bluuebunny/crossref_metadata_2025_split huggingface dataset:
CASE REPORT Concurrent pilomatrix carcinoma and giant pilomatrixoma
Authors: Khammash Muhammad R , Todd David J , Abalkhail Ali 
Published: March 2003

SUMMARYA 52‐year‐old man presented with a large, fungating mass on the inner aspect of his left thigh and a smaller hard mass on the inner aspect of his left knee with normal overlying skin. Both lesions had first been noted by the patient 1 year previously and for the first 6 months had a similar appearance until the thigh mass rapidly increased in size and fungated. Pathology of the large thigh lesion showed pilomatrix carcinoma while that of the smaller knee lesion was typical of pilomatrixoma. The pilomatrix carcinoma was widely excised and there has been no evidence of recurrence or metastasis after 3 years. The clinical course of the thigh lesion suggested that pilomatrix carcinoma may arise from a pre‐existing pilomatrixoma. On review of the literature, pilomatrix carcinoma of the lower limb may be more likely to metastasize than those on other sites.
CASE REPORT Giant congenital melanocytic naevus and symptomatic thoracic arachnoid cyst
Authors: Holmes Gary , Wines Nina , Ryman William 
Published: March 2003

SUMMARYA 43‐year‐old female with multiple congenital naevi presented with a 5‐year history of right upper quadrant pain. Magnetic resonance imaging demonstrated a large epidural thoracic arachnoid cyst. This case highlights the need to consider that the management of patients with giant congenital melanocytic naevus is variable depending on the age of the patient, the location of lesions and the presence of complications such as neurocutaneous melanosis. The value of magnetic resonance scanning as a screening device is discussed.
CASE REPORT Focal facial dermal dysplasia or aplasia cutis congenita: A case with a hair collar
Authors: Wells Jennifer M , Weedon David 
Published: March 2003

SUMMARYAplasia cutis congenita describes localized defects of skin that may have many causes. A 6‐month‐old male presented with bilateral atrophic patches on his cheeks distributed along a line from the preauricular area to the angle of the mouth. They had been present since birth. He had no other abnormalities detectable on examination and no family history of similar lesions. A distinct collar of long pale hairs surrounded the lesions, especially the largest one. Histology showed changes consistent with aplasia cutis congenita or focal facial dermal dysplasia. We propose our patient’s lesions may be the result of failure of ectodermal fusion over embryological closure lines. This may be a distinct subgroup of atrophic facial lesions.
VIGNETTE IN CONTACT DERMATOLOGY Allergic contact dermatitis from ciclopirox olamine
Authors: Foti Caterina , Diaferio Annalisa , Bonamonte Domenico 
Published: March 2003

SUMMARYA 50‐year‐old man with interdigital tinea pedis developed an allergic dermatitis spreading from the toes to the lower shins. Patch tests were strongly positive to ciclopirox olamine 1% pet. Sensitization to this topical antifungal agent has rarely been reported in the literature.
Effects of low‐dose ultraviolet radiation on in vivo human cutaneous recall responses
Authors: Damian Diona L , Barnetson Ross StC , Halliday Gary M 
Published: March 2003

SUMMARYRelatively few studies have examined the effects of low‐dose ultraviolet (UV) radiation on in vivo human cutaneous immunity, or the ability of sunscreens to prevent UV‐induced immunosuppression. We have studied the effects of solar‐simulated UV radiation on nickel contact hypersensitivity (CHS) in nickel‐allergic volunteers, and on delayed type hypersensitivity responses in Mantoux‐positive volunteers. Nickel CHS and Mantoux responses were significantly suppressed by acute, suberythemal UV exposures equivalent to less than 8 min summer sunlight. Both UVA and UVB wavebands were immunosuppressive, but UVA‐induced immunosuppression was transient, whereas UVB had a more sustained effect. Dose–responses for UV immunosuppression were determined using the nickel method, enabling calculation of in vivo sunscreen immune protection factors in a manner analogous with sun protection factor measurement. Sunscreens were found to confer significantly less protection against UV‐induced immunosuppression than against UV‐induced erythema.
Spironolactone‐induced hepatitis
Authors: Thai Keng‐Ee , Sinclair Rodney D 
Published: March 2003

