bluuebunny/crossref_metadata_2025_split huggingface dataset:
POLAR AND SUBPOLAR DIFFUSE CUTANEOUS LEISHMANIASIS IN BRAZIL: CLINICAL AND IMMUNOPATHOLOGIC ASPECTS
Authors: BARRAL ALDINA , COSTA JACKSON M.L. , BITTENCOURT ACHILLA L. , BARRAL‐NETTO M. , CARVALHO EDGAR M. 
Published: May 2007

Abstract Background. Diffuse cutaneous leishmaniasis (DCL) is a rare manifestation of human leishmaniasis, characterized by multiple, slowly progressive nodules or plaques without ulceration, involving almost the entire body. It has been suggested, that DCL results from a lack of cell‐mediated immunity to leishmanial antigen, leading to uncontrolled parasite growth. Methods. We have performed detailed clinical, histopathologic, and immunologic investigations in six patients with DCL. Biopsies were taken from the nodules, processed, and examined for determination of the macrophagic pattern present, based on the intensity of vacuolation and the frequency of vacuolated cells, the parasite index, and the presence of eosinophils. Immunologically, patients were evaluated by their response to intradermal skin test to PPD or leishmania antigen, determination of antileishmania antibodies by immunofluorescent assay, and lymphocyte proliferation assay. Results. There seemed to be a negative relation between nodules and skin ulcerations, whereas the highest number of parasites were observed in patients with the greatest number of vacuolated macrophages. The delayed hypersensitivity skin test to leishmanial antigen was negative, and antileishmania IgG antibodies were positive in all patients. Conclusions. Although all cases fulfill the criteria for being classified as DCL, they present a wide spectrum. Three cases were clearly at the unresponsive pole, and three other cases belonged to the subpolar form of DCL, exhibiting varying weak signs of antiparasite responsiveness.
DIAGNOSTIC EVALUATION OF THE LUPUS BAND TEST IN DISCOID AND SYSTEMIC LUPUS ERYTHEMATOSUS
Authors: GEORGE RENU , KURIAN SUSY , JACOB MARY , THOMAS KURIAN 
Published: May 2007

Abstract Background. The usefulness of the lupus band test (lbt) in the diagnosis of cutaneous lupus erythematosus remains controversial. The study was done to determine the sensitivity, specificity, and predictive value of the lbt in discoid lupus erythematosus (dle) and systemic lupus erythematosus (sle). Methods. During the study period, 32 patients with SLE and 28 patients with DLE were included. The final classification of cases was based on the American Rheumatism Association Criteria (ara) for sle, histopathology, and consensus of the clinical staff. Thirty controls, 15 each for DLE and sle, were chosen from a group of patients, who had lesions clinically simulating dle and sle, but could be excluded by histopathology, laboratory tests, and follow‐up. Histopathologic examinations and direct immunofluorescence (DIF) tests were done on lesional skin. Results. In dle, the sensitivity of the LE band test was 58% and the specificity 87%. The positive predictive value was 95% and negative predictive value was 32%. In sle the sensitivity was 93% and specificity 87%. The positive predictive value was 64% and negative predictive value 98%. Conclusions. The high negative predictive value of lbt in sle suggests that it is valuable in excluding diseases clinically similar to sle.
AGE AND SITE PREVALENCE OE HISTOLOGIC SUBTYPES OE BASAL CELL CARCINOMAS
Authors: BETTI ROBERTO , INSELVINI ELENA , CARDUCCI MAURO , CROSTI CARLO 
Published: May 2007

Abstract Background. Basal cell carcinomas (bcc) are the most frequently diagnosed skin cancers. The relationships between some clinical parameters, such as sex, age, and location of the tumor, and the histologic patterns play an important role as factors predictive of recurrence and treatment implications. Methods. A total of 693 patients with bcc, divided according to sex, age, and location of the tumor were studied. The histologic patterns considered were nodular, superficial, and morpheiform bcc and fibroepithelioma. The correlation between clinical and histologic parameters was analyzed. Results. All histologic patterns considered were most commonly represented in the 7th and 8th decades. There were no sex differences. A prevalence of a superficial pattern for sun‐unexposed areas and of a nodular pattern for sun‐exposed areas was observed. The morpheiform pattern showed no correlation with any body site. The fibroepithelioma showed an absolute prevalence for the lumbosacral region. Conclusions. Age does not seem to be a discriminant or permissive factor for a particular histologic pattern of bcc. The prevalence of some subtypes for a particular body area may be explained on the basis of local predisposing conditions affecting the histologic development of the tumor.
ENVIRONMENTAL FACTORS INFLUENCING THE BIOLOGIC BEHAVIOR OF PATTERNS OF PEMPHIGUS VULGARIS: EPIDEMIOLOGIC APPROACH
Authors: KYRIAKIS KYRIAKOS P. , VARELTZIDIS ANTHONY G. , TOSCA ANDRONIKI D. 
Published: May 2007

