bluuebunny/crossref_metadata_2025_split huggingface dataset:
TREATMENT OF ALOPECIA AREATA WITH SQUARIC ACID DIBUTYLESTER
Authors: MICALI GIUSEPPE , CICERO ROSA LICASTRO , NASCA MARIA RITA , SAPUPPO ANTONIO 
Published: August 2010

Abstract Background. Among contact allergens that are frequently used in the treatment of alopecia areata (AA), squaric acid dibutylester (SADBE) stands out for its good tolerability and its mild side effects. Methods. One hundred and forty‐four patients with AA of varying degrees were treated with SADBE. Of these, 71 had AA affecting less than 50% of the scalp, and 73 had a severe form, including 13 patients with alopecia totalis (at) and two with alopecia universalis (AU). The patients were treated using both traditional and nontraditional methods. Results. In the less severe form, we obtained a 80% rate of regrowth, compared to the 49% of the more severe form including 13 cases of at and the two of au. The failure rate was higher for patients with the more severe form (29%) compared to a 7% rate only for patients with mild AA. We also observed four cases of initial regrowth on the side of the scalp opposite to the site of application (‘castling phenomenon‘). Among those patients who were treated with application of SADBE on the right side of the back, three displayed regrowth on the left side of the scalp, (i.e., on the opposite side) and in an area distant from the site of application; for two patients the regrowth began on the right side of the scalp and one of them also displayed growth of fine hairs in the right dorsal region, the site of application of the compound. Conclusions. Our data further support the hypothesis of a systemic action of SADBE; however, further confirmation on a larger sample of cases is needed.
Subcutaneous fat necrosis of the newborn
Authors: Mather CPT Mary K. , Sperling LTC Leonard C. , Sau COL Purnima 
Published: August 2010

The patient in this study was an 18‐day‐old healthy boy, delivered by caesarean section at 33 weeks gestation, and the product of a pregnancy complicated by gestational diabetes and preterm labor. At 10 days old, three dermal and subcutaneous nodules were noted on the midline of the back (Fig. 1). The nodules measured 1–3 cm in size; they were firm, mobile, and multilobulated in quality. The overlying epidermis was slightly erythematous, but otherwise appeared normal.A skin biopsy obtained 8 days after the lesions were first noted is shown in Fig. 2(a); necrosis of the fat with giant cell formation and characteristic needle‐shaped clefts within residual fat cells can be seen (Fig. 2b).
Basal cell carcinoma of trunk and extremities
Authors: Maafs Eduardo , Barreda Fernando De la , Delgado Ricardo , Mohar Alejandro , Alfeirán Antonio 
Published: August 2010

Abstract Background Basal cell carcinoma is the most common malignancy in Caucasians. Information about basal cell carcinoma in the Mexican population is scarce. Objective To determine the epidemiologic and clinical characteristics and treatment results of basal cell carcinoma located on the trunk and extremities of patients seen at the Institute Nacional de Cancerología of Mexico. Methods A retrospective study was performed of patients with confirmed diagnosis of basal cell carcinoma located on the trunk and extremities seen at the Institute Nacional de Cancerología of Mexico between 1966 and 1993. Results Ninety‐one patients with basal cell carcinoma located on the trunk and extremities were found (6% of all patients with diagnosis of basal cell carcinoma). The median age was 64 years; 52% of the patients were women and 48% were men. A total of 119 basal cell carcinomas at these locations were diagnosed. The size of the skin tumor ranged from 0.3 to 22 cm (mean, 3.9 cm). Treatment results were evaluated in 62 patients (follow‐up ranged from 24 to 240 months; mean, 80 months). Overall tumor control was accomplished in 95% of cases. Three patients died as a result of basal cell carcinoma. Conclusions Basal cell carcinoma in the Mexican population is not as infrequent as previously thought, although it is less commonly located on the trunk and extremities than in Caucasians.
Conjunctival involvement in familial chronic benign pemphigus (Hailey‐Hailey disease)
Authors: Oguz Oya , Gokler Gökhan , Ocakoglu Özcan , Og̀uz Velittin , Demirkesen Cuyan , Aydemir Ertug̀rul H. 
Published: August 2010

