bluuebunny/crossref_metadata_2025_split huggingface dataset:
VULVITIS CIRCUMSCRIPTA PLASMACELLULARIS
Authors: HAUTMANN GIUSEPPE , GETI VINICIO , DIFONZO ELISA MARGHERITA 
Published: May 2007

A 56‐year‐old woman reported that an erythematous lesion, accompanied by severe burning, had appeared on the left labium minus about 2 years earlier. She had treated herself with topical deoxymethasone and estrogen topical medications that temporarily relieved the subjective synnptoms, but did little to help the clinical manifestations. The patient's history revealed an adnexectomy and ovariectomy at age 40 after an ectopic pregnancy and a left saphenectomy for ectatic varicose veins at age 54.We noted a bright red, shiny, almost lacquerlike lesion with clearly defined edges on the left labium minus that started from the external vaginal orifice and extended over half of the labium (Fig. 1). The lesion was not infiltrated and there was no inguinal lymphoadenopathy.Routine blood chemistry was normal and culture tests for bacteria and fungi were negative. The histologic examination showed a basically healthy epidermis with the exception of a focal reduction of the granular layer, a flattening of the dermoepidermal junction, capillary vasodilatation in the superficial dermis, and an infiltrate consisting of granulocytes, lymphocytes, and numerous plasma cells (Fig. 2).Direct immunofluorescence (DIF) performed with antigammaglobulin antiserum revealed numerous cell elements that tested positive with anti‐lgA antiserum with cytoplasmatic fluorescence at the dermal and subjunctional level (Fig. 3).On the basis of the clinical and histopathologic data we diagnosed a chronic circumscribed plasmacellular vulvitis, or Zoon's vulvitis. Excellent results were obtained after 3 months of topical treatment with cyclosporine.
NODULAR FASCIITIS OF THE UPPER LIP MIMICKING A SARCOMA
Authors: CHARTIER SUZANNE , ALLAIRE GUY , TOSCANO MARIE 
Published: May 2007

A 39‐year‐old white man in good health noticed a rapidly progressive swelling of his upper lip for which he consulted an otorhinolaryngologist. No pain or other symptoms were mentioned. Physical examination revealed an ill‐defined swelling of the upper lip extending in the region under the nose. This mass was hard and fixed to the underlying tissues. There was no ulceration or discoloration of the overlying skin (Fig. 1).Complete blood count, liver enzymes, renal function, sinus and chest x‐rays were normal. The patient was sub‐mitted to an excisional biopsy of the tumor.Histopathologic evaluation revealed an unencapsulated cellular proliferation of spindle‐shape or stellate cells extending into the dermal, fat, and muscular layers. The cells were pleomorphic without atypia, growing haphazardly or in a storiform pattern. There were very few mitotic figures and no abnormal forms, A few multinucleated cells were also present. The stroma appeared edematous or myxoid in the dermis but more densely collagenized In the hypodermis and muscular layer. The proliferation was accompanied by a well‐developed capillary network (Fig. 2).Clinically, the swelling of the superior lip persisted and another biopsy revealed the same histologic changes.Since the histopathology was oriented towards a benign condition and a complete excision would require extensive mutilating surgery, a wait‐and‐see policy was justified, A periodic follow‐up was arranged and a slowly progressive resolution of the swelling of the upper lip was noted. Six months after the second biopsy, there was only a discrete residual induration.
GENERALIZED PUSTULAR PSORIASIS PRECIPITATED BY TOPICAL CALCIPOTRIOL CREAM
Authors: GEORGALA SOFIA , RIGOPOULOS DIMITRIOS , ARONI KIRIAKI , STRATIGOS JOHN T. 
Published: May 2007