Abstract Background. Pemphigus vulgaris is an autoimmune disorder, in which environmental factors seem to play a role, both in the pathogenesis and the activity of the disease. The purpose of the study was to correlate the biologic activity of pemphigus vulgaris with sun exposure and air temperature. Methods. An epidemiologic study was carried out, analyzing results of serology, skin involvement, and proportional morbidity rates, related to sun exposure and air temperature. The study was based on retrospective and prospective series of patients. All data were evaluated in a yearly seasonal distribution. Results. Strong correlations were shown between climatologic data and pemphigus activity in the populations studied. Conclusions. Environmental factors have a significant impact on the disease expression. This stresses the necessity of preventive measures against exposure to sun and high temperature.
CO‐MORBIDITY BETWEEN DERMATOLOGIC DISEASES AND PSYCHIATRIC DISORDERS IN PAPUA NEW GUINEA
Authors: JOHNSON FELIX Y. ATTAH , MOSTAGHIMI H. 
Published: May 2007

Abstract Background. Neurodermatitis (now subdivided into lichen simplex chronicus and atopic dermatitis) was included among the psychosomatic disorders. Psychologic causes have been suggested for many skin conditions, such as urticaria, lichen simplex chronicus, atopic dermatitis, psoriasis, alopecia areata, and pruritus. The evidence for psychologic causation is neither strong nor convincing; however, psychiatric disorders are common among people with established skin diseases. Recent investigators have published data reporting co‐morbidity between certain psychiatric disorders and skin diseases. The objective of the research was a prospective clinical study of 132 consecutive patients, who attended the dermatologic outpatient clinic of the Port Moresby General Hospital during 1992. Methods. The instrument for the study is the Harding Self‐Rating Questionnaire (sro) that has been demonstrated to work well as a gross screening instrument in the Urban Primary Health Care Clinic setting. The questionnaire was administered to 132 outpatients by one of the investigators (hm). Those patients who scored above the cut‐off point of seven were referred to the second investigator (fyaj) for examination of their mental state. Results. The results of the study showed all 132 patients were adults, aged between 16 and 75 years. There were 67/132 (50.75%) men and 65/132 (49.24%) women patients. The psychiatric diagnoses for the women patients were: normal variation 17/65, anxiety neurosis 11/65, and neurotic depression 37/65. For the men patients, the psychiatric diagnoses were: normal variation 21/67, anxiety neurosis 15/67, and neurotic depression 30/67. One man with psoriasis also presented with clinical features of schizophrenic psychosis. Conclusions. The results of the study support the hypothesis, that there is a co‐morbidity between some psychiatric disorders and some skin diseases.
MUCOCUTANEOUS MANIFESTATIONS OF LYMPHOMAS AND LEUKEMIAS IN BLACK KENYAN CHILDREN
Authors: RIYAT MALKIT S. 
Published: May 2007

Abstract Background. Childhood leukemia and lymphoma are common problems in Tropical Africa, including Kenya. Studies done in Western populations indicate that 25–50% of patients with leukemia and lymphoma have specific or nonspecific cutaneous signs. In dark‐skinned patients, reports of such mucocutaneous manifestations are scarce. The lesions in these patients may easily be missed, if not specifically looked for. Method. Eighty‐six indigenous Kenyan children with a confirmed diagnosis of leukemia or lymphoma were specifically examined for any mucocutaneous manifestations at presentation, during their treatment, and during subsequent follow‐up. Whenever possible, an attempt was made to determine the causes of these lesions. All patients were given standard therapy for the primary hematologic disorder. Results. Two‐thirds of the patients had mucocutaneous symptomatology at presentation: 17.4% had skin infiltration by the malignant cells. During therapy an even larger number developed nonspecific skin manifestations. Most of these were the result of myelosuppression, immunosuppression, or direct cytotoxic effects on tissues. Conclusions. Mucocutaneous manifestations in black children with leukemia and lymphoma are very common.
GENERALIZED NON‐LANGERHANS CELL HISTIOCYTOSIS: FOUR CASES ILLUSTRATE A SPECTRUM OF DISEASE
Authors: MULLANS ELIZABETH A. , HEEM THOMAS N. , TAYLOR JAMES S. , HELM KLAUS F. , OLIN JEFFREY W. , BERGFELD WILMA F. 
Published: May 2007