A 25‐year‐old woman with a 1‐year history of malodorous, red, and eroded lesions in frictional sites was seen in the dermatology department. She did not give a family history of a similar condition. She had an 18‐month‐old baby and her initial complaint was of genital pruritus with profuse vaginal discharge which appeared within 2 months of delivery. She was treated for candidal vaginitis but pruritus persisted and skin lesions occurred on both sides of the groin. The lesions subsided as long as the local treatment for candidal vaginitis was continued, but recurred more than three times in a year, each time with additional and more severe lesions involving the axillae, retroauricular sites, and scalp. She received no specific treatment during this time and her complaint about the eyes was the reason she was referred to a dermatologist.On dermatologic examination, impetigo‐like, serpiginous plaques with severe erythema, erosions, and an active border were observed behind the ears, in the axillae, and in the pubis; these tended to expand peripherally and were partly covered with greasy yellowish scales particularly on the scalp. Satellite pustules and vesicles were observed at the adjacent sites (Fig. 1). Conjunctivae were bilaterally hyperemic and fine yellowish scales were also apparent on the palpebral rim (Figs 2 and 3). Ophthalmologic examination revealed severe conjunctival oedema and ulcerating blepharitis. Cornea appeared normal and vision was unimpaired. Results of Schirmer's test (15 and 17 mm) were within the normal range of tear secretion without an anaesthetic. Swab cultures from the peripheral pustules and erosions showed S. aureus infection while Sabourraud culture remained negative. Skin and conjunctiva biopsies for direct microscopy and immunofluorescence were performed. Histopathologic features were identical in either specimen disclosing suprabasal blister formation, acantholysis, and villus‐like protrusions lined by a single layer of basal cells (Fig. 4). IgG, IgA, IgM, and complement C3 immunofluorescence was not detected at the epidermis of the skin adjacent to serpiginous lesions. A direct immunofluorescent test of conjunctival biopsy also remained negative.The patient was given clarithromycine 500 mg/day for 10 days and topical treatment was also applied. A rapid response was obtained within the first week of treatment.
Candida folliculitis mimicking tinea barbae
Authors: Kapdaǧli Halit , Öztürk Gunseli , Dereli Tugrul , Inci Ramazan , Hilmioǧlu Zuleyha , Kazandi Ali Can , Erboz Sezer 
Published: August 2010

A 55‐year‐old man, a farmer, was referred to our dermatology department in June 1993 with inflammatory and infiltrated nodular lesions on his left cheek and neck. These nodular lesions had appeared about a month previously and had enlarged quickly. He was unaware of any antecedent trauma.Physical examination revealed a painless, slightly erythematous, soft, fluctuant plaque which measured 8 cm in diameter. It consisted of follicular papules and pustules and was partially covered with brown‐black crusts (Fig. 1), Two similar plaques, 3 cm in diameter, were also detected on the neck. The regional lymph nodes were not palpable. The hair on the lesions was easily removed with a pair of forceps without causing pain.The patient had not previously had any skin disease. Laboratory investigations, including full blood count, erythrocyte sedimentation rate, serum concentrations of sodium, potassium, chloride, transaminases, alkaline phosphatase, sugar, cortisol, and renal function tests, were all normal. No fluorescence was seen on Wood's light examination.Direct microscopic examination with 15% potassium hydroxide solution revealed yeast cells and hyphae in three consecutive scrapings of the lesions. Candida albicans was isolated from the mycologic cultures; but no growth was observed in mycologic cultures of oral and anogenital mucosae swabs. Bacteriologic cultures of the lesions were also negative.A skin biopsy was performed for histologic confirmation. Examination of the biopsy specimen revealed dermal oedema and PAS(‐I‐) yeast cells among the infiltration of lymphocytes and plasma cells (Fig. 2).The patient was started on a regimen with fluconazole 100 mg once a day orally for a week, after which the dosage was decreased to 100 mg once every other day for a month. Also, the hair on the lesions was depilated. We noted a significant clinical improvement at the fifth week of the therapy (Fig. 3). Repeated mycologic examinations of the lesions were all negative even 1 month after the end of the therapy
Gastrointestinal malignant melanoma
Authors: Woollons Arjida , Derrick Elizabeth K. , Price Margaret L. , Darley Charles R. 
Published: August 2010