An 18‐year‐old woman had a 3‐year history of previously stable plaque‐type psoriasis that covered most parts of her body, arms, and legs.In June 1993, she started treatment with calcipotriol cream, which was prescribed by her dermatologist.Two weeks after starting this treatment, she had an exacerbation of her psoriasis with a generalized pustular eruption and she was admitted to the dermatology unit of “A. Sygros” Hospital.On admission, the clinical examination revealed a bright red erythema of most of her skin and numerous pinhead‐sized pustules that covered all the psoriasis lesions (Fig. 1).The eruption covered the patient's body, legs, and arms, whereas flexures and genitalia remained free. She also complained of malaise. The patient's laboratory studies showed the following values: hemoglobin 12.8 g/dL; hematocrit 39%; WBC 14,000/mm3; platelets 28,000/mm3; erythrocyte sedimentation rate 48/h. The blood chemistry surveys were all in the normal range and so were all enzyme studies. Urinalysis was normal. Chest x‐ray showed no abnormality.Previous treatmentDuring the 3‐year history, the patient had been using different treatments to control her disease. The last treatment was fluocinamide 0.05% cream, which she had stopped 8 weeks before starting treatment with calcipotriol. On clinical examination no signs of cutaneous atrophy, suggesting the overuse of topical steroid, was found.Histopathologic FindingsA 4‐mm punch biopsy was taken from a lesion and it revealed the epidermis to be slightly acanthotic and the formation of intraepidermal pustules underneath the stratum corneum with spongiform pustules at the shoulders of the lesion. In the dermis there was a perivascular infiltrate of lymphocytes and a few neutrophils with dilatation of blood vessels (Fig. 2).CourseCalcipotriol cream was immediately withdrawn and treatment with methotrexate (MTX) was started (25 mg i.m. weekly). The dose was gradually decreased and discontinued 8 weeks later with no relapse of pustules or the plaque‐type psoriasis until now.
PREVALENCE OF THYROID DISEASES IN PATIENTS WITH ALOPECIA AREATA
Authors: PUAVILAI SIRIPEN , PUAVILAI GOBCHAI , CHARUWICHITRATANA SOMYOT , SAKUNTABHAI ANAVAJ , SRIPRACHYA‐ANUNT SUCHAI 
Published: May 2007

Abstract Background. The prevalence of thyroid disease in patients with alopecia areata previously reported varied from 0 to 28%. These thyroid diseases include Hashimoto's thyroiditis. Graves' disease, simple goiter, and others. Methods. The prevalence of thyroid diseases was determined in 152 consecutive patients with alopecia areata who presented to the dermatology clinic. A complete history was taken and a physical examination was performed. Thyroxine, triiodothyronine, thyroid‐stimulating hormone, and microsomal antibody levels were measured in every patient. The control group consisted of 152 age‐ and sex‐matched volunteers who had skin diseases other than alopecia areata or autoimmune disorders. Results. Among 152 patients, age 10–59 years, four cases (2.6%) had a small simple goiter. Microsomal antibodies were detected in seven other patients (4.6%) with liters ranging from 1:100 to 1:1600. None of these seven patients had signs or symptoms of thyroid disease. Five cases (3.3%) of the control group had positive microsomal antibody tests with titers ranging from 1:100 to 1:400. The prevalence of positive microsomal antibodies in the alopecia areata group was not statistically different from the control group (x2= 0.347, df= 1, P = 0.5558). Conclusions. Among 152 patients with alopecia areata, 4.6% of patients had microsomal antibodies and 2.6% had a small simple goiter. Thus the prevalence of thyroid disease among these patients was 7.2%. The prevalence of positive microsomal antibodies in 4.6% of the patients was not statistically different from that of the control group.
MYCOSIS FUNGOIDES WITH SIGNET‐RING CELLS AND MONOCLONAL GAMMOPATHY
Authors: MISA RICARDO F. DE , AZAÑA JOSÉ M. , BELLAS CARMEN , PEREZ BIBIANA , ROCAMORA ANTONIO , LEDO ANTONIO 
Published: May 2007

A 73‐year‐old white woman was admitted to our hospital for evaluation of a chronic dermatitis. Personal history was remarkable only for arterial hypertension and noninsulin‐dependent6 diabetes mellitus. Clinical and histopathologic findings were consistent with a diagnosis of mycosis fundoides (mf and staging procedures including bolld cell counts, serum biochemistry, urinalysis, bone marrow biopsy, Sé zary cell counts in peripheral bolld, computerized tomography (ct scans, abdominal ultrasonography, chest roentgenograms, serum protein electrophoresis, and immunoelectrophoresis disclosed normal or negative results (T2 N0 M0 B0).After 2 years of standard treatment, the patient's condition had progressively worsened and she presented generalized erythematious plaques and a few, small, red‐bluish tumors (Fig. 1). A biopsy specimen of a tumor showed an intense lymphoid infiltrate composed mainly of large and medium‐sized cells, many of which exhibited clear interacytoplasmic vacuoles (Fig. 2). These vacuoles were negative for periodic acid‐Schiff, alcian blue, and oil‐red‐O staining. Most of the neoplastic cells stained with uchl1 antibody, and none expressed B‐cell markers. Some of the malignant cells reacted wih the Ber‐h2 and mb3 monoclonal antibodies. No evidence of immunoglobulin libht chain production was observed. Negative staining with cd68 monoclonal antibody ruled out a monocyte‐macrophage lineage of the malignant cells.On physical examination, no palpable lymph nodes were found. The quantitative immunoglobulin study showed an IgG level of 6,950 mg/dL (noral values, 800–1,800 mg/dL), IgA level of 126 mg/dL (normal, 90–450 mg/dL), IgM level of 130 mg/dk (normal, 70–280 gm/dL).Serum immunoelectrophoresis showed an IgG lambda monoclonal protein. Further studies including blood cell count, serum biochemistry, urinalysis, bone marrow biopsy, peripheral blood Sézary cell counts, Bence‐Jones proteinuria, ct scans, abdominal ultrasonography, and chest roentgenograms yielded negaive or normal results. Thus, diagnosis of monoclonal gammopathy of unknown significance (mgus) was made. Despite treatment with systemic chemotherapy, the diesease followed an aggressive course and the patient died from Staphylococcus epidermidis septicemia.
SUCCESSFUL SURGICAL MANAGEMENT AND LONG‐TERM FOLLOW‐UP OF EPIDERMOLYSIS BULLOSA
Authors: IKEDA SHIGAKU , YAGUCHI HITOSHI , OGAWA HIDEOKI 
Published: May 2007

