bluuebunny/crossref_metadata_2025_split huggingface dataset:
ALLERGIC CONTACT DERMATITIS: CLINICAL FEATURES AND PROFILE OF SENSITIZING ALLERGENS IN RIYADH, SAUDI ARABIA
Authors: AL‐SHEIKH OMAR AHDULAZIZ , EL‐RAB MOHAMED OSMAN GAD 
Published: May 2007

Abstract Background. No reports are available on allergic contact dermatitis in Saudi Arabia, although it seems to be a common skin problem. We attempted to explore certain clinical aspects in addition to the profile of sensitizing allergens in our area. As no standard panel for patch testing is available in our geographic region, we examined the suitability of the European Standard Series. Methods. Patch testing was performed on 271 consecutive patients with various forms of dermatitis, referred for evaluation of possible allergic contact dermatitis. The study included 147 women and 124 men. The patients were between 12 and 75 years of age. Results. Out of 271 subjects, 152 (56.1%) showed one or more positive reactions. Of these, 80 (52.6%) were women and 72 (47.4%) were men. Almost one quarter of the patients (25.7%) presented with hand dermatitis.Positive reactions to 21 out of the 22 allergens were found. Sensitization was most common to nickel sulfate (39.5%), potassium dichromate (32.9%), and cobalt chloride (30.9%). Reactions to the other allergens ranged between 14.5% and 1.3%. Less than one percent of the patients (0.66%) reacted to benzocaine and showed no reaction to primin. Conclusions. Allergic contact dermatitis is a common skin problem in Saudi Arabia. Further studies that address the prevalence and incidence of the disease are indicated. The European Standard Series is suitable for patch testing patients in our community; however, we suggest exclusion of benzocaine and primin. The addition of three allergens of local relevance, black seed oil, local perfume mix, and henna, are presented and discussed. The formulation of a regional standard series for patch testing dermatitis patients in our geographic area requires further collaborative studies.
SUNLIGHT AND AIR TEMPERATURE AFFECT AUTOANTIBODY ACTIVITY AND SKIN INVOLVEMENT OF BULLOUS PEMPHIGOID
Authors: KYRIAKIS KYRIAKOS P. , PANTELEOS DEMETRIUS N. , TOSCA ANDRONIKI D. 
Published: May 2007

Abstract Background and Design. Sunlight and air temperature are environmental parameters with considerable influence upon autoimmunity. Their impact on idiopathic bullous pemphigoid (BP) was studied 1) in a prospective series of 27 patients with regard to clinical activity and 2) in a retrospective series of 232 cases during a 7‐year period with regard to immunoserology. Results. Skin involvement and the onset of disease showed an immediate and cumulative pattern of response to sunlight and air temperature. Immunoserologic analysis showed a strong correlation of autoantibody expressivity with these two environmental measurements. Conclusions. This study verifies previous sporadic clinical and experimental data concerning the influence of environmental factors on BP. Accordingly, preventive measures against exposure to sunlight and high temperature are recommended.
FAILURE OF INTERFERON‐ALPHA 2B IN THE TREATMENT OF MATURE KELOIDS
Authors: AL‐KHAWAJAH MARWAN M. 
Published: May 2007

Abstract Background. An unchecked proliferation of fibrous tissue after an injury to the skin is the basic mechanism for keloid formation. Recent studies have shown the inhibitory effect of interferons on dermal fibroblast growth and/or collagen production. Various therapeutic modalities have been used for the treatment of keloids, although only with limited success. There are only a few reports on the use of interferons in the treatment of keloids. To our knowledge no controlled clinical trials have examined the efficacy of intralesional interferon‐alpha 2b on mature keloid lesions. In this study, recombinant human interferon‐alpha 2b was examined for its ability to modify keloids clinically. Methods. Twenty‐two patients with at least two mature keloids were studied twice weekly for 3 weeks. Patients were treated by injection of recombinant human interferon‐alpha 2b, 0.5 million per cm2 of keloid, into one lesional site and diluent alone into another lesional site. Lesions were measured before and on days 8, 15, 22, and 29 after starting treatment. Results. Only 13 of 22 patients could be evaluated at the end of the study; seven patients withdrew from the study because of severe local pain during injection. Three of the 13 patients showed insignificant reduction in the height of keloids after interferon treatment. No serious laboratory abnormalities were detected. Conclusions. Recombinant interferon‐alpha 2b is not efficacious in the treatment of mature keloids.
TOXIC EPIDERMAL NECROLYSIS
Authors: PASRICHA JAGJIT S. , KHAITAN BINOD K. , SHANTHARAMAN RAMAN , MITAL ASIT , GIRDHAR MUKESH 
Published: May 2007

