bluuebunny/crossref_metadata_2025_split huggingface dataset:
The relation between nailfold bleeding and capillary microscopic abnormality in pateints with connective tissue diseases
Authors: Ohtsuka Tsutomu 
Published: March 2003

Background Patients with connective tissue diseases, mainly scleroderma, show nailfold bleeding and nailfold capillary abnormality. An attempt was made to determine the possible relation between nailfold bleeding and nailfold capillary abnormality. MethodsThe correlation between nailfold bleeding and nailfold capillary abnormality was studied using quantitative nailfold capillary microscopy. ResultsThe frequencies of nailfold bleeding in scleroderma, mixed connective tissue disease, dermatomyositis/polymyositis, and secondary Raynaud's phenomenon were significantly higher than those of normal controls. The distributions of abnormal values of capillary parameters in scleroderma, mixed connective tissue disease, dermatomyositis/polymyositis, systemic lupus erythematosus, primary Sjögren's syndrome, secondary Raynaud's phenomenon, primary Raynaud's phenomenon, and diabetes mellitus were significantly higher than those of normal controls. In normal controls, scleroderma, mixed connective tissue diseases, dermatomyositis/polymyositis, systemic lupus erythematosus, primary Sjögren's syndrome, primary Raynaud's phenomenon, and diabetes mellitus, all nailfold bleeding was observed in subjects with nailfold capillary abnormality. The distribution of nailfold bleeding in secondary Raynaud's phenomenon with abnormal values of capillary parameters was significantly higher than that with normal values. ConclusionsThere is a close relationship between nailfold bleeding and nailfold capillary abnormality.
Cytokines in leprosy, I. Serum cytokine profile in leprosy
Authors: Moubasher Alaa El‐Din A. , Kamel Neveen A. , Zedan Hatem , Raheem Diaa El‐Din Abdel 
Published: March 2003

Abstract Background Leprosy is a chronic infectious disease characterized by a broad spectrum of clinical forms depending on the patient's immune response, in particular cell‐mediated immune response. Methods Cytokines can play a role in the cell‐mediated immune response. Serum levels of interferon‐gamma (IFN‐γ), interleukin‐2 (IL‐2), interleukin‐2 receptor (IL‐2R), interleukin‐10 (IL‐10), tumor necrosis factor‐alpha (TNF‐α), and interleukin‐1beta (IL‐1β) were measured by enzyme‐linked immunosorbent assay (ELISA) in 55 untreated leprosy patients and 35 reactional leprosy patients, in addition to 20 age‐ and sex‐matched healthy controls. Results Leprosy patients showed significantly higher serum levels of the studied cytokines (except IL‐2) compared with healthy controls. When the two poles were compared, tuberculoid leprosy (TT) patients showed significantly higher levels of IFN‐γ and TNF‐α with significant negative correlations with the bacterial index (BI), whereas lepromatous leprosy (LL) patients showed significantly higher serum levels of IL‐2R, IL‐10, and IL‐1β with significant positive correlations with the BI. Both type I and type II reactional patients showed significantly higher serum IFN‐γ, IL‐2R, and IL‐1β, in addition to IL‐10 in type II reactional patients, compared with nonreactional leprosy patients. When compared with each other, type I reactional patients showed increased levels of IFN‐γ, whereas type II reactional patients showed increased levels of IL‐10. Conclusions In leprosy patients, both IFN‐γ and TNF‐α are immunoprotective, whereas IL‐2R, IL‐10, and IL‐1β are immunosuppressive. Our results indicate that type I reaction, with increased levels of IFN‐γ, is a cell‐mediated immune response, whereas type II reaction, with increased levels of IL‐10, is essentially an immune complex disease.
Short treatment schedules of itraconazole in dermatophytosis
Authors: Chow Kim W. , Ting Hoon C. , Yap Yen P. , Yee Kim C. , Purushotaman A. , Subramanian S. , Badsha S. A. 
Published: March 2003