Abstract Background. The proliferation of non‐Langerhans cell histiocytes is a poorly understood process of unknown cause. Variation in the clinical features and/or histopathology of histiocytic proliferation has led to subclassification of the general category of non‐Langerhans cell histiocytes. Although the current classification may provide some useful generalizations in regard to the anticipated clinical course, wide variability in presentation and outcome make this classification less than optimal when dealing with individual patients. The objectives of the study were to present four cases of generalized non‐Langerhans cell histiocytosis. Materials and Methods. Medical records and slides of four patients diagnosed with non‐Langerhans cell histiocytosis at the Cleveland Clinic are reviewed. Results. The patients exhibit features of more than one subtype of non‐Langerhans cell histiocytosis. Conclusion. The overlap among the clinical and histologic features of the generalized cutaneous non‐Langerhans cell histiocytic disorders suggests that they represent one disease entity with a wide spectrum of presentations rather than many distinct disorders.
CONJUNCTIVAL MELANOMAS
Authors: ENG ANA M. , ROSNER MORDECHAI 
Published: May 2007

Abstract Background. The nomenclature and the clinical and pathologic features of cutaneous and conjunctival melanomas are different. A comparison is made to familiarize dermatologists and ophthalmologists with these differences. Methods. Five cases of conjunctival malignant melanoma from December 1983 to December 1990 were reviewed. Results. The nomenclature of primary acquired melanosis is not used for cutaneous melanomas, and terms such as dysplasia and Clark's nevus are not used for conjunctival melanomas. Technical difficulties exist in orienting thin conjunctival tissues because of a tendency to curl during fixation, resulting in tangential sectioning and making a false diagnosis of a prognostically ominous pagetoid spread for an otherwise banal basilar hyperplastic pattern. Excision, cryotherapy, and rarely exenteration are the therapeutic measures in managing conjunctival melanomas; these have far more serious consequences for the patient compared with the excision of a skin melanoma. Conclusion. Differences exist in several aspects between melanomas located in the skin and the eye.
INTERFERON REDUCES RECURRENCES OF BASAL CELL AND SQUAMOUS CELL CANCERS
Authors: IKIĆ DRAGO , PADOVAN IVO , PIPIĆ NEDIM , ČAJKOVAC VLADIMIR , KUSIĆ ZVONKO , DAKOVIĆ NIKOLA , GREGUREK‐NOVAK TEODORA , SOLDO‐BELIĆ ANTICA , SPAVENTI ŠIME , BELICZA MLADEN , FERENČIĆ ŽELJKO 
Published: May 2007

Abstract Background.Interferon is considered to be an important curative agent for dermatologic diseases. We report the follow‐up experience of patients with basal cell or squamous cell carcinomas treated with human natural leukocyte interferon (hnli). Results. Among 52 patients with basal cell carcinoma (bcc) treated with hnli more than 10 years ago, and among 58 treated more than 5 years ago, only 2 recurrences were observed. There were no recurrences in 75 patients who had a complete response to hnli treatment, nor were there any in 20 patients with either a partial or complete response to r.IFM alpha 2c treatment.Of 52 patients with squamous cell carcinoma (scc), 31 had been treated more than 10 years earlier, two recurrences of the disease at the site of the original lesion were observed. Conclusion. Interferon treatment makes it possible to achieve a persistent cure in patients with BCC and sec in a high proportion of cases. The potential advantage of nonsurgical treatment are an enhancement of cosmetic results through the prevention of destruction of important anatomic structures.
MIXED TUMORS WITH FOLLICULAR DIFFERENTIATION: COMPLEX NEOPLASMS OF THE PRIMARY EPITHELIAL GERM
Authors: RODRÍGUEZ‐DÍAZ ELOY , ARMIJO MIGUEL 
Published: May 2007

Abstract Background. Some mixed tumors of the apocrine variety also show characteristics of follicular and/or sebaceous differentiation. This can be explained because of the common embryologic origin of the three structures in the primary epithelial germ of the superficial ectoderm. Methods. Twenty specimens of apocrine mixed tumors were studied by conventional microscopy. The specimens were evaluated searching for some features of folliculo‐sebaceous differentiation. Results. Certain features of folliculo‐sebaceous differentiation were found in 45% of the samples examined. Additionally, different tumoral architectures were observed, resembling several well‐characterized adnexal organoid neoplasms. In some tumors, there were also follicular structures of mesenchymal origin, similar to the dermal hair papilla and the arrector pili muscle. Conclusion. Apocrine mixed tumors of the skin illustrate the ability of pluripotential primordial cells to differentiate in different directions within an individual tumor. Moreover, mixed tumors appear as a compendium of different folliculo‐sebaceous neoplasms. We suggest that these proliferations should be interpreted as “complex neoplasms of the primary epithelial germ.”
UV‐PROTECTIVE SUNGLASSES FOR UVA IRRADIATION PROTECTION
Authors: LEOW YUNG HIAN , THAM SIEW NEE 
Published: May 2007

