bluuebunny/crossref_metadata_2025_split huggingface dataset:
Atypical hemorrhagic bullous pyoderma gangrenosum
Authors: Altunay İlknur Kıvanç , Sezgin Saliha Aslan , İleri Ümran , Ekmekçi Tuğba Rezan , Kuran İsmail , Köşlü Adem , Baş Lütfü 
Published: March 2003

A 55‐year‐old woman was seen in the Plastic and Reconstructive Surgery Clinic because of a nonhealing wound on her left leg of approximately 2 months' duration. She had an 8‐month history of multiple wounds appearing on her arms and legs. The patient noted that the majority of the wounds had been treated and healed with the use of topical medications. One wound on her left leg had continued to enlarge rapidly despite topical treatments. Therefore, hyperbaric oxygen therapy had been administered for 15 sessions. No additional healing had occurred with this treatment. Skin grafting was performed on the affected area. She developed ulcers and blistering lesions at surgical and nonsurgical sites after skin grafting. The patient was referred to the Dermatology Department.Dermatologic examination revealed a deep, necrotic ulcer, 30 cm × 10 cm, with surrounding violaceous erythema on the donor area, ulceration (18 cm × 8 cm) on the graft area, a hemorrhagic bullous plaque (5 cm × 15 cm) over the right malleolus, scattered ecchymotic lesions and small hemorrhagic bullae on both legs, and small pustules around the staplers (Fig. 1a,b). Cutaneous biopsy of a new lesion revealed a focal, dense neutrophilic infiltrate, liquefaction degeneration in the center, lymphocytic and mild plasmacytic infiltration around the venules, and fibrinoid deposits in the walls and lumen of the vessels (Fig. 2a). In addition, excessive polymorphonuclear leukocytes and extravasated erythrocytes were present in the papillary and reticular dermis (Fig. 2b). The patient had a 14‐year history of asthma bronchiale. Physical examination did not reveal any abnormality, except for crackling rales at the base of each lung. Laboratory examinations were within normal limits, except for the sedimentation rate (55 mm/h). Protein electrophoresis, peripheral blood smear, abdominal ultrasound, and thorax and abdominopelvic computed tomography scans were all normal. Swab cultures from the ulcers were negative.(a) Hemorrhagic bullous lesion on the right malleolus. (b) Ulceration on the donor areaimage(a) Histopathologic section of a bullous lesion. Mild subepidermal separation, dense polymorphonuclear infiltration, and fibrinoid deposits in the lumen of the vessels (hematoxylin and eosin, × 10). (b) Focal, dense, neutrophilic infiltrate, liquefaction degeneration, and considerable separationimageBullous pyoderma gangrenosum was diagnosed on clinical and histopathologic grounds. Prednisolone 80 mg/day was started. Rapid epithelialization was observed within 2 months of treatment. The dose of prednisolone was gradually decreased to 20 mg/day, and was used as a maintenance dose for an additional 6 months. Complete improvement was achieved in 8 months. The patient has been followed up for approximately 1 year. There were no side effects observed during the treatment and in addition no new lesions developed at the follow‐up.
X‐Linked ichthyosis associated with congenital dislocation of the hip
Authors: Okano Masaki , Tanaka Harukazu 
Published: March 2003

A 59‐year‐old man was referred to us for evaluation of a rough scaly skin and an abnormal gait of undetermined duration. He had been noted at birth to be covered with thick, dark scales over much of his body, and also he had developed displacement of the femoral head out of the right acetabular socket. He had a strong family history of ichthyosis, implying an X‐linked feature. No other members of the family were known to have musculoskeletal abnormalities. Initial examination revealed large, thick, ichthyotic scales over much of the body, including the preauricular areas and flexure surfaces of the extremities, with sparing of the palms and soles. When he stood up straight, he had to bend the left knee joint, because of apparent shortening of the right leg (Fig. 1). A shambling gait was evident. There were no accompanying symptoms, such as anosmia, hypogonadism, mental retardation, or short stature. Histopathology of the skin demonstrated hyperkeratosis and a conspicuous granular layer of the epidermis. Roentgenograms of the hip disclosed a marked lateral and upward displacement of the head of the right femur (Fig. 2). The spine revealed scoliosis. Epiphyseal dysplasia was not found. A commercial assay for steroid sulfatase demonstrated a deficient enzyme activity of lymphocytes. We made a diagnosis of X‐linked ichthyosis associated with congenital dislocation of the hip. The patient has had no operative therapy to date.Standing pose with the left knee joint bent. Large, thick, ichthyotic scales cover the buttocks and the legsimageX‐ray findings of the hip. A marked displacement of the right femoral headimage
Type III Ehlers–Danlos syndrome: correlations among clinical signs, ultrasound, and histologic findings in a study of 35 cases
Authors: Iurassich Stefano , Rocco Daniela , Aurilia Anna 
Published: March 2003