Abstract Background. Most studies on drug‐induced toxic epidermal necrolysis (TEN) report a high mortality rate. This has been attributed partly to the use of corticosteroids for its treatment. However, we consider corticosteroids to be the sheet anchor for saving the patients having TEN. Materials and Methods. Our approach to the treatment of this disease consists of administering a relatively high dose of corticosteroids to control the reaction at the earliest possible time and then withdrawing corticosteroids at the fastest possible rate. Results. As illustrated by the five case reports, the reaction is controlled within 24 to 48 hours and the corticosteroids are withdrawn within the next 7 to 10 days. During this period, the skin also shows almost complete healing. With the confidence gained with this approach, we undertake the provocation test as a rule in every patient to find the actual drug responsible for the reaction. Conclusions. Corticosteroids used in an appropriate dosage schedule constitute an important component of the treatment for TEN to ensure early recovery.
MICROBIOLOGY OF INFECTED ATOPIC DERMATITIS
Authors: BROOK ITZHAK , FRAZIER EDITH H. , YEAGER JOSEF K. 
Published: May 2007

Abstract Background. Bacterial infections occur frequently in lesions of atopic dermatitis (AD). The objectives of the study were to establish the aerobic and anaerobic microbiology of secondarily infected AD. Methods. A retrospective review was carried out of clinical and microbiology laboratory records and of data obtained from patients with secondarily infected AD lesions, whose specimens of infected sites were processed for the presence of aerobic and anaerobic bacteria. Results. Bacterial growth was noted in 41 specimens. Aerobic or facultative anaerobic bacteria only were present in 15 patients (36%), anaerobic bacteria only in eight (20%), and mixed anaerobic‐aerobic flora was present in 18 (44%). Seventy‐ two isolates were recovered (1.8 per specimen), 34 aerobic or facultative bacteria, 35 strict anaerobes, and three Candida sp. The predominant aerobic and facultative bacteria were Staphylococcus aureus (12 isolates). Group A beta hemolytic streptococcus in five isolates, and Escherichia coli in four. The predominant anaerobes were peptostreptococcus spp. (13 isolates), pigmented Prevotella and Porphyromonas spp. in eight, and Fusobacterium spp. in four isolates. Single bacterial isolates were recovered in 14 patients (34%), seven of which were S. aureus. Twenty‐one of the organisms isolated from 16 patients (39%) produced the enzyme beta‐lactamase. Organisms that resided in the mucous membranes close to the lesions predominated in these infections. Enteric gram‐negative rods and bacteroides fragilis group predominated in lesions on legs and buttocks. Group A beta‐hemolytic streptococci, pigmented Prevotella, and Porphyromonas and Fusobacterium spp. were most frequently recovered in lesions of the finger, scalp, face, and neck. Conclusions. The polymicrobial etiology of secondarily infected AD lesions and the association of bacterial flora with the anatomic site of the lesions are demonstrated.
CHRONIC ULCERATIVE STOMATITIS WITH STRATIFIED EPITHELIUM‐SPECIEIC ANTINUCLEAR ANTIBODIES
Authors: LEWIS JOHN E. , BEUTNER ERNST H. , ROSTAMI REZVAN , CHORZELSKI TADEUSZ P. 
Published: May 2007

Abstact Background. In 1990 a new disease‐associated antinuclear antibody was first recognized as a specific immunologic marker for a chronic form of ulcerative stomatitis (cus). Methods. Another case is reported herein and the subject of chronic ulcerative stomatitis with stratified epithelium‐specific antinuclear antibodies (SES‐ANA) is reviewed. Intraoral biopsies from this patient were submitted for microscopic examination and direct immunofluorescence. Indirect immunofluorescence studies were also performed. Serial SES‐ANA titers were obtained with the patient on maintenance treatment with hydroxychloroquine. A skin biopsy of a recent lichenoid eruption was obtained and skin explants grown in the serum of this patient were studied in tissue culture with reference to SES‐ANA binding and complement fixation. Results. Biopsy and serum studies confirmed a diagnosis of cus with SES‐ANA in the patient reported. Skin biopsy showed lichen planus. The patient was treated with hydroxychloroquine with a favorable response. Serial SES‐ANA titers did not parallel the disease activity. Among the substantive observations made from skin explants cultured in the serum of this patient was widespread fixation of C3 to the nuclei of basal cells. Conclusions. The case described herein extends the findings in cus to include lichenoid skin lesions. Records show that at least four of 11 cases of cus had skin lesions, whereas all had oral lesions. Stratified epithelium‐specific antinuclear antibodies serve as the key marker of cus. Skin explants grown in the serum of this cus patient bind SES‐ANA in tissue culture. Sections of explants fix complement. Titers of SES‐ANA have been reported to parallel disease activity in one case, but not in the present case. Thus, there appears to be case‐to‐case variation. The treatment of choice for cus is hydroxychloroquine.
TREATMENT OF ACTINIC PRURIGO IN CHIMILA INDIANS
Authors: DURÁN MARIA M. , ORDOÑEZ CLARA P. , PRIETO JUAN C. , BERNAL JAIME 
Published: May 2007