Case 1 A 69‐year‐old man was referred for investigation of abdominal pain, progressive weight loss, and iron deficiency anaemia. Faecal occult bloods were positive and there was no medical history of note. Physical examination revealed a firm mobile mass in the right iliac fossa. There was no organomegaly or lymphadenopathy, the retinae were clear, and no cutaneous lesions were evident. Abdominal ultrasound scan, small bowel enema, and colonoscopy were all normal, as were renal and liver function tests. Abdominal CT showed a soft tissue mass within the right iliac fossa. The patient underwent a right hemicolectomy and a large 10 × 10 cm caecal tumor was removed which was infiltrating the surrounding small bowel. Histology showed this to be metastatic malignant melanoma, confirmed by morphologic and immunochemical studies, and the tumor infiltrated the submucosa. The tumor cells stained positively with S100 protein. Resection was complete (Fig. 1a). On close enquiry postoperatively the patient recalled a mole on his back that had disappeared spontaneously 20 years previously. Five years after surgery he remained in good health with no signs of recurrence and no cutaneous lesions. Case 2 A 60‐year‐old man was referred with a 3‐month history of nausea, lower abdominal pain, and weight loss. The medical history was unremarkable. Clinical examination showed a mass in the right iliac fossa, but no lymphadenopathy or organomegaly. Sigmoidoscopy to 15 cm was normal, and a barium enema showed diverticular disease only. Ultrasound examination of the abdomen was normal. Gastroscopy showed a small polyp in the body of the stomach; biopsies showed this to be malignant melanoma.One week later the patient presented as an emergency with an acute abdomen. At laparotomy an intestinal perforation was found with nodular metastases in the stomach, duodenum, and small bowel. An amelanotic nodule on his right thigh was biopsied at the same time, and histology of these lesions showed malignant melanoma. The stomach lesions showed extensive infiltration of the antrum and proximal duodenum by solid sheets of malignant melanocytes, invading throughout the full thickness of the muscularis propria (Fig. 1b). A Polya gastrectomy was performed a month later, by which time the patient had developed further cutaneous deposits of melanoma. Two months after discharge he was readmitted with pancreatic spread and obstructive jaundice which was relieved when a stent was inserted. He was transferred to the local hospice for terminal care, and died shortly afterwards.
Leukocytoclastic vasculitis ‐ correlation between different histologic stages and direct immunofluorescence results
Authors: Grunwald Marcelo H. , Avinoach Ilana , Amichai Boaz , Halevy Sima 
Published: August 2010

Abstract Background Leukocytoclastic vasculitis is a well‐known clinico‐pathologic entity. A good correlation between clinical and direct immunofluorescence (DIF) findings has been shown only in the early stages of vasculitis. Our purpose was to determine the correlation between different stages of vasculitis, etiology of vasculitis, and DIF findings. Methods Histologic and DIF studies were performed and evaluated from 40 patients with leukocytoclastic vasculitis. Results Thirty‐seven out of 40 patients (92%) showed positive DIF findings in the blood vessel walls. Eight patients were in the early stage of vasculitis and exhibited deposits mainly of fibrinogen, C3, and IgM. Seventeen patients were at the fully developed vasculitis stage and showed albumin, fibrinogen, and IgG deposits. Fifteen patients were in the late stage of vasculitis and showed deposits of mainly fibrinogen and C3 in the blood vessel walls. Conclusions The present study demonstrates that DIF examination is a very sensitive test in the diagnosis of vasculitis, and can be used in all stages of vasculitis and not only in the early stages as has been shown in previous studies.
Steatocystoma multiplex localized only in the face
Authors: Ahn Sung Ku , Hwang Sang Min , Lee Seung Hun , Lee Won Soo 
Published: August 2010

A 60‐year‐old man presented with lesions on his face to the Department of Dermatology, Wonju Christian Hospital on November 10, 1994. There were over 10, slightly elevated, flat‐topped, yellowish colored, subcutaneous nodules on the face (Fig. 1). The lesions had first appeared on the left upper eyebrow at the age of 58 years, and since then they had abruptly increased in size and number and had spread into both temporal areas. Their size varied from 3 to 10 mm in diameter. No other lesions were observed on the extremities or trunk. The patient's past and family history were noncontributory and the results of routine laboratory findings were within normal limits or were negative.Histopathologic examination of the lesion on the forehead showed a folded empty cyst in the mid‐dermis. The wall of the cyst was composed of two or three layers of squamous epithelium without a granular layer, and they contained flattened sebaceous lobules of varying sizes (Fig. 2). These findings were consistent with steatocystoma. Some of the lesions were removed, but the patient refused further treatment.
Nodular fat necrosis associated with lupus‐induced pancreatitis
Authors: Stanford Alan R. , Mezebish David S. , Cobb Mark W. 
Published: August 2010