Patients were recruited from 1 December 1994 until 31 August 1995. Those presenting with tinea cruris/corporis received 200 mg of itraconazole every day for 7 days, whereas patients presenting with tinea pedis/manus were treated with 200 mg twice a day for 7 days. Those eligible were men and women at least 18 years of age, with a clinically diagnosed dermatophytosis, confirmed by KOH examination and culture. Pregnant or nursing patients and those who did not use adequate birth control methods were excluded. Patients with a known history of chronic liver disease or other concomitant serious disease were also excluded. Patients who had received any oral antifungal or corticosteroid therapy within 30 days before enrollment or any topical antifungal or corticosteroid treatment within a week before enrollment were not eligible.Clinical and mycologic (KOH and culture) evaluation was carried out at baseline, at completion of therapy (day 7) and at the end of follow‐up (day 28 for tinea cruris/corporis and day 35 for tinea pedis/manus). The investigator evaluated the following clinical symptoms at each visit: desquamation, erythema, infiltration, pruritus, exudation, maceration, vesiculation, and pustules. Clinical results were rated as: healed, markedly improved, considerable residual lesions, not changed, or worse. The categories healed and markedly improved were considered as responders.All mycology was performed centrally at the Department of Microbiology, University of Malaya.
Autoantibodies to autologous skin in guttate and plaque forms of psoriasis and cross‐reaction of skin antigens with streptococcal antigens
Authors: Pérez‐Lorenzo Rolando , Zambrano‐Zaragoza José Francisco , Saul Amado , Jiménez‐Zamudio Luis , Reyes‐Maldonado Elba , García‐Latorre Ethel 
Published: March 2003

Abstract Background Psoriasis is a chronic disease of the skin that appears to be of autoimmune nature. It has a strong association with throat streptococcal infections, as well as with stressful events. Although many groups consider psoriasis to be a T‐cell‐mediated autoimmune disease, autoantibodies could also play a role in the development of this process. Methods In this work, we looked for autoantibodies to psoriatic skin in 21 psoriatic patients and four healthy donors (controls). The immunoperoxidase technique was used to look for autoantibodies in autologous sera in skin sections obtained from lesions or from healthy areas of the same patient, before and after immunoadsorption with a Streptococcus pyogenes extract. The skin biopsies were also analyzed with a pool of sera from mice immunized with the streptococcal extract. Results We found that all psoriatic patients had autoantibodies to antigens present in keratinocytes, whereas healthy subjects did not. These antibodies did not recognize epitopes on healthy skin from the same psoriatic patients or controls. Immunoadsorption of autologous sera removed the reactivity to antigens in skin lesions in all cases. Mouse anti‐streptococcal sera recognized epidermal antigens present in lesional psoriatic skin, but not in healthy skin from psoriatic patients or controls. Deposits of immunoglobulin G (IgG) were not detected in the lesions. Conclusions It seems that autoantibodies, although they do not appear to participate in the pathogenesis of psoriasis, are an important feature, and that skin antigens, which appear in lesional immature keratinocytes, cross‐react with S. pyogenes and contribute to the autoimmune process in psoriasis.
The genetics of vitiligo in Korean patients
Authors: Kim Soo Min , Chung Hae Shin , Hann Seung‐Kyung 
Published: March 2003

AbstractBackground Vitiligo is a common disorder whose exact cause is unknown, but genetic factors are thought to be involved. We analyzed 120 Korean proband families to clarify which genetic factors are involved in the pathogenesis of vitiligo in Korean patients.Methods The genetics of vitiligo were analyzed in 120 Korean proband families out of 1030 vitiligo patients. Each family was analyzed through a proband afflicted with vitiligo.Results In 51 (42.5%) of 120 proband families, at least one first‐degree relative of the proband had vitiligo. The incidence of those affected among 1755 relatives (first‐,second‐, and third‐degree) was found to be 8.0 ± 0.6%. There was a statistically significant departure for segregation analysis which was inconsistent with inheritance as an autosomal or X‐linked locus model. On the basis of our results, the inheritance pattern of vitiligo is more likely to tend toward the model of multifactorial inheritance. The threshold trait among first‐degree relatives (7.2%) appeared to tend more toward the square root of the frequency in the general population (10%) than towards those of dominant (50%) or recessive (25%) models.Conclusions These results indicate that there are certain genetic factors involved in the etiology of vitiligo, and that vitiligo seems to have a polygenic nature.
Electron microscopy comparison of CO2 laser flash scanning and pulse technology one year after skin resurfacing
Authors: Trelles Mario A. , Rigau Josepa , Pardo Lourdes , García‐Solana Luisa , Vélez Mariano 
Published: March 2003