Abstract Background. Actinic prurigo has a high prevalence in women of child‐bearing age. Its treatment has been, among others, with thalidomide. To avoid the deleterious effects of this drug on the embryo, therapeutic alternatives have been sought. Among these, tetracycline and vitamin E have been investigated as to their influence on the symptoms of actinic prurigo. Both these drugs affect superoxide radicals that are thought to be involved in the pathogenesis of actinic prurigo. Materials and Methods. Patients (Chimila Indians with a high prevalence of actinic prurigo) received either (a) tetracycline, 500 mg three times daily, for 6 months, or (b) vitamin E, 100 IU daily, for 6 months. The patients were seen once monthly. There were eight patients in each group. Results. Both drugs used were effective. Pruritus was remarkably improved by either treatment. None of the side effects were severe enough to lead to interruption of treatment, but the observation period posttreatment was relatively short, 4 months for tetracycline and 2 months for vitamin E. The improvement occurred in spite of the continuation of extensive exposure to the sun. Conclusions. Tetracycline and vitamin E are efficacious in relieving the pruritus of actinic prurigo. Preliminary trials of a combination treatment with these two drugs is a new avenue which has shown in preliminary trials to yield synergistic effects which might allow the dosage of tetracycline to be reduced.
DETECTION OF T LYMPHOCYTES AND T LYMPHOCYTE SUBSETS IN LICHEN PLANUS: IN SITU AND IN PERIPHERAL BLOOD
Authors: AL‐FOUZAN ABDULWAHAB S. , HABIB MOHAMED A. , SALLAM TARIF H. , EL‐SAMAHY MAY H. , ROSTOM AMR I. 
Published: May 2007

Abstract Background. Abnormal immune mechanisms are thought to be important in the pathogenesis of lichen planus (LP). This is a study to clarify the changes that occur in T lymphocytes and T lymphocyte subsets, both in situ and in peripheral blood. Methods. A group of 100 patients with LP were included in this study. T lymphocytes and T lymphocyte subsets were detected in lesional skin by immunoperoxidase cell surface staining using monoclonal antibodies. Peripheral T lymphocytes and T lymphocyte subsets were also detected by indirect immunofluorescence using monoclonal antibodies. A group of 10 normal healthy subjects were used as controls. Results. The study of the lesional T lymphocytes and T lymphocyte subsets demonstrated that helper T cells was the predominant subset in LP lesions in most of the patients. This predominance was evident irrespective of the duration of the disease and was more evident in late than in early lesions. The percentage of both total T lymphocytes and helper T cells in peripheral blood was decreased significantly in patients compared with controls. A significant decrease in helper T cells and the helper/cytotoxic T cell ratio was detected in patients with a longer duration of the disease. Conclusion. Activation of helper T lymphocytes that were found to be the predominant subsets in LP lesions may be responsible for epidermotropic cellular infiltrates leading to damage and destruction of epidermal cells.
UTILITY OF BONE MARROW AND LIVER BIOPSIES FOR STAGING CUTANEOUS T‐CELL LYMPHOMA
Authors: MARTÍ ROSA M. , ESTRACH TERESA , REVERTER JUAN C. , CAMPO ELÍAS , BRUGUÉS ROSA , BRUGUERA MIGUEL , MASCARÓ JOSÉ M. 
Published: May 2007