SUMMARYThere is widespread use of spironolactone in medical practice and the indications for its use well established and side effect profile well known. Herein, we present a case of drug‐induced hepatitis occurring in a 50‐year‐old woman using spironolactone for the treatment of androgenetic alopecia. Six weeks after commencement of spironolactone the patient became unwell, complained of an extensive itch, but no icterus or jaundice. Liver function tests found abnormally elevated bilirubin and enzymes levels. After withdrawal of spironolactone, the patient’s symptoms resolved and liver function improved. To date, there has only been one other report of spironolactone‐induced hepatitis.
Lichen planus‐like eruption following autologous bone marrow transplantation for chronic myeloid leukaemia
Authors: Pagliaro John A , White Stephen , Strutton Geoffrey , Guerin Deirdre 
Published: March 2003

SUMMARYA 47‐year‐old female treated with an autologous bone marrow transplant and cytotoxic chemotherapy developed a lichen planus‐like eruption 12 months later. It involved the skin and oral mucosa, with the histological features of a lichenoid graft‐versus‐host reaction, including satellite cell necrosis. This eruption developed de novo. The eruption resolved with topical betamethasone valerate 0.1% cream despite the ongoing use of the immunomodulatory agent interferon‐α2b. Such a reaction in an autologous setting has only been described once previously.
Frictional amyloidosis: A study of 10 cases
Authors: Venkataram Mysore N , Bhushnurmath Shivayogi R , Muirhead David E , Al‐Suwaid Abdul Raouf 
Published: March 2003

SUMMARYTen patients with macular amyloidosis were studied with particular reference to the role of friction. All 10 patients had a history of prolonged rubbing over a period of 2–5 years with various objects, such as bath sponges, brushes, towels, plant sticks and leaves. The presence of amyloid was confirmed by histochemical stains in six cases and by electron microscopy in four cases. The study confirms the role of friction in the causation of macular amyloidosis and hence, the term ‘frictional amyloidosis’ aptly describes the condition. The study also emphasizes the need for electron microscopy in the diagnosis of frictional amyloidosis.
Drug‐induced linear IgA bullous disease following antibiotics
Authors: Wiadrowski Todd P , Reid Catherine M 
Published: March 2003

SUMMARYA 69‐year‐old woman presented with pneumonia and subacute bacterial endocarditis. Nine days after intravenous vancomycin and ciprofloxacin were commenced, the patient developed a bullous mucocutaneous eruption. Clinical presentation and histopathology were consistent with drug‐induced linear IgA bullous disease (LABD). The patient’s lesions resolved with cessation of antibiotics. A review of the features of drug‐induced LABD and the drugs that have been implicated are presented.
Allergic contact stomatitis caused by acrylic monomer in a denture
Authors: Koutis Dennis , Freeman Susanne 
Published: March 2003

SUMMARYA 71‐year‐old edentulous man developed a severely painful red mouth at sites of contact with a new denture. Patch testing showed allergy to samples of the denture material and to 2‐hydroxyethyl methacrylate. Patch testing to methyl methacrylate was negative. Prolonged boiling of the denture resulted in reversal of his symptoms and samples of this fully cured denture material produced negative patch tests. While allergy to acrylates is a rare cause of stomatitis, this possibility must be considered in patients presenting with oral symptoms. Material safety data sheets are unreliable in providing information regarding the type of acrylate present in the material. Hence, patch testing should be performed with a battery of acrylate allergens as well as with small samples of the denture material.
Antiepiligrin (laminin 5) cicatricial pemphigoid complicated and exacerbated by herpes simplex virus type 2 infection
Authors: Gilmour Tanya K , Meyer Paul AR , Rytina Ed , Todd Pamela M 
Published: March 2003

SUMMARYA 50‐year‐old man with antiepiligrin (laminin 5) cicatricial pemphigoid (AeCP) involving the eyes, mouth and skin required a combination of systemic drug therapies to suppress the ocular disease. Herpes simplex virus type 2 infection of the mouth and pharynx precipitated an acute deterioration, with laryngeal involvement and an increase in oral ulceration. This is an unusual complication of long‐term immunosuppression and illustrates some of the difficulties in the management of patients with AeCP. Clinical improvement was obtained with oral antiviral therapy and adjustment of his immunosuppressive regimen.
Collagenous and elastotic marginal plaques of the hands
Authors: Mortimore Rohan J , Conrad Roderick J 
Published: March 2003