AbstractBackground  Patients with type III Ehlers–Danlos syndrome show hypermobile joints, luxation, and minimal atrophic scars. The disease has an incidence of 9–16% and the molecular defect that underlies this subtype is unknown. In order to widen diagnostic investigations in type III Ehlers–Danlos syndrome, skin and articular areas were studied by ultrasound (US) test.Methods  Thirty‐five patients, 20 women and 15 men, aged from 18 to 25 years, with type III Ehlers–Danlos syndrome were enrolled in this study. Patients showed hypermobile joints (35 cases), minimal atrophic wrinkled scars (35 cases), and a few ice‐pick acne scars. Hypermobility of phalangeal joints was studied by means of the Beighton scoring system and by a US test (performed by Sonora Logic 400 MD unit with 10 MHz probe). The following US parameters were considered: the distance of the intra‐articular space and the thicknesses of the extensor tendon and of the overhanging dermis and subcutis.Result US reports showed an increase in distance of the intra‐articular space and a reduction in the thickness of the extensor tendon and of the dermis and subcutis covering it. The dermis showed high and homogeneous echogenicity with irregular hyperechogenic lines.Conclusion The Beighton scoring system, the US findings, and the aspect and diameter of the scars suggested that the disease can be divided into three different stages which allow the correlation, over progressive intervals of values, of the articular hypermobility and atrophic wrinkled scars. Our results showed that US test is able to confirm the clinical diagnosis and to evaluate the seriousness of hypermobile joints.
Mongolian spots with involvement of the temporal area
Authors: Leung Alexander K. C. , Kao C. Pion , Lee Thomas K. M. 
Published: March 2003

A Chinese baby girl was born after an uncomplicated pregnancy and a normal spontaneous vaginal delivery to a gravida 2, para 1, 32‐year‐old mother at 37 weeks' gestation. Neither parent had a history of alcohol or drug ingestion. There was no history of consanguinity.The Apgar scores were 7 at 1 min and 9 at 5 min. Her birth weight was 5 lb 14 oz and her length was 46 cm. At birth, she was noted to have grayish areas on the face and lower back.The infant was seen at 3 months of age because of persistent regurgitations. On average, she regurgitated 7–8 times a day. Physical examination showed that the infant was not in distress. Her weight was 6 lb 4 oz and length 47 cm. She had a Mongolian spot measuring 0.8 × 1.2 cm in the left temporal area (Fig. 1) and another Mongolian spot measuring 4 cm in diameter in the lumbar area. The Mongolian spots were grayish in color and the pigmentation was uniform in intensity. The rest of the examination was essentially normal. The infant was diagnosed to have Mongolian spots and gastroesophageal reflux. The latter was treated with postural therapy, thickened feedings, and metoclopramide 0.35 mg q.i.d.Mongolian spot in the left temporal areaimageThe infant was seen again at 4 months of age for a reassessment. There was no noticeable change in shape, size, or color of the Mongolian spots.
Congenital atrophic dermatofibrosarcoma protuberans
Authors: Marini Mario , Saponaro Alberto , Magariños Gabriel , De Baldrich Alejandra , Lynch Patricia , Remorino Laura 
Published: March 2003

