bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is there a role for infliximab in the current therapy of hidradenitis suppurativa? A report of three treated cases
Authors: Moschella Samuel L. 
Published: August 2010

AbstractBackground  Hidradenitis suppurativa is one of the follicular occlusion diseases favoring the flexural areas of the body. Because of the past failure of medical therapy, surgery is today the definitive therapeutic approach. There is a need for effective medical anti‐inflammatory therapy to control the disease and minimize the pathologic and socioeconomic consequences of the disease process. Generally the patients fail to respond to topical or systemic antibiotics and retinoids. Temporary responses are achieved with intralesional steroids and cyclosporin.Methods  The association of hidradenitis suppurativa with inflammatory bowel disease permitted the opportunity to utilize infliximab and to observe not only its impact on the bowel, but also skin.Results  Infliximab dramatically and favorably impacted on three cases of hidradenitis, but also in one of the patients who also had pyoderma gangrenosum.Conclusions  Infliximab appears to be an effective medical approach to the management of hidradenitis suppurativa and also to prepare the patient for “curative” surgery. However, one must be cognizant of the potential of acquired drug resistance or adverse drug reactions, which can be minimized by “no vacations” from this systematic therapy and the use of methotrexate to minimize the above potential problems.
Leflunomide in subacute cutaneous lupus erythematosus – two sides of a coin
Authors: Suess Anke , Sticherling Michael 
Published: August 2010

AbstractBackground  Subacute cutaneous lupus erythematosus (SCLE), a distinct clinical subset of lupus erythematosus, remains a therapeutic challenge, especially in cases resistant to topical and standard systemic therapy. Leflunomide, a novel antirheumatic drug, has shown efficacy in the treatment of systemic lupus erythematosus in pilot studies.Methods  We report two patients with SCLE who demonstrated the spectrum of possible clinical responses to leflunomide therapy.Results  One patient experienced a complete clinical remission of symptoms, whereas the other developed a massive skin reaction which was distinctly related to the commencement of leflunomide therapy.Conclusion  To our knowledge, this is the first time that remission and deterioration of SCLE by leflunomide therapy have been described.
Clinical importance of Demodex folliculorum in patients receiving phototherapy
Authors: Kulac Mustafa , Ciftci Ihsan Hakkı , Karaca Semsettin , Cetinkaya Zafer 
Published: August 2010

AbstractBackground  Patients with immunodeficiency are prone to infestation with Demodex folliculorum mites. Ultraviolet (UV) radiation can lead to immunosuppression and sebaceous gland hyperplasia. Although some cases of demodicidosis related to UV radiation exposure have been reported, no studies have been performed on the incidence of D. folliculorum and its clinical characteristics in patients receiving phototherapy.Objective  To investigate the effects of phototherapy on the density of D. folliculorum infestation and its clinical characteristics.Methods  This was a cross‐sectional study. Forty‐five patients receiving phototherapy and 43 age‐ and sex‐matched healthy controls were enrolled to the study. The sociodemographic characteristics, occupational information, and skin types (2, 3, 4, or 5) of both patients and controls were carefully recorded. The dermatologic diseases requiring phototherapy, type and number of phototherapy treatments, and cumulative UV doses of all patients were noted. The clinical findings that may relate to demodicidosis were recorded. Standardized skin surface biopsies were taken from three anatomic regions (forehead, cheek, and nasal dorsum) and suspected lesions; five or more D. folliculorum mites per square centimeter of skin was defined as demodicidosis.Results  Twelve (26.7%) patients received psoralen plus UV‐A (PUVA) and 33 (73.3%) received narrow‐band UV‐B. Demodicidosis was detected in 13 (28.9%) patients and three (7%) controls. The difference in the demodicidosis rate between patients and controls was statistically significant (P = 0.01). In eight of the 13 patients (61.5%) with demodicidosis, clinical demodicidosis was present. Demodicidosis was present in seven of the 12 patients (58.3%) receiving PUVA and in six of the 33 patients (18.2%) receiving narrow‐band UV‐B. The difference in demodicidosis rates between patients receiving PUVA and those receiving narrow‐band UV‐B was statistically significant (P = 0.02). A statistically significant difference was also found between the mean D. folliculorum densities of patients and controls in all anatomic regions.Conclusion  Demodicidosis should be included in the differential diagnosis of facial eruptions in patients receiving phototherapy.
Hydroquinone‐induced exogenous ochronosis: a report of four cases and usefulness of dermoscopy
Authors: Charlín Raúl , Barcaui Carlos B. , Kac Bernard Kawa , Soares Deborah Brazuna , Rabello‐Fonseca Rosa , Azulay‐Abulafia Luna 
Published: August 2010