SUMMARYA 49‐year‐old woman presented with an asymptomatic indurated linear plaque extending from the medial surface of the right thumb along the junction of the dorsal and palmar skin of the hand onto the lateral aspect of the index finger. The left hand showed a similar but less extensive plaque. A skin biopsy showed an acellular zone in the reticular dermis composed of thickened bundles of collagen haphazardly arranged, some perpendicular to the epidermis, admixed with elastic fibres and amorphous basophilic elastotic material. Granular calcium deposits were identified, particularly within degenerate collagen bundles. These clinical and histological features are diagnostic of collagenous and elastotic marginal plaques of the hands, a slowly progressive but largely asymptomatic condition. Actinic degeneration and chronic pressure have been proposed as aetiological agents, but our patient did not exhibit marked actinic degeneration and had no history of chronic occupational pressure.
Dowling–Degos disease——A heat aggravated variant
Authors: Kossard Steven , Krivanek Joseph 
Published: March 2003

SUMMARYA 22‐year‐old woman presented with a 5‐year history of a micropapular eruption localized to the flexor aspect of her limbs as well as persistent reticulate pigmentation of her neck and upper chest resembling Darier’s disease. The eruption was associated with pruritus that was precipitated by heat and was worse in summer. The axillae, groins and inframammary areas had multiple papules but lacked reticulate pigmentation. Multiple biopsies showed an epidermis with club‐ and antler‐like rete ridges but no acantholysis or dyskeratosis. This distinct clinical presentation may represent an unusual heat aggravated variant of Dowling–Degos disease that clinically shares features with Darier’s disease and transient acantholytic dermatosis.
Allergic contact dermatitis due to thiuram exposure from a fungicide
Authors: Saunders Helen , Watkins Frances 
Published: March 2003

SUMMARYA 49‐year‐old man developed a widespread eczematous eruption following contact with plants sprayed with a fungicide. Patch testing revealed a strong reaction to thiuram mix and several of the individual thiuram mix constituents. The fungicide contained tetramethylthiuram disulphide, a thiuram chemical. Thiurams are widely recognized as a cause of rubber‐glove allergy; however, they are also used extensively in fungicides.
Menopause and the skin
Authors: Wines Nina , Willsteed Elizabeth 
Published: March 2003

SUMMARYWomen live one‐third of their lives in the post‐menopausal state. Significant hormonal alterations occur at the time of menopause, leading to a range of physiological disorders affecting multiple organ systems in the body. The effects of menopause on the skin have been underresearched. Many skin changes occur at the time of menopause and the cutaneous effects of hormone replacement therapy are significant. Menopausal changes in hormones may alter the biomechanical properties of the skin and certain disorders are more common in menopausal women, such as lichen sclerosus, atrophic vulvovaginitis, flushing and dysaesthetic vulvodynia. Hair and oral changes may also be associated. As the average life expectancy increases, dermatologists need to be familiar with skin diseases affecting women in this age group.
Langerhans cell histiocytosis
Authors: Chu Tony 
Published: March 2003

SUMMARYLangerhans cell histiocytosis is a rare condition that can affect any organ of the body. Patients of all ages may present to the dermatologist and it is important to make the diagnosis as quickly as possible, because time from presentation to diagnosis is of prognostic importance in adults with the disease. Langerhans cell histiocytosis is now classified as a class I histiocytosis and research into this disease has been very active over the past 10 years. We now know that the disease represents a clonal expansion of a Langerhans cell, which shows phenotypic evidence of activation. The tissue damage induced by the disease appears to be related to local cytokine release.In single system disease, Langerhans cell histiocytosis is responsive to local therapy but, in resistant single system disease or in multisystem disease, etoposide is the most effective monochemotherapy. Some patients will need maintenance treatment with azathioprine or 6‐mercaptopurine with or without methotrexate. In such cases, physicians who are used to treating chronic and relapsing diseases and who have experience with these drugs, such as dermatologists, are the most appropriate to manage patients with Langerhans cell histiocytosis.
Inflammatory linear verrucous epidermal naevi: A review of 23 cases
Authors: Lee Simon H , Rogers Maureen 
Published: March 2003

SUMMARYTwenty‐three patients diagnosed with inflammatory linear verrucous epidermal naevi (ILVEN) over a 13 year period are reviewed retrospectively. These ILVEN showed a predilection for the buttock and legs and were usually unilateral. Onset of the lesions was usually within the first 6 months of life and extension beyond the original margins occurred in 26% of cases. Sixteen of the 23 patients were male. Ten patients had ILVEN predominantly involving the left side, 12 were on the right side and, in one case, the side involved was not recorded.
Report of 19 cases of photoallergic contact dermatitis to sunscreens seen at the Skin and Cancer Foundation
Authors: Cook Natasha , Freeman Susanne 
Published: March 2003

