bluuebunny/crossref_metadata_2025_split huggingface dataset:
GENERALISED GRANULOMA ANNULARE SUCCESSFULLY TREATED WITH PENTOXIFYLLINE
Authors: Rubel D. M. , Wood G. , Rosen R. , Jopp‐McKay A. 
Published: June 2007

SummaryGeneralised granuloma annulare (GA) is a chronic disease of unknown aetiology and is recalcitrant to many treatment regimes. Some investigators have suggested that an immune medicated vasculitis may be involved in the pathogenesis of GA. We describe a patient with a ten year history of generalised GA, who showed dramatic clearing of the majority of papules after four weeks of treatment with pentoxifylline. This drug has shown promising results in the treatment of many dermatologic disorders including necroboisis lipoidica diabeticorum, leukocytoclastic vasculitis and Raynaud's phenomenon.Pentoxifylline is thought to reduce blood viscosity via effects on all major blood components, and its clinical effectiveness in generalised GA lends support to a model of immunemedicated vasculitis in the pathogenesis of this disorder. Thus, pentoxifylline offers a well‐tolerated and effective alternative to the treatment options available for patients with granuloma annulare.
CONSIDERATION OF THE COST OF INTERFERON ALFA‐2b IN THE TREATMENT OF BASAL CELL CARCINOMA
Authors: Shiell Alan 
Published: June 2007

SummaryInterferon alfa‐2b is an effective but expensive way of treating basal cell carcinoma. In this paper, the cost‐effectiveness of interferon relative to conventional treatment is considered. Circumstances where surgery is contra‐indicated and would not otherwise be performed are not considered.The cost of achieving cure by interferon alfa‐2b in the form of Intron A® is compared with the cost of conventional treatment in four situations; simple lesions, lesions in which protacted healing is expected, lesions in areas where cosmetic result is important and large lesions where hospitalisation for skin grafting may be necessary.For simple lesions, treatment with interferon alfa‐2b costs between $500 and $760 more per cure than conventional treatment. However, it is less expensive than conventional methods in cases that would require extensive home nursing or hospitalisation. The difference in cost in simple cases also represents the price which must be paid for the better cosmetic result achieved by interferon alfa‐2b.In conclusion, interferon alfa‐2b adds another effective option to the treatment of BCC but it is expensive. To exploit its advantages properly, it must be targeted on those who will benefit from it the most.
KINETICS AND SPECIFICITY OF NICKEL HYPERSENSITIVITY IN THE MURINE MODEL
Authors: Siller Gregory M. , Seymour Gregory J. 
Published: June 2007

SummaryNickel contact dermatitis appears to be almost exclusively a disease of females despite the increasing exposure of males to nickel. Successful murine models of nickel allergic contact dermatitis have been described. The purpose of this study is to investigate the kinetics and specificity of the response in this model and to examine if any differences exist between male and female. Mice were sensitised epicutaneously with nickel sulphate in aqueous solution of varying concentration, volume and duration of application. Following intradermal challenge, dose dependent response kinetics which approximated linearity were demonstrated upto the point of toxicity. Sensitised mice were challenged with Cobaltous chloride, Chromic chloride and Cupric sulphate and demonstrated no evidence of cross sensitivity to cobalt or chrome. Copper produced an irritant response making interpretation difficult. Earlier and stronger responses were observed in female mice, however these differences fell short of statistical significance. The results of the present study therefore establishes a reliable model for nickel hypersensitivity, that demonstrates both specificity and dose dependent kinetics without significant sex differences.
EXTEMPORANEOUS PRESCRIBING (1)
Authors: Artemi Phillip , Land William A. 
Published: June 2007

SummaryAn outline of the pharmacology of important components of extemporaneous prescriptions will be undertaken over four issues of the Journal.Substances such as dithranol, salicylic acid and coal tar will be examined in some depth with regard to their mode of action, uses and side effects. In addition, examples of extemporaneous formulations containing these substances will be provided along with regarding their use.Substances such as sulphur, calamine, podophyllin and menthol will also be reviewed the same format but in less detail. The articles are designed to provide practical knowledge in the area of extemporaneous prescribing. Complicated areas of pharmaceutical chemistry, unless relevant to the clinical setting, will not be discussed.
TOPICAL TRETINOIN IMPROVES THE APPEARANCE OF PHOTO DAMAGED SKIN
Authors: Lowe Patricia M. , Woods Jane , Lewis Anne , Davies Alison , Cooper Alan J. 
Published: June 2007