AbstractHydroquinone is the first choice of topical bleaching agents used in treatment of melasma. In Brazil, hydroquinone is widely prescribed by physicians and often used by patients without a prescription. The principal adverse effects of its chronic use are confetti‐like depigmentation and exogenous ochronosis. The latter manifests clinically with gray‐brown or blue‐black hyperpigmentation, as well as pinpoint hyperchromic papules that look like caviar, and therefore called caviar‐like. On histopathology, curved ochre‐colored structures, ‘banana‐shaped’ fibers, appear in the papillary dermis. No description of dermoscopy in ochronosis is found in the literature. We report four cases of hydroquinone‐induced exogenous ochronosis. Dermoscopy was performed in two patients on the areas with ochronosis, and in addition to the melasma findings, amorphous densely pigmented structures obliterating some follicular openings were observed. Exogenous ochronosis is an avoidable dermatosis that is difficult to treat. Dermatologists should be able to differentiate it from melasma and immediately discontinue hydroquinone. Dermoscopy might become a valuable resource in approaching exogenous ochronosis.
Pseudoxanthomatous mastocytosis
Authors: Srivastava Neeraj , Chand Satish , Singh Sanjay 
Published: August 2010

A 50‐year‐old woman presented with itchy, multiple, flat, yellowish, waxy papules and plaques diffusely involving her face, trunk, and upper extremities for 5 years (Fig. 1). Itching was moderate to severe in intensity and was episodic, without any identifiable aggravating or relieving factors. On rubbing the lesions with a blunt object erythema was elicited. Her ophthalmological examination was normal. Her complete hemogram was normal along with other routine investigations. Patient's slit skin smear for acid‐fast bacilli and rk39 dip‐stick ELISA for post‐kala‐azar dermal leishmaniasis were negative. Ultrasound examination of her abdomen was normal and skeletal survey showed no evidence of bony changes. Histological examination showed diffuse dense infiltrate of numerous mast cells filling up the papillary dermis and most of upper‐ and mid‐reticular dermis. Overlying epidermis showed moderate epidermal hyperplasia and hyperpigmentation. There was sparse scattering of neutrophils within the infiltrate. Extracellular mast cells granules were also seen (Fig. 2). Diagnosis of diffuse cutaneous mastocytosis of pseudoxanthomatous variety was made.Pretreatment photographs of the patient; (a) face; (b) trunkimageHistopathology showing dense diffuse infiltrate of numerous mast cells filling up the papillary dermis and most of the upper and mid‐reticular dermis (H&E; a, ×100; b, ×400)imageThe patient was prescribed treatment in the form of H1 and H2 blockers (fexofenadine and ranitidine) and trimethylpsoralen and ultraviolet A (PUVA) photochemotherapy. After 2 months of treatment, there has been marked improvement in the appearance and itching.
Rosacea with extensive extrafacial lesions
Authors: Pereira Teresa M. , Vieira Ana Paula , Basto A. Sousa 
Published: August 2010

AbstractRosacea is a very common skin disorder in the clinical practice that primarily affects the convex areas of the face. Extrafacial rosacea lesions have occasionally been described, but extensive involvement is exceptional. In the absence of its typical clinical or histological features, the diagnosis of extrafacial rosacea may be problematic. We describe an unusual case of rosacea with very exuberant extrafacial lesions, when compared with the limited involvement of the face.
NailQoL: a quality‐of‐life instrument for onychomycosis
Authors: Warshaw Erin M. , Foster Jovonne K. , Cham Peter M. H. , Grill Joseph P. , Chen Suephy C. 
Published: August 2010

AbstractBackground  The disease burden onychomycosis is not trivial. The aim is to develop a quality of life instrument to measure the onychomycosis burden.Methods  402 patients with mycologically‐confirmed onychomycosis completed a baseline questionnaire of 39 quality of life items (modified Skindex‐29 questions and 10 additional nail‐specific questions). Internal consistency, reproducibility and responsiveness of the final instrument, NailQoL were measured.Results  15 items consisting of symptom (3), emotion (10), and functional (2) domains were retained in NailQoL. Symptom and emotion subscales = 0.80–0.92. Administration α demonstrated good internal consistency (Cronbach's of the instrument to 46 patients at one month after baseline revealed good reproducibility (ICC 0.88–0.91). Responsiveness was measured in 292 patients at 18 months; statistically significant better NailQoL scores were found in individuals with complete cure (mycological and clinical) (P < 0.01).Conclusion  NailQoL represents a new concise, valid, reliable, and responsive instrument for measuring burden of skin disease for patients with onychomycosis.
Body‐site distribution of common acquired melanocytic nevi associated with severe sunburns among children in Lithuania
Authors: Valiukeviciene Skaidra , Gollnick Harald , Stang Andreas 
Published: August 2010