SUMMARYWe report on our experience with sunscreen allergy between 1992 and 1999 and also review the international literature on sunscreen allergy. There were a total of 21 allergic reactions to sunscreen chemicals observed in 19 patients over the 8 years. There were nine positive photopatch reactions to oxybenzone, eight to butyl methoxy dibenzoylmethane, three to methoxycinnamate and one to benzophenone. No positive reactions were observed to para aminobenzoic acid. Six patients also had positive patch tests to components of the sunscreen base. In our experience, sunscreen chemicals are the most common cause of photoallergic contact dermatitis.
Artefactual skin disease in children and adolescents
Authors: Rogers Maureen , Fairley Michael , Santhanam Radhika 
Published: March 2003

SUMMARYAs in adults, artefactual skin disease in children and adolescents has heterogenous presentations with multifactorial aetiology. We report a series of 32 young patients aged 8–16 years. There were 24 females and 8 males. In over half of the cases the lesions were on the head and neck. The types of lesions encountered included physical injury producing grazing, erosions and deep ulcers, chemical and thermal burns, hair cutting and shaving and skin painting. We discuss the approach that we believe should be taken with these patients, emphasizing the role of dermatology– psychiatry liaison in their management. Of great importance is the avoidance of confrontation of the patient but the clear exposition of the nature of the problem to the parents. The major aim should be to have the family accept the need for expert psychiatric assistance.
Bullous lesions in Bazex syndrome and successful treatment with oral psoralen phototherapy
Authors: Gill David , Fergin Peter , Kelly John 
Published: March 2003

SUMMARYA 59‐year‐old man presented with a psoriasiform dermatitis with associated bullae and destructive nail dystrophy of the hands and feet. He had lost 10 kg weight over 6 months and a mass in the neck was noted. He was provisionally diagnosed with Bazex syndrome (acrokeratosis paraneoplastica) and subsequent investigations revealed a squamous cell carcinoma in the right piriform fossa. His skin lesions were treated with oral psoralen and ultraviolet A phototherapy and this cleared the cutaneous changes, but the nail changes have persisted at 18 months follow up.
Reactive perforating collagenosis: A condition that may be underdiagnosed
Authors: Satchell Andrew C , Crotty Kerry , Lee Stephen 
Published: March 2003

SUMMARYReactive perforating collagenosis is a perforating disorder developing in adults, usually in association with diabetes mellitus or renal failure. We present three cases diagnosed at the Royal Prince Alfred Hospital in a 5 month period. All three patients had long‐standing diabetes mellitus, hypertension, hypercholesterolaemia and ischaemic heart disease. Each patient presented with generalized pruritus and a papular eruption across the trunk and limbs. More than one biopsy or multiple levels were needed before the diagnostic histological features were seen. The first patient responded to 0.5% phenol with 10% glycerine in sorbolene cream. The second patient did not respond to topical betamethasone diproprionate 0.5 mg/g cream and antihistamines (hydroxyzine 25 mg nocte) and required narrow‐band ultraviolet (UV) B. The third patient, having failed to respond to topical betamethasone diproprionate 0.5 mg/g cream and wet dressings, antihistamines (hydroxyzine 25 mg tds and doxepin 50 mg nocte) and UVB required acitretin 25 mg orally per day. Because reactive perforating collagenosis responds to treatment, we believe this condition should be considered in patients with diabetes mellitus or renal failure presenting with pruritus and that biopsy of intact lesions may need multiple levels to help establish the diagnosis.
Merkel cell carcinoma and multiple cutaneous squamous cell carcinomas in a patient with pityriasis rubra pilaris
Authors: Huynh Nghi T , Hunt Michelle J , Cachia Adrian R , Veness Michael J 
Published: March 2003

SUMMARYA 79‐year‐old female was diagnosed with Merkel cell carcinoma (MCC) and multiple cutaneous squamous cell carcinomas (SCC) occurring on a background of pityriasis rubra pilaris. At the time of initial diagnosis and treatment for upper limb MCC, axillary nodal metastases were clinically evident. In the ensuing months, she developed multiple rapidly progressing SCC and eventually a left arm soft tissue deposit of metastatic MCC. Treatment involved multiple courses of fractionated radiotherapy. The salient clinical features and supporting evidence for this case are presented.
Studies in long‐pulsed potassium tritanyl phosphate laser for the treatment of spider naevi and perialar telangiectasia
Authors: Goodman Greg J , Roberts Stefania , Bezborodoff Alex 
Published: March 2003