Abstract Background The recent adaptation of laser technology in plastic and dermatologic surgery has provided a means to reduce efficiently the irregularities of the surface of the skin. Previous studies have analyzed the short‐ and medium‐term clinical and histologic results of two laser systems: the Sharplan 40C SilkTouchTM and the 5000C Coherent Ultrapulse® with Computer Pattern Generator® (CPG). This paper contains the long‐term ultrastructural findings observed with the aid of transmission electron microscopy (TEM). Materials and Methods Twenty skin biopsy specimens were taken from ten Caucasion patients, between 54 and 72 years of age, who had undergone facial skin resurfacing with a CO2 laser 1 year previously. The treated areas of the face were divided into two equal parts. One half of the face was treated with the Sharplan SilkTouchTM laser and the other half with the Coherent Ultrapulse® laser. Using TEM, the cell composition of the epidermis was studied ultrastructurally, as were the dermal–epidermal junction (DEJ) and the different fibers and cells in the superficial and middle dermis. Results On the side treated by the SharplanTM laser, little melanin was observed, the DEJ was thicker, and there were abundant collagen fibers well compacted in the dermis. Also present was abundant elastin fiber with scarce interstitial spaces. On the side treated by the Coherent®, the melanin was abundant and the DEJ was well structured. There were fibroblasts with lax chromatin in the dermis and collagen fibers in the papillary dermis oriented in a vertical and horizontal manner in relation to the epidermis. There was little elastin. The interstitial spaces were abundant. Conclusions The SharplanTM laser system seems to provoke a significantly more intense tissue response, with abundant dermal collagen and elastic fibers. This indicates that the Sharplan 40C SilkTouchTM might produce longer lasting clinical effects.
Cutaneous diphtheria in a child
Authors: Pandit Neela , Yeshwanth Malathy 
Published: March 2003

A 2‐year‐old, nonimmunized, lower socioeconomic stratum girl from the rural outskirts of Bangalore, southern India, was brought to the hospital with complaints of nonhealing “kissing ulcers” over the right thigh and inguinal region and fever of 1 month. The lesions started as small pustules. There was no history of respiratory illness or contact with tuberculosis. On physical examination, the child weighed 10 kg, was afebrile, and had mild anemia. The inguinal lymph nodes were enlarged. Systemic examination was essentially normal. Local examination revealed punched out ulcers with grayish slough over the ulcer measuring 3 cm × 4 cm (Fig. 1). The differential diagnosis of cutaneous tuberculosis, ecthyma, tropical ulcer, and mycotic ulcer were considered.Two “kissing ulcers” with adherent sloughimageLaboratory examination revealed the following. Hemoglobin was 10.3 g/dL. White blood cell count (WBC), 13,500/cm2. Differential count: P 58, L 40, E 2. The rest of the routine blood and urine tests were normal. The Mantoux test was negative. An X‐ray of the chest was normal. An electrocardiogram was not taken. Gram stain of the pus from the lesion revealed no pus cells, but many Gram‐positive cocci, Gram‐positive bacilli and Gram‐negative bacilli. Albert stain of the smear was positive for Corynebacterium diphtheria. Bacterial cultures grew organisms morphologically and biochemically characteristic of C. diphtheria and susceptible to ampicillin, erythromycin, gentamycin, co‐trimoxazole, ciprofloxacin, amikacin, vancomycin, and netilmycin. No other pathogens were cultured from the wound. The organisms isolated were confirmed as C. diphtheria (Baren EJ, Peterson LR, Finegold SM. Aerobic, non‐spore‐forming, Gram‐positive bacilli. In: Baily, Scott, eds. Diagnostic Microbiology, 9th edn. Town: C.V. Mosby. 1994: 457–473). Serum antitoxin levels were not measured.With confirmation of the diagnosis of cutaneous diphtheria, the child was treated with 20,000 units of anti‐diphtheria serum and injected intramuscularly with procaine penicillin 400,000 units daily for 10 days. The ulcer healed over a period of 10–12 days without any other complications of diphtheria.
Atypical acral persistent papular mucinosis
Authors: Abalde Teresa , Ginarte Manuel , Fernández‐Redondo Virginia , Toribio Jaime 
Published: March 2003