AbstractBackground  The aim of this cross‐sectional study is to provide information on subsite‐specific densities of melanocytic nevi by age, sex, and in relation to the history of severe sunburns.Materials and methods  This study was conducted in Kaunas, Lithuania, on a sample of 484 children aged 1–2 years, 4–5 years, 9–10 years, and 14–15 years. The questionnaire provided information about the history of severe sunburns since birth. Site‐specific numbers and densities of melanocytic nevi of all sizes and nevi 2 mm or greater were studied. We used log‐linear and Poisson regression models to estimate the effects of age, sex, and severe sunburns on the nevus density.Results  The predicted total body density of nevi shows a considerable increase up to the age of roughly 10 years. Thereafter, the density increase tapered off. Median densities of nevi were highest on the face. The median density of nevi on the upper arms is higher than on the forearms. Similarly, the median density of nevi on the thighs is higher than on the lower legs. Estimates of the relative nevus densities related to the history of severe sunburns tend to be small with the exception of the legs for nevi 2 mm or greater (relative nevus density = 2.09, 95% CI 1.49–2.93).Conclusion  Nevus densities are highest on maximally or intermittently sun‐exposed skin areas. With the exception of the legs among women, the subsite‐specific ranking of nevus densities among adolescents follows a similar ranking as the skin melanoma incidence in Lithuania.
Complications after body piercing in patient suffering from type 1 diabetes mellitus
Authors: Antoszewski Bogusław , Jędrzejczak Marta , Kruk‐Jeromin Julia 
Published: August 2010

AbstractBackground  Body piercing has been a well‐known practice of body ornamentation. Nowadays, it is believed to involve from 6.5% to 50% of the population. Complications after body piercing procedures are variable.Objective  The aim of this report is to present complications after body piercing in a patient suffering from type 1 diabetes mellitus.Methods  A twenty‐four‐year‐old woman came to our plastic surgery outpatient clinic complaining of penetration of earring clips to her earlobes. This caused inflammation and continuous decubitus ulcers on the posterior surfaces of both earlobes.Conclusion  On the basis of observations of the described patient, it can be concluded that unregulated diabetes is a contraindication to body piercing procedures.
Spontaneous resolution of a delayed granulomatous reaction to cosmetic tattoo
Authors: Jones Brad , Oh Carol , Egan Conleth A. 
Published: August 2010

AbstractA 27‐year‐old woman presented with linear, flesh‐colored papules along her vermillion borders, 4 years after a cosmetic lip tattoo was applied. A biopsy of the lesion was performed and histology showed it to be a granulomatous reaction surrounding the tattoo pigment. Following the biopsy, the lesions began to resolve spontaneously within 4 weeks and were not noticeable at a follow‐up review. Granulomatous reactions are rare after cosmetic facial tattoos and may respond to topical corticosteroids or laser ablation. We present a unique report of a delayed granulomatous reaction to a cosmetic tattoo completely resolving without any specific treatment.
A mixed immunoblistering disorder exhibiting features of bullous pemphigoid and pemphigus foliaceus associated with Spirulina algae intake
Authors: Kraigher Oliver , Wohl Yonit , Gat Andrea , Brenner Sarah 
Published: August 2010