Abstract Background. Esophageal stenosis and hand deformity are serious complications of recessive dystrophic epidermolysis bullosa that influence the prognosis of patients. To control such complications we have used surgical treatments with favorable results. Additional objectives were to summarize the results of long‐term follow‐up. Methods. Six patients with esophageal stenosis and nine patients (13 hands) with hand deformity (contracted fingers, mitten‐like deformity) were treated surgically after anemia and malnutrition were corrected by intravenous iron infusion, high‐energy diet, and blood transfusion. As intubation was contraindicated, topical anesthesia was used (eg., lidocaine spray to the nasopharyngeal mucosa for esophageal dilatation and brachial block, ketamine drip, and nitrous oxide inhalation for reconstruction of contracted fingers). We established a new method for esophageal dilatation using a microvasive rigiflex balloon catheter. This catheter was advanced to the stenotic area under radiography and then expanded by injecting contrast medium into the balloon. For reconstruction of hand deformities, the epidermal glove was initially peeled off, and then the combined digits separated carefully by hand, if the release of the contracture was not sufficient, a skin incision was made avoiding injury to nerves and blood vessels. Any skin defects that appeared after the release of the contracture were covered with skin grafts taken from the abdominal wall. K‐wire fixation was used to maintain the extended position of the fingers. Three weeks after the operation, the K‐wires were removed and rehabilitation was commenced. Results. The esophageal stenosis was successfully dilated with the balloon catheter; in all six cases the dysphagia was relieved immediately. There was no recurrence in any of the patients on long‐term follow‐up. After reconstruction of the hand, daily activity improved in 12 of the 13 hands. The remaining hand was difficult to reconstruct due to severe mutilation and bone deformity. During follow‐up, 6 of the 12 hands maintained successful reconstruction, whereas the remaining 6 hands showed slight to moderate recontraction of the fingers. Conclusion. Esophageal dilatation with a balloon catheter is safer and has fewer side effects compared to other surgical procedures. This method can provide favorable results and can be carried out repeatedly in a short time. Daily and social activities of patients can be improved upon reconstruction of hand deformities.
THREE CASES OF PEMPHIGUS VEGETANS: INDUCTION BY ENALAPRIL—ASSOCIATION WITH INTERNAL MALIGNANCY
Authors: BASTIAENS MAARTEN T. , ZWAN NEL VERBURGH‐VD , VERSCHUEREN GUY L.A. , STOOF TOM J. , NIEBOER CEES 
Published: May 2007

Abstract Background. Pemphigus vegetans, a rare form of pemphigus vulgaris, consists of vegetating plaques localized to flexural areas. Two types, the Neumann and the Hallopeau type, are recognized with their own characteristics. Methods. Three patients with pemphigus vegetans were examined, two with Hallopeau type and one with Neumann type. The microscopic and immunofluorescence findings were recorded. Results. Two remarkable features were present. In one case pemphigus vegetans was possibly induced by the use of enalapril. Only in three previous cases has enalapril been described in relation to pemphigus. A second case was associated with a malignant lung tumor, a phenomenon which could not be traced in the literature. Conclusions. Two types of pemphigus vegetans must be distinguished. Induction of pemphigus (also vegetans) is an accepted side effect of captopril. The effect of enalapril on pemphigus is still in debate. To the best of our knowledge, this is the first time that a patient with pemphigus vegetans and a simultaneously occurring internal malignancy is described.
CUTANEOUS LUPUS ERYTHEMATOSUS: COMPARISON OF DIRECT IMMUNOFLUORESCENCE FINDINGS WITH HISTOPATHOLOGY
Authors: RAOUF AL‐SUWAID ABDUL , NAGARAJ VENKATARAM MYSORE , RUDRIAH BHUSHNURMATH SHIVAYOGI 
Published: May 2007