SUMMARYA multicentre clinical trial has been conducted to assess the efficacy and safety of tretinoin 0.05% cream (Retin‐A®) in the treatment of photodamaged Australian skin. Subjects with cutaneous facial photodamage were randomised to treatment with tretinoin (62) or vehicle (63) cream. After an initial two week run‐in, all subjects applied the cream to the face, neck and left forearm/hand, once nightly for 24 weeks. Changes in clinical signs of photodamage and parameters of cutaneous irritation were assessed by investigators using a 7 point scale, whilst changes in signs of photodamage were rated by subjects using a 5 point scale. Changes in skin biopsies and silicone skin surface replicas were also assessed. Significant improvements in skin wrinkles, mottled hyperpigmentation, laxity, lentigines and roughness of tretinoin treated subjects were noted by investigators. Subjects receiving tretinoin noted significant improvements in skin wrinkles, tightness, colour and pores. Improvement in overall severity of photodamage was significantly greater for tretinoin treated subjects and was progressive over the study period. Histological findings included a significant increase in mean epidermal thickness. Significant topographical changes were not detected in skin surface replica sets. Cutaneous irritation, the most common side effect, was usually mild and transient. We conclude that tretinoin 0.05% cream significantly improved the appearance of photodamaged skin.
Lichen sclerosus in childhood
Authors: Fischer Gayle O 
Published: June 2007

SUMMARYLichen sclerosus in childhood involves predominantly the genital area, often with purpura and erosions, which raises concerns of sexual abuse. Potent topical corticosteroids give a good clinical response over several months, although maintenance with weaker formulations is usually required. The long‐term prognosis remains uncertain.
Management of drug eruptions
Authors: Breathnach SM 
Published: June 2007

SUMMARYIn this second of two articles on adverse cutaneous drug reactions, the management of drug eruptions is reviewed. This necessitates, above all, a full history and may involve observation of the effects of drug elimination. Skin testing may be helpful in some circumstances, but is hampered by false positive and negative results, and lack of knowledge of the significant antigenic determinants for most drugs. In vitro tests are for the most part unreliable and are research tools. Challenge tests are safe in fixed drug eruption, but are absolutely contraindicated in Stevens–Johnson syndrome and toxic epidermal necrolysis. The approach to the treatment of the more serious adverse cutaneous drug reactions, including angioedema/anaphylaxis, exfoliative dermatitis erythroderma and toxic epidermal necrolysis is reviewed. For those patients who develop reactions to an essential medication for which there is no alternative, desensitization is possible.
Subcutaneous fat necrosis following traumatic pancreatitis
Authors: Lee May‐Sen , Lowe Patricia M , Nevell David F , Fryer Judith , Guay John Le 
Published: June 2007

SUMMARYA 25 year old female who developed subcutaneous fat necrosis and polyarthritis secondary to post‐traumatic pancreatitis is reported. This is a well documented but uncommon phenomenom, affecting less than 1% of patients with pancreatic disease.
Skin necrosis following subcutaneous heparin injection
Authors: Mar Adrian W‐Y , Dixon Barry , Ibrahim Kamal , Parkin John D 
Published: June 2007

SUMMARYHeparin‐induced skin necrosis is a rare but serious complication of subcutaneously administered heparin. Previous reports indicate that the skin necrosis is often accompanied by thrombocytopenia and occasionally by lethal thromboembolism. It thus shows features similar to the heparin‐induced thrombocytopenia (HIT) syndrome and probably represents a localized form of this condition. Caution is required in the event of skin necrosis; heparin therapy should be ceased immediately and not used again if the complications of HIT are to be avoided.
Streptococcal septic vasculitis
Authors: O'Brien Timothy J , Mcdonald Malcolm I , Reid Barry F , Trethewie Douglas 
Published: June 2007

SUMMARYA case of invasive streptococcal disease is presented. Bacteraemic spread from a peritonsillar abscess produced acral purpuric plaques that blistered and ulcerated. Histology showed a vasculitic picture. Group A beta‐haemolytic Streptococcus was cultured from the skin biopsy and seen on Gram stain.
Paediatric vulvovaginitis
Authors: O'Brien Timothy J 
Published: June 2007