An 82‐year‐old healthy woman presented with bullae, partly hemorrhagic, on the trunk and extremities (Fig. 1), secreting erosions, and submammary macerations (Fig. 2). The blistering disease developed over a 2‐year period, during which she reported taking no drugs. She did, however, begin using a food supplement containing the blue–green alga Spirulina platensis 1 year before the onset of the eruption.Hemorrhagic bullae on the extremitiesimageSubmammary bullae, secreting erosions, and macerationsimage At admission, the Nikolsky sign was positive. The first biopsy showed a subepidermal bulla with a denuded surface and sparse perivascular lymphocytic infiltrate with scattered eosinophils (Fig. 3). The second biopsy, taken during admission, demonstrated an intra‐ and subcorneal vesicular dermatitis with slight superficial acantholysis. Direct immunofluorescence disclosed immunoglobulin G (IgG) and C3 at the dermoepidermal junction. Indirect immunofluorescence was also positive at the dermoepidermal junction. A salt split test demonstrated IgG, IgM, and C3 on the upper side of the bulla. Immunoblotting of the serum was negative and showed no pemphigoid or pemphigus antigens. Enzyme‐linked immunosorbent assay (ELISA) for desmoglein 1 and 3 antibodies was also negative.The first biopsy showing subepidermal hemorrhagic bulla with denuded surface and sparse perivascular lymphocytic infiltrate with scattered eosinophils (hematoxylin and eosin, ×10)image Diagnostic investigations for neoplasia, Wood's lamp exposure of urine, purified protein derivative (PPD), and antinuclear antibody (ANA) were negative. With a diagnosis of mixed immunoblistering disorder exhibiting features of bullous pemphigoid and pemphigus foliaceus, prednisone 60 mg was started and gradually tapered, and topical treatment was begun with creams containing silver sulfadiazine and triamcinolone/neomycin. Suspecting the involvement of Spirulina in the disease, the food supplement was stopped. With this treatment, the patient steadily improved with no appearance of new blisters. An in vitro interferon‐γ release test with the Spirulina‐containing food supplement, conducted to explore the connection between the agent and the eruption, yielded a slight increase in interferon (19%). The result was considered to be borderline, but, in view of the clinical picture and the fact that the patient was being treated with 20 mg prednisone at the time, the test can be considered as positive. Three months after completion of the prednisone treatment, and with avoidance of the Spirulina‐containing supplement, the patient was free of lesions with no recurrences.
Paleodermatology
Authors: Lupi Omar 
Published: August 2010

AbstractThe study of the human skin evolution, allows a new vision to ancient questions such as the significance of human skin color variation, the correlations between bipedality and loss of body hair, and the correlations among epidermal appendages and structures of the skin with the changes on environment and evolution of humans.Paleodermatology would be an appropriated term to designate the study of the human skin evolution. The etymology of this word comes from a Greek root (paleo = ancient). It is a multidisciplinary subject for researchers such as dermatologists, anthropologists, physiologists, and orthopedics. It should include the evaluations regarding physiology, thermoregulation, and the evolution of the human skin structures.
Frequency of acyclovir‐resistant herpes simplex viruses isolated from the general immunocompetent population and patients with acquired immunodeficiency syndrome
Authors: Ziyaeyan Mazyar , Alborzi Abdolvahab , Japoni Aziz , Kadivar Mohammad , Davarpanah Mohammad Ali , Pourabbas Bahman , Abassian Amin 
Published: August 2010

AbstractBackground  Herpes simplex virus (HSV) infections are usually chronically recurrent in the normal population and represent a significant cause of morbidity in immunocompromised patients. Acyclovir (ACV) is widely used for the treatment and prophylaxis of HSV infections. The emergence of ACV‐resistant strains has been frequently reported as a result of long‐term ACV therapy.Aim  Despite the widespread use of ACV, there are no data available in our area on the frequency of ACV‐resistant HSVs. The purpose of this study was to evaluate the susceptibility of HSV isolated from normal subjects and patients with acquired immunodeficiency syndrome (AIDS) to ACV.Methods  HSVs were isolated from the orofacial region of normal individuals and patients with AIDS. The susceptibility of isolated HSV strains to various concentrations of ACV was determined by plaque reduction assay. The sensitivity of the viral strains was expressed as IC50 (the concentration of drug reducing the viral plaque by 50%).Results  One hundred and thirty‐three isolates from 102 normal subjects and 31 patients with AIDS were tested. One HSV‐1 isolate from normal individuals had intermediate susceptibility. Two ACV‐resistant isolates (one HSV‐1 and one HSV‐2), with IC50 ≥ 2 to ≤ 3 µg/mL, and one highly resistant HSV‐2 isolate, with IC50 ≥ 5 µg/mL, were detected in patients with AIDS.Conclusions  Our data show that the prevalence of ACV‐resistant strains is very low in the general immunocompetent population; however, in patients with AIDS, the prevalence of ACV‐resistant strains is remarkable (P = 0.001). Alternative antiherpetic agents should be employed to control and reduce the emergence of ACV‐resistant strains in patients with AIDS.
Role of BP180NC16a‐enzyme‐linked immunosorbent assay (ELISA) in the diagnosis of bullous pemphigoid in China
Authors: Feng Suying , Lin Lin , Jin Peiying , Wu Qinxue , Zhou Wuqing , Sang Honggui , Shao Changgeng 
Published: August 2010