Abstract Background. Direct immunofluorescence (DIF) is considered to be a major advance in the diagnosis of connective tissue diseases, particularly lupus erythematosus (LE); however, the reliability of the technique depends on several factors, such as age and site of the lesion, type of immunofluorescence, type of immunoglobulin, etc. False positives and false negatives can occur. Objective and Methods. To determine the diagnostic value of DIF we studied 18 clinically established cases of cutaneous lupus erythematosus (CLE). Lesional biopsies were subjected to routine histopathologic examination and direct immunofluorescence. The results were compared. Results. Direct immunofluorescence was positive in 72.7% and histopathology in 66% cases. Combination of the two techniques (with one or both methods giving characteristic findings) was positive in 83% cases. The most common antibody was IgG, seen in 77.8% cases. A homogeneous pattern of immunofluorescence, with IgG, was seen in 55.5% of the cases. Although histopathology gave positive or suggestive results in all cases, DIF was negative in two cases of early cutaneous LE. Conclusion. Although DIF is an extremely useful diagnostic tool, it should always be used in conjunction with histopathology and the combination of the two methods yields the best results.
CUTANEOUS MYIASIS: REVIEW OF 13 CASES IN TRAVELERS RETURNING FROM TROPICAL COUNTRIES
Authors: JELINEK TOMAS , DIETER NOTHDURFT HANS , RIEDER NATASCHA , LÖSCHER THOMAS 
Published: May 2007

Abstract Background. Cutaneous myiasis is frequently reported in patients from tropical countries. Most commonly infestation is due to Cordylobia anthropophaga and Dermatobia hominis, whereas Hypoderma lineatum is less likely to affect humans. Methods. The clinical and parasitologic aspects in a series of 13 patients with cutaneous myiasis seen in a German travel clinic are reviewed. Results. Six patients were infected with larvae of the tumbu fly, Cordylobia anthropophaga, six with larvae of the botfly, Dermatobia hominis, and one patient presented with an infection with Hypoderma lineatum. Dermatobia hominis was exclusively acquired in the American tropics and Cordylobia anthropophaga exclusively in Africa, whereas infection with Hypoderma lineatum was acquired in Nepal. The number of larvae removed from the skin was markedly higher in patients infected with the tumbu fly (average of five larvae) compared to the botfly (average of 1.7 larvae), whereas pain was more frequently reported from patients with botfly infestation. Treatment consisted in the removal of the larvae by forceps or surgical incision in tumbu or botfly infection and oral application of infection in infection with Hypoderma lineatum. This led to complete recovery in all patients. Conclusions. In patients presenting with cutaneous lesions after return from tropical countries, myiasis has to be considered as a differential diagnosis. Simple and effective therapy is available through removal of the maggots.
SERUM EOSINOPHIL CATIONIC PROTEIN (ecp) IN BULLOUS PEMPHIGOID
Authors: CAPRONI MARZIA , PALLESCHI GIOVANNI MARIA , FALCOS DIMITRI , D'AGATA ALBERINO , CAPPELLI GINO , FABBRI PAOLO 
Published: May 2007

Abstract Background. The importance of eosinophils in the pathogenesis of the major forms of pemphigoid (bullous pemphigoid, cicatricial pemphigoid, herpes gestationis) remains to be confirmed. Methods. To evaluate the role of eosinophilic Infiltrates in these diseases and to detect the presence and activity of eosinophils, we compared the serum levels of eosinophil cationic protein (ecp), an eosinophil‐derived protein, in 11 healthy subjects and in 10 patients with pemphigoid diseases (8 with bullous pemphigoid, one with cicatricial pemphigoid, and one with herpes gestationis). The serum of two patients with epidermolysis bullosa acquisita (lEBA) and one with linear IgA bullous dermatosis (labd) were utilized as a further control. Results. There was a significant difference between the mean of serum ecp levels in patients with pemphigoid diseases (25.1 ± 12.3 μg/L, M = SD) and control subjects (2.30 ± 2.41, μg/L ± SD 2.41) (T = 4.272 P < 0.0001). The two patients with EBA (10.8 and 17.7 μg/L) showed contrasting results; the patient with labd had normal ecp serum levels. The serum levels of ecp were not significantly correlated with the blood eosinophil count (R = 0.103; P = 0.777) in any of the cases. Conclusions. In pemphigoid disease, the serum levels of ecp seem to be correlated with the activated secreting and tissue‐damaging eosinophils found in the dermis, supporting the concept of an active participation of eosinophils in generating cutaneous lesions.
ORAL PHOTOCHEMOTHERAPY IN VITILIGO: FOLLOW‐UP, PATIENT COMPLIANCE
Authors: AL‐ABOOSI MUSTAFA M. , AJAM ZUHAIR A. 
Published: May 2007