A 16‐year‐old girl presented with a congenital atrophic plaque on the anterior aspect of her right leg. The lesion had slowly enlarged until she was 9 years of age; subsequently, several tumors appeared on the surface and later became reddish, hot, and mildly painful. Within a few months, all the tumors flattened and involuted. A previous biopsy showed a congenital fibroma. The patient was in good health; the physical examination, chest X‐ray films, and laboratory studies were normal. No history of personal or familial diseases was recorded.Initially, the atrophic plaque measured 6 × 8 cm; shortly after, multiple 0.5–2 cm tumors appeared. These tumors alternated with atrophic and ill‐defined livedo‐like areas (Fig. 1). A satellite lesion, measuring 2 cm in diameter, was also observed. A new biopsy revealed dermatofibrosarcoma protuberans.(A) 6 × 8 cm plaque on the anterior aspect of the right leg. Multiple tumors alternate with atrophic and ill‐defined livedo‐like areasimageImmunohistochemical findings included positive vimentin and CD34, and negative Factor XIIIa, S‐100 protein, and muscle actin (Fig. 2). One month later, several tumors had almost disappeared. The patient was successfully treated with Mohs' micrographic surgery and remained disease free 9 months later.The cells are characteristically arranged in a ‘‘storiform’' pattern, sometimes centered around small blood vessels. Involvement of the subcutaneous fat is usualimage
Subungual epidermoid cysts
Authors: Del Mar Sáez‐de‐Ocariz María , Domínguez‐Cherit Judith , García‐Corona Cristina 
Published: March 2003

Case 1 A 50‐year‐old woman presented to our Dermatology Department with a 2‐month history of edema and pain in the third right toe. She had a past history of common warts, chronic venous insufficiency, fibromyalgia, and noninsulin‐dependent diabetes mellitus. No previous trauma to the toe could be recalled.Physical examination revealed digital clubbing, minimal lateral onycholysis, and subungual keratosis (Fig. 1). Mycologic examinations (KOH and culture) were negative on two separate occasions and the X‐ray revealed only soft tissue augmentation without evidence of bone involvement. A nail biopsy was performed with the clinical diagnosis of glomus tumor vs. neuroma vs. neurilemmoma. Histologic sections showed a dermal unilocular cyst lined by an epidermis‐like epithelium with a granular cell layer, filled with laminated orthokeratin (Fig. 2); a diagnosis of subungual epidermoid cyst was established. The patient experienced recurrent pain 1 month after surgery, and a re‐excision was performed. The second biopsy showed only fibrous collagen bundles consistent with scar tissue. Intralesional steroid was injected to the site of the scar, and the patient is currently free of pain.Digital clubbing of the third finger. There is also lateral onycholysis and subungual keratosisimageHyperkeratosis and, in the dermis, a subungual epidermoid cyst. The wall is composed of stratified squamous epithelium, and the cyst is filled with laminated orthokeratinimage Case 2 A 40‐year‐old woman presented to our Dermatology Department with a 5‐year history of throbbing pain in the first right toe. Her medical history was only relevant for syringomas and onychomycosis, and no traumatic event was recalled.Physical examination revealed a slight increase in volume in the lateral aspect of the toe. There were no changes in the skin. Palpation increased the painful sensation. With the presumptive diagnosis of neuroma, a nail biopsy was performed, showing a subungual epidermoid cyst. The patient is currently free of pain 15 months after surgery.
Cutaneous leishmaniasis in Hormozgan, Iran
Authors: Zare Shahram , Baghestani Shahram 
Published: March 2003

Abstract Background  Epidemiology of Cutaneous Leishmaniasis in Hormozgan province during April 1994 to March 1998 was studied.Methods  Data were collected from the Health service Centres throughout the province as well as from dermatologists. The patients were diagnosed clinically or paraclinically and all important details were recorded on specially designed forms.Results  A total of 4094 patients with 7255 lesions were diagnosed. 42.24% of the sufferers were under 20 years and 6.47% were over 40 years old. 52.10% of the patients had one lesion and 33.98% had two lesions. Most of the cases were seen during January to March. The incidence rate per 10000 ranged from 5.90 in 1998 to 16.98 in 1996.Conclusions  A decreasing trend in the number of cases after 1996 may be due to the awareness of local health authorities, preventative activities and education.
Striated palmoplantar keratoderma of Brunauer‐Fohs–Siemens
Authors: Kotcher Lauren B. , Jih Ming H. , White Katherine L. , Kimyai‐Asadi Arash 
Published: March 2003

A 67‐year‐old African American man presented with callosities of his hands (which he had since adolescence) that were exacerbated by manual labor. His father suffered severe callosities of his feet, but no other family member was afflicted. Physical examination revealed symmetrically distributed linear hyperkeratotic plaques on the palms extending onto the full length of the volar aspect of his digits (Fig. 1). There was no personal or family history of hair, nail, or dental abnormalities. Histologic evaluation showed marked acanthosis, hypergranulosis, and hyperkeratosis of the lesions (Fig. 2). There was no evidence of epidermolytic hyperkeratosis.Linear hyperkeratotic plaques extending the length of the digits and focally present on the palmsimageMarked acanthosis, hypergranulosis, and hyperkeratosis of palmoplantar skin (hematoxylin and eosin, × 200)image
Acneiform lesions in Becker's nevus and breast hypoplasia
Authors: Santos‐Juanes Jorge , Galache C. , Curto J. R. , Carrasco M. P. , Ribas A. , Sánchez del Río J. 
Published: March 2003