AbstractBackground  Autoantibodies of bullous pemphigoid (BP) patients react with two components of the hemidesmosome of stratified epithelia: the BP antigen 230 (BP230) and the BP antigen 180 (BP180). Recently, strong evidence has been provided that autoantibodies to BP180 play a key role in subepidermal blister formation in BP patients, and NC16A contains an important antigen determinant of BP.Objective  To study the role of BP180NC16a enzyme‐linked immunosorbent assay (BP180NC16a‐ELISA) in the diagnosis of BP in China.Methods  Sera from BP patients (n = 42) and control subjects (normal controls, n = 24; pemphigus patients, n = 18) were measured by BP180NC16a‐ELISA. All BP sera were obtained at presentation from patients who had not received previous systemic treatment. The values of immunoglobulin G (IgG) antibody levels measured by ELISA were compared with those measured by indirect immunofluorescence (IIF) (gold standard for the diagnosis of BP) on salt‐split skin.Results  Using BP180NC16a‐ELISA, 41 of the 42 BP sera were positive, whereas only one of the serum samples from 24 normal controls was positive and all the pemphigus sera showed a negative result. Thus, the sensitivity and specificity of BP180NC16a‐ELISA were both 97.62%. There was no correlation between the mean ELISA values and IIF titers. The ELISA and IIF results were further compared and analyzed using a 2 × 2 contingency table, which showed that they were not significantly different.Conclusions  It is suggested that BP180NC16a‐ELISA is a useful tool for the diagnosis of BP.
Human mesenchymal stem cells may be involved in keloid pathogenesis
Authors: Akino Kozo , Akita Sadanori , Yakabe Aya , Mineda Takao , Hayashi Tomayoshi , Hirano Akiyoshi 
Published: August 2010

AbstractBackground  The pathogenesis of keloid is poorly understood. Although vigorous investigations have attempted to elucidate the mechanisms or causative factors of keloid, there are little data on why keloids are very intractable and recur easily in each patient.Methods  In an attempt to analyze the possible interaction between human mesenchymal stem cells and keloid‐derived fibroblasts, the dual‐chamber cell‐migration assay, cell proliferation, ultrastructural morphology, and Western blot analysis were used to investigate the production of the extracellular matrices of the coculture.Results  Cell proliferation was not significantly different between keloid‐derived fibroblasts and normal dermal fibroblasts during a 4‐day observation period. There was a significant cell migration of human mesenchymal stem cells when keloid‐derived fibroblasts were placed in the bottom chamber, compared to when normal dermal fibroblasts were placed in the same way in 8‐µm diameter pore membranes (190.6 ± 51.45 and 32.0 ± 6.20 cells/field, respectively, P < 0.01). With 3‐µm diameter pores, the human mesenchymal stem cells migrated in the pores only when the keloid‐derived fibroblasts were placed in the bottom chambers (6.4 ± 3.84 cells/field). Monolayer coculture of human mesenchymal stem cells and keloid‐derived fibroblasts demonstrated further functional differentiation, such as collagen secretion and abundant rough endoplasmic reticulum. Western blot analysis of the cells in the modified dual‐chamber culture demonstrated most significantly abundant fibronectin expression when the human mesenchymal stem cells contained keloid fibroblasts.Conclusion  The results of this study may indicate that human mesenchymal stem cells participate and recruit in keloid pathogenesis by differentiating themselves toward keloid recalcitrant formation and progression.
Comorbidity of psychiatric disorders in children and adolescents with alopecia areata in a child and adolescent psychiatry clinical sample
Authors: Ghanizadeh Ahmad 
Published: August 2010

AbstractBackground  This study reports the comorbidity of lifetime psychiatric disorders in children and adolescents with alopecia areata (AA) in a child and adolescent psychiatry clinical sample.Methods  Fourteen patients with AA were interviewed using the Diagnostic and Statistical Manual of Mental Disorders‐Fourth edition (DSM‐IV) criteria and the Kiddie‐Schedule for Affective Disorders and Schizophrenia‐Present and Lifetime‐Farsi Version (KSADS‐PL‐Farsi Version).Results  The rate of at least one psychiatric disorder was 78%. The rate of major depressive disorder was 50%, and the most common anxiety disorder was obsessive–compulsive disorder (OCD) (35.7%).Conclusions  There is a very high rate of psychiatric disorders in children and adolescents with AA. This high rate of OCD has not been reported previously. There seems to be a clinical association between OCD and AA in children and adolescents.