SUMMARYVulvovaginitis in the prepubertal child may present with itch, irritation, pain, dysuria or discharge as a result of poor hygiene, contact irritants, sexual abuse or skin diseases involving the genital area. Common infectious causes include threadworms, group A beta‐haemolytic streptococci and Haemophilus influenzae. A full history and examination are essential. Investigations may include swabs, midstream urine, biopsy, ultrasound and examination under anaesthesia.
The commonest causes of symptomatic vulvar disease: A dermatologist's perspective
Authors: Fischer Gayle O 
Published: June 2007

SUMMARYA prospective study of 141 consecutive adult patients with chronic vulvar symptoms referred to a dermatologist was carried out to determine the commonest conditions seen. Eighty‐nine per cent of patients underwent vulvar biopsy. The commonest cause of chronic vulvar symptoms in this group of patients was dermatitis, seen in 54% of patients. The other commonly seen conditions were lichen sclerosus (13%), chronic vulvovaginal candidiasis (10%), dysaesthetic vulvodynia (9%) and psoriasis (5%). Although 38% of patients had previously been diagnosed as suffering from human papillomavirus (HPV) vulvitis, histopathological evidence of HPV was seen in only 5%. All cases showing HPV also demonstrated spongiotic dermatitis on biopsy. In this study group, a majority (overall 72%) of patients with a chronic vulvar complaint had a corticosteroid responsive dermatosis rather than a gynaecological condition. The patients with HPV on biopsy also responded to topical corticosteroids, and it was concluded that their symptoms may have been due to dermatitis unrelated to the presence of HPV. In such patients, the assumption that ‘subclinical HPV’ is a cause of symptoms and the practice of focusing medical and particularly surgical treatment on eradication of the virus may be inappropriate. A review of the commonest vulvar conditions seen by the author is presented.
Dermal melanocytosis: A clinical spectrum
Authors: Stanford Duncan G , Georgouras Katherine E 
Published: June 2007

SUMMARYWhile most dermal melanocytoses are congenital or have an onset in early childhood, there is a group which is clearly acquired, with an onset in adult life. While the Mongolian spot typically disappears in childhood, other dermal melanocytoses persist for life. A brief review of the clinical spectrum of the dermal melanocytoses is undertaken and three illustrative cases are described: a case of congenital naevus of Ota, a case of acquired bilateral naevus of Ota‐like macules, and an unusual case of a congenital dermal melaaocytotic lesion on the left hand which began to spread in adulthood. The possibilities regarding the pathogenesis of this intriguing group of disorders are considered.
The Acne Disability Index: Usefulness confirmed
Authors: Oakley Amanda MM 
Published: June 2007

SUMMARYOne hundred and four patients with acne completed a questionnaire derived from the Cardiff Acne Disability Index Questionnaire. In addition, 59% of patients returned an identical follow‐up questionnaire 6 months later. Significant disability from acne was identified in many patients, with the median initial Acne Disability Index (ADI) being 6 (maximum possible 15), improving to 3 after treatment. Scores correlated poorly with the clinical severity of acne. The questionnaire proved useful for identifying patients with poor self‐image who might benefit from more potent treatment for their acne, and to evaluate the effect of treatment.
Pseudoscleroderma secondary to phytomenadione (vitamin K1) injections: Texier's disease
Authors: Pang Bryan K , Munro Vincent , Kossard Steven 
Published: June 2007

SUMMARYCutaneous reactions to vitamin K1 (phytomenadione) are uncommon. They can present as acute eczematous reactions or late reactions that resemble localized scleroderma after vitamin K1 injections. A case is reported here of a patient who developed bilateral sclerodermoid plaques in a cowboy's holster pattern, which persisted for more than 10 years after subcutaneous vitamin K1 injections. Positive intradermal test with vitamin K1 that persisted as an erythematous indurated plaque at the test site for more than 5 months confirmed marked cutaneous hypersensitivity to vitamin K1 in this patient. Serial biopsies of the erythematous plaque at the test site showed transition from spongiotic eczematous features initially to inflammatory morphoea‐like histology over a 5 month period. Possible pathogenic mechanisms for phytomenadione‐induced pseudoscleroderma are discussed.
Cimetidine for mucosal warts in an HIV positive adult
Authors: Wargon Orli 
Published: June 2007

