumruay , Sutthipinittharm Puan 
Published: August 2010

AbstractBackground  Direct immunofluorescence (DIF) studies in patients with lichen planus (LP) show the deposition of multiple immunoglobulins (Igs) at the cytoid bodies (CBs) and fibrin at the dermoepidermal junction (DEJ). The deposition of Ig at the DEJ, as in patients with lupus erythematosus (LE), is occasionally found. For cases with no specific clinical and histologic characteristics, or with ambiguous features, DIF studies may be helpful in disease differentiation.Methods  From 1996 to 2004, data from 72 patients with LP, diagnosed on the basis of clinical and histologic criteria at the Department of Dermatology, Siriraj Hospital, Bangkok, Thailand, were collected. The results of DIF studies were analyzed.Results Deposits at the DEJ and CBs were detected in 53% and 60% of cases, respectively. A combination of DEJ (mostly fibrin) and CB (mostly IgM) deposits was found in 38% of cases. A combination of IgM and other immunoreactant deposits, including fibrin at the CBs, was found in 56% of cases.Conclusions  This study showed that the positive yield of DIF in LP was 75%. Shaggy fibrin deposition at the DEJ, which is the single best indicator in the diagnosis of LP, was found in 56% of cases. The presence of CBs only, which is a poorer indicator than the shaggy deposition of fibrin along the DEJ, was found in 22% of cases. There were no statistically significant differences in positive DIF yield between specimens derived from glabrous skin and oral lesions (P = 0.67). Forty‐four per cent of cases had immunoreactants other than fibrin deposited along the DEJ, which resembled those of LE.
Tanning bed exposure increases the risk of malignant melanoma
Authors: Ting William , Schultz Kara , Cac Natalie N. , Peterson Michael , Walling Hobart W. 
Published: August 2010

AbstractBackground  Epidemiologic studies have associated tanning bed exposure and cutaneous melanoma. The relationship between the extent of tanning bed exposure and the risk of melanoma has not been elucidated in detail.Methods  Surveys assessing the extent of tanning bed exposure and the history of skin cancer, including malignant melanoma, were collected from academic dermatology clinic patients (n = 1518). Of these, 551 (36.3%) completed all components of the survey. The available medical records, including pathology reports (n = 501; 33%), were reviewed to confirm cases of skin cancer. Data on potential confounding factors, including indoor vs. outdoor occupation and leisure activities, Fitzpatrick skin type, history of blistering sunburn, use of sunscreen and sun protective clothing, history of phototherapy, and level of education, were assessed and compared.Results  Of the patients surveyed, 487 (32.1%) reported tanning bed exposure. Women aged 45 years or younger accounted for about 60% of all tanning bed users. Seventy‐nine cases of malignant melanoma were reported, 22 in women aged 45 years or younger. In the entire cohort, the “ever‐use” of tanning beds was found to be a significant risk factor for the development of melanoma [P < 0.05; odds ratio (OR), 1.64; 95% confidence interval (95% CI), 1.01–2.67]. The risk was greater in women aged 45 years or younger (P < 0.05; OR, 3.22; 95% CI, 1.01–11.46). Patients with a history of melanoma were significantly more likely to report tanning bed sessions exceeding 20 min (P < 0.01; OR, 3.18; 95% CI, 1.48–6.82); this association was even stronger for women aged 45 years or younger (OR, 4.12; 95% CI, 1.41–12.02).Limitations  The study was subject to recall bias, included only patients at a midwestern academic practice, and had a relatively low response rate.Conclusion  Exposure to tanning beds increases the risk of malignant melanoma, especially in women aged 45 years or younger. These findings reinforce the hazards of tanning bed exposure.
Myxoinflammatory fibroblastic sarcoma – report of a rare case at an unusual site with review of the literature
Authors: Premalata Chennagiri S. , Rama Rao Clementina , Padma Maneya , Vijaykumar Manavalan 
Published: August 2010

AbstractWe report a case of myxoinflammatory fibroblastic sarcoma in a thirteen year old gilrl who presented with a tender swelling in the left upper back. The tumor consisted of varying proportions of inflammatory, myxoid and hyalinized areas. Large bizarre cells with virocyte like inclusions and lipoblast like cells were present. To the best of our knowledge this is the first reported case of myxoinflammatory fibroblastic sarcoma of the back, the extremities being the commonest site of involvement. Due to its varied histologic appearance, the tumor should be differentiated from various benign and malignant soft tissue lesions.
Pigmentatio maculosa eruptiva idiopathica: a case report and review of the literature
Authors: Stinco Giuseppe , Favot Francesca , Scott Cathryn Anne , Patrone Pasquale 
Published: August 2010

AbstractBackground  Pigmentatio maculosa eruptiva idiopathica is a rare pediatric disease characterized by asymptomatic, brownish macules involving the neck and trunk with no preceding inflammatory process or history of drug exposure.Methods  A 9‐year‐old girl presented with brown–gray, nonconfluent, asymptomatic macules on the trunk, neck, and limbs, ranging from 5 to 30 mm in diameter. The macules appeared suddenly with no lesions preceding their occurrence. Histopathologic examination showed basal cell layer hyperpigmentation, and abundant melanophages with a mild perivascular lymphohistiocytic infiltrate in the papillary dermis.Results  The lesions disappeared spontaneously 1.5 years later with no therapy. No relapse occurred.Conclusion  Pigmentatio maculosa eruptiva idiopathica must be differentiated from other skin disorders with hyperpigmentation in pediatric practice in order to avoid unnecessary treatment, as spontaneous resolution is expected. Following a literature review, we underline the importance of spontaneous regression as an additional clinical feature for this disease.