A 70‐year‐old woman presented with a 10‐year history of cutaneous lesions on her calves that worsened with solar exposure. Her past medical history was irrelevant. Physical examination revealed 10–15 erythematous, firm nodules with a diameter of 2–5 mm, which were slightly painful on palpation. The lesions were located on both calves, although some elements extended to the posterior side of the thighs ( Fig. 1). General physical examination did not show any abnormalities. A biopsy specimen from one of the elements showed a normal epidermis and, in the upper dermis, a slight inflammatory infiltrate of mononuclear cells, with the presence of splits between collagen fibers (
Fig. 2). Alcian blue stain at pH 2.5 revealed the existence of mucinous material in these spaces (
Fig. 3). An electron microscopic study did not show any abnormalities.Clinical appearance of the lesionsimageHistopathologic picture (hematoxylin and eosin, ×40)imageAlcian blue stain showing the presence of mucin in the dermis (Alcian blue, ×100)imageThe patient was diagnosed as having papular mucinosis. The following studies were normal or negative: complete cell blood count, serum biochemistry, serum protein electrophoresis, serum immunoelectrophoresis, serologic test for human immunodeficiency virus (HIV), hepatitis B and C viruses, and syphilis, antinuclear antibodies, and thyroid hormone levels. No treatment was carried out.
Management of vitiligo. Results of a questionnaire among dermatologists in The Netherlands
Authors: Njoo M. David , Bossuyt Patrick M. M. , Westerhof Wiete 
Published: March 2003

Abstract Background Several therapeutic options are available for the treatment of vitiligo. Concern exists that there is no uniform approach towards the management of vitiligo among Dutch dermatologists. Methods A written survey concerning the management of vitiligo was sent to 332 dermatologists in The Netherlands. Results The response rate was 86%. “Giving information and reassurance concerning the nature of disease” was regarded by most dermatologists (68%) as being the most important goal in the management of vitiligo. Only 16% of the dermatologists aimed for active treatment in vitiligo. The reported therapy choices in children resembled those of adults, except that slightly more dermatologists did not prescribe active therapy in children. Nine different therapeutic modalities were mentioned as first choice therapies. Topical corticosteroids were indicated by most dermatologists as first choice therapy (241 out of 266, i.e. 91%); however, only 2% indicated that 50% or more of the patients achieved a successful treatment; 66% found that less than 25% of the patients were successfully treated with topical corticosteroids. Only 15% of the respondents reported that 50% or more of the patients were treated successfully with narrow‐band UVB. The observed response profile to broad‐band UVB therapy was found to be comparable with that of narrow‐band UVB. The classical therapy with oral psoralen plus UVA (PUVA) was prescribed as first choice therapy by only 12% (32 out of 266) of the dermatologists. Only 6% of these respondents observed that 50% or more of the patients achieved successful therapy using oral PUVA. The recommended maximum treatment duration for topical corticosteroids, oral PUVA, and UVB therapy was found to vary from 3 to 12 months. Conclusions Most dermatologists in The Netherlands do not offer active treatment in vitiligo, probably because the estimated effectiveness of (nonsurgical) repigmentation therapy is low. In cases where treatment is prescribed, there appears to be no consensus on the choice of therapies and treatment strategies. The development of practice guidelines may be helpful in reducing inappropriate care and improving treatment outcome.
Dissemination in cutaneous leishmaniasis due to Leishmania major in different ethnic groups in Saudi Arabia
Authors: Al‐Qurashi Abdul Rahman , Ghandour Ahmed Mohamed , Osman Mirghani , Al‐Juma Mariam 
Published: March 2003

AbstractBackground  Dissemination in patients with cutaneous leishmaniasis has previously been recorded in human infection with Leishmania major and L. tropica. In this study, the potential for dissemination in different ethnic groups in Saudi Arabia was compared.Methods  The data were recorded from a group of 73 patients with suspected cutaneous leishmaniasis (43 Saudi and 30 non‐Saudi) attending the Dermatology Clinics at King Fahd Hospital of the University and Al‐Khobar Government Hospital at Al‐Khobar, Eastern Region of Saudi Arabia. The patients were of various age groups (all male) between 1 and 55 years. The diagnosis of cutaneous leishmaniasis was confirmed clinically and by smear and skin biopsy. The following data were recorded for each patient: type, number, and anatomic sites of disseminative lesions and the frequency of co‐occurrence of more than one type of lesion.Results  Three types of disseminative lesions due to zoonotic cutaneous leishmaniasis were recorded in 16 patients (21.92%): subcutaneous nodules, satellite papules, and subcutaneous induration. The percentage of disseminative lesions in non‐Saudi patients (36.66%) was higher than in Saudi patients (11.63%). This was also true for the number of lesions: a mean of 12.27 ± 10 and 6.4 ± 3, respectively. The coexistence of more than one type of disseminative lesion was higher in non‐Saudi patients (63.63%) than in Saudi patients (20.0%), as well as the occurrence of lesions on more than one body site: 36.4% in non‐Saudi patients and 20.0% in Saudi patients.Conclusions  The potential for dissemination due to cutaneous leishmaniasis was significantly higher in the nonindigenous population than in the indigenous population in Saudi Arabia. Disseminative lesions must be clinically differentiated from other skin diseases and appropriately treated by avoiding the use of intralesional drugs or physical therapy.
A century of the synthesis of dapsone: its anti‐infective capacity now and then
Authors: Wolf Ronni , Orni‐Wasserlauf Ruth 
Published: March 2003