SUMMARYAn HIV‐positive adult presented with recalcitrant mucosal warts which failed to respond to therapies including curettage and cautery, cryocautery and oral etretinate. There was an apparent complete resolution of intra‐ and perioral warts with the histamine H2 antagonist, cimetidine.
Vesiculobullous Hailey‐Hailey disease: Successful treatment with oral retinoids
Authors: Hunt Michelle J , Salisbury Elizabeth LC , Painter Dorothy M , Lee Stephen 
Published: June 2007

SUMMARYA 56‐year‐old male presented with a pruritic, generalized vesiculobullous eruption. His past history revealed classical symptoms of limited Hailey‐Hailey disease for 34 years. Clinically, vesicles, bullae and occasional pustules were present and multiple biopsies confirmed this to be an unusual presentation of Hailey‐Hailey disease. Various therapeutic modalities including topical and oral antibiotics, oral prednisone and dapsone failed to achieve sustained remission. Treatment with lowdose oral etretinate (25 mg daily) produced marked clinical improvement with complete suppression of new vesicle formation after 6 weeks.
Lamotrigine‐induced toxic epidermal necrolysis treated with intravenous cyclosporin: A discussion of pathogenesis and immunosuppressive management
Authors: Sullivan John R , Watson Alan 
Published: June 2007

SUMMARYThere is growing evidence that the final common pathway of toxic epidermal necrolysis (TEN) is mediated by the cellular immune system which targets drug altered epithelial antigens. This provides a rationale for immunosuppressive therapy. The ideal regimen for quickly turning off epidermal damage in TEN has not yet been determined and the use or benefit of routine immunosuppression remains highly controversial. This article reviews recent advances in the pathogenesis of TEN along with the theoretical benefits of early immunosuppressive treatment in severe cases, specifically utilizing cyclosporin. We describe a 29‐year‐old woman with TEN due to the anticonvulsant lamotrigine whose successful management included intravenous cyclosporin. The extension of her lesions ceased within 24 hours of initiating cyclosporin (day 7 of her admission). Complications included: scarring alopecia; Enterococcus faecalis septicaemia due to an infected central line; and ulceration and squamous metaplasia of conjunctivae, The potential role of lamotrigine as a cause of TEN is discussed.
Compliance problems in paediatric atopic eczema
Authors: Fischer Gayle 
Published: June 2007

SUMMARYCompliance problems are a common cause of apparent treatment failure in atopic eczema. The results of a survey of parents with children attending dermatologists for atopic eczema is presented. Major reasons for failure to comply include a poor understanding of the chronic nature of the disease, a fear of topical corticosteroids, the belief that atopic eczema is due to an allergy, and the time and cost of treatment. The explanation that treatment is a control and not a cure is also important in the parent's perception of treatment results. Suggested solutions to some of these points are discussed.
Marine stingers in Far North Queensland
Authors: Holmes John L 
Published: June 2007

SUMMARYTwo box jellyfish in particular cause problems in tropical Queensland waters. Chironex fleckeri inhabit calm waters close to the shore between November and May. The venom includes three major components: haemolytic; dermatonecrotic; and myocardial. The dermatonecrotic toxin causes a ladder pattern of whiplash lesions to the skin which ulcerate, become necrotic and heal very slowly over months. Neuromuscular paralysis and cardiovascular collapse may be fatal within minutes of envenomation. Emergency treatment comprises inactivation of stinging capsules by vinegar, removal of tentacles, analgesia, cardiopulmonary resuscitation and the administration of the specific antivenom. Carukia barnesi (‘Irukandji’) are found in both coastal and open waters. A patch of erythema with papules at the sting site is characteristically followed 30 min later by the onset of a catecholamine mediated syndrome. Headache and severe abdominal and back pain are usual and may be followed by hypertension, tachyarrhythmias and cardiogenic shock.
Psoriasis: Changing clinical patterns
Authors: Rotstein Harvey 
Published: June 2007