A 29–year‐old black vi/oman presented with a 6–year history of lupus nephritis, cerebritis, arthritis, and recurrent facial erythema. She was admitted to the National Naval Medical Center following an acute lupus flare manifested by the onset of acute tubular necrosis requiring the initiation of hemodialysis. The patient had also developed a Staphylococcus aureus septicemia secondary to an infected IV site. During the first and second weeks in hospital, the patient responded well to aggressive antibiotic therapy and oral prednlsone. As the oral prednisone was decreased from 60 mg to 40 mg per day on day 19 in hospital, the patient developed several tender, erythemafous, subcutaneous nodules over the lower extremities (Fig. 1). There was no cutaneous ulceration or drainage. Although the initial clinical diagnosis was erythema nodosum, a deep incisional biopsy was performed to rule out infectious, vasculitic, or lupus panniculitis.Histologic findings of a representative leg nodule included lobular panniculitis with extensive fat necrosis,' ghost cell' formation, acute suppurative inflammation, and focal calcification (Fig. 2). Stains and cultures for organisms were negative. These findings were felt to be pathognomonic for nodular fat necrosis associated with pancreatic disease.Laboratory data revealed serum amylase and lipase to be markedly elevated at 1342 U/L (A/=28–110 U/L) and 4160 U/L (W=7–60 U/L), respectively; white blood cell count and differential were within normal limits. Other significant laboratory data included an anti‐DNA of 692 lU/mL (A/=<100 IU/mL) and positive anti‐Sjogren's syndrome‐A.Simultaneous punch biopsy of an erythematous facial macule revealed epidermal atrophy, vacuolar interface change, and a mild perivascular and periadnexal lymphohistiocytic infiltrate, consistent with lupus erythematosus. Computed tomography (CT) scan and ultrasound exannination of the abdominal cavity failed to provide further evidence of pancreatitis.Although the patient was initially asymptomatic, 1 week following the onset of her leg nodules she developed severe ankle and knee arthralgias, abdominal pain, nausea, and vomiting which were attributed to her pancreatitis. She was treated with high‐dose prednisone and Cytoxan for control of her lupus flare, which brought about the resolution of her leg nodules and associated symptoms over the following 6 weeks. Only post‐inflammatory hyperpigmentation remained in the skin overlying the sites of nodular fat necrosis.
Granular cell tumor (Abrikossoff tumor) of the clitoris
Authors: Ortiz‐Hidalgo Carlos , de la Vega Guillermo , Moreno‐Collado Clemente 
Published: August 2010

A 60‐year‐old woman presented to the Department of Dermatology of the ABC Medical Center in Mexico City with a 2‐month history of a progressive growth in the region of the clitoris that had been increasing rapidly. Examination revealed a firm growth measuring 3 cm in diameter; the overlying surface was smooth and free of ulceration. Vaginal speculum examination showed no mucosal irregularities or displacement. Rectal examination was normal. Inguinal lymph nodes were clinically negative. A wide excisional biopsy was performed with ample skin margins.The specimen consisted of a mass measuring 3.5 × 1.2 × 0.5 cm that was pale tan, homogeneous, and firm. Prepared sections showed a cellular tumor composed of compact irregular strands and nodules of polyhedral cells containing centrally located, round to oval vesicular nuclei with no significant atypia of mitosis. These cells had granular eosinophilic cytoplasm with distinct cell borders (Fig. 1). The cytoplasmic granules were diastase‐resistant periodic acid‐Schiff (PAS) positive. The tumor cells were positive for S–100 protein and for neuron‐specific enolase (NSE), and were negative for actin, desmin, and cytokeratin. The tumor showed compression and obliteration of the cavernous sinuses (Fig. 2) outlined by the S–100 immunostain and actin. (Figs 3 and 4).
A case of nevus comedonicus syndrome associated with neurologic and skeletal abnormalities
Authors: Seo Young‐Joon , Piao Yong‐Jun , Suhr Ki‐Beom , Lee Jeung‐Hoon , Park Jang‐Kyu 
Published: August 2010