AbstractBackground  Although dapsone was first synthesized in 1908, a quarter of a century was to pass before it was used in the treatment of bacterial infections. Dapsone was, however, too toxic for humans (because of the excess dosage which was administered at that time) and was thus considered to be of no value in the treatment of common bacterial infections. Since the early 1950s, dapsone has been recognized as being uniquely effective against a number of noninfectious, inflammatory diseases and, today, this is its main indication. Thus, the reason why dapsone was first introduced into medicine, namely the treatment of bacterial infections, has been set aside and its main current applications are the treatment of noninfectious, inflammatory, autoimmune, and bullous diseases.Objective  To study the anti‐infective capacity of dapsone against common bacterial infections. As many patients who receive dapsone for the treatment of noninfectious, inflammatory diseases have a concomitant bacterial infection or a superinfection of their skin disease, we thought that, if dapsone proved to be effective against common bacterial infections, it may obviate the need for an additional antimicrobial drug in these patients.Methods  Three bacterial ATCC> strains (Streptococcus pyogenes, Staphylococcus aureus, and Escherichia coli) were tested by a macrodilution minimal inhibitory concentration (MIC) test for dapsone. Dapsone concentrations were between 0.06 and 1125 μg/mL.Results  Even the highest concentration of dapsone of 1125 μg/mL did not inhibit bacterial growth.Conclusions  Our results indicate that dapsone has no antibacterial effects whatsoever. Even at very high concentrations, it does not suppress the growth of most susceptible strains of bacteria. The story of dapsone (i.e. the long time that elapsed between its synthesis to its use for the chemotherapy of infectious diseases) will not repeat itself this time.
Degos' disease
Authors: Güven Füsun Özder , Bozdağg Kübra Eren , Ermete Murat , Karaman Ahmet 
Published: March 2003

A 47‐year‐old woman presented with slightly pruritic, burning lesions on her submammary area and legs of 3.5 years' duration. Similar lesions had appeared on her arms and feet. She was hospitalized at the Pulmonary Diseases Hospital, İzmir, with a complaint of thoracic pain, and was diagnosed with nonspecific pleuritis by pulmonary X‐ray, thoracic computed tomography (CT) scanning, bacterial cultures of phlegm, and pleural biopsy examination. Fifteen days after leaving hospital, she was admitted to the Surgical Clinic of Atatürk Training Hospital, İzmir, with a complaint of severe abdominal pain, and diagnosed with nonspecific peritonitis.On dermatologic examination, she had multiple, scattered papules (2–3 mm in diameter), with a typical, central, white, porcelain‐like zone of atrophy, on the trunk ( Fig. 1), legs (
Fig. 2), and arms. The lesions were encircled by a slightly raised erythematous border. Some of the lesions had coalesced giving polycyclic atrophic areas and ulcerations.Papules with a typical, central, white, porcelain‐like zone of atrophy, encircled by a slightly raised erythematous borderimageTypical papules on the legsimageHistopathologic examination of the skin biopsy specimen showed hyperkeratosis, epidermal atrophy, dermo‐epidermal separation, edema, and necrosis in the papillary dermis ( Fig. 3). Fibrinoid necrosis and thrombosis were seen in the papillary dermis and in the vessels below the lesions.Hyperkeratosis, epidermal atrophy, dermo‐epidermal separation, edema, and necrosis in the papillary dermis and fibrinoid necrosis of the blood vesselsimageThe patient was diagnosed with Degos' disease from these clinical and histopathologic findings. She was treated with anti‐inflammatory drugs. One year later, the patient was hospitalized at the Department of Internal Medicine of Atatürk Training Hospital, İzmir, with a diagnosis of pericarditis and pleuritis.