An 18‐year‐old woman was referred for the evaluation of a dull gray macule on the left breast. From the age of 13 years, the patient noted breast asymmetry beginning with the development of the left breast and the presence of a pigmented stain on its border. Physical exploration revealed hypoplasia of the left breast and a homogeneous, light brown macule on the side of the breast (Fig. 1) without infiltration. Papules and pustules were located mainly around the Becker's nevus on the left anterior chest wall. Biopsy specimens with Fontana's stain disclosed a hyperpigmented acanthotic epidermis. A diagnosis of Becker's nevus, acne, and hypoplasia of the breast was made.Hypoplasia of the left breast and a homogeneous light brown macule with acneiform lesionsimage
Prayer marks
Authors: Abanmi Abdullah A. , Al Zouman Abdulrahman Y. , Al Hussaini Husa , Al‐Asmari Abdulrahman 
Published: March 2003

AbstractBackground Prayer marks (PMs) are asymptomatic, chronic skin changes that consist mainly of thickening, lichenification, and hyperpigmentation, and develop over a long period of time as a consequence of repeated, extended pressure on bony prominences during prayer.Methods Three hundred and forty‐nine Muslims and 24 non‐Muslims were examined for the appearance of PMs at different body sites.Results The prospective study of 349 Muslims (both males and females) with regular praying habits showed the occurrence of PMs on specific locations, such as the forehead, knees, ankles, and dorsa of the feet, leading to dermatologic changes consisting of lichenification and hyperpigmentation. The incidence of PMs was significantly higher in males than in females. Older subjects (over 50 years of age) demonstrated a significantly higher frequency of lichenification and hyperpigmentation, suggesting that repeated pressure and friction for prolonged periods are the causative factors for the development of PMs. Histologic examination of skin biopsies from the affected sites showed compact orthokeratosis, hypergranulosis, dermal papillary fibrosis, and dermal vascularization. PMs were not associated with any risk of secondary complications, such as erythema, bullous formation, and infections.Conclusions PMs are commonly occurring dermatologic changes in Muslims who pray for prolonged periods.
Squamous cell carcinoma in a patient with Netherton's syndrome
Authors: Saghari Sogol , Woolery‐Lloyd Heather , Nouri Keyvan 
Published: March 2003

AbstractA 29‐year‐old white woman with a history of Netherton's syndrome presented with two squamous cell carcinomas on the right dorsal hand and the left upper arm. She reported a 2‐year history of these lesions, which were originally treated as warts. She denied excessive sun exposure, immunosuppressive therapy, or a previous history of skin cancer.Her past medical history included acute renal failure, multiple urinary tract infections, meningitis, and recurrent otitis media as a child. In addition, she had an ovarian abscess at 4 years of age with resulting salpingo‐oophorectomy. She also reported a history of severe myopia, glaucoma, and multiple ocular infections with a resulting corneal scar. In addition to atopic dermatitis, she had a 10‐year history of psoriasis. Her medications included topical steroids and emollients for atopic dermatitis and psoriasis, in addition to Timolol ophthalmic drops for glaucoma. Her family history was significant for a 22‐year‐old sister with Netherton's syndrome (Fig. 1). She denied any history of skin cancer in her sister or other members of her family.Patient and sibling with Netherton's syndrome. Features of erythroderma, ichthyosis, and hair abnormalitiesimageOn physical examination, she had an exfoliative erythroderma, madarosis, and diffuse patchy alopecia. In the bilateral axilla, she had well‐defined pink scaly plaques which were confirmed as psoriasis by biopsy. On the right dorsal hand, she had a 1.5 × 1.0 cm pink verrucous plaque (Fig. 2). On the left upper arm, she had a 1.5 × 0.8 cm pink scaly plaque. Biopsies of both sites confirmed squamous cell carcinomas. Both lesions were completely excised with 4 mm margins.Eroded pink papule on the right dorsal handimage
Trichostasis spinulosa: itchy follicular papules in young adults
Authors: Strobos Michiel A. , Jonkman Marcel F. 
Published: March 2003