Abstract Background. Eye protection with uva‐blocking solar shields is recommended on the day of puva treatment and the following day for our patients; however, many patients found this eyewear cosmetically unacceptable. Method. We investigated 34 pairs of sunglasses to determine their suitability for providing adequate protection. The method used was modified from the technique used by Moseley et al. in 1988. Results. We found that 21 (61.8%) of the 34 pairs of sunglasses and only 9 (53%) of the 17 pairs of sunglasses used by our patients were “satisfactory.” Expensive brands and polarizing sunglasses do not guarantee optimal uva protection. Conclusion. We recommend that all patients should use wrap‐around solar shields for optimal eye‐protection, while undergoing puva treatment. The availability of more cosmetically acceptable glasses will encourage better patients' compliance to protect their eyes with optical aids.
MORPHOLOGIC OBSERVATIONS ON THE DERMAL NERVES IN VITILIGO: AN ULTRASTRUCTURAL STUDY
Authors: AL'ABADIE MOHAMMED S.K. , WARREN M. ALASTAIR , BLEEHEN STANLEY S. , GAWKRODGER DAVID J. 
Published: May 2007

Abstract Background. Vitiligo is a common idiopathic skin disorder. The etiology is unknown, although various hypotheses have been advanced. These include the neuronal hypothesis, where neuronal factors are thought to play a role in the pathogenesis of this disease. Methods. Skin biopsies were taken from marginal and central parts of four vitiligo patients. Biopsies were also taken from nonvitiliginous skin of each patient and from four normal control subjects. Sections were examined under the electron‐microscope. Nerve fibers in the superficial dermis were examined. Results. Subtle ultrastructural changes, including regeneration and degeneration, were consistently found in dermal nerves of vitiligo lesions. The most consistent feature, seen in all four vitiligo patients studied (in both lesional and marginal areas), was an increased thickness of the basement membrane of Schwann cells. This change was found in approximately three‐quarters of all dermal nerves in vitiligo biopsies, but in only about one‐quarter of dermal nerves in normal control skin. About half the abnormal dermal nerves in vitiligo skin showed minor axonal damage, although indicators of regeneration (increased mitochondria and rough endoplasmic reticulum) predominated. The dermal nerves in vitiligo showed no difference in fiber diameter or fiber density in comparison with controls. Conclusions. In vitiligo both axonal degeneration and nerve regeneration may occur, with the latter possibly being a reactive change to earlier axonal damage. These findings support the hypothesis that there is a neuronal component to this disease.
CIRCULATING IMMUNE COMPLEXES IN VARIOUS FORMS OF BEHÇET'S DISEASE
Authors: ABDALLAH MOHAMMED A. , RAGAB NADER , KHALIL RASHA , KAMEL NADIA 
Published: May 2007

Abstract Background. The etiology of Behget's disease (BD) is uncertain but there is strong evidence that the immune system is implicated in its pathogenesis. Methods. We assessed circulating immune complexes (CIC) in peripheral blood of 34 patients with BD, forming eight clinical groups, using a laser nephelometer to obtain more insight in the pathogenesis of different clinical forms of bd. Twenty healthy controls and eight patients with recurrent oral ulcerations were also included in the study. Results. Levels of CIC were significantly higher in patients (1.83 ± 0.93 μg/mL) than in controls (0.84 ± 0.51 μg/mL; P < 0.001). High titers were found in the groups of patients with erythema nodosum (3.14 ± 0.44 μg/mL), neurologic manifestations (2.9 ± 0.58 μg/mL), and ocular manifestations (2.34 ± 0.93 μg/mL). Compared to patients with recurrent oral ulcerations (1.91 ± 0.77 μg/mL), the mean value of CIC in patients with BD did not differ significantly, but the groups of patients having erythema nodosum, positive pathergy, and neurologic manifestations had significantly higher levels (P < 0.05) and the group of patients at the mild end of the spectrum (group 8) had a significantly lower level (1.09 ± 0.41 μg/mL) (P < 0.05). Only the groups having erythema nodosum, positive pathergy, and neurologic manifestations had significantly higher levels of CIC when compared to other groups lacking these clinical features, whereas group 8 had a significantly lower level (P < 0.05) when compared to all other groups. Conclusion. Our results show that CIC may be involved in the pathogenesis of BD, especially in those clinical forms of the disease with erythema nodosum, neurologic manifestations, and ocular manifestations. Patients at the mild end of the BD spectrum do not show significant changes in CIC levels compared to healthy control subjects. We can, therefore, suggest that in BD CIC may be implicated more in the pathogenesis of some features than of others.
HYPOPIGMENTED MACULES IN ACANTHOLYTIC DISORDERS
Authors: ROWLEY MATTHEW J. , NESBITT LEE T. , CARRINGTON PATRICK R. , ESPINOZA CARMEN G. 
Published: May 2007