SUMMARYUtilization of a 1–10 msec vascular laser to treat facial vessels to limit purpura has become available in recent years. Its efficacy and morbidity in the treatment of common vascular lesions require exploration. We have assessed the relative outcomes and morbidity from a single treatment session of two patterns of ‘difficult to treat’ facial telangiectasia – perialar vessels and spider naevi – with such a system. Two prospective clinical studies with long pulse 532 nm potassium tritanyl phosphate (KTP) laser were performed with subjective and independent objective assessment at 3 days, 1 week and 4 weeks in both studies. Perialar vessels showed good to excellent improvement subjectively at 4 weeks in 53% (8/15), spider naevi in 83% (20/24). Pain of treatment was substantially greater treating perialar telangiectasia than when treating spider naevi (P < 0.01). Morbidity was low in both groups with no long‐term complications. Despite the clinical end‐point of vessel disappearance at time of treatment and good early improvement in the appearance of perialar vessels, the failure rate was significant at 1 month follow up. It would appear that spider naevi behave more predictably, with vessel disappearance at time of treatment most often forecasting a successful outcome. Although not statistically significant, spider naevi probably respond better than perialar vessels to a single treatment with this laser.
Myeloma‐associated systemic amyloidosis presenting with acquired digital cutis laxa‐like changes
Authors: Dicker Tony J , Morton James , Williamson Richard M , Chick Jeff 
Published: March 2003

SUMMARYA 59‐year‐old woman presented with a 6‐year history of lax skin on the distal fingers of both hands, as well as a recent increase in the size of her tongue. Histopathology of skin from her distal finger showed amyloid deposition and bone marrow biopsy revealed an underlying plasma cell dyscrasia. Initial treatment with cyclophosphamide, vincristine, adriamycin and methylprednisolone has produced a significant reduction in the swelling of both her hands and tongue. Acquired digital cutis laxa‐like changes are a rare cutaneous manifestation of systemic amyloidosis.
Clinical and histological spectrum of elastotic changes induced by penicillamine
Authors: Poon Eric , Mason Graham H , Oh Chris 
Published: March 2003

SUMMARYA 79‐year‐old‐man with cystinuria requiring long‐term penicillamine therapy presented with a 6‐month history of itchy annular lesions in both axillae. Clinical examination revealed lesions consisting of crusted keratotic papules coalescing in an annular distribution. Associated findings included generalized skin laxity accentuated on the upper trunk and arms, as well as small yellowish papules on the neck. Histological evaluation revealed short, thick, eosinophilic elastic fibres with nodular protrusions. Transepidermal elimination of abnormal elastic fibres was also evident. We discuss the histological and clinical spectrum of penicillamine‐induced elastotic changes and compare these changes to those seen in primary elastotic disorders.
Immediate‐type latex hypersensitivity in a hairdresser
Authors: Sajjachareonpong Praneet , Lee Adriene , Nixon Rosemary 
Published: March 2003

SUMMARYHairdressers commonly develop contact dermatitis caused by either skin irritants or allergens to which they are exposed. Those using latex gloves are also at risk of developing immediate hypersensitivity reactions to latex. We present a hairdresser with hand dermatitis, primarily as a result of immediate‐type hypersensitivity to latex causing contact urticaria, diagnosed with radioallergosorbent testing. Only three previous studies have reported latex allergy in hairdressers. This condition needs to be considered as a differential diagnosis in hairdressers presenting with hand dermatitis and a history of wearing either rubber or disposable latex gloves.
Diseases of the generative nail apparatus. Part II: Nail bed
Authors: Goodman Greg J , Nicolopoulos Jenny , Howard Anne 
Published: March 2003

SUMMARYNail bed insults may affect the resultant nail product in a number of ways. If focal in nature, the severity and duration of the insult will determine the appearance of the nail product. Widespread insults may alter the size, shape or colour of the nail plate. Nail bed insults tend to present with more immediacy than nail matrical insults, as there is no need to wait until the nail grows out until the sign is obvious. We are less interested in the history of the event, than we are with the clinical sign being presented to us. Should treatment be required for focal nail bed insults, treatment is likely to be local and curative. Widespread nail bed insults may be associated with systemic diseases and if a result of local problems these may be difficult to treat.