Abstract Background. Vitiligo is a common, acquired condition of unknown etiology. The only practical treatment for patients with vitiligo is psoralen ultraviolet A (puva). NO satisfactory method is available to measure the influence of certain factors on the therapeutic response. Methods. Twenty‐nine patients with generalized vitiligo were studied for the effectives of puva therapy. The comparative study revealed the importance of certain variables (i.e., the proper dose of psoralen, the regular attendance of the patient, and the duration of the treatment). A scoring system had been designed and employed to evaluate these factors. Results. The follow‐up of these patients showed that 18 of the 29 completed their treatment. An almost total improvement was obtained in 67% of these patients within 12 months (range 6–18 months). The average number of exposures was 64. A statistically significant difference was obtained between patients with good compliance and those with poor compliance. Conclusions. The scoring system is a simple practical measure applicable to patients that proved eventually to be very useful for providing more effective treatment and a good response.
SECONDARY SYPHILIS: A CLINICOPATHOLOGIC STUDY
Authors: PANDHI R. K. , SINGH NAVJEEVAN , RAMAM M. 
Published: May 2007

Abstract Background. With the resurgence of syphilis in the hiv era, a greater awareness of the clinicopathologic features of the disease is desirable. This report describes and correlates the clinical and histopathologic features of secondary syphilis seen at a teaching hospital in Delhi, India. Methods. Forty biopsies of mucocutaneous lesions from 31 consecutive patients with secondary syphilis, seen between September 1987 and January 1991, were studied and the histopathologic findings correlated with the clinical findings. Results. A spectrum of histopathologic changes ranging from a minimal infiltrate to granulomatous inflammation throughout the dermis was seen. The pattern of inflammation correlated well with the type of skin lesion, with macules showing the least and nodules the most prominent changes. The predominant cell type in the infiltrate was the mononuclear cell/lymphocyte. Plasma cells were seen infrequently. except in condylomata lata. Endothelial proliferation, the “classical” feature of the histopathology of syphilis was noted infrequently. Conclusions. The histologic manifestations of secondary syphilis appear to be as varied as the clinical ones. This calls for close interaction between the clinician and the pathologist to correlate the clinical, serologic, and histologic findings to establish the diagnosis of syphilis.
NEVUS SEBACEUS: CLINICAL OUTCOME AND CONSIDERATIONS FOR PROPHYLACTIC EXCISION
Authors: CHUN KEVIN , VÁZQUEZ MIGUEL , SÁNCHEZ JORGE L. 
Published: May 2007

Abstract Background and Objective. Nevus sebaceus is a hamartoma of the skin with the potential to develop benign and malignant neoplasms. Prophylactic surgical excision has been advocated, usually before puberty, to prevent their occurrence; however, it is the clinical impression of the authors that the development of cutaneous neoplasms is infrequent and, if they develop, they are usually benign and nonaggressive. Our objective was to investigate the clinical outcome and histopathologic findings of every single nevus sebaceus that had been excised in our institution in a five‐year period. Methods. Two hundred and twenty‐five consecutive cases, coded as nevus sebaceus corresponding to 175 patients were submitted to our institution between September 1987 and May 1992, and were identified among a total of 64,827 specimens. All cases were reviewed histopathologically and clinical information was obtained from the records. Specimens from 10 patients were excluded. Results. A total of nine benign neoplasms (5.4%) were identified in the 165 patients. Three patients were in their second decade of life, two in their third, two in the fifth and two in the sixth. There were five trichoblastomas, three specimens of syringocystadenoma papilliferum, and one aprocrine cystadenoma. No malignant neoplasms were found. Six of the tumors were removed either for prophylactic or cosmetic reasons and in only three cases were the neoplasms suspected clinically and excised. Conclusions. If this same tendency prevails in other prospective studies, we strongly believe that prophylactic excision of all nevus sebaceus is not warranted. Excision should be recommended only when benign or malignant neoplasms are clinically suspected or for cosmetic considerations.