Abstract Background. Widespread hypopigmented macules are rarely seen in heavily pigmented patients with Darier's disease. Previous hypotheses concerning the cause of decreased pigmentation suggest it is a postinflammatory phenomenon or that the hypomelanosis is evidence of sub‐clinical acantholysis. Patients. This report presents 2 patients: a new case of disseminated guttate leukoderma in a black patient with Darier's disease and the first such case in a patient with transient acantholytic dermatosis (Grover's disease). Direct immunofluorescence and electron‐microscopic studies were carried out on lesional biopsies. Observations. Numerous small hypopigmented macules were observed in two black patients followed for acantholytic disorders. Three biopsies of the hypopigmented macules revealed acantholysis, while one showed only decreased melanin. Direct immunofluorescence studies were negative. Electron‐microscopic studies of the leukodermic macules showed sparse melanocytes and melanosomes that were mostly pigmented stage IV melanosomes. Conclusions. Disseminated guttate leukoderma can occur in transient acantholytic dermatosis, as well as in Darier's disease. It is readily apparent on darkly pigmented skin because of contrast. The etiology of this phenomenon is still unknown.
BASAL CELL CARCINOMA AND LIFESTYLE CHARACTERISTICS
Authors: SAHL WILLIAM J. , GLORE STEPHEN , GARRISON PEGGY , OAKLEAF KATY , JOHNSON STACY D. 
Published: May 2007

Abstract Background. A number of lifestyle factors are important in the etiology of basal cell carcinoma. Previous studies have investigated smoking, alcohol, diet, and sun exposure as possible contributing factors. No previous studies have investigated case‐controlled lifestyle influences in basal cell carcinomas referred for Mohs micrographic surgery. Methods. Cases were obtained from Mohs‐referred basal cell carcinoma patients. Matched controls were selected from a busy dermatology clinic. The only criteria for selection of controls was never having had cancer previously. Cases and controls were surveyed regarding lifestyle characteristics. Results. Forty‐six age, sex, and skintype‐matched controls were compared. Sun exposure, alcohol, and smoking were not significant factors. Dietary fat, fiber, and the vitamins A, C, and beta carotene, as well as selenium showed important, but not significant differences. Caffeine consumption was higher in the cancer group. Conclusions. Our findings agree with previously published studies in regard to antioxidant consumption as a protective factor for basal cell carcinoma. Caffeine consumption was higher in the cancer patients.
MALIGNANT SYPHILIS (LUES MALIGNA) AND CONCURRENT INFECTION WITH HIV
Authors: DON PHILIP C. , RUBINSTEIN RACHEL , CHRISTIE SHARON 
Published: May 2007

Abstract Background. During the past 2 1/2 years we observed six patients who had a reactive serology for syphilis, of which four developed widespread noduloulcerative and two vesiculonecrotic lesions. The purpose was to report the occurrence of lues maligna, a rare form of secondary syphilis, in five patients infected with the human immunodeficiency virus (HIV) and in one patient with risk factors for infection. Methods. Tzanck preparations, viral cultures, and skin biopsies were performed to evaluate the etiology of the lesions. Results. Syphilis serology titers ranged from 1:32 to 1:128 and in one instance was as low as 1:8. Such titers can also be found in patients with the latent form of syphilis. Therefore, confirmation of the clinical diagnosis of lues maligna was dependent on skin biopsies that were compatible with secondary syphilis and negative viral studies that excluded varicella, disseminated varicella‐zoster or herpes simplex. Lues maligna takes an aggressive course in HIV‐infected patients since four of the patients required hospitalization and the two patients who refused to complete treatment, subsequently developed more severe skin and constitutional symptoms. Conclusions. HIV‐infected patients are at risk for developing lues maligna. Despite its malignant presentation, lues maligna lesions respond rapidly to treatment with penicillin. Secondary syphilis should be added to the list of diseases known to be more aggressive in HIV‐infected patients.