AbstractTrichostasis spinulosa is a common inapparent follicular disorder of retained bundles of vellus hairs. There exist two variants: the classical variant presenting with a non‐itching, comedo‐like lesion on the face in the elderly, and the pruritic variant presenting with itching, follicular papules located on the limbs in young adults. Here we present the microscopic study of the pruritic variant of trichostasis spinulosa in two patients and provide a review of the literature.
Multiple synchronous cutaneous melanomas: implications for prevention
Authors: Carli Paolo , De Giorgi Vincenzo , Chiarugi Alessandra , Stante Marcello , Giannotti Benvenuto 
Published: March 2003

AbstractBackground A subset of about 3–5% of melanoma patients present a second primary melanoma.Observations We describe two cases of primary multiple synchronous melanomas consecutively observed in the last 6 months in our department in two male patients presenting multiple atypical nevi. In both patients, the second melanoma was diagnosed by the clinician who had identified the first one, but at the time of the first follow‐up consultation, 3 months later. The delayed discovery of the second melanoma required another referral for surgery with additional discomfort for the patients. Concern about the first lesion (the thickest in both cases) probably rendered the second one less evident to both patients and clinician, until the first follow‐up examination after excision of the first lesion.Conclusion We stress the need for careful and thorough examination of the whole body surface at the time of detection of a cutaneous melanoma in subjects with multiple atypical moles because the finding of synchronous multiple melanomas is not uncommon.
Topical prostaglandin analog (PGE2) in vitiligo – a preliminary study
Authors: Parsad Davinder , Pandhi Roma , Dogra Sunil , Kumar Bhushan 
Published: March 2003

AbstractBackground Several therapeutic options are available for the treatment of vitiligo, but none is uniformly effective. Prostaglandin has been shown to play a role in melanocyte proliferation and melanogenesis. Topical application of prostaglandin E2 (PGE2) over mice skin has been shown to increase melanocyte density.Aim To evaluate the role of topical PGE2 in the treatment of vitiligo.Methods We enrolled 27 patients with limited vitiligo lesions in this study. Patients were instructed to apply a translucent gel containing 0.5 mg/3 g (166.6 µg/g) PGE2 to depigmented skin.Results Twenty‐four patients were evaluated at the end of 6 months, as three patients withdrew for reasons unrelated to the study. At the end of treatment, 15 patients showed marked to complete repigmentation and three patients showed moderate repigmentation. The remaining six patients showed none to minimal repigmentation.Conclusions Marginal repigmentation with hyperpigmented borders was seen in the majority of lesions. Our results are encouraging and offer a new and potentially efficacious treatment for this pigmentation disorder.
Assessment of histologic criteria in the diagnosis of mycosis fungoides
Authors: Naraghi Zahra Safee , Seirafi Hassan , Valikhani Mahin , Farnaghi Forshad , Kavusi Susan , Dowlati Yahya 
Published: March 2003

AbstractBackground The histologic diagnosis of early mycosis fungoides (MF) can be difficult to establish in many instances because the subtle changes observed in patches of MF are also present in many inflammatory dermatoses.Methods To assess the frequency and significance of many of these histologic parameters, we retrospectively reviewed 50 slides from patients with documented MF in patch, plaque, and tumor stages. The diagnosis of MF was unequivocally established either by the progression of patients to advanced stages of the disease or by indubitable histologic findings. In the second phase of the study, we compared the histologic parameters observed in 24 patch stage MF patients with those in 24 non‐MF patients. The non‐MF group were patients whose pathologic pattern was suspicious for MF, but who definitely did not have MF on clinical grounds. The two groups were matched by histologic pattern. Two different observers evaluated the slides and the intensities of 32 histologic parameters were graded on a four‐point scale to minimize the subjective variability in the histologic reports.Results On univariate analysis, the following parameters achieved significance in distinguishing MF from non‐MF: Pautrier's microabscesses, haloed lymphocytes, disproportionate epidermotropism, epidermal lymphocytes larger than dermal lymphocytes, hyperconvoluted lymphocytes in the epidermis and dermis, absence of dyskeratosis, and papillary dermal fibrosis. None of these features proved to have additional discriminating power on multivariate analysis.Conclusions The efficacy of single histologic features in the diagnosis of early MF is generally poor and, to discriminate MF from its inflammatory simulators, a combination of cytologic and architectural features must be used.