Abstract Background. The wide use of staging procedures, looking for visceral involvement in patients with cutaneous T‐cell lymphoma (CTCL), is controversial, especially in the early stages. In this study, we analyzed the results of bone marrow biopsy and laparoscopy with liver biopsy in a series of 43 patients with CTCL. Methods. Clinicopathologic stages were established by a modification of the TNM system proposed in 1979. Results of staging procedures were correlated with blood cell counts and laboratory tests. The usefulness of the staging procedures was analyzed particularly in patients without clinical or biologic evidence of extracutaneous disease. Results. The patient's median age was 66 years; 35 patients were men and eight women. The clinicopathologic stages were as follows: T1: 3 cases; T2: 15; T3: 14; T4: 11; NO: 15; N1: 28; MO: 38; Ml: 5; BO: 37; and B1: 6 cases. Internal lymph node disease, diagnosed by lymphangiography and/or abdominal scanning, was demonstrated in 37% of patients. Bone marrow infiltration was seen in 12% of patients and was the only form of visceral involvement. All liver biopsies were negative. Serum lactate dehydrogenase (LDH) levels were raised in patients with lymph node disease; it was the only laboratory test that correlated with extracutaneous involvement. Staging procedures changed three of the nine patients with a clinical T1‐T2N0M0B0 stage (33%) to a more advanced stage. The abdominal lymph node evaluation allowed a reclassification from NO to N1 in two of nine cases (22%); one of the remaining cases was reclassified from MO to M1 on the basis of bone marrow biopsy results. Conclusions. Our results indicate that bone marrow biopsy is a useful investigational procedure for determining extracutaneous disease in CTCL. Peritoneoscopy with liver biopsy rarely is informative; however, as our study does not include a very large number of patients, these preliminary conclusions must be confirmed in the future by including more cases.
EXPRESSION OF KERATOHYALIN‐TRICHOHYALIN HYBRID GRANULES IN MOLLUSCUM CONTAGIOSUM
Authors: MANABE MOTOMU , YAGUCHI HITOSHI , BUTT KHALID IQBAL , O'GUIN W. MICHAEL , SUN TUNG‐TIEN , OGAWA HIDEOKI 
Published: May 2007

Abstract Background. Recently, in the filiform papillae epithelium of mouse dorsal tongue, we showed the presence of hybrid granules in which filaggrin and trichohyalin were both present, but physically segregated. Further, trichohyalin was also detected in scattered granular cells of a number of hyperplastic skin diseases. Methods. The epidermis infected with molluscum contagiosum virus (MCV) was studied by conventional electron microscopy in conjunction with light and electron‐microscopic immunohistochemistry, using both antifilaggrin and antitrichohyalin antibodies as probes. Results. We found that the granular cells of MCV‐infected epidermis contained both filaggrin and trichohyalin. Subsequent electron‐microscopic examination showed that the granular cells contained morphologically heterogeneous granules that appeared to be composed of discrete areas of distinct electron densities. Double‐labeling, using antibodies to filaggrin and trichohyalin, clearly indicated that filaggrin and trichohyalin were both present in the hybrid granules and that the electron‐dense regions contained trichohyalin while the more electron‐lucent regions contained filaggrin. Conclusions. The expression of trichohyalin was a common feature observed in the epidermis from a heterogenous group of hyperplastic conditions, including MCV Infection. This finding has led us to speculate that trichohyalin may be specifically or preferentially involved in interacting with the hyperproliferation‐related keratin pair (K6/K16), whereas the function of filaggrin is more closely linked to the skin‐type keratin pair (K1/K10) that are normal keratins found in the differentiated epidermis.
DOUBLE‐BLIND STUDY OF PREDNICARBATE VERSUS FLUOCORTIN BUTYL ESTER IN ATOPIC DERMATITIS
Authors: ALIAGA ADOLFO , RODRÍGUEZ M. , ARMIJO M. , BRAVO J. , LÓPEZ AVILA A. , MASCARO J.M. , FERRANDO J. , RIO R. DEL , LOZANO R. , BALAGUER A. 
Published: May 2007

Patients and Methods This parallel‐group, double‐blind trial compared the efficacy and tolerability of topical prednicarbate, 0.25% ointment, with that of fluocortin butyl ester, 0.75% ointment.The trial included 79 outpatients at three participating centers. All patients had a diagnosis of atopic dermatitis on the basis of Hanifin and Rajka's criteria.1 Other inclusion criteria were: age ≥ 18 years and stability or worsening of the condition for at least 1 week in the current episode. Patients were required to have been treatment‐free for minimum periods of: 7 days if previously treated with other topical corticosteroids; 1 month if previously treated with systemic corticosteroids; 3 days if previously treated with shortacting antihistamines; 2 months if previously treated with astemizole.Exclusion criteria were: severe incapacitating dermatitis; infectious processes or association with other skin changes; need for the concomitant administration of antihistamines or antimicrobials; serious concurrent illness. Women not using adequate contraception were also excluded.A thin layer of topical prednicarbate (N = 42) or fluocortin butyl ester (N = 37) was applied to the affected area of skin twice daily, without occlusion. The duration of treatment was set at 21 days, but it could be interrupted earlier, at the discretion of the investigator, on the grounds of total disappearance of the condition, inefficacy, or the appearance of any adverse reaction. A daily application of an emollient oil and/or a cleaning or emollient aqueous cream could be used at the investigator's discretion.At the start of treatment and at 4, 7, 14, and 21 days, each of the following features was rated on a scale of 0 to 3 (0; absent, 1: mild, 2: moderate, 3: severe): pruritus; excoriations; erythema; scaling; lichenification; vesiculation; hyper‐keratosis. On the basis of these scores, the overall efficacy of treatment was rated as: improvement > improvement of > 50 to 75%; improvement of > 25 to 50%; improvement < 25%; no improvement; worsening.If the treatment ended before 21 days, owing to either cure or inefficacy, the score for the last evaluation was used for all subsequent followup points. At the end of treatment the investigator and the patient rated treatment as excellent, good, fair, or poor. Cosmetic acceptance by the patient was evaluated in the same terms.
LINEAR SCLERODERMA IN CHILDREN
Authors: EUBANKS LEIGH ELLEN , McBURNEY ELIZABETH I. , GALEN WESLEY , REED RICHARD 
Published: May 2007