SUMMARYAlthough psoriasis has been recognized at least since Biblical times, new forms, associations and influences continue to be described in the twentieth century. New forms include the rupioid, erythema annulare centrifugum‐like and follicular patterns. Associations with vitiligo, bullous pemphigoid and lupus erythematosus have been recently described. Endoscopic surgery has increased para‐umbilical psoriasis while Sun Smart campaigns have reduced photo‐aggravated psoriasis. Infections such as paediatric perianal streptococcal cellulitis and drugs including angiotensin converting enzyme inhibitors and cytokines exacerbate psoriasis.
Copper vapour laser treatment of port‐wine stains in brown skin
Authors: Chung Jin Ho , Koh Woo Seok , Lee Dong Youn , Lee Young Suk , Eun Hee Chul , Youn Jai Il 
Published: June 2007

SUMMARYForty‐seven Korean patients with port‐wine stains were treated with a copper vapour laser and clinical responses were assessed at three months after the last treatment by comparing photographs taken before each treatment The immediate histologic changes within 15min after laser treatment were also observed by routine H & E and nitroblue tetrazolium chloride staining. When we treated port‐wine stains with minimal whitening doses of 6‐8 J/cm2, no or slight colour changes were obtained. Thus, all port‐wine stain lesions in this study were treated with non‐specific energy densities ranging from 10‐20 J/cm2. Good to excellent results were obtained in 18 (38.2%) of 47 Korean patients with port‐wine stains. Repeated treatment can continue to reduce colour. Darker lesions (purple or red) are more likely to result in a marked colour change. At above threshold dose, there was wedge‐shaped diffuse coagulation necrosis and loss of viability of the epidermis and underlying dermis. Even though copper vapour laser treatment of port‐wine stains in brown skin is not as selective as in white skin because of epidermal melanin, our clinical data demonstrate the usefulness of the copper vapour laser for the treatment of port‐wine stains in brown skin.
Pityriasis rubra pilaris and focal acantholytic dyskeratosis
Authors: Cowen Peter , O'Keefe Rodney 
Published: June 2007

SUMMARYA 65‐year‐old man presented with a widespread erythematous maculopapular eruption. Skin biopsy showed spongiosis and focal acantholytic dyskeratosis consistent with Grover's disease. Clinically the eruption evolved to erythroderma with typical features of pityriasis rubra pilaris. On review of the histology, changes consistent with this diagnosis were also present in addition to the acantholytic dyskeratosis.
Cutaneous manifestations of chronic graft‐versus‐host disease
Authors: Andrews Megan L , Robertson Ivan , Weedon David 
Published: June 2007

SUMMARYGraft‐versus‐host disease (GVHD) occurs in a number of clinical settings. It is well recognized after bone marrow transplantation, an increasingly used therapeutic option for haematologicl disorders. Chronic GVHD, occurring at an interval greater than 100 days post‐transplant, has many systemic manifestations, but it is the cutaneous manifestations which are most frequent and often most troubling to the patient In this review article, the wide spectrum of cutaneous chronic GVHD (including involvement of hair, nails and mucosae), and its complications and associations are discussed. The clinical and histological features and management guidelines are presented to assist the dermatologist with diagnosis and treatment of this condition.
Trigeminal trophic syndrome
Authors: Su John C , Downes Nicholas P 
Published: June 2007

SUMMARYA case report of a 51‐year‐old woman who developed trigeminal trophic syndrome Following craniectomy is presented. This syndrome represents trophic ulceration by self‐induced trauma to skin in the trigeminal area. Treatment of the present case was complicated by the patient's underlying psychological problems.
Haber's Syndrome
Authors: McCormack Christopher J , Cowen Peter 
Published: June 2007

SUMMARYHaber's syndrome is a rare genodermatosis characterised by an early onset rosacea‐like eruption associated with multiple truncal keratoric lesions. The present study reports the clinical presentation, histology and response to therapy of two cases of Haber's syndrome. The cases presented with the typical features of Haber's syndrome. Case 1 also had diffuse palmoplantar keratoderma and prominent nail cuticles, and case 2 had diffuse palmar keratoderma. These features have not been previously reported in Haber's syndrome. In the present study Haber's syndrome is reviewed, and its relationship to Dowling‐Degos disease and acropigmentation of Kitamura are discussed.
Pseudomonas folliculitis
Authors: Hogan Peter A 
Published: June 2007

SUMMARYPrevious reports of Pseudomonas folliculitis in children identified heated pools, hot tubs or spa baths as the source of the infection. This report presents a 4‐year‐old female with Pseudomonas folliculitis acquired from the family bath tub. The source of the infection was contaminated bath toys and bath plug.