A 12‐year‐old male was referred to us with recurrent pus discharge from tender nodules on the right axilla dating from the neonatal period. The nodules were black, characterized by scarring with dilated follicular openings and there were black papules filled with comedo‐like keratin plugs in both axillae. Physical examination revealed a bowing deformity of the right third finger and retardation in language ability. The patient was referred to the Departments of Neurology and Orthopedics in Chungnam National University Hospital, Korea.Histologic examination of one of the black comedo‐like lesions showed a bulbous and dilated infundibulum that contained laminated keratin, indicating a diagnosis of nevus comedonicus. A CT scan of the brain revealed dysgenesis of the corpus callosum. The IQ (intelligence quotient) score of the patient, measured by the Korean Wechsler Intelligence Scale for Children‐Revised, was 94. The only difficulty noted for ordinary life was learning language. A radiograph of the right hand revealed hyperextension and an ulnar drift deformity of the right middle finger. Corrective osteotomy with external fixation and an iliac bone autograft were performed. Intermittent neurologic follow‐up visits were ordered for the noted language deficit. At present the patient only exhibits difficulty in calculation.Oral antibiotics were administered to the skin lesions on occasion for secondary infections and inflammation of the cysts and comedones. Extraction of the comedones was performed as needed.
Scurvy in a 10‐month‐old boy
Authors: Larralde Margarita , Santos Muñoz Andrea , Boggio Paula , Di Gruccio Vanesa , Weis Isaac , Schygiel Adolfo 
Published: August 2010

AbstractWe report a 10‐month‐old boy with inflammatory and necrotic gingival lesions, fever, irritability, and pseudoparalysis of the legs. Laboratory examinations revealed moderate anemia and skeletal X‐rays showed osteopenia, scorbutic rosary at the costochondral junctions, and “corner sign” on the proximal metaphyses of the femora. The boy had been fed only with diluted cow's milk. He had never taken solid food, vitamin C, or iron complement. Seventy‐two hours after starting oral vitamin C supplementation, there was significant improvement in the patient's gingival lesions and general health. The clinical presentation and laboratory and imaging findings, together with the dramatic response to ascorbic acid intake, allowed us to confirm the diagnosis of infantile scurvy.Scurvy, a dietary disease due to the deficient intake of vitamin C, is uncommon in the pediatric population. In an infant who has never received vitamin C, the combination of gingival lesions, pseudoparalysis, and irritability strongly suggests a diagnosis of scurvy. The clinical picture, together with the laboratory data, radiological studies, and therapeutic response to vitamin C administration, confirmed the diagnosis.
Efficacy of 10% silver nitrate solution in the treatment of common warts: a placebo‐controlled, randomized, clinical trial
Authors: Ebrahimi Sedigheh , Dabiri Nader , Jamshidnejad Esmaeel , Sarkari Bahador 
Published: August 2010

AbstractBackground  Warts are a common skin lesion, especially in children and young adults, caused by human papillomaviruses. So far, there is no definitive therapy for warts and the treatment is modified regularly to obtain the best result with the least discomfort to the patient. The aim of this placebo‐controlled clinical trial was to evaluate the clinical efficacy, tolerability, and safety of 10% silver nitrate solution for the treatment of common warts.Methods  Sixty individuals attending pediatrics and dermatology clinics and health centers in Yasuj, south‐west of Iran, were recruited. The patients were divided into two groups: 30 patients received 10% silver nitrate solution (case group) and 30 control patients received black ink (placebo group). Silver nitrate solution was used every other day for 3 weeks. After 3 weeks, the patients were evaluated for healing, and treatment was continued for another 3 weeks if the lesions were still present.Results  Complete regression of lesions was achieved in 19 of the 30 (63.33%) case patients. No significant side‐effect was noted in the treated patients apart from temporary brownish discoloration of the skin which resolved 1 week after treatment.Conclusion  This study demonstrated that 10% silver nitrate solution can be used effectively for the treatment of warts with no serious complications.
Cutaneous tumefaction in empyema necessitatis
Authors: Reyes Cesar V. 
Published: August 2010

AbstractBackground  Empyema necessitatis refers to a collection of exudative fluid that extends directly from the pleural cavity to the thoracic wall to form a mass in the extrapleural soft tissue of the chest. It was an uncommon complication of tuberculous pleural effusion even in the pre‐antibiotic era, and has also been associated with bacterial lung abscess, actinomycosis, blastomycosis, and malignancies.Methods  Seven instances of chest wall mass lesion secondary to empyema necessitatis, diagnosed by fine‐needle aspiration biopsy (FNAB), are reported.Results  Three cases were tuberculous, two were mesotheliomatous, one was caused by pulmonary small cell carcinoma, and another was due to coexisting Actinomyces and Actinobacillus. In all patients, subsequent pleural fluid cytologies demonstrated empyema with the respective etiologies identified.Conclusions  The usefulness of FNAB in the diagnosis of empyema necessitatis, supported by radiographic imaging and ancillary procedures, is well illustrated by these seven cases.