Abstract Background. Linear scleroderma is a cutaneous disease of unknown etiology. It most often affects children, who develop band‐like lesions in an asymmetric distribution. The literature is reviewed as to the diagnosis, pathogenesis, and treatment of linear scleroderma. Case Report. Six new cases of linear scleroderma in children are reported. Their ages ranged from 6 to 17 years, and five were girls. A 17–year‐old girl had en coup de sabre. Multiple treatment modalities were used. All laboratory testing was negative. Conclusions. Linear scleroderma is a clinical diagnosis. The pathogenesis remains unknown. A consistently effective therapy has not been found, although diphenylhydantoin and ticlopidine hydrochloride should be evaluated in clinical trials.
ACCESSORY MAMMARY TISSUE ASSOCIATED WITH CONGENITAL AND HEREDITARY NEPHROURINARY MALFORMATIONS
Authors: URBANI CARLO ENRICO , BETTI ROBERTO 
Published: May 2007

Abstract Background and Objectives. The association between polythelia (supernumerary nipple) and kidney and urinary tract malformations (KUTM) is controversial. Some authors reported this association in newborns and infants. Case‐control studies dealing with adult subjects are not found in the literature. The purpose of this study is to determine the frequency of the association between accessory mammary tissue (AMT) and congenital and hereditary nephrourinary defects in an adult population compared to a control group. Methods. The study was performed in 146 white patients (123 men, 23 women) with AMT out of 2645 subjects consecutively referred to us for physical examination. The following investigations were undertaken: ultrasonographic examination of the abdomen and the kidneys, ECG, echocardiogram, roentgenogram of the vertebral column, urinalysis, and other laboratory tests. A sex‐ and age‐matched control group without any evidence of AMT or lateral displacement of the nipples underwent the same examinations. Results. Kidney and urinary tract malformations were detected in 11 patients with AMT (nine men, two women) and in one control. These data indicate a significantly higher frequency of KUTM in the AMT‐affected patients compared to controls (7.53% vs. 0.68%, P < 0.001). A broad spectrum of KUTM was discovered in association with AMT: adult dominant polycystic kidney disease, unilateral renal agenesis, cystic renal dysplasia, familial renal cysts, and congenital stenosis of the pyeloureteral joint. Conclusion. Accessory mammary tissue offers an important clue for congenital and hereditary anomalies of the kidneys and urinary collecting systems. Patients with AMT should, therefore, be extensively examined for the presence of occult nephrouropathies.
ETIOLOGIES OF THE SICCA SYNDROME: PRIMARY SYSTEMIC AMLOIDOSIS AND OTHERS
Authors: RICHEY TROY K. , BENNION SCOTT D. 
Published: May 2007

Abstract Background. The sicca syndrome has been defined as the occurrence of xerostomia and xerophthalmia. Sjögren's syndrome is the most common cause of the sicca syndrome; however, these two syndromes are not synonymous and there are many potential etiologies of the sicca syndrome. A less known cause of sicca syndrome is amyloidosis that to date has only been reported in the nondermatology literature. Observations. A 79‐year‐old man with known amyloidosis presented with persistent xerostomia. He had the classic cutaneous findings of periorbital and “pinch” purpura. A labial biopsy showed diffuse deposition of amorphous eosinophilic material surrounding salivary acini. Apple‐green birefringence was noted with Congo red staining and the diagnosis was made of amyloidosis in the minor salivary glands causing xerostomia. Conclusions. The sicca syndrome can be caused by systemic amyloidosis. Because this fact is not in the dermatologic literature, many dermatologists are not aware of this uncommon presentation. The knowledge of the many causes of the sicca syndrome and an understanding of the differences between this and Sjögren's syndromes are